Babcock University Medical Journal

Pheochromocytoma presenting with abdominal pain and predominant norepinephrine secretion in a young adult Nigerian: A case report

Oluyemisi Okwudishu — 2026-04-01

Background: Pheochromocytoma is a rare neuroendocrine tumour of adrenal chromaffin cells, accounting for a tiny proportion of hypertension cases and adrenal masses. The neoplasm is commoner in the fourth and fifth decades of life but can uncommonly occur in younger people. In sporadic cases, abdominal pain can be an infrequent clinical presentation. With variable quantities of norepinephrine, pheochromocytoma primarily secretes epinephrine.

Case Presentation: A 25-year-old male with left flank pain, hypertension, and weight loss presented to our endocrinology outpatient clinic. Physical examinations revealed tachycardia, hypertension, and tenderness in the left flank. Urinalysis revealed glucosuria, proteinuria, ketonuria, and haematuria. Urinary and plasma catecholamines were markedly elevated (predominantly norepinephrine). An abdominal ultrasound revealed a mass in the left upper quadrant, with no metastasis or invasion. Post-admission, he struggled with poor glycaemic and blood pressure control. He was placed on basal bolus insulin therapy and antihypertensives. He underwent an exploratory laparotomy and left adrenalectomy, and has been in remission.

Conclusion: Persistent or resistant hypertension in a young adult accompanied by abdominal pain and hyperglycaemia should prompt consideration of pheochromocytoma, as recognising this pattern is crucial for timely biochemical testing and definitive diagnosis.

Redefining head and neck cancer treatment with targeted therapy: Current landscape and emerging directions

Omar Abdul Qader — 2026-04-01

Background: This comprehensive review discusses the current role of targeted therapies in head and neck squamous cell carcinoma, with a focus on known resistance mechanisms, recent combination strategies, and the direction of personalised treatment.

Main Text: We performed a literature search between March and July 2025 across PubMed, Scopus, and Web of Science. The search focused on both MeSH terms and free-text keywords, including “Head and Neck Neoplasms,” “EGFR inhibition,” “Immune Checkpoint Inhibitors,” and “Combination Therapy.” Clinical trials, original research articles, and major reviews relevant to the scope of this review were included, with no restriction on publication year, resulting in a comprehensive synthesis of the available evidence.

Cetuximab remains the only epidermal growth factor receptor targeting drug formally approved for head and neck squamous cell carcinoma, though its benefits are limited to specific patient groups. Immunotherapies like pembrolizumab and nivolumab demonstrate meaningful survival benefits in recurrent and metastatic settings, and their application is expanding into earlier disease stages. Combination strategies, including EGFR and programmed cell death protein 1 blockade, have shown promising activity. Consequently, dual-target regimens and adaptive strategies are attracting increasing attention. Liquid biopsy and biomarker-guided treatment selection are under active investigation to refine the personalisation of therapy.

Conclusion: The management of head and neck squamous cell carcinoma is shifting toward more personalised and adaptive strategies that combine targeted therapies with immunomodulation. The integration of molecular profiling, real-time monitoring, and smarter trial designs will likely play a key role in improving the precision and durability of treatment responses.

In vitro antifungal activity of ZnO, CuO, and SiO₂ nanoparticles against Lecanicillium lecanii isolated from honeybee (Apis mellifera)

Hani Al-Hussaini — 2026-04-01

Objective: The entomopathogen fungus Lecanicillium lecanii threatens the health of the honeybee (Apis mellifera). Due to the increasing resistance of fungi to conventional antifungal agents, environmental concerns have led to a focus on nanoparticle-based alternatives. This study aimed to evaluate the antifungal activity of zinc oxides (ZnO) and copper oxides (CuO), and silica (SiO₂) nanoparticles (NPs) against L. lecanii.

Methods: The fungal isolate was identified using molecular techniques targeting the internal transcribed spacer (ITS) region, sequencing and phylogenetic tree analysis. In vitro antifungal activity was determined by the broth microdilution at 0, 10, 100, and 500 µg/mL for each nanoparticle. In the same way, the sensitivity of L. lecanii to Amphotericin B, Nystatin, Fluconazole, and Griseofulvin (four common antifungal agents) was also tested.

Results: ZnO nanoparticles exhibited the highest mycelial growth inhibition, followed by CuO and SiO₂ NPs. The effect of ZnO was significant at higher concentrations. Amphotericin B and Nystatin were highly effective drugs, Fluconazole had moderate activity, and Griseofulvin had little effect. The prominent antifungal activity of ZnO-NPs might be attributed to their ability to produce reactive oxygen species (ROS), causing cell damage.

Conclusion: ZnO-NPs demonstrated antifungal activity comparable to some conventional antifungals, suggesting their applicability as a safe and environmentally sustainable option for managing fungal infection in honey bees. Further in vivo and molecular studies are needed to evaluate their safety and mechanisms of action.

Association of nicotinamide adenine dinucleotide content and glucose levels with the oxidative stress in human leukaemia cells

Zainab Al-Abady — 2026-04-01

Objectives: This research underscores the pivotal role of NAD in regulating the oxidant/antioxidant system and controlling ROS production in cancer cells. The present study sought to determine whether increasing NAD levels through supplementation can effectively reduce ROS generation in different cell types, including cancer cells.

Methods: HL-60 cells and Raji cell lines were cultured, and HL-60 cells were differentiated into neutrophil-like cells using all-trans retinoic acid (ATRA). Oxidative stress was quantified using the thiobarbituric acid reactive substance (TBARS) assay and NAD. Cells were then challenged with glucose, and the oxidative stress test was repeated. The HL-60 cells are CD38-negative, and the Raji cells are CD38-positive.

Results: NAD levels in HL-60 cells-CD38 negative were significantly (p=0.001) higher than ATRA-differentiated cells and RAJI cells. The TBARS levels were significantly (p<0.05) higher in cells with lower levels of NAD, particularly in ATRA-differentiated cells, compared to RAJI cells and undifferentiated HL-60 cells. Regarding the incubation of cells with glucose or NAD, cells were incubated with 100 µM NAD for 24 hours to elevate intracellular NAD+ levels. Interestingly, ROS production was significantly reduced in ATRA-differentiated cells, undifferentiated HL-60 cells, and Raji cells after NAD treatment.

Conclusion: Manipulating NAD concentration may indirectly regulate ROS production, potentially offering adjuvant therapeutic advantages in treating diseases associated with oxidative stress, such as cancer.

Evaluation and effectiveness of sulfur nanoparticles against colon cancer prepared from capsicum plant extract

Hassan Al-Redha — 2026-04-01

Objective: Using green chemistry, an effective, inexpensive, and environmentally safe method, sulfur nanoparticles with specific properties can be prepared and used in nanotechnology. This research aimed to prepare sulfur nanoparticles from chilli pepper extract and determine their effectiveness against colon cancer.

Method: Chilli pepper extract obtained from local markets was treated with aqueous sodium thiosulfate (Na₂S₂O₇.5H₂O). After mixing, it was continuously stirred, heated, and filtered. NaBH₄ was then added, resulting in a yellow precipitate. The precipitate was centrifuged, purified, and dried at 250°C.

Results: Standardised tests such as UV-Vis, XRD, SEM, TEM, AFM, and EDX were used, resulting in sulfur nanoparticles with an average nanosize of 38.7 nm that were effective against HT-29 colon cancer cells.

Conclusion: Sulfur nanoparticles prepared from chilli pepper extract using green chemistry have proven highly effective against colon cancer cells, following cell culture and clinical testing. Tests revealed that these nanoparticles exhibited strong resistance at this site, due to their uniquely small nanoscale size.

Inhibitory effects of zinc oxide nanoparticles and morin on virulence-associated gene expression in Staphylococcus aureus

Rasha Ahmed — 2026-04-01

Objective: The emergence of multidrug-resistant Staphylococcus aureus has prompted interest in antivirulence strategies that attenuate pathogenicity without exerting bactericidal pressure. This study evaluated the inhibitory effects of zinc oxide nanoparticles (ZnO-NPs) and the flavonoid morin, individually and in combination, on transcriptional regulation of key S. aureus virulence genes.

Methods: ZnO-NPs were synthesised and characterised using X-ray diffraction (XRD) and scanning electron microscopy (SEM). The reference strain S. aureus ATCC 25923 and multidrug-resistant clinical isolates were employed. Minimum inhibitory concentrations (MICs) were determined by broth microdilution following CLSI guidelines. Sub-MIC concentrations of ZnO-NPs, morin, and their combination were used to evaluate transcriptional changes in eta, seb, agrA, sarA, and RNAIII by RT–qPCR, with 16S rRNA as a housekeeping control.

Results: ZnO-NPs demonstrated high crystallinity and nanoscale morphology (70–92 nm). At sub-MIC concentrations, ZnO-NPs significantly suppressed seb (0.12-fold) and eta (0.42-fold). Morin strongly inhibited seb (0.05-fold) but paradoxically induced eta (6.82-fold). Ciprofloxacin also upregulated eta (2.97-fold). The ZnO-NPs + morin combination neutralised morin-induced eta upregulation (3.01-fold) and produced complete suppression of agrA transcripts, with marked inhibition of sarA and RNAIII.

Conclusions: ZnO-NPs and morin act synergistically to repress S. aureus virulence gene expression, particularly through suppression of global regulators and toxin genes. Unlike conventional antibiotics, this combination reduces pathogenicity without applying bactericidal selection pressure. These findings highlight ZnO-NP–flavonoid combinations as promising antivirulence therapeutics, warranting further in vivo and translational studies.

Effects of intermittent fasting on blood glucose, lipid profile and renal-hepatic biomarkers of streptozotocin-induced rats fed with a high-fat diet

Ademola Akinlade — 2026-04-01

Objectives: Intermittent fasting (IF) is increasingly adopted as a dietary strategy for managing diabetes mellitus, yet its effects on vital metabolic organs such as the liver and kidneys remain unclear. This study investigated the impact of different IF regimens on hepatic and renal functions in streptozotocin-induced diabetic rats.

Methods: Fifty male Wistar rats were divided into five groups (n=10): control (group 1), diabetic (group 2), and three diabetic groups subjected to distinct IF protocols with a high-fat diet—time-restricted feeding (group 3), alternate-day fasting (group 4), and the 5:2 diet (group 5). The experiment lasted four weeks. Weekly body weight and blood glucose (BG) levels were monitored. Serum lipid profile, liver enzymes (ALT, AST, ALP), renal markers (urea, creatinine), and histopathological changes were assessed using standard methods. Data were analysed by one-way ANOVA at p<0.05.

Results: All groups gained weight, but BG and biochemical parameters varied significantly. Groups 2 and 5 showed the greatest BG reduction (104.0 ± 10.23 to 63.3 ± 15.37 mg/dL and 93.8 ± 6.65 to 42.8 ± 4.72 mg/dL, respectively; p=0.05). The 5:2 diet produced the lowest total cholesterol (3.0 ± 0.06 mg/dL), AST (56.5 ± 7.92 U/L), and urea (1.43 mg/dL), with elevated HDL and creatinine. Histological analysis showed varying degrees of hepatic alteration across IF groups.

Conclusion: Intermittent fasting, particularly the 5:2 regimen, improved glycemic and lipid profiles despite mild hepatic and renal stress. IF may support metabolic regulation in diabetes, though dietary fat modification and cautious fasting durations are advised to protect organ integrity.

Aframomum melegueta seeds ethanol extract reduces food intake, body weight, and hyperglycaemia in high-fat-diet streptozotocin-induced diabetic Wistar rats

Folasade Makinde — 2026-04-01

Objective: This study investigated the therapeutic potential of Aframomum melegueta ethanol seed extract (AMsext) and compared it with the standard drug, metformin, in high-fat-diet streptozotocin-induced type-2 diabetes mellitus (T2DM) Wistar rats.

Methods: Thirty high-fat diet (HFD) streptozotocin-induced T2DM male Wistar rats (FBG >240mg/dl) were randomised into five groups: 1. High-fat-diet normal control (HNC), 2. non-treatment diabetic control (NtDC), and 3. Treatment diabetic groups: 3a = Diabetes +100 mg/kg metformin (Metf), 3b = Diabetes +150 mg/kg AMsext (AMsext150), and 3c = Diabetes +300 mg/kg AMsext (AMsext300). Relative food intake (RFI) was calculated while body weight and fasting blood glucose (FBG) level were determined using standard methods.

Results: Treatment for seven days reduced FBG level in AMsext300 (181.33 ± 63.14, p = 0.004) and Meft (168.00 ± 60.02, p = 0.002) groups compared to NtDC (394.00 ± 67.82). In 14 days, FBG level was reduced in AMsext150 (181.67± 58.62, p = 0.004), AMsext300 (148.00 ± 29.46, p = 0.001) and Metf (112.67±10.60, p = 0.000) compared to NtDC (355.67 ± 64.42). Relative food intake was markedly reduced in AMsext300 (58.51± 20.24, p = 0.024) and Metf (54.29 ± 24.59, p = 0.009) compared to NtDC (98.23 ± 1.21). Rats in the AMsext300 group had 39% greater body weight loss compared to AMsext150 and Metf groups.

Conclusion: AMsext reduced food intake, body weight, and hyperglycaemia in a dose-dependent manner comparable to metformin. Findings validate the ethnnomedicinal and complementary use of Aframomum melegueta seeds in the treatment of diabetes mellitus and weight control.

Machine learning classification of Plasmodium falciparum virulence genes using genomic differentiation scores and boosting algorithms

Khalaf Hussein — 2026-04-01

Objective: This study aims to identify virulence-associated genes in Plasmodium falciparum by applying machine learning models to genomic differentiation features, to aid in the discovery of novel therapeutic targets.

Methods: We utilised a dataset of 5,561 P. falciparum genes, labelled based on membership in known virulence gene families (VAR, RIF, EPF, RESA). Three genomic differentiation scores, Global Differentiation, Local Differentiation, and Distance to Higher Local Differentiation, served as input features. We evaluated five classifiers: Random Forest, Gradient Boosting, Support Vector Machine, XGBoost, and LightGBM. To handle class imbalance, the Synthetic Minority Over-sampling Technique (SMOTE) was applied strictly within stratified 5-fold cross-validation folds, alongside hyperparameter tuning. Performance was assessed using accuracy, precision, recall (sensitivity), F1-score, and Area Under the Precision-Recall Curve (AUC-PR).

Results: LightGBM achieved the highest performance with a test accuracy of 85.14% ± 1.2% and an AUC-PR of 0.87 ± 0.02, significantly outperforming the next best model, XGBoost (p = 0.018). Feature importance analysis via SHAP (Shapley Additive Explanations) identified Local Differentiation Score as the most predictive feature.

Conclusion: Boosting algorithms, particularly LightGBM, are highly effective for classifying virulence genes based on genomic differentiation patterns. This approach provides a scalable, data-driven method for prioritising candidate virulence factors in P. falciparum for functional validation.

Inhibitory effect of chlorhexidine on biofilm formation by prosthetic surface pathogens: An in vitro study

Farhood Kadhum — 2026-04-01

Objective: The research investigated how 0.12% chlorhexidine affects the initial growth of single-species biofilms, which include typical prosthetic surface bacteria that colonise different types of prosthetic materials.

Methods: Discs of titanium, zirconia, cobalt-chromium alloy, PMMA, and PEEK were inoculated with five common prosthetic pathogens (S. aureus, S. mutans, E. faecalis, C. albicans, P. aeruginosa). After 24-hour biofilm formation, specimens were treated with 0.12% CHX for 60 seconds. Biofilm biomass was assessed by crystal violet staining and CFU enumeration.

Results: The tested materials showed decreased early biofilm development after Chlorhexidine exposure at different levels, which depended on material surfaces and bacterial species. The surface materials of titanium and zirconia showed the most significant decrease in biofilm biomass, but PMMA and PEEK surfaces maintained more biofilm than the other materials. The susceptibility tests showed that S. aureus and S. mutans became more responsive to chlorhexidine treatment, yet C. albicans and P. aeruginosa developed stronger resistance against the treatment.

Conclusion: Chlorhexidine shows different levels of biofilm inhibition on prosthetic implant surfaces when tested under laboratory conditions based on both the material used and the species being studied. The research results confirm that chlorhexidine should be used as an additional measure for prosthesis cleaning, but the study shows that choosing the right materials remains essential to prevent biofilm-related problems. The research needs additional investigations, which should include surface analysis and multiple species biofilm experiments.

Comparative review of hepatic and renal toxicities in Hodgkin and non-Hodgkin lymphoma chemotherapy

Saeed AL-Hasani — 2026-04-01

Objective: This review aimed to comparatively analyse the existing literature on the impact of standard chemotherapy regimens on hepatic and renal function parameters in patients with Hodgkin Lymphoma (HL) versus Non-Hodgkin Lymphoma (NHL).

Methods: A comprehensive literature search was conducted across PubMed, ScienceDirect, and Google Scholar from inception to March 2024. The review included original research, reviews, meta-analyses, and case reports published in English that focused on hepatic and/or renal function in adult HL or NHL patients receiving standard chemotherapy. Studies solely on paediatric populations, those focusing on other toxicities without a significant hepatic/renal focus, and non-peer-reviewed works were excluded. Data on regimens, organ function abnormalities, toxicity incidence, risk factors, and mechanisms were synthesised.

Results: The analysis revealed distinct toxicity profiles. HL regimens (ABVD, BEACOPP) are associated with direct, though often transient, hepatotoxicity and a lower risk of renal impairment. In contrast, NHL regimens (R-CHOP, R-CVP, BR) carry a significant risk of Hepatitis B Virus reactivation, leading to severe hepatotoxicity. Furthermore, aggressive NHL subtypes are highly susceptible to acute kidney injury driven by Tumour Lysis Syndrome. Key risk modifiers include baseline viral status, pre-existing organ dysfunction, and cumulative drug doses.

Conclusion: The patterns of chemotherapy-induced hepatic and renal toxicity differ markedly between HL and NHL. Recognising these differences is crucial for implementing tailored prophylactic strategies, vigilant monitoring, and timely interventions to mitigate adverse outcomes and improve patient safety and quality of life.

Enhancing physiotherapy practice: A quasi-experimental study comparing training alone versus training with support tools among physiotherapists in Ogun State, Nigeria

Omobolanle Akadri — 2026-04-01

Objective: This study was designed to determine whether adding a modified pain assessment tool and home-program prescription sheets to a training program improves the knowledge, motivation, behavioural skills and uptake of standardised tools by physiotherapists.

Methods: A quasi-experimental study involving two groups of physiotherapists: experimental group (n=30) and control group (n=30); recruited from four tertiary hospitals in Ogun state, Nigeria. The interventions included lectures, participatory discussions and practical demonstrations for both groups, with modified pain assessment tools and home-program prescription sheets introduced to only the experimental group. A structured questionnaire was used to collect data in three phases: baseline, immediate post-intervention and six-week follow-up. Data were analysed using SPSS version 23. The level of significance was set at p-values less than 0.05.

Results: At baseline, the scores of all measured variables were similar in the two study groups. Immediately post-intervention, the scores in the experimental group were significantly higher than those in the control group across all measured variables (p< 0.001). At follow-up, the scores of measured variables were significantly higher in the experimental group compared to the control group for knowledge (p=0.005), motivation (p<0.001), behavioural skills (p<0.001), and utilisation (p<0.001). In the experimental group, the scores of all measured variables significantly increased from baseline values in all the measured variables: knowledge (p<0.001), motivation (p=0.047), behavioural skills (p<0.001), and utilisation (p<0.001).

Conclusion: The addition of support tools to the training program of physiotherapists improved their knowledge, motivation, behavioural skills and use of these tools in their routine practice.

Biochemical and histological profiles of gallstones in pre- and postmenopausal women

Eman Hussein — 2026-04-01

Objective: Cholesterol gallstones are frequently observed in postmenopausal women due to hormonal and metabolic alterations. Objective: To study differences in biochemical and histological gallbladder profiles between pre-and postmenopausal women with cholesterol gallstones.

Methods: A total of 100 patients with gallstones and 80 healthy controls. Inflammatory markers (CRP, IL-6, MDA), liver enzymes, lipids, and bilirubin were measured. Stone composition and gallbladder histology were examined.

Results: CRP, IL-6 and MDA were significantly increased in patients with gallstones compared to controls. IL-6 levels were increased in postmenopausal women, whereas MDA was higher in premenopausal patients. Serum total cholesterol and triglyceride levels were higher in postmenopausal patients. AST and ALT were raised in both groups. Magnesium levels were increased in postmenopausal gallstone patients, whereas no significant differences were found in the calcium, sodium, and potassium contents of the stones. Histology revealed severe inflammatory infiltration, RAS, mucosal hyperplasia, haemorrhage and muscular hypertrophy in chronic cholecystitis. Subepithelial foamy lipocytes, ulceration of the mucosa, vascular congestion, haemorrhage, thrombosis, and necrosis characterise acute cholecystitis. Hypertrophic muscle bundles were commonly contiguous with these structures. The wall of gallbladders with cholesterol stones demonstrated a focal destruction of muscle fibres, congestion, widespread necrosis and an invasion by neutrophils and vacuolated cells.

Conclusion: Menopausal status strongly affects the biochemical and histopathological profiles of cholecystitis disease, with postmenopausal patients demonstrating greater metabolic and inflammatory disturbances, highlighting the importance of age- and hormone-specific approaches in diagnosis and management.

Influence of clinical biomarkers and demographic characteristics on predicted FEF25–75 in Iraqi patients with Asthma

Aula Hamod — 2026-04-01

Objective: This study aimed to investigate the associations between predicted Forced Expiratory Flow at 25–75% of pulmonary volume (FEF25–75) and selected clinical biomarkers, namely serum periostin, peripheral blood eosinophil count, and immunoglobulin E (IgE) levels, in a cohort of Iraqi patients diagnosed with bronchial asthma. Given that FEF25–75 reflects small airway function and is considered a sensitive marker of early airway obstruction, this study sought to explore its potential correlation with established indicators of airway inflammation and allergic response.

Methods: A cross-sectional analytical design was employed to assess the relationship between mid-expiratory lung function and inflammatory biomarkers among adult asthmatic patients. The study was conducted at a private respiratory clinic in Hillah, Iraq, and spanned a duration of one year. Patients were enrolled based on a clinical diagnosis of asthma according to Global Initiative for Asthma (GINA) guidelines, and spirometric measurements were obtained to assess lung function. Blood samples were collected for biomarker analysis using standard laboratory techniques.

Results: The mean age of patients is 38.1, and the percentage of female patients is 54.8%. Patients with low predicted FEF25–75 (≤65%) had significantly higher levels of serum periostin (p=0.035), blood eosinophil counts (p=0.03), and IgE (p=0.05) compared to those with normal FEF25–75. There are no significant associations found with age, sex, or BMI. However, family history was associated.

Conclusion: This supports the use of FEF25–75 alongside biomarker profiling for improved asthma phenotyping.

Efficacy and safety of Picosecond ND: YAG laser in the treatment of post-acne erythema by comparison of 1064 nm picosecond micro-lens array vs 595 nm picosecond waves: split face clinical study

Hindreen Aqrawi — 2026-04-01

Objective: To assess the efficacy and safety of two picosecond-laser wavelengths, 1064 nm neodymium-doped yttrium aluminium garnet with a micro-lens array and 595 nm, in the treatment of PAE using a split-face design.

Methods: Each of them received three sessions of Picosecond laser every two weeks using two Handpieces, the short wave fractional 1064 nm applied to the right side of the face, and the 595 nm dye picosecond handpiece used for the left side of the face. All the patients were observed through multiple photos taken before, during, and two months after the last session.

Results: Treatment with both wavelengths demonstrated significant (p<0.05) reductions in erythema. Still, the comparison of results between left and right laser treatments revealed that the larger mean difference (1.750) for the right side compared to the left side (1.200) suggests that the laser treatment had a more substantial effect on reducing right clinician erythema assessment scores (p=0.0001). No severe adverse events were reported, highlighting the safety of both modalities.

Conclusion: The micro-lens array 1064 nm handpiece of the picosecond laser demonstrated superior efficacy compared to the short pulse 595 nm handpiece for treating post-acne erythema (PAE). The picosecond laser also exhibited an excellent safety profile with minimal adverse effects, making it a valuable and recommended treatment modality for PAE management.

Healthcare service utilisation among undergraduate students: Knowledge, attitude, and experiences at a Nigerian university health service

Saheed Lawal — 2026-04-01

Objective: This study examines undergraduate students’ knowledge, attitude and experiences on the utilisation of healthcare services at the University hospital.

Method: A descriptive cross-sectional survey design was adopted. Data were collected from 420 undergraduate students using a multi-stage sampling approach. Interviewer-administered questionnaires were used for data collection. The questionnaire consisted of 42 items, including demographic information of respondents, knowledge of health services, attitude towards healthcare services, experience with use of health services and factors influencing the use of health services at BUTH.

Results: The findings reveal a generally neutral stance toward healthcare experiences, with respondents expressing mixed feelings regarding service accessibility and the responsiveness of healthcare staff. Notably, long waiting times and perceived staff attitudes were major barriers to utilisation. Although students demonstrated knowledge of available healthcare services, their experiences did not translate into strong confidence or recommendations to others. Factors influencing healthcare utilisation included the severity of symptoms and the reputation of healthcare professionals. The study underscores the need for service improvements to enhance healthcare satisfaction and utilisation among university students.

Conclusion: The study shows that undergraduate students possess adequate knowledge of university healthcare services; however, neutral perceptions and barriers such as prolonged wait times, care quality and staff attitudes limit utilisation. Enhancing service efficiency and responsiveness is essential to improving student satisfaction and healthcare engagement.

Evaluation of an instructional program on Primigravida women’s knowledge about exclusive breastfeeding

Balqees Aljbory — 2026-04-01

Objective: To evaluate the effectiveness of an instructional program on improving knowledge about exclusive breastfeeding (EBF) among primigravida women in primary healthcare centres.

Methods: A quasi-experimental study (one-group pretest-post-test design) was conducted from October 1, 2024, to January 1, 2025. A purposive sample of 60 primigravida women attending a primary health centre in Iraq was recruited. Participants completed a validated questionnaire assessing EBF knowledge before and after a structured instructional program. The program consisted of a single 45-minute session using lectures and visual aids. Data were analysed using descriptive statistics and a paired samples t-test.

Results: A significant improvement in mean knowledge scores was observed post-intervention (67.4 ± 3.4) compared to pre-intervention (42.1 ± 8.7), with a mean difference of 25.3 points (t(59) = 25.12, p < 0.001). High post-test knowledge was noted regarding the definition of EBF (95%), the sufficiency of breastmilk (95%), and the initiation of breastfeeding (88.3%). However, knowledge regarding EBF's protective effects against sudden infant death syndrome (46.7% "I know") and acute otitis media (50% "I know") remained moderate. No significant associations were found between post-test knowledge scores and demographic characteristics (age, education, occupation, residence; p > 0.05).

Conclusion: The instructional program significantly improved knowledge of EBF among primigravida women. Integrating such structured educational sessions into routine antenatal care at primary health centres is recommended to promote EBF practices.

Role of DEXA-derived bone mineral density in orthopaedic surgical planning: A cross-sectional study

Dalya Mohammed — 2026-04-01

Objective: This study aims to clarify the role of site-specific bone density measurement in surgical decision-making by comparing BMD in the spine and bilateral femurs of males and females.

Method: Cross-sectional comparative study of two hundred consenting individuals consisting of 100 osteoporotic patients and 100 healthy controls (in terms of the total spine and femur (left and right femurs)), matched for age and sex. The volunteers aged between 40 and 75, with heights between 158 and 180 cm, and weights between 63 and 87 kg.

Results: There were no significant differences in the mean values of the normal BMDs between the lumbar spine and right femur, or between the lumbar spine and left femur. There were statistically significant (P ˂ 0.001) differences in the mean BMD for the normal lumbar spine and osteoporosis of the left and right femurs in both male and female cases, separately.

Conclusion: The significant reduction in femoral BMD among osteoporotic patients underscores the need to focus on bones other than the lumbar vertebrae and hip bones, which are traditionally assessed without taking into consideration the affected bone(s). Further, routine DEXA screening plus the bone(s) of interest (other than the lumbar spines and hip bones) should be integrated into orthopaedic practice to optimise patient outcomes, reduce the risk of fractures, and enhance surgical success rates in osteoporotic individuals. Osteoporotic patients requiring fracture fixation should undergo site-specific DEXA screening of the affected bone to guide fixation feasibility and procedure selection.

Evaluation of implant stability using resonance frequency analysis in two functional implant zones

May Estephan — 2026-04-01

Objective: The study aimed to compare implant stability between sinus and ischemic zones at three time points via resonance frequency analysis.

Methods: 37 dental implants were placed in 14 patients aged between 30 and 60 years. These implants were predominantly placed in regions of the mouth with sinus cavities and ischemic areas. Six implants were excluded from the study because they failed early, or the patients did not follow the treatment plan. That left 31 implants to be studied. The analysis assessed how stable the implants were using a special test on the day of surgery and then again at 8 weeks and 12 weeks afterwards.

Results: Implant stability slightly dropped at 8 weeks after surgery. By 12 weeks, stability had increased significantly, showing that the implants were becoming more securely attached to the bone.

The size of the implants did not vary much between the sinus and ischemic areas. Although primary stability was lower in the sinus zone compared to the ischemic zone, the difference was not significant (p = 0.103). Implant stability was significantly higher in the ischemia zone at 8 and 12 weeks after surgery (p=0.0004 and <0.0001, respectively). At 8 and 12 weeks, implants in ischemic areas were significantly more stable than those in sinus areas.

Conclusion: Where the implant is placed in the mouth can affect how well it bonds with the bone. In the early healing stages, areas with poor blood supply (ischemic zones) might actually provide better conditions for implant stability.

Clinical characteristics and survival analysis of hospitalised COVID-19 patients in Ogun State, Nigeria

Janet Bamidele — 2026-04-01

Objective: Despite the end of the pandemic, COVID-19 remains a disease of global concern. This study aimed to describe the clinical characteristics, outcomes, and survival analysis of hospitalised COVID-19 patients in Ogun State, Nigeria, with a view to providing evidence on the survival of hospitalised COVID-19 patients.

Methods: The study examined the medical records of COVID-19 patients at the Olabisi Onabanjo University Teaching Hospital COVID-19 Isolation Centre in Sagamu, Ogun State, between March and December 2020. Data was analysed using SPSS version 22, with chi-square tests for association and logistic regression for mortality predictors. Kaplan-Meier curves and Log-rank tests were used for survival analysis.

Results: The study involved 273 patients, with a mean age of 45.33±16.9 years. The majority were males, had symptoms (51.6%), and had SPO2 ≥ 94% (82.4%) at presentation. Most were discharged (94.1%), while 5.1% died. Over half presented with fever (55.3%) and cough (51.8%), and one-third had comorbidities. Most of those with comorbidities had hypertension (73.3%). The presence of two or more comorbid conditions (AOR 9.5, 95% CI 1.8 – 50.6; p = 0.008) and oxygen saturation less than 94% at admission (AOR 19.5, 95%CI 3.0 – 128.0; p = 0.002) were predictors of mortality. A significant difference was observed in the Kaplan-Meier curve regarding age group, symptom presence, comorbid conditions, and oxygen saturation at admission.

Conclusion: The study found higher mortality rates due to co-morbidities and low oxygen saturation at admission, emphasising the need for early diagnosis, prompt referral, and management of patients with co-morbidities.

Pattern of distribution of Hodgkin lymphoma and non-Hodgkin lymphoma subtypes among adults: An experience of a Nigerian tertiary health facility

Ngozi Ugwu — 2026-04-01

Objective: Lymphomas are a heterogeneous group of malignancies with varying geographic and demographic distributions. This study aimed to describe the pattern of distribution of Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) subtypes among adults.

Methods: This was a retrospective study of patients diagnosed with lymphoma at our institution between January 2019 and December 2023. Data were extracted from the record of the histopathology department of the institution. Lymphoma subtypes were classified according to the World Health Organisation (WHO) classification.

Results: There were 59 cases of lymphoma during the study period, made up of 30 (50.8%) males and 29 (49.2%) females. The overall mean age at diagnosis was 45±18 years. HL accounted for 35.6% (21/59) of the cases, while NHL accounted for 64.4% (38/59) of the cases. Among the HL, classical HL contributed 85.7% while Nodular lymphocyte-predominant HL contributed 14.3%. The distribution of the different histologic subtypes of HL showed mixed cellularity 10 (47.6%) as the commonest subtype, followed by nodular sclerosis 5 (23.8%) subtype. Among the NHL, B-cell lymphoma accounted for 76.3% while T-cell lymphoma accounted for 23.7%. Overall, Small Lymphocytic Lymphoma (SLL)/ Chronic Lymphocytic Leukaemia (CLL) was the commonest subtype and accounted for 42,1% (16/38), followed by diffuse large B-cell lymphoma (DLBCL) 18.5% (7/38), and follicular lymphoma (FL) 7.9% (4/38).

Conclusion: This study provides insight into the distribution pattern of lymphoma subtypes among adults in our environment, with mixed cellularity as the most common HL histologic subtype and SLL/CLL as the predominant NHL subtype.

The frequency of hypocalcaemia among patients who underwent total thyroidectomy: A prospective cohort study

Hassan Melek — 2026-04-01

Objective: Hypocalcaemia is the most common early metabolic complication following total thyroidectomy, primarily due to parathyroid dysfunction. To determine the frequency, severity, and predictors of post-thyroidectomy hypocalcaemia in a prospective cohort.

Methods: A prospective observational study was conducted over 18 months (January 2023–June 2024) on 217 consecutive adult patients undergoing total thyroidectomy at a tertiary care centre in Iraq. Serum calcium (Ca²⁺) and intact parathyroid hormone (iPTH) were measured preoperatively and at 6, 24, and 48 hours postoperatively. iPTH was measured using ELISA. Symptomatic hypocalcaemia was defined as serum calcium (Ca²⁺) <8.0 mg/dL with neuromuscular symptoms. Multivariate logistic regression identified independent predictors.

Results: The overall incidence of biochemical hypocalcaemia was 38.7% (n=84); symptomatic hypocalcaemia occurred in 17.1% (n=37). Permanent hypocalcaemia occurred in 1.4% (n=3). An iPTH cutoff of <10 pg./mL (derived from ROC analysis) predicted symptomatic hypocalcaemia with high accuracy (AUC 0.93). Independent predictors included low 6-hour iPTH (OR 8.2, p<0.001), female sex (OR 2.1, p=0.03), and central neck dissection (CND) (OR 3.4, p=0.002).

Conclusion: Hypocalcaemia is frequent but predominantly transient. Early iPTH measurement—even via ELISA- is feasible and effective in resource-limited settings for early risk stratification. Early postoperative iPTH measurement accurately predicts hypocalcaemia and enables targeted calcium supplementation, reducing unnecessary treatment and hospital stay.

Sleep quality and mental well-being among healthcare workers: A cross-sectional study at Babcock University Teaching Hospital, Nigeria

Adebola Omotosho — 2026-04-01

Objective: There is a lack of research on how sleep quality affects the mental well-being of healthcare workers, prompting this study. This study aims to explore the relationship between sleep quality and mental well-being among Babcock University Teaching Hospital healthcare workers.

Method: This study was done among the healthcare workers of Babcock University Teaching Hospital. It was a cross-sectional study done via a multi-stage sampling technique. A total of 246 valid responses were analysed. Sleep quality was measured using the Pittsburgh Sleep Quality Index, and mental well-being was assessed using the General Health Questionnaire-12. The data was presented in tables, percentages, and frequencies, while association was analysed using chi-square.

Results: The findings revealed that 69.5% of healthcare workers had poor sleep quality (mean PSQI score = 6.28 ± 5.612). Additionally, 48.4% of respondents experienced mental distress. Despite these high levels of poor sleep and mental distress, no statistically significant association was found between sleep quality and mental well-being (χ²= 0.126, p=0.723).

Conclusion: The study revealed a high prevalence of poor sleep quality and considerable mental distress among healthcare workers, underscoring the growing concern for their overall well-being. Although no statistically significant association was found between sleep quality and mental well-being, the elevated proportions observed suggest that both domains warrant independent attention. Interventions aimed at improving sleep hygiene and promoting psychological support within healthcare settings remain essential to enhance workforce health and performance.

Perception and behaviour of undergraduate students to on-campus food operations in a tertiary Nigerian institution in southwest Nigeria: A cross-sectional study

Oluyemisi Okwudishu — 2026-04-01

Objective: A useful and inviting college cafeteria is a factor in the success of university students. This study assessed students’ perceptions and behaviour toward on-campus food operations.

Methods: It was a descriptive cross-sectional survey, carried out at Babcock University, Ogun State, Nigeria, involving 450 respondents using multistage sampling. Descriptive analysis was used to analyse demographics, perceptions, students’ behaviour, and recommendations. Measures of association between the demographics and the students' perception were measured using the Chi-Square Test.

Result: 51.1% of the respondents had a positive perception of the cafeteria food services, while 48.9% had a poor perception. The majority (74.7%) disagree that the food provided is palatable, and that the food does not offer good value for money (65.6%). About half of the students are not comfortable eating in the cafeteria because it is not properly ventilated (65.3%) and not conducive when eating (63.3%). 49.1% disagree that the staff maintains standard hygiene protocol while serving food, while more than half (53.3%) disagree that the staff are friendly and approachable and do not respond promptly to their complaints (62.0%). More so, 66.0% of the study participants disagree that the number of cafeteria staff is enough to satisfy the students’ needs.

Conclusion: The study showed that a little above half had a good perception of the on-campus food services. Ambience, service quality, and meal options are significant determinants of the negative perception of on-campus food services. Expanding the cafeteria space to accommodate more students and training the staff will improve their perception.

Knowledge and awareness of polycystic ovarian syndrome among female undergraduates in a selected private university: A descriptive study

Ayomide Adebimpe — 2026-04-01

Objectives: This study assessed the knowledge and awareness of polycystic ovary syndrome (PCOS) among female undergraduates at a selected private university in Nigeria.

Method: The study utilised a cross-sectional descriptive design. Multistage sampling was used to select the specific settings, resulting in 413 sampled respondents. A pretested instrument was used in collecting the data. Descriptive and inferential (Pearson correlation) statistics were used to analyse data at 5% level of significance.

Results: Findings revealed that 61.4% of respondents demonstrated average knowledge, and 63.4% showed high awareness of PCOS. A positive correlation was found between awareness and knowledge (r = 0.351; p < 0.05). There were significant differences in the level of knowledge between the social and health sciences students (Mean diff. = 2.609, p < 0.05), and the level of awareness between 200-level and 500-level female undergraduates (Mean diff. = 0.44, p < 0.05).

Conclusion: This study emphasises the importance of continuous health education, early intervention, and multidisciplinary collaboration to improve understanding, early diagnosis and management of PCOS among female undergraduates.

Association of serum lactate dehydrogenase and C-reactive protein with disease severity in hospitalised COVID-19 patients

Mohanad Nsaif — 2026-04-01

Objective: Coronavirus disease 2019 (COVID-19), caused by the SARS-CoV-2 virus, can lead to critical illness in hospitalised patients. Elevated levels of certain biomarkers are often associated with worse clinical outcomes. Two such biomarkers are lactate dehydrogenase (LDH), an enzyme found in nearly all body tissues that is released upon cell damage, and C-reactive protein (CRP), a protein produced by the liver in response to inflammation. This manuscript examines the relationship between LDH and CRP levels and their association with disease severity and clinical outcomes in critically ill patients with COVID-19.

Methods: A cross-sectional study was conducted on 200 hospitalised COVID-19 patients and 20 age- and sex-matched healthy controls. SARS-CoV-2 infection was confirmed by RT-PCR targeting the ORF1ab, E, and N genes. Serum LDH and CRP levels were measured using a Cobas C111 clinical chemistry analyser.

Results: COVID-19 patients had significantly higher median serum LDH and CRP levels [Provide values, e.g., LDH: 450 U/L (IQR: 350-580)] compared to healthy controls [LDH: 180 U/L (IQR: 150-210), p<0.001]. Both biomarkers showed a significant positive correlation with disease severity (p<0.001), with the highest levels observed in the severe patient group. Patients over 50 years old had significantly higher concentrations than younger patients.

Conclusion: Elevated serum LDH and CRP levels are associated with increased disease severity in hospitalised COVID-19 patients, suggesting their potential utility as accessible prognostic biomarkers.

Microbiological and Immunological Profiles of Psoriasis and Atopic Dermatitis Patients in Diyala Province, Iraq

Ibtihal Mohsin — 2026-04-01

Objective: Psoriasis (Ps) and atopic dermatitis (AD) are chronic inflammatory skin diseases, occurring worldwide with high prevalence.

Methods: A case-control study included 70 participants divided into 25 patients diagnosed with psoriasis and 45 patients with atopic dermatitis, whereas the other 30 did not serve as controls. Swab Specimens were examined microscopically and aerobically, and antibiotic susceptibility was conducted on isolated bacteria. Interleukin- 23 and Interleukin-13, C-reactive protein and Complement 3 protein were measured.

Results: Staphylococcus aureus was isolated in 61.4% of patients with psoriasis and atopic dermatitis. Resistance of these isolates was significantly high to nalidixic and norfloxacin (100%), whereas most isolates remained sensitive to amikacin (100%). Results of IL-13 and IL-23 revealed higher significant differences between psoriatic and atopic patients and controls in the levels of IL-13 (11.40 ± 4.50pg/mL, 43.80 ± 9.76 for PsO and AD, respectively and 9.70 ± 3.20 pg/mL for controls) and IL-23 (87.90 pg/mL and 25.6 ± 5.80 for PsO and AD, respectively and 13.80 ± 3.66 pg/mL for controls). The result showed that 64.7% of atopic dermatitis patients had a positive CRP test compared to 26.5% of Psoriasis patients and 8.8 % in the control group. C3 level increased in both Psoriasis and atopic dermatitis patients' levels (41.40 ± 4.11 and 39.45 ± 5.76 mg/dl) compared to 25.55 ± 3.18 mg/dl in the control group.

Conclusion: This study found atopic dermatitis (AD) significantly more prevalent than psoriasis in patients. The Staphylococcus aureus pathogen exhibited concerning antibiotic resistance. Elevated IL-13 and IL-23 suggest an immune activation pattern common to both diseases.

Brain–Heart axis dysfunction in hypertensive patients: A clinical correlation study

Bassam Saleh — 2026-04-01

Objective: To investigate the clinical correlates of brain–heart axis dysfunction in hypertensive patients by evaluating cardiovascular, neurological, autonomic, and inflammatory profiles.

Methods: A prospective clinical correlation study was conducted from October 2024 to September 2025 at Tikrit Teaching Hospital. A total of 350 hypertensive adults (aged 40–75 years) were classified into two groups: 200 with brain–heart axis dysfunction and 150 without. Assessments included cardiovascular (blood pressure, ECG, echocardiography, ambulatory blood pressure monitoring, pulse wave velocity), neurological (MRI, Montreal parameters (cardiac biomarkers, inflammatory markers, oxidative stress markers).

Results: The study group demonstrated significantly higher systolic and diastolic blood pressure, left ventricular mass index, arterial stiffness, and ECG abnormalities (all p < 0.001). Neurological assessment revealed lower cognitive scores, higher white matter lesion burden, reduced heart rate variability, and impaired baroreflex sensitivity (all p < 0.001). Laboratory findings indicated elevated troponin, NT-proBNP, hs-CRP, IL-6, and malondialdehyde, alongside reduced superoxide dismutase activity (all p < 0.001).

Conclusion: Brain–heart axis dysfunction is associated with more severe cardiovascular, neurological, and inflammatory derangements in hypertensive patients. Integrated assessment of autonomic, cognitive, and inflammatory markers may improve risk stratification and guide targeted interventions.

Impact of paediatric osteoporosis on orthodontic tooth movement and the role of chlorhexidine in periodontal health

Khulood Al-Makhzomi — 2026-04-01

Objective: This study aimed to compare the efficacy of three orthodontic treatment strategies, low-force fixed appliances, removable appliances, and force-controlled segmental appliances, on tooth movement, craniofacial development, and post-treatment stability in children with paediatric osteoporosis versus healthy controls, and to assess the role of adjunctive chlorhexidine mouthrinse in maintaining periodontal health.

Methods: An interventional clinical study was done on children found to have osteoporosis and age-matched normal children. Osteoporotic subjects were submitted to orthodontic treatment by three explicit strategies: (1) low-force fixed appliances, (2) removable appliances and (3) segmental mechanics with force levels under control. The rate of tooth movement, craniofacial patterns and retention stability after treatment were analysed on clinical and radiographic bases. As an adjunctive therapy to maintain periodontal health during the treatment, mouthrinse with chlorhexidine was recommended.

Results: Teeth were slower in moving in children with osteoporosis in comparison with healthy subjects. Changes in craniofacial growth pattern, such as internal and external open bite tendencies, were noticed during treatment. The retention stability was not the same between osteoporosis and non-osteoporosis. When orthodontic approaches were personalised in relation to bone type and patient age, results of treatment were better.

Conclusion: In children with paediatric osteoporosis, a customised orthodontic approach utilising BMD- and age-adjusted segmental appliances, supported by adjunctive chlorhexidine mouthrinse, significantly improved the rate of tooth movement, enhanced post-treatment stability, and maintained periodontal health.

Clinical tissue response to different concentrations of chlorhexidine applied to hybrid and chitosan-based dermal fillers: An in vivo study

Basma Ahmed — 2026-04-01

Objective: The study investigated how different chlorhexidine concentrations affect tissue reactions in living animals through an in vivo animal study.

Methods: Twelve healthy adult New Zealand white rabbits were allocated into two groups according to filler type: hybrid filler and chitosan-based filler (n = 6 each). The researchers performed subcutaneous injections of dermal fillers and applied chlorhexidine solution at three different strengths of 0.2% and 2.0% and 2.2% to different injection areas. The semi-quantitative inflammation scoring system allowed researchers to evaluate local tissue reactions at three different time points (7, 12 and 20 days post-application). The researchers used appropriate statistical methods to determine which chlorhexidine concentrations and filler materials influenced tissue tolerance.

Results: The 0.2% chlorhexidine solution caused brief and slight inflammatory reactions, which occurred in both hybrid and chitosan-based filler materials. The tissue showed increased inflammation at higher concentration levels of 2.0% and 2.2%, which resulted in prolonged skin redness and swelling. The chitosan-based fillers produced higher inflammation scores than hybrid fillers during tests which used identical chlorhexidine concentrations (P < 0.05).

Conclusions: The study findings demonstrate that tissue tolerance depends on two main elements, which are chlorhexidine concentration and filler material composition. The 0.2% chlorhexidine solution demonstrates potential for medical applications with hybrid and chitosan-based dermal fillers, but it causes inflammatory responses when used at elevated concentrations, which damages chitosan-based materials. The study results show that dermal filler procedures require individualised antiseptic protocols to achieve the best possible tissue protection.

Biological and clinical impact of chlorhexidine on peri-implant tissues and early peri-implant healing: A combined in vitro and clinical evaluation

Muntathar Muhsen — 2026-04-01

Objective: To evaluate the short-term biological and clinical effects of 0.12% chlorhexidine (CHX) on peri-implant tissues using a combined in-vitro and randomised clinical approach.

Methods: An in-vitro study assessed the effects of 0.01%, 0.05%, and 0.12% CHX on cell viability and extracellular matrix (ECM) protein expression via MTT assay, immunofluorescence, and ELISA. In parallel, a clinical study randomised 40 patients receiving dental implants to either a 0.12% CHX mouthrinse group (twice daily, starting 24h post-op) or a control group (standard hygiene). Plaque index, bleeding on probing (BOP), and marginal bone levels were assessed at baseline, 1, and 3 months. Data were analysed using linear mixed-effects models.

Results: In vitro, 0.01% CHX showed minimal effects, while 0.05% and 0.12% caused significant, concentration-dependent cytotoxicity and suppressed collagen I and fibronectin expression (all p<0.001). Clinically, the CHX group had significantly lower plaque scores at 1 month (mean difference −0.8; p=0.001) and 3 months (−0.7; p=0.002), and reduced BOP at 3 months (−17.7%; p=0.003). Marginal bone loss did not differ between groups (−0.05 mm; p=0.46). No serious adverse events occurred.

Conclusion: Short-term postoperative 0.12% CHX use improved peri-implant plaque control and soft-tissue inflammation without short-term adverse bone effects, despite in-vitro cytotoxicity at higher concentrations. Larger, long-term trials are needed to confirm safety and efficacy.

Systemic Physiological Changes Induced by CO₂ Pneumoperitoneum in Laparoscopic Cholecystectomy

Haidar Mohammed — 2026-04-01

Objective: Carbon dioxide pneumoperitoneum is crucial for laparoscopic surgery but has adverse cardiorespiratory effects due to raised intra-abdominal pressure, diaphragmatic displacement, and systemic CO₂ resorption. We aimed to investigate intraoperative variations in respiratory and cardiovascular parameters induced by CO₂ pneumoperitoneum and to determine the factors contributing to this effect, including BMI and anaesthetic techniques.

Methods: A total of 150 adult ASA I–II patients undergoing laparoscopic cholecystectomy were monitored prospectively in this clinical study. Respiratory (EtCO2, PIP) and hemodynamic (MAP, HR, SpO2, temperature) parameters were measured at six time points during anaesthesia. Repeated-measures ANOVA and subgroup comparisons were performed in statistical analysis.

Results: EtCO₂ and PIP increased significantly after CO₂ insufflation (p < 0.001). Both MAP and HR initially decreased transiently and then took a stabilised course. Respiratory variations were higher in obese patients. The longer the pneumoperitoneum time, the higher the EtCO₂ concentration.

Conclusions: CO₂ pneumoperitoneum induces a predictable but clinically important depressor effect that must be closely followed and managed accordingly, including the need for respiratory strategies to enable the control of its effects, particularly in high-risk patients.

Lived experiences of patients with type 2 diabetes mellitus regarding self-care management and diabetes-related distress in teaching hospitals in Ogun State

Foluso Ojewole — 2026-04-01

Objective: Type 2 Diabetes Mellitus (T2DM) requires sustained self-care, yet the everyday realities shaping patients’ experiences in low-resource settings remain insufficiently understood.

Objective: This study explored the lived experiences of self-care management and diabetes-related distress among adults with T2DM attending tertiary hospitals in Ogun State, Nigeria.

Methods: A hermeneutic phenomenological design was used. Semi-structured in-depth interviews were conducted with 20 purposively selected adults (N=20) receiving care at two teaching hospitals. Interviews were audio-recorded, transcribed verbatim, and interpreted thematically using an iterative hermeneutic approach. Data collection and analysis proceeded concurrently, and saturation was reached at the twentieth interview.

Results: Two interconnected interpretive domains were identified: Structured Self-Care Behaviour Within Structural and Relational Constraints and Diabetes-Related Distress as Cumulative Emotional and Material Burden. Participants described self-care as highly routinised but strongly shaped by financial limitations, bodily constraints, and reliance on social support. Distress accumulated over time through treatment workload, economic pressure, and the emotional demands of sustained self-management.

Conclusion: Among adults with T2DM in this setting, self-care is negotiated within intersecting structural and relational constraints rather than enacted as purely individual behaviour. Integrating affordable care resources and routine psychosocial support into diabetes services may help reduce the everyday burden experienced by patients.

A phenomenological study of lived experiences of parents caring for children with Down syndrome in Iju, Lagos State, Nigeria

Foluso Ojewole — 2026-04-01

Objective: Caring for persons with Down Syndrome (DS) presents complex emotional, social, and practical challenges for families, particularly in resource-constrained settings. However, context-specific evidence on the lived experiences of parents in Nigeria remains limited. This study explored the lived experiences of parents caring for children with Down Syndrome in Iju, Lagos State, Nigeria.

Methods: A qualitative phenomenological design was employed. Eight participants (n = 8), comprising seven parents and one sibling, were purposively recruited through the Down Syndrome Foundation Nigeria (DSFN), Iju, Lagos State. Data were collected using in-depth semi-structured interviews and analysed using thematic analysis guided by phenomenological principles.

Results: Five interconnected themes emerged: emotional and psychological trajectory, multidimensional caregiving burden, adaptive coping strategies, navigating stigma and social visibility, and support systems and structural gaps. Parents described an initial period of shock followed by gradual acceptance and resilience. Financial strain, employment disruptions, and emotional fatigue were prominent challenges. Participants relied heavily on family, religious networks, and the DSFN for support, while perceiving limited formal governmental assistance.

Conclusion: Parenting persons with Down Syndrome in this setting is an emotionally demanding yet adaptive journey shaped by persistent caregiving pressures and uneven structural support. Strengthening formal support systems, expanding financial and psychosocial assistance, and addressing disability-related stigma are essential to improving family well-being.