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.
Effects of a 12-Week Resistance Training Program on Glycemic Control and Insulin Sensitivity in Adults With Type 2 Diabetes in Akwa Ibom State
The study examined the effects of a 12-week resistance training program on glycemic control and insulin sensitivity among adults with type 2 diabetes in Akwa Ibom State, Nigeria. The purpose of the study was to determine whether structured resistance training could improve fasting blood glucose, glycated hemoglobin (HbA1c), and insulin sensitivity in this population. The study was guided by three research questions and three corresponding null hypotheses. A quasi-experimental pretest–posttest control group design was adopted. Forty adults aged 30–60 years with diagnosed type 2 diabetes were purposively selected and assigned to an intervention group (n = 20) and a control group (n = 20). The intervention group participated in a supervised 12-week resistance training program conducted 2–3 times per week, while the control group received usual medical care without structured exercise. Data were collected using standardized instruments, including a glucometer for fasting blood glucose, laboratory assays for HbA1c, and fasting insulin measurements used to compute insulin sensitivity via the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). Data were analyzed using descriptive statistics and t-tests at the 0.05 level of significance. The findings revealed significant reductions in fasting blood glucose and HbA1c levels, as well as a significant improvement in insulin sensitivity among participants in the intervention group, while no significant changes were observed in the control group. These results indicate that resistance training is an effective non-pharmacological strategy for improving metabolic control in adults with type 2 diabetes. The findings imply that integrating resistance training into routine diabetes management could enhance treatment outcomes and reduce complication risk. It is recommended that healthcare providers and policymakers promote structured resistance training as part of standard diabetes care in Akwa Ibom State.
Impact of Overweight and Obesity on the Metabolic Presentation of Type 1 Diabetes Mellitus Among Iraqi Children
Background: The increasing prevalence of childhood overweight and obesity has raised concerns regarding their influence on the clinical and metabolic presentation of type 1 diabetes mellitus (T1DM). Excess body weight may contribute to insulin resistance, alter disease manifestations, and increase the risk of metabolic complications at diagnosis. This study aimed to evaluate the impact of overweight and obesity on the metabolic presentation of newly diagnosed T1DM among Iraqi children. Methods: A cross-sectional study was conducted at Al-Zahra Teaching Hospital, Kut, Iraq, between January 2021 and January 2026. Ninety-two children newly diagnosed with T1DM were included. Demographic, anthropometric, clinical, and laboratory data were obtained from medical records. Participants were classified as normal weight, overweight, or obese according to the World Health Organization BMI-for-age Z-score criteria. Metabolic parameters, including blood pH, serum bicarbonate (HCO₃⁻), pCO₂, blood glucose, HbA1c, C-peptide levels, and the severity of diabetic ketoacidosis (DKA), were compared across BMI categories using appropriate nonparametric statistical tests. Results: Overweight children presented with significantly more severe metabolic disturbances at diagnosis, including lower blood pH, bicarbonate, and pCO₂ levels compared with children of normal weight. Obese children demonstrated significantly higher C-peptide concentrations, indicating greater residual pancreatic beta-cell function. However, both overweight and obese children showed a higher prevalence of DKA than their normal-weight counterparts. The combined prevalence of overweight and obesity among children with newly diagnosed T1DM was 20.6%. Conclusion: Overweight is associated with a more severe metabolic presentation of newly diagnosed T1DM in Iraqi children, while obesity is characterized by relatively preserved residual beta-cell function despite an increased frequency of DKA. Early recognition of T1DM symptoms in overweight and obese children may facilitate timely diagnosis and reduce the risk of severe metabolic complications.
Analysis of Factors Contributing to the Development of Cardiovascular Disorders and Atherosclerotic Changes in Rheumatoid Arthritis
Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease primarily characterized by symmetrical involvement of peripheral joints and a wide spectrum of extra-articular manifestations. Patients with RA exhibit significantly higher morbidity and mortality rates than those observed in the general population, with cardiovascular disease representing one of the leading causes of death. The prevalence of traditional atherosclerotic risk factors is substantially higher among individuals with RA than among those without the disease. Numerous studies have demonstrated an increased frequency of concomitant conditions, including arterial hypertension, dyslipidemia, obesity, and diabetes mellitus, in this patient population. Nevertheless, the markedly elevated incidence of cardiovascular events in RA cannot be fully explained by conventional risk factors alone. Generalized systemic inflammation, accompanied by excessive production of pro-inflammatory cytokines and elevated levels of acute-phase proteins, is considered a major contributor to the initiation and progression of premature atherosclerotic changes. This review provides a comprehensive analysis of cardiovascular risk in rheumatoid arthritis, the distinctive features of RA-associated dyslipidemia, the phenomenon known as the "lipid paradox," and the impact of chronic systemic inflammation on the development and progression of atherosclerosis in patients with RA.
Copyright (c) 2026 American Journal of Pediatric Medicine and Health Sciences https://creativecommons.org/licenses/by/4.0
Modern Diagnostic Features of Forensic Medical Examination in Mechanical Asphyxia
Mechanical asphyxia is a type of death caused by obstruction of the airways or suffocation resulting from external mechanical force. This article examines the modern diagnostic features of forensic medical examination in cases of mechanical asphyxia. The study was conducted based on scientific publications published between 2022 and 2025 and analyzes the pathological, histological, and biochemical changes observed in deaths caused by hanging, strangulation, ligature strangulation, and compression. Modern diagnostic methods, including virtual autopsy (PMCT and PMMRI), proteomics, miRNA analysis, and three-dimensional photogrammetry, are discussed with particular emphasis on their clinical significance and their complementary role to conventional autopsy. The findings indicate that neck compression accounts for approximately 55% of mechanical asphyxia-related deaths; however, the absence of petechial hemorrhages in 38% of victims complicates the diagnostic process. Proteomic analysis identified 78 differentially expressed proteins specific to mechanical asphyxia. Virtual autopsy demonstrated a diagnostic sensitivity of 90–100% in traumatic deaths, whereas its sensitivity in asphyxial deaths remained below 30%. Based on the obtained findings, the article proposes a unified algorithmic approach for forensic medical experts.
Socio-Psychological Stress Reduction Among Women: Institutional and Practical Approaches
This article examines the role of institutional structures (state, civil society, and family) and their effectiveness in reducing stress among women from a scientific and practical perspective. The social mechanisms for enhancing stress resilience, the protective function of social networks, and innovative forms of community-based psychological support are analysed. Based on empirical research, practical recommendations for optimising psychological services provided to women have been developed.
Improving the Assessment of Shoulder Joint Dislocation Through Additional Diagnostic Examinations
The shoulder (glenohumeral) joint is the most mobile joint in the human body and, consequently, the most susceptible to traumatic dislocation, accounting for approximately 45% of all major joint dislocations. More than 95% of shoulder dislocations are anterior and are frequently associated with Bankart (labral) and Hill–Sachs (humeral head) lesions. Although conventional radiography is sufficient for confirming dislocation and evaluating bony structures, it has significant limitations in detecting soft tissue injuries involving the labrum, rotator cuff, and capsuloligamentous complex. This article evaluates the diagnostic performance of additional imaging modalities used in the assessment of shoulder dislocation, including magnetic resonance imaging (MRI), magnetic resonance arthrography (MRA), computed tomography (CT) with three-dimensional (3D) reconstruction, computed tomography arthrography (CTA), and ultrasonography (US). The analysis demonstrated that CT remains the gold standard for assessing glenoid bone loss and Hill–Sachs defects, whereas MRI/MRA provides superior visualization of soft tissue injuries. The combined application of these imaging techniques significantly improves diagnostic accuracy and facilitates appropriate selection of conservative or surgical treatment strategies.
Characteristics Of Diatom Plankton During The Flood Season Across The Districts Of Andijan Region
This study aimed to investigate the composition, species diversity, quantitative parameters, and ecological characteristics of diatom plankton (phylum Bacillariophyta) during the flood period across the 14 districts of Andijan Region. Methods: During the spring seasons (March–May) of 2022–2024, plankton samples were collected from 18 sampling stations, including the Andijan Reservoir, the Kara Darya River, the Khojaobod Canal, and lakes in Jalakuduk District, using plankton nets (No. 78 silk mesh). A total of 540 samples were analyzed. Results: The study identified 147 species and infraspecific taxa belonging to the phylum Bacillariophyta, of which 38 were dominant species characteristic of the flood period. The dominant genera were Navicula (27 species), Nitzschia (24 species), Cyclotella (12 species), Fragilaria (11 species), Aulacoseira (9 species), and Gomphonema (8 species). Cell density ranged from 12,400 to 189,600 cells/L. According to the Sládeček saprobity index, water quality corresponded to the β-mesosaprobic level (S = 1.8–2.3). The results indicate that the diatom plankton community during the flood period in Andijan Region is characterized by high biological diversity, with bioindicator species reflecting organic loading caused by agricultural activities predominating.
Effect of Vitamin D Supplementation on Sex Stimulating hormone in Polycystic Ovary Women
Polycystic ovarian syndrome (PCOS) is the most frequent form of persistent anovulation caused by androgen excess, affecting 5 to 10% of women of reproductive age. PCOS is defined by a metabolic disease in which hyperinsulinaemia is a major hallmark, in addition to its reproductive consequences. Polycystic ovary syndrome (PCOS) is a complex condition having implications for reproductive, metabolic, and psychological characteristics. The fundamental cause of the condition is an anomaly in the ovaries; however other factors such as weight and environmental factors influence the development of particular symptoms. PCOS has been identified as a risk factor for diabetes. Despite the fact that PCOS signs and symptoms appear before those of insulin resistance, it is thought that insulin resistance, rather than the other way around, may have a role in the development of PCOS. Aim to our study to investigate the impact of Vit D supplementation on the plasma glucose, lipid and other metabolic and endocrine parameter follicular stimulating hormone (FSH),sex hormone binding globulin(SHBG),and total testosterone(TT) also to evaluate the therapeutic effect of Vit D and how improve hormonal levels in patients with PCOS. From January 5th through June 10th, 2025, a follow-up research was conducted in Kirkuk. There were 80 PCOS women in the research, both married and unmarried, ranging in age from 15 to 45 years old. These patients were hospitalized to Azadi Teaching Hospital's obstetrics and gynecology section.in the present study, 80 PCOS was diagnosed based on the presence of two of the Rotterdam criteria: oligo and/or anovulation, clinical and/or biochemical signs of hyperandrogenism, and polycystic ovaries in ultrasound, which were defined as the presence of 12 or more follicles measuring 2-9 mm in diameter in each ovary and/or ovarian volume greater than 10 cm3. All 80 PCOS patients were given a comprehensive medical examination as well as anthropometric measurements such as weight and height, as well as a generic questionnaire to fill out. The formula for calculating the Body Mass Index (BMI) was weight (kg)/height2 (m2). The mean of BMI for PCOS patients were 28.2 (Kg /m²) and mean for age 30 years our study. serum level of FSH in PCOS patients after three months vitamin D administration was increased with not significant at P value (0.1547 ),while the correlation between vitamin D and FSH over three months vitamin D administrate, was no correlation, and serum testosterone level in PCOS patients after three months vitamin D intake was increased significant at P value (< 0.0001) and give no correlation between vitamin D and testosterone level ,while SHBG level was not significant at P value (0.0767) and there is no correlation between vitamin D and SHBG . By our study insulin level decreased significantly at P value (0.0045 ) with statically no correlation between vitamin D and insulin after three months of vitamin D administrate , while insulin resistance level was reduced significantly at P value (< 0.0001) with negative correlation between vitamin D and insulin resistance ,while serum FSB level was raised significantly at P value < (0.0001). The majority of women with PCOS that enrolled in this study were within the child bearing age, and the majority of PCOS women were overweight, Vitamin D was most deficient in PCOS women, in PCOS women hirsutism, acne, and irregularity of menstrual cycle were more frequently occur. There are significantly reduced of cholesterol, triglyceride, LDL and VLDL with VIT.D in PCOS patients, while HDL with VIT.D in PCOS patients is significantly increased, there is raised significantly of testosterone with no significant of SHBG in PCOS patients and no significant reduced of FSH in PCOS patients.
Factors Associated with Postpartum Hemorrhage among Pregnant Women in Enugu North Local Government Area, Enugu State, Nigeria
Background: Maternal mortality remains a major global health challenge, with postpartum hemorrhage (PPH) identified as the leading direct obstetric cause of maternal deaths, particularly in low- and middle-income countries. Despite being largely preventable, PPH continues to contribute significantly to maternal morbidity and mortality in Nigeria. This study assessed the factors associated with postpartum hemorrhage among pregnant women in Enugu North Local Government Area, Enugu State, Nigeria. Methods: A descriptive cross-sectional study design was employed among 220 pregnant women selected from health facilities in Enugu North LGA. Data were collected using a structured questionnaire covering sociodemographic characteristics, obstetric history, antenatal care utilization, and awareness of PPH. Data were analyzed using SPSS version 25. Descriptive statistics were presented using frequencies and percentages, while chi-square tests were used to determine associations at a 5% level of significance (p < 0.05). Results: The prevalence of postpartum hemorrhage among respondents was 23.6%. Significant factors associated with PPH included age (p = 0.006), parity (p = 0.007), antenatal care attendance (p = 0.003), history of PPH (p < 0.001), prolonged labour (p = 0.009), anaemia in pregnancy (p = 0.002), place of delivery (p = 0.006), and skilled birth attendance (p = 0.040). Although general awareness of PPH was relatively high (73.6%), only 39.1% of respondents demonstrated good overall knowledge. Conclusion: Postpartum hemorrhage remains a significant maternal health challenge in Enugu North LGA, driven by obstetric risk factors and suboptimal utilization of antenatal and skilled birth services. Strengthening antenatal care, improving early risk identification, and ensuring skilled birth attendance are essential to reducing the burden of PPH in the study area.
Copyright (c) 2026 American Journal of Pediatric Medicine and Health Sciences (2993-2149)
Coronary Artery Disease in Postmenopausal Women with Hypothyroidism: Interaction of Estrogen Deficiency and Thyroid Insufficiency
Objective: to systematize data on the mechanisms by which estrogen deficiency and thyroid insufficiency potentiate coronary artery disease (CAD), and to summarize available evidence on the cardiovascular significance of subclinical hypothyroidism in postmenopausal women. Materials and methods: a structured narrative review was conducted using PubMed, Scopus, eLIBRARY.RU and CyberLeninka databases for the period 2000–2024. Search terms included: hypothyroidism, menopause, coronary artery disease, estrogen deficiency, dyslipidemia, endothelial dysfunction. Inclusion criteria: cohort and case-control studies (n ≥ 100), meta-analyses (≥ 5 primary studies), systematic reviews with described methodology. A total of 23 sources were included in the final analysis. Results: overt hypothyroidism increases total cholesterol by up to 50%; subclinical hypothyroidism raises it by 10–20%. Concurrent estrogen and thyroid hormone deficiency suppresses LDL receptor expression through independent promoter elements (ERE and TRE), reducing LDL clearance by 60–70% in hepatocyte experiments. The Rotterdam Study (n = 1,149 women over 55 years) demonstrated a twofold increase in CAD risk associated with subclinical hypothyroidism (OR 2.3; 95% CI 1.3–4.0) after adjustment for traditional risk factors. Conclusions: the synergism of two hormonal deficiencies elevates cardiovascular risk to a clinically meaningful level. Standard risk scores (Framingham, SCORE) do not incorporate thyroid status and may underestimate prognosis in this population. Prospective RCTs stratified by menopausal status and TSH level are needed.
Precancerous Lesions Of The Oral Mucosa And Vermilion Border Of The Lips: Clinical-Morphological Features And Early Diagnostic Approaches
Oral squamous cell carcinoma is characterized by high mortality rates, primarily due to delayed clinical detection. Timely recognition of potentially malignant oral disorders within the oral mucosa and the vermilion border of the lips provides a crucial window for secondary prevention. This study aims to analyze the distinct clinico-morphological characteristics of major precancerous lesions and evaluate contemporary early diagnostic approaches to enhance risk stratification and diagnostic accuracy. A retrospective descriptive analysis was conducted on documented clinical profiles and histopathological records of various conditions, including verrucous leukoplakia, erythroplakia, speckled erythroleukoplakia, and actinic cheilitis. Lesions were evaluated based on macroscopic features, color, borders, and texture, and microscopic findings, including epithelial dysplasia, hyperkeratosis, and cellular pleomorphism. Furthermore, adjunctive screening tools—such as tissue autofluorescence, toluidine blue vital staining, and brush cytology—were assessed alongside the gold-standard scalpel biopsy. Distinct clinico-morphological correlations were established. Erythroplakia and speckled erythroleukoplakia demonstrated the highest risk profiles, histopathologically correlated with severe epithelial dysplasia, cellular pleomorphism, and prominent vascularity. Actinic cheilitis showed a strong correlation with solar elastosis and early architectural disorder. While visual inspection remains the baseline, adjunctive non-invasive methods like tissue autofluorescence significantly enhanced the demarcation of high-risk lesion borders, optimizing the site selection for definitive scalpel biopsy. Precise knowledge of clinico-morphological boundaries in OPMDs is vital for early oncological intervention. Integrating advanced non-invasive diagnostic adjuncts with histopathological verification provides a robust framework for preventing malignant transformation and improving patient survival outcomes.
Diagnosis and Surgical Treatment of a Foramen Ovale Defect in Older Patients Complicated by Pulmonary Artery Hypertension
Atrial septal defect (ASD) is one of the most common congenital heart defects in adult patients, accounting for all congenital heart defects — ASD) is one of the most common congenital heart defects in adults, accounting for 10–15 percent of all congenital heart defects and 25–30 percent of congenital heart defects diagnosed for the first time in adulthood. Its long-term undiagnosed course leads to chronic increases in pulmonary blood flow, causing pulmonary vasculature remodeling and the development of pulmonary artery hypertension (PAH), which significantly complicates the treatment strategy. This article reviews modern diagnostic methods for BADN complicated by PAH in adult patients—transthoracic and transesophageal echocardiography, right heart catheterization, assessment of pulmonary vascular resistance (PVR) — as well as treatment tactics, including percutaneous and surgical closure, and the “treat and repair” strategy used in severe PAH cases, are analyzed. In a retrospective registry of 632 patients, PH20 (mean pulmonary arterial pressure >20 mm Hg) was identified in 56.8% of patients before BADN closure, In the study of 117 patients, PAH normalization was observed in 80% of cases after transcatheter closure, and in a meta-analysis of 1,073 patients, PH prevalence decreased from 44% to 18% post-closure. The results obtained confirm the clinical importance of early diagnosis of BADN complicated by PAH and the selection of individualized treatment tactics.
Association of Obesity with Growth and Pubertal Development in Iraqi Children: A Cross-Sectional Study
Background: It has been said that overweight during childhood may disturb the normal pattern of somatic growth and sexual maturation. There is increasing evidence that adiposity influences both stature and the timing of pubertal onset, although the magnitude and direction of these effects may vary by sex. Such information among Iraqi children is lacking. Objective: To investigate the relationship between obesity, linear growth, and pubertal development in Iraqi children and adolescents. Methods: This was a hospital-based cross-sectional study conducted in the Pediatric Endocrinology Outpatient Clinic of Al-Zahra Teaching Hospital from January 2021 to December 2025. The study involved 250 participants between 3 and 18 years of age. Nutritional status was assessed based on body mass index percentiles adjusted for age and sex, and participants were classified as obese or non-obese. Height and weight were measured in standard units, and pubertal staging was done by Tanner criteria. Postmenarchal girls gave details of their menstrual history. The data were analyzed using IBM SPSS Statistics; p<0.05 was considered to be statistically significant. as p < 0.05. Results: There were 250 children enrolled in this study. One hundred and thirty-six (54.4%) were males, and 114 (45.6%) were females. Only 26 (10.4%) children were found to be obese, whereas 224 (89.6%) children had normal or non-obese body mass index values. The children with obesity were taller on average and were at more advanced pubertal stages compared to their nonobese counterparts. For the girls, obesity was associated with earlier breast maturation and a lower age at menarche. For the boys, higher body mass index was associated with earlier genital development and larger testicular volume. There were positive correlations between body mass index and the indicators of pubertal progression. Conclusion: Childhood obesity was associated with higher values of stature and pubertal maturation in this Iraqi sample. Such findings emphasize the requirement for early identification and effective management of overweight to attain healthy growth and developmental outcomes.
Clinical and Laboratory Diagnostics and Modern Treatment Strategies for Gastritis
This scientific article provides a detailed analysis of the etiopathogenesis of acute and chronic gastritis, modern classification systems, contemporary laboratory and instrumental diagnostic methods, and treatment regimens based on international protocols. The article places special emphasis on invasive and non-invasive methods for detecting Helicobacter pylori infection, assessing gastric acidity, and analyzing biomarkers. Additionally, it covers eradication therapy based on the Maastricht VI consensus, new generations of antisecretory drugs, and strategies for preventing neoplasia.
The Role of Nurses in Primary Health Care and Improving the Health of Adolescent Girls
The formation of a healthy lifestyle is the foundation of preserving public health, and primary health care nurses play an important role in this process. This study aims to analyze life-expectancy indicators, young people’s attitudes toward health, and the strategic importance of qualified nurses in promoting HLS among adolescent girls. A theoretical and descriptive analysis was carried out based on data from World Health Organization experts, retrospective demographic indicators, and the results of a sociological survey examining young people’s attitudes toward physical activity and their own health. According to WHO experts, 50% of human health depends directly on a healthy lifestyle. Lack of physical activity is one of the leading risk factors for death worldwide, accounting for 6% of all deaths 3.2 million people per year). Although 95.7% of young people in the survey had a positive attitude toward sport, in practice laziness 31.6% of girls 14.5% of boys, lack of time 25.5% of girls, 11.9% of boys were found to be the main barrier to HLS. Transitioning the medical system to a family-medicine model and systematically retraining PHC personnel are key factors in raising the population’s medical literacy and forming healthy habits among adolescents.
Cycades of The Family Cicadellidae, Genus Kyboasca Modern Pests of Cotton
The article presents the results of the study of cotton field pests from the Cicadellidae family, genus Kyboasca, species composition, harmfulness, nature of damage caused, natural enemies and recommends modern control measures. The issues of working out mathematical models of cicadas’ development and spread, built based on the populations specifics, the nature of their reactions to environmental factors, which makes it possible to model and effectively manage them, are considered.
Health-Promoting Principles of Conducting Sports Training with Children with Musculoskeletal Disorders
The article is devoted to the differentiated approaches to the training process and rehabilitation methods for musculoskeletal disorders in young athletes by means of therapeutic physical training.
Risk Factors Associated With Pelvic Organ Prolapse In Women Of Reproductive And Perimenopausal Age
Pelvic organ prolapse (POP) is a common condition that significantly affects women's quality of life. This study aimed to identify the main risk factors associated with POP through clinical and anamnestic analysis. A total of 130 women were examined, including 90 patients with prolapse symptoms and 40 healthy controls. The analysis demonstrated that heavy physical labor, obesity, high parity, short interpregnancy intervals, early age at first delivery, complicated vaginal deliveries, and increased fetal birth weight were significantly associated with POP development. Chronic respiratory diseases, connective tissue disorders, varicose veins, and hernia were also more prevalent among women with prolapse. Logistic regression analysis indicated that fetal birth weight greater than 3500 g was an important predictor of prolapse. Early identification of these risk factors may contribute to improved prevention, timely diagnosis, and reduction of disease progression.
Hygiene and Sanitation Practices and Their Association with Health Outcomes among Residents of Informal Settlements in Ibadan, Nigeria
Introduction: Inadequate water, sanitation, and hygiene (WASH) conditions remain major drivers of preventable infectious diseases in urban informal settlements. Residents of such environments are disproportionately exposed to waterborne diseases due to poor infrastructure and suboptimal hygiene practices. This study assessed hygiene and sanitation practices and their association with health outcomes among residents of informal settlements in Ibadan, Nigeria. Aim: The study aimed to examine WASH practices and determine their relationship with health outcomes among households in selected informal settlements in Ibadan. Methods: A community-based cross-sectional design was employed among households in informal settlements. Data were collected using a structured interviewer-administered questionnaire covering socio-demographic characteristics, water access and treatment practices, sanitation facilities, environmental hygiene conditions, and self-reported health outcomes. Descriptive statistics were used to summarize variables, while chi-square tests and multivariate logistic regression were used to assess associations between WASH practices and health outcomes at p < 0.05 significance level. Results: A substantial proportion of respondents relied on unimproved water sources, shared sanitation facilities, and inadequately managed environmental conditions. Poor WASH practices were significantly associated with higher health risk. Use of unimproved water sources (p = 0.006), lack of water treatment (p < 0.001), unsafe water storage (p = 0.002), unimproved sanitation facilities (p < 0.001), and poor environmental hygiene indicators such as blocked drainage and stagnant water (p < 0.01) were all significantly associated with adverse health outcomes. Multivariate analysis further identified knowledge level and housing conditions as key predictors of health risk, while better housing type was protective. Conclusion: The study demonstrates that inadequate WASH conditions significantly increase health risks among residents of informal settlements in Ibadan. Addressing these challenges requires integrated interventions combining improvements in water supply, sanitation infrastructure, and environmental management alongside sustained hygiene promotion. Structural investment, rather than behavior change alone, is essential for reducing the burden of waterborne diseases in urban informal settlements.
Perioperative Complications Associated with Spinal Versus General Anesthesia in Adult Surgical Patients: A Comparative Study
Spinal and general anesthesia are common methods of adult surgical patients, and each is characterized by unique physiological effects and complication rates. To maximize the outcomes of perioperative conditions, it is necessary to understand their relative safety. The purpose of the study is to compare the complications during the perioperative period between general and spinal anesthesia in adult patients undergoing elective surgery. Prospective comparative study was done at Al-Salam Teaching Hospital involving 100 patients aged 1865 years (ASA I-III). Patients were divided into two groups (spinal anesthesia n = 50 and general anesthesia n = 50). Intraoperative hemodynamics and perioperative complications such as: hypotension, bradycardia, respiratory complications, postoperative nausea and vomiting (PONV), headache, and urinary retention had to be noted and analyzed. There were similar baseline characteristics across groups (p > 0.05). The rates of hypotension (40% vs. 20; p = 0.03) and bradycardia (25% vs. 10; p = 0.04) were higher in the spinal anesthesia group. Conversely, general anesthesia experienced considerably more respiratory problems (18% vs. 4%; p = 0.02) and PONV (35% vs. 15%; p = 0.02). Post-dural puncture headache (18% vs. 5%; p = 0.04) and urinary retention (22% vs. 10%; p = 0.05) were more frequent in the spinal group. The rates of overall complications were similar in groups (p > 0.05). There are varying perioperative complication profiles in spinal and general anesthesia. Spinal anesthesia is more prone to the occurrence of hemodynamic instability and less prone to respiratory complications, but general anesthesia is prone to higher PONV and respiratory risks. The decision on anesthetic method must be personalized in regard to the patient's features and the operation's needs.
Modern Aspects of Diagnosis and Treatment of Hepatic Echinococcosis in Children
A retrospective analysis of diagnostic and treatment outcomes was performed in 21 children with hepatic echinococcosis treated between 2015 and 2026. The patients were aged 4 to 16 years. All children underwent ultrasonography, multislice computed tomography (MSCT), laboratory and serological investigations. All patients received surgical treatment combined with antiparasitic therapy using albendazole. Boys predominated among the examined patients — 14 (66.7%), while girls accounted for 7 (33.3%). Solitary hepatic hydatid cysts were identified in 17 (81.0%) children, while two cysts were detected in 4 (19.0%) patients. Concomitant pulmonary echinococcosis was diagnosed in 4 (19.0%) children. The postoperative period was uneventful in 18 (85.7%) patients. Complications developed in 3 (14.3%) children.
Hybrid CNN-VIT Model for Automated Multi-Stage Malaria Parasite Classification in Microscopy Images
The diagnosis of malaria continues to be a big problem for treatment and surveillance of the disease in a timely manner, especially in places with limited resources where there are no expert microscopists. In this research, a new method that uses deep learning is presented combining EfficientNetB0-based convolutional neural network (CNN) with a Vision Transformer (ViT) in a very effective way to the automatic multi-stage malaria parasite classification from blood smear microscopy images. The local morphological features are extracted hierarchically by the CNN component, whereas the global spatial relationships and the long-range contextual dependencies within the infected cells are modeled by the ViT module enabling the improvement in the discrimination of the visually similar parasite stages. To increase the model’s generalization between the different datasets and staining variabilities to even further extent, contrastive self-supervised learning (CSSL) has been integrated during the model training alongside morphology-aware data augmentation, so that the model can learn feature representations that are stage-consistent and stain-invariant. The results of the experiments reveal that the hybrid CNN–ViT model is a better performer than conventional deep learning architectures by a large margin, thus attaining 99.1% accuracy, 98.9% precision, 99.0% recall, and an F1-score of 98.9% on the validation set. These results underscore the integration of convolutional feature extraction and transformer-based global attention in the automation of malaria parasite analysis and point out that the proposed framework provides a trustworthy and scalable alternative to manual microscopy in clinical and field settings.
The Role of Tumor Markers in the Laboratory Diagnosis of Oncological Diseases
Tumor markers are defined as biochemistry substances produced by the malignant cells or by the host responsive for the neoplastic processes. These can be found in a number of biological samples, such as blood, urine, and tissues. The current review is a reassessment of a variety of tumor markers (AFP, PSA, CEA, CA 125, CA 19-9, HER2/neu, CA 15-3 and beta-hCG) used in laboratory oncology diagnosis and their clinical usefulness. When studying 127 studies involving ~284,500 patients, no single marker was found to be sufficiently sensitive and specific for independent diagnosis of cancer. The use of combination diagnostic algorithms (ROMA and PHI) led to significant improvements in diagnostic performance with AUC range between 0.88 and 0.96. New liquid biopsy methods using circulating tumour DNA (ctDNA) also have proven high sensitivity in various cancer types. When combined with imaging techniques and a multi-disciplinary clinical evaluation, tumor markers will continue to play a crucial role in the monitoring of therapy, in the assessment of prognosis, and in the detection of recurrence.
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.
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.
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.
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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.