The Nigerian Postgraduate Medical Journal[JOURNAL]
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200 papers
Severity Assessment of Acute Pancreatitis Using the Modified Computed Tomography Severity Index and Revised Atlanta Classification: Correlation with Bedside Index for Severity in Acute Pancreatitis Clinical Scoring.
Padma MS, Bandari K, Narayanan YR … +1 more , Aiyappan SK
Niger Postgrad Med J · 2026 Jan · PMID 41479195 · Publisher ↗
BACKGROUND: Acute pancreatitis (AP) is a pancreatic inflammatory condition characterised by a varied clinical course, ranging from mild self-limiting episodes to severe disorder associated with significant morbidity and...
BACKGROUND: Acute pancreatitis (AP) is a pancreatic inflammatory condition characterised by a varied clinical course, ranging from mild self-limiting episodes to severe disorder associated with significant morbidity and mortality. Proper severity evaluation is crucial for prompt intervention and enhanced outcomes. AIMS: This study assesses the efficacy of the Modified Computed Tomography (CT) Severity Index (MCTSI) and Revised Atlanta Classification (RAC) in conjunction with the Bedside Index for Severity in AP (BISAP) for evaluating disease severity and forecasting clinical outcomes. METHODS: A cross-sectional observational study was performed at SRM Medical College Hospital involving 45 patients with AP. BISAP was carried out following 24 h of admission, whereas MCTSI was evaluated using contrast-enhanced CT. Severity was categorised utilising RAC, and clinical-radiological connections were examined. RESULTS: RAC indicated that 40%, 46.7% and 11.1% of patients encountered mild, moderately severe and severe AP, respectively. The mean BISAP and MCTSI scores were 1.8 ± 0.9 and 6.1 ± 2.3, respectively. Despite individual variations in raw scores, correlation analysis employing Spearman's rank test revealed a statistically significant moderate positive correlation between BISAP and MCTSI (rho = 0.563, P < 0.01). This suggests that as BISAP ratings escalated, MCTSI levels similarly increased, demonstrating a correlation between the two scoring systems in assessing illness severity. CONCLUSION: BISAP and MCTSI provide combined advantages in predicting the severity of AP. The RAC continues to be a reliable classification system. The integration of clinical and imaging methods improves early risk assessment and leads to appropriate care.
Prevalence and Determinants of Gestational Diabetes Mellitus at a Tertiary Health Facility in Lagos, Nigeria.
Senbanjo OC, Akinlusi FM, Rabiu KA
Niger Postgrad Med J · 2026 Jan · PMID 41479194 · Publisher ↗
BACKGROUND: Gestational diabetes mellitus (GDM) is a major public health concern worldwide. AIMS: This study aimed to determine its current prevalence and identify contributing factors among pregnant women attending a he...
BACKGROUND: Gestational diabetes mellitus (GDM) is a major public health concern worldwide. AIMS: This study aimed to determine its current prevalence and identify contributing factors among pregnant women attending a health facility in Lagos, Nigeria. METHODS: This cross-sectional study was conducted at a tertiary health facility in Lagos, Nigeria, involving 400 consenting pregnant women with a gestational age of 24-28 weeks. Data on socio-demographic characteristics and obstetric history were collected. Participants underwent fasting plasma glucose and oral glucose tolerance tests, consuming 75 g of glucose in 300 ml of water. Glucose levels were measured using the oxidase-peroxidase method, and GDM was diagnosed according to the International Association of Diabetes and Pregnancy Study Groups/World Health Organization (IADPSG/WHO 2013) criteria. RESULTS: Participants' ages ranged from 18 to 51 years, with a mean age of 31.0 ± 5.3 years. A total of 76 participants met the IADPSG/WHO 2013 criteria, resulting in a GDM prevalence of 19.0%. The identified significant risk factors for GDM included macrosomia (χ2 = 4.33, P = 0.037), family history of diabetes (χ2 = 4.4, P = 0.036), previous miscarriages (χ2 = 15.8, P = 0.001) and congenital anomalies (χ2 = 6.4, P = 0.011). Notably, having previously delivered a macrosomic baby was independently and significantly associated with GDM (odds ratio 4.3, 95% confidence interval = 1.08-16.9, P = 0.039). CONCLUSIONS: The high prevalence of GDM underscores the need to screen all pregnant women, particularly those with a history of macrosomia. Larger and longitudinal studies are encouraged to identify other relevant factors that could aid in effectively screening and identifying all affected pregnant women.
Comparison of Scoring Systems (SMART-COP vs. CURB 65) in Predicting the Need for Vasopressor and Mechanical Ventilation Support in Patients with Community-acquired Pneumonia.
Reddy KK, Prakash SS, Chandrasekaran ND … +3 more , Kumar JS, Nalabothula R, Sandeep MLN
Niger Postgrad Med J · 2026 Jan · PMID 41479193 · Publisher ↗
BACKGROUND: Community-acquired pneumonia (CAP) is one of the major causes of morbidity and mortality worldwide, and it often requires intensive care interventions with vasopressor support and mechanical ventilation. Accu...
BACKGROUND: Community-acquired pneumonia (CAP) is one of the major causes of morbidity and mortality worldwide, and it often requires intensive care interventions with vasopressor support and mechanical ventilation. Accurate risk stratification is essential for optimising clinical decision-making. While both SMART-COP and CURB-65 scoring systems are used for CAP severity assessment, their predictive abilities for intensive care needs remain debated. AIMS: The aim of the study was to see if SMART-COP or CURB-65 more accurately predicts the need for vasopressors and ventilators in CAP patients. MATERIALS AND METHODS: This prospective observational study observed patients over a 9-month period at SRM Medical College Hospital and Research Center, enrolling 98 adult CAP patients. Clinical and laboratory parameters were recorded at admission, and patients were stratified using SMART-COP and CURB-65 scores. Statistical analyses included sensitivity, specificity, Chi-square tests, logistic regression, and receiver operating characteristic (ROC) curve analysis. RESULTS: SMART-COP demonstrated superior sensitivity for predicting vasopressor support (85.7%) and mechanical ventilation (80.0%) compared to CURB-65 (42.9% and 36.0%, respectively). The area under the ROC curve for SMART-COP was higher (0.782 for vasopressor support, 0.745 for mechanical ventilation) than CURB-65 (0.612 and 0.595, respectively). Logistic regression confirmed SMART-COP as a stronger predictor of critical care interventions (P < 0.001). CONCLUSION: SMART-COP more accurately predicts the need for vasopressors and ventilators in CAP patients than CURB-65. These findings support its integration into clinical protocols for better risk stratification and resource allocation. Further studies are required to validate these findings in larger cohorts.
Establishment and Validation of a Risk Scoring Model Based on Autophagy Subcluster-related Modular Genes for Prognostic Prediction in Osteosarcoma.
Lu X, Zheng X
Niger Postgrad Med J · 2026 Jan · PMID 41479192 · Publisher ↗
AIMS: This study aims to determine the clinical significance of autophagy in OS prognosis and explore the potential molecular mechanisms between it and tumour-infiltrating immune cells. MATERIALS AND METHODS: Autophagy-a...
AIMS: This study aims to determine the clinical significance of autophagy in OS prognosis and explore the potential molecular mechanisms between it and tumour-infiltrating immune cells. MATERIALS AND METHODS: Autophagy-associated gene (AAG) expression data were retrieved from The Cancer Genome Atlas to construct an AAG expression matrix for osteosarcoma (OS). Using univariate Cox and LASSO regression analyses, three key prognostic AAGs (CCL2, DDN and GJA5) were identified. Based on these genes, we calculated individual risk scores and established an autophagy-associated prognostic model. OS patients were stratified into high- and low-risk groups according to autophagy-related risk scores to explore prognosis-associated mechanisms. Gene enrichment analyses were conducted to investigate the involved biological pathways, a nomogram integrating clinical parameters was developed, and the tumour immune infiltration landscape was assessed. Furthermore, the differential expression of the three AAGs was experimentally validated by quantitative real-time polymerase chain reaction (qRT-PCR) in a normal osteoblast cell line (hFOB1.19) and OS cell lines (143B, MG63 and U2OS), supporting the predicted transcriptional trends. RESULTS: We integrated three autophagy-related prognostic genes to construct a nomogram, which demonstrated high predictive accuracy and robustness as evidenced by calibration curves and survival analyses. These AAGs exhibited dual functions in immune regulation and were implicated in multiple cytokine signalling pathways. Tumour immune infiltration analysis revealed distinct immune landscapes between risk groups, consistent with findings from pathway enrichment analysis. Furthermore, qRT-PCR validation in normal osteoblasts (hFOB1.19) and osteosarcoma cell lines (143B, MG63 and U2OS) confirmed that DDN was significantly upregulated, whereas CCL2 and GJA5 were downregulated in tumour cells, aligning with the transcriptional trends predicted by the model. CONCLUSION: Our findings suggest that excessive autophagy is closely associated with poor prognosis and altered immune cell infiltration, particularly involving macrophages, in osteosarcoma. These results highlight the dual roles of autophagy in tumour progression and immune regulation. However, macrophage-related autophagy in OS remains poorly understood, warranting further mechanistic studies and experimental validation.
Doping Detection through Haematological Parameters and D-dimer Levels amongst Athletes and Sports Administrators in Ibadan, Southwestern Nigeria.
Adegbesan O, Akingbola TS, Adeniyi AF … +3 more , Ayorinde JO, Ogundeji SP, Ojo A
Niger Postgrad Med J · 2026 Jan · PMID 41479191 · Publisher ↗
BACKGROUND: The haematology module is an important component of the Athlete Biological Passport, which is being used by World Anti-doping Agency in doping detection. This module consists of complete blood count (CBC) par...
BACKGROUND: The haematology module is an important component of the Athlete Biological Passport, which is being used by World Anti-doping Agency in doping detection. This module consists of complete blood count (CBC) parameters, which are measured in a longitudinal manner and deviation from the established pattern may indicate doping. There is a paucity of data on CBC parameters in Nigerian athletes. AIMS: The aim of this study, therefore, was to measure and analyse CBC parameters in a group of athletes and sports administrators in Ibadan, southwestern Nigeria. MATERIALS AND METHODS: A cross-sectional descriptive study of 144 athletes and sports administrators in a training centre was undertaken. A closed-ended structured questionnaire was used to collect socio-demographic data, and samples were taken for CBC and D-dimer assay. The participants' blood samples were taken after a training session. CBC, reticulocyte count and D-dimer were run. OFF-hr score was calculated and values >125. 0 were considered to suggest doping. CBC parameters were compared between both genders using Student's t-test. Significance value was set at P ≤ 0.05. RESULTS: The athletes had relatively higher lymphocyte counts than neutrophil counts. The group OFF-hr score shows that the majority (134/154, 87.6%) had normal range values, while 5 (3.3%) had values >104.6. None of the participants had a score >125.6, which indicates doping. D-dimer level was comparable between both genders, but the median value (1.3, interquartile range: 3.4 µg/L) was significantly higher than that of the control sample <0. 4 µg/L). CONCLUSION: Athletes tend to have higher lymphocyte counts than neutrophil counts. The OFF-hr score did not indicate doping in any athlete. More research should be conducted to understand the thrombotic status of athletes because of high dimer levels found in this study.
The Clinical Patterns and Disease Severity of Knee Osteoarthritis in Duhok/Kurdistan Region, Iraq.
Sulaiman SW, Rasool MT
Niger Postgrad Med J · 2026 Jan · PMID 41479190 · Publisher ↗
BACKGROUNDS: Knee osteoarthritis (KOA) is a highly prevalent and progressive joint disease. Given the diverse clinical presentations and multifactorial nature of KOA, alongside observed regional variations, a localised u...
BACKGROUNDS: Knee osteoarthritis (KOA) is a highly prevalent and progressive joint disease. Given the diverse clinical presentations and multifactorial nature of KOA, alongside observed regional variations, a localised understanding of the disease is vital for effective healthcare planning. AIMS: This study aimed to identify the clinical characteristics and disease severity of patients diagnosed with KOA at the specialised tertiary centre in the Kurdistan Region. PATIENTS AND METHODS: This study employed a cross-sectional design among patients who attended the 'Specialized Center of Rheumatic Diseases and Medical Rehabilitation' in Duhok City, Iraqi, Kurdistan and are diagnosed with KOA. In this regard, patients with any socio-demographic characteristics were included in the study. The patients with other rheumatic diseases were excluded from the study. RESULTS: The study involved 262 knee patients with KOA, predominantly females aged 40-69 years (81.29%). Most of the patients were retired (39.69%) with a body mass index (BMI) averaging 32.72 kg/m2, indicating overweight or obesity (based on the CDC criteria). Symptoms such as pain (98.85%) and difficulty walking (49.62%) were common, with pain severity averaging 6.77/10. Most commonly used treatments included NSAIDs (63.74%) and physical therapy (8.78%), with many patients affected by mild-to-severe functional limitations. Younger patients had lower disease grades and pain levels, whereas higher grades correlated with increased pain and activity restrictions. CONCLUSIONS: Age and BMI impact KOA severity, including pain and functional limitations. The patients need for better diagnostic and nonpharmacological approaches to improve patient outcomes.
Impact of Environmental Noise on Hearing Threshold in Soundproof and Non Soundproof Booths amongst Mine Workers in Rajasthan India - A Cross sectional Comparative Study.
Nandi SS, Tank ND, Ingole SV … +1 more , Dhatrak SV
Niger Postgrad Med J · 2026 Jan · PMID 41479189 · Publisher ↗
BACKGROUND: In many industrial dispensaries, audiometric testing is often conducted in small, enclosed rooms, where ambient noise exceeds the maximum permissible ambient noise level (MPANL). This environmental noise can...
BACKGROUND: In many industrial dispensaries, audiometric testing is often conducted in small, enclosed rooms, where ambient noise exceeds the maximum permissible ambient noise level (MPANL). This environmental noise can interfere with accurate audiometric testing, leading to overestimated hearing thresholds and false-positive diagnoses of hearing impairments. AIM: The study aimed to compare audiometric results obtained in soundproof booths versus field settings with ambient noise and to assess the impact of environmental noise on hearing threshold assessments in the occupational settings. SUBJECT AND METHODS: This cross-sectional study was conducted amongst 164 mine workers in Rajasthan, India. Audiometric tests were performed using a portable calibrated audiometer across frequencies ranging from 0.5 kHz to 8 kHz. Each participant underwent two audiometric assessments: One in a soundproof booth adhering to standards and the other in a field setting with ambient noise. Background noise levels were measured using a sound-level meter. Hearing impairment was determined based on the average hearing threshold across all the tested frequencies. RESULTS: The soundproof booth maintained acceptable background noise levels (International Organisation for Standardisation 8253-1:2010), while the field noise exceeded the MPANL. The mean hearing threshold differences between the booth and field conditions were statistically significant for all frequencies (P < 0.0001). The largest difference was at 0.5 kHz (21.22 dB) and the smallest at 4 kHz (7.52 dB). In the booth, 41.46% of participants showed hearing impairment, whereas 100% exhibited hearing loss in the field setting. CONCLUSION: This study found that environmental noise in field conditions significantly increased hearing thresholds, leading to false-positive diagnoses of hearing impairment. These findings emphasise the need for soundproof booths in occupational audiometric testing to ensure accurate hearing assessment and avoid unnecessary diagnostic referrals.
Association between Gastric Cancer and Urinary Fumonisins: A Case-control Study.
Mumbula EM, Funjika E, Banda C … +2 more , Chilufya L, Kayamba V
Niger Postgrad Med J · 2026 Jan · PMID 41479188 · Publisher ↗
BACKGROUND: Fumonisins are mycotoxins produced by Fusarium spp. They are classified as Group 2B carcinogens by the International Agency for Research on Cancer. AIM: We aimed to investigated the association between gastri...
BACKGROUND: Fumonisins are mycotoxins produced by Fusarium spp. They are classified as Group 2B carcinogens by the International Agency for Research on Cancer. AIM: We aimed to investigated the association between gastric cancer (GC) and urinary fumonisins levels. METHODS: We conducted this age- and sex-matched case-control study in Lusaka, Zambia. Cases were patients with histologically confirmed GC while controls did not have cancer. We tested the urine samples for fumonisins using high-performance liquid chromatography, collected information on risk factors using interviewer-administered questionnaires and analysed the reults in Stata version 15. RESULTS: A total of 52 participants were included in the study, 26 GC cases and 26 controls. In each group, 15 (58%) were females. The median age was 54 years; interquartile range (IQR) 46-66. Fumonisins was detected in 10 (19%) of the samples. Quantitatively, levels of fumonisins were higher in cases (73 µg/ml; IQR 40-109) than in controls (21 µg/ml (IQR 5-47), but this difference was not statistically significant, P = 0.25. Qualitatively, there was no association between GC and presence of fumonisins in urine (odds ratio 1.0, 95% confidence interval [CI] 0.2-5.1, P = 1.00). Lack of formal education and low socio-economic status were associated with urinary fumonisins P = 0.04 and 0.02, respectively. However, on regression analysis, only low socio-economic status remained statistically significant with a regression coefficient of 50, (95% CI 29-70); P < 0.001. CONCLUSIONS: This study has demonstrated that urinary fumonisins levels are associated with low socio-economic status but not to GC.
Evaluating Focal Hepatic Lesions with Triple Phase Contrast Computed Tomography: A Prospective Observational Study.
Mittal A, Kumbhar RR
Niger Postgrad Med J · 2026 Jan · PMID 41479187 · Publisher ↗
BACKGROUND: Detection and characterisation of focal liver lesions (FLLs) remain challenging. Computed tomography (CT) provides crucial information on lesion number, location, nature and growth dynamics of FLLs over time....
BACKGROUND: Detection and characterisation of focal liver lesions (FLLs) remain challenging. Computed tomography (CT) provides crucial information on lesion number, location, nature and growth dynamics of FLLs over time. AIM: The study evaluated the use of contrast-enhanced triple-phase CT (TPCT) amongst patients with suspected FLLs in a tertiary hospital setting. METHODS: This was a prospective, observational study. Patients with clinically suspected FLL or prior history of FLLs who underwent contrast-enhanced TPCT scans at the tertiary care centre between June 2022 and November 2023 were enrolled. Descriptive statistics were used for presenting study outcomes. Biopsy was performed selectively, particularly for representative lesions (up to 2 in number) in patients with multiple FLLs. Where histopathology was not feasible, diagnoses were confirmed through a composite reference standard. The accuracy and adequacy of TPCT in the diagnosis of FLLs were also evaluated. A P < 0.05 was considered statistically significant. RESULTS: Eighty patients were enrolled, the mean age was 54.1 ± 12.14 years and most were males (61.3%). Of the 299 FLLs, 154 were benign, while 145 were malignant. Metastases and haemangiomas were the most commonly identified malignant and benign lesions, respectively. The FLLs were categorised as hypovascular (59%) and hypervascular (41%). TPCT showed 100% sensitivity and specificity for diagnosing abscesses, cysts, intrahepatic cholangiocarcinoma and focal nodular hyperplasia. The specificity for diagnosing all cases was 100%. CONCLUSIONS: This study further validates the significance of TPCT in assessing FLLs and characterising focal liver abnormalities across various pathological scenarios and stages of the disease.
Effect of Priming with Atracurium or Pancuronium on the Onset Time of Pancuronium in Patients Undergoing General Anesthesia for Elective Surgery: A Randomised Controlled Trial.
Okonkwo TC, Adigun TA, Idowu OK
Niger Postgrad Med J · 2026 Jan · PMID 41479186 · Publisher ↗
BACKGROUND: Suxamethonium, a rapid-acting muscle relaxant, has been conventionally preferred during rapid sequence induction (RSI). The priming principle, which uses non-depolarising muscle relaxants, is an alternative i...
BACKGROUND: Suxamethonium, a rapid-acting muscle relaxant, has been conventionally preferred during rapid sequence induction (RSI). The priming principle, which uses non-depolarising muscle relaxants, is an alternative in situations where it is contraindicated. Unfortunately, its efficacy has not been sufficiently documented in Nigerian patients. AIMS: The study aimed to use atracurium and pacuronium to evaluate the efficacy of the priming principle. MATERIALS AND METHODS: In this randomised controlled trial, ninety adults undergoing elective surgery under general anaesthesia were randomly allocated into three equal groups. Group A (Atracurium), Group P (Pancuronium) and Group C (control) received 0.05 mg/kg atracurium, 0.01 mg/kg pancuronium and 1 ml saline, respectively, as the priming agent. Three minutes after, anaesthesia was induced with 2 mg/kg propofol and then the intubating dose of pancuronium administered. The onset time of neuromuscular block, intubating condition and occurrence of muscle weakness during the priming interval were noted. Data were analysed using the Statistical Package for the Social Sciences version 25, and a P < 0.05 was considered statistically significant. RESULTS: The mean onset time in Groups A, P and C was 215.7 ± 59.9 s, 237.1 ± 76.5 s and 265.8 ± 72.0 s, respectively, P = 0.024. Post hoc analysis showed that the onset time was only significant between Groups A and C (P = 0.02). The intubating condition was comparable in all groups (P = 0.25). The incidence of muscle weakness during the priming interval was 6.67% in the priming groups. CONCLUSION: In adults, priming with atracurium but not pancuronium shortens the onset time of pancuronium. However, during RSI, where a fast onset is crucial, the shortened onset time with priming is not clinically relevant.
Rhythmic Breathing Combined with Hugo Point Acupressure versus Vapocoolant Spray on Pain Intensity during Needle Insertion into Arteriovenous Fistula in Haemodialysis Patients: A Randomised Controlled Trial.
Al-Waeli HR, Hattab WAA
Niger Postgrad Med J · 2026 Jan · PMID 41479185 · Publisher ↗
BACKGROUND: Pain from needle insertion during haemodialysis is a common challenge requiring effective pain management for patient comfort. AIMS: The aim of this study to compared rhythmic breathing combined with Hugo poi...
BACKGROUND: Pain from needle insertion during haemodialysis is a common challenge requiring effective pain management for patient comfort. AIMS: The aim of this study to compared rhythmic breathing combined with Hugo point acupressure versus vapocoolant spray on pain intensity during needle insertion in haemodialysis patients. SUBJECTS AND METHODS: A randomised controlled trial was conducted in Iraq between 4 December 2024 and 16 January 2025, and involved 157 patients. Participants were assigned into five groups: control (n = 34), rhythmic breathing (n = 24), Hugo point acupressure (n = 35), combination rhythmic breathing with acupressure (n = 37) and vapocoolant spray (n = 27). Pain intensity was assessed using the Visual Analogue Scale immediately following needle insertion. Data analysis was performed using SPSS. RESULTS: The control group reported the highest mean pain score (64.79), followed by rhythmic breathing (37.79), Hugo point acupressure (33.14), the combination group (28.35) and vapocoolant spray (25.59). All interventions significantly reduced pain compared with the control group (P < 0.001). The combination group was superior to rhythmic breathing or acupressure alone (P < 0.001). Vapocoolant spray was also more effective than each single intervention (P < 0.01), yet the difference between vapocoolant spray and the combination group was not significant (P > 0.05). CONCLUSIONS: The combination of rhythmic breathing and Hugo point acupressure reduced pain more effectively than either intervention alone. Although vapocoolant spray was highly effective, it did not significantly outperform the combination. Thus, the combined method provides a reliable alternative, especially for patients unable to use vapocoolant spray or in resource-limited settings.
Prevalence and Predictors of Rapid Estimated Glomerular Filtration Rate Decline in Patients with Non-albuminuric Diabetic Kidney Disease: A Single-centre Retrospective Cohort Study.
Rani P, Nagaraju SP, Swaminathan SM … +5 more , Bhojaraja MV, Prabhu AR, Rangaswamy D, Rao IR, Shenoy SV
Niger Postgrad Med J · 2026 Jan · PMID 41479184 · Publisher ↗
BACKGROUND: Non-albuminuric diabetic kidney disease (NADKD) is increasingly recognised and strongly associated with heightened cardiovascular risk and rapid decline in estimated glomerular filtration rate (eGFR). AIMS: T...
BACKGROUND: Non-albuminuric diabetic kidney disease (NADKD) is increasingly recognised and strongly associated with heightened cardiovascular risk and rapid decline in estimated glomerular filtration rate (eGFR). AIMS: This single-centre retrospective cohort study aimed to determine the prevalence of NADKD, characterise clinical and laboratory features, assess microvascular and macrovascular complication rates and identify predictors of rapid progression. MATERIALS AND METHODS: This retrospective cohort study analysed 44 NADKD patients from January 2018 to 2022, excluding chronic kidney disease stage 5, albuminuric DKD and <6 months of follow-up. The primary outcome was the prevalence and profile of rapid progressors (eGFR fall of >5 mL/min/1.73 m2/year) in NADKD and secondary outcomes were the onset of microvascular and macrovascular complications and risk factors for rapid progression. RESULTS: The median 1-year follow-up showed rapid eGFR drop in 36.4% of patients, with a median yearly decline of 8.0 mL/min/1.73 m2/year (Interquartile range [IQR]: 6.2-12.1) compared to 1.0 mL/min/1.73 m2/year (IQR: 0.5-1.8) in non-progressors (P < 0.001). Presence of hypertension (P = 0.04), cardiovascular disease (CVD) (P = 0.03), dyslipidaemia (P = 0.02) and acute kidney injury (AKI) incidents (P = 0.01), as well as the incidence of diabetic retinopathy (P = 0.01) and CVD (P = 0.04), were reported to be higher in rapid progressors. Rapid eGFR reduction was independently predicted by hypertension (Odds ratio [OR] 1.9, 95% confidence interval [CI]: 1.5-4.8), CVD (OR 2.8, 95% CI: 1.8-4.7, P = 0.01) in multivariate analysis. CONCLUSION: One-third of NADKD were rapid progressors, and the prevalence of hypertension, dyslipidaemia, CVD, AKI episodes and incidence of diabetic retinopathy was higher in rapid progressors. Hypertension and CVD were found to be strong predictors for rapid eGFR decline.
Lost in the Digital World: The Effects of Internet Addiction and Internet Gaming Disorder on Sleep and Mental Well-being of Medical Students in the Konkan Region of India.
Borkar A, Masurkar B, Deshmukh N … +2 more , Velhal G, Shemar H
Niger Postgrad Med J · 2026 Jan · PMID 41479183 · Publisher ↗
BACKGROUND: Internet Addiction (IA) and Internet Gaming Disorder (IGD) may provide significant challenges for medical students as it is linked to sleep and mental health can obstruct academic pursuits, affect long-term p...
BACKGROUND: Internet Addiction (IA) and Internet Gaming Disorder (IGD) may provide significant challenges for medical students as it is linked to sleep and mental health can obstruct academic pursuits, affect long-term professional aspirations and yield extensive adverse effects on society at large. OBJECTIVES: To find the prevalence of IA, IGD, insomnia and depression amongst medical undergraduates and to examine their correlation. MATERIALS AND METHODS: A mixed-methods study was conducted amongst 402 undergraduate medical students at a rural medical college. Data were gathered by a semi-structured, self-administered questionnaire encompassing socio-demographic information, the Young Internet Addiction Test, the short form of the Internet Gaming Disorder Scale (IGDS-SF), the Insomnia Severity Index (ISI) and the Patient Health Questionnaire. Focus group discussions were done with 56 students chosen for their high scores in IA and IGD. Thematic analysis was employed to discern patterns and themes within the qualitative data. Data triangulation was conducted to interpret and elucidate the quantitative results using qualitative observations. RESULTS: The mean age of the study participants was 20.39 ± 1.43 years. IA was present in 41.04%, gaming disorder in 20.89%, insomnia in 36.56% and depression in 14.42% participants. Year of study and hostel stay had a statistically significant association with all (P < 0.002). There was a strong and statistically significant association found between IA and IGD with depression and insomnia (P < 0.0001). Furthermore, a statistically significant correlation was found between scores and grades of IA and IGD; and insomnia and depression. CONCLUSION: Internet usage amongst medical students was notably high (40%) and showed a significant association with insomnia and depression. Hence, early identification of students at risk for IA and IGD is crucial, as these addictions often overlap with other psychological issues.
Adverse Drug Reaction to First-Line Oral Antitubercular Drugs: An 8-Year Analysis from a Tertiary Centre in Eastern India.
Tripathy R, Singh P, Behera D … +3 more , Paikray E, Subhankar S, Das MC
Niger Postgrad Med J · 2026 Jan · PMID 41479182 · Publisher ↗
BACKGROUND: Tuberculosis (TB) is caused by Mycobacterium tuberculosis. Treatment regimen with the first-line anti-tubercular drug remains the foundation of treatment for drug-sensitive TB. The fixed-dose combination of d...
BACKGROUND: Tuberculosis (TB) is caused by Mycobacterium tuberculosis. Treatment regimen with the first-line anti-tubercular drug remains the foundation of treatment for drug-sensitive TB. The fixed-dose combination of drugs regime is associated with adverse drug reactions (ADRs) such as drug-induced liver injury (DILI), myalgia, arthralgia, hearing loss, gastrointestinal disturbances, visual disturbances, central nervous disorders and hypersensitivity reactions. AIMS: This study aimed to analyse the spectrum and severity of ADRs with emphasis on DILI. METHODS: This retrospective study was conducted from 2015 to 2023 at a tertiary care teaching hospital. A total of 108 patients were included in the study. The spectrum of ADRs was classified as per the World Health Organization systems organ classes. The seriousness of the reaction was classified as serious and non-serious. The severity of DILI was categorized into five grades. RESULTS: A total of 126 ADRs were reported. DILI was the most reported ADR followed by vomiting and itching. CONCLUSION: This study seeks to enhance the clinicians' understanding of the diverse ADRs linked to anti-TB treatment, encouraging them to provide better patient counselling, prioritise safety and actively report even mild ADRs.
Perception of Brain Death amongst Neurologists, Neurosurgeons and Intensivists in Saudi Arabia: A Cross-sectional Study.
Alharbi LF, Shaheen MW, Alnaim RS … +3 more , Alsherian SN, Aljaffar N, Hadhiah K
Niger Postgrad Med J · 2026 Jan · PMID 41479181 · Publisher ↗
BACKGROUND: Brain death (BD) is the irreversible loss of brain function, assessed through consciousness, brainstem reflexes and apnoea testing. Previous research indicates that experienced physicians perform better in BD...
BACKGROUND: Brain death (BD) is the irreversible loss of brain function, assessed through consciousness, brainstem reflexes and apnoea testing. Previous research indicates that experienced physicians perform better in BD determination, underscoring the need for structured education. OBJECTIVE: This study evaluates the level of knowledge about BD amongst physicians in Saudi Arabia, comparing expertise across neurology, neurosurgery and intensive care and investigating knowledge gaps. SUBJECTS AND METHODS: Amongst 162 physicians surveyed, the majority were aged 25-35 years (61.7%) and male (65.4%). Most were Saudi nationals (84.6%) and worked in governmental hospitals (92.0%). Intensivists comprised the largest speciality group (45.1%). Despite 95.1% having encountered BD patients, 41.4% felt that criteria were not well understood in their medical community. Confidence in diagnosis was 49.4%, while 51.9% had formal training. A cross-sectional study was conducted using an online questionnaire, targeting neurologists, neurosurgeons and intensivists through snowball sampling. Data were analysed using the SPSS 29.0.0. RESULTS: Significant associations were found between knowledge levels and factors such as age (P < 0.001), nationality (P = 0.009), experience (P < 0.001), and confidence in diagnosis (P = 0.025). Multivariate analysis identified years of experience (P = 0.011, Exp (B) = 2.338, 95% confidence interval: 1.211-4.514) as the strongest predictor of high knowledge.. CONCLUSION: The findings highlight the variability in physicians' understanding of BD, emphasising the need for enhanced training programmes and refresher courses to improve competency in diagnosis and criteria adherence.
Comparative Assessment of PANC-3 and Acute Physiology and Chronic Health Evaluation II Scores in Acute Pancreatitis: A Prospective Study.
Savant SS, Jadhav NN
Niger Postgrad Med J · 2026 Jan · PMID 41479180 · Publisher ↗
BACKGROUND: The global incidence of acute pancreatitis (AP) is increasing, and it has an unpredictable course. As AP is associated with high mortality rates, it is important to effectively assess severity and manage the...
BACKGROUND: The global incidence of acute pancreatitis (AP) is increasing, and it has an unpredictable course. As AP is associated with high mortality rates, it is important to effectively assess severity and manage the disease. AIMS: We assessed the use of PANC-3 scores for predicting the severity of AP and compared these scores with the Acute Physiology and Chronic Health Evaluation II (APACHE-II) scores. MATERIALS AND METHODS: A prospective study in patients with AP at a tertiary care hospital in Karad, India. Demographic characteristics, clinical presentation, laboratory findings and radiological data of the patients were recorded within 24 h of admission. The severity of AP was assessed using PANC-3 and APACHE-II scores. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of both the scoring systems were calculated and compared. RESULTS: A total of 80 patients with AP were included in the study. Most of the patients were in their early thirties (31-35 years), and alcohol consumption was the leading aetiological factor. The PANC-3 scores exhibited a strong predictive accuracy for severity of AP. There was excellent agreement between the PANC-3 and APACHE-II scores (κ =0.8855). Sensitivity (94.1% vs. 88.2%), PPV (94.1% vs. 93.8%) and NPV (98.4% vs. 96.9%) were higher in APACHE-II, but specificity was equivalent between both systems (both 98.4%). CONCLUSIONS: Using PANC-3 scores, we were able to accurately predict the severity of AP in a tertiary care hospital setting. We observed that the performance in predicting the severity of AP was similar using the PANC-3 and APACHE-II scores.
Effect of Plyometric Training on Neuromuscular Function after Anterior Cruciate Ligament Reconstruction: A Meta-analysis of Multi-dimensional Outcomes.
Hao F, Malek IZBA, Saleh MZB … +1 more , Kahar JBA
Niger Postgrad Med J · 2026 Jan · PMID 41479179 · Publisher ↗
Neuromuscular deficits persist after anterior cruciate ligament reconstruction (ACLR), limiting functional recovery and increasing re-injury risk. Plyometric training (PLYO) may address these gaps, but its multi-dimensio...
Neuromuscular deficits persist after anterior cruciate ligament reconstruction (ACLR), limiting functional recovery and increasing re-injury risk. Plyometric training (PLYO) may address these gaps, but its multi-dimensional efficacy remains unclear. The objective of this study is to evaluate the effects of on neuromuscular function across subjective outcomes, limb symmetry, strength and dynamic balance in ACLR patients. Following PRISMA guidelines (PROSPERO), 7 randomised controlled trials (RCTs) were identified from PubMed/EMBASE/MEDLINE/CENTRAL/Scopus/Web of Science (up to June 2025). Random-effects meta-analyses synthesised standardised mean differences (SMDs) or mean differences (MDs) for the key outcomes. Evidence certainty was assessed using GRADE. A total of 267 patients were included across studies. Plyometric training significantly enhanced quadriceps strength (Peak Torque: 12.06; 3.65-20.57) and overall LSI gains were clinically marginal (8.2%; 0.51-15.89). Subjective function showed inconsistent effects, with benefits linked to longer training duration (β = 0.78) and athletic populations (β = 0.65). Dynamic balance demonstrated no significant overall effect (2.90; -1.88-7.67). Plyometric training enhances strength and complex task symmetry post-ACLR, but effects on subjective function and dynamic balance are task-and population-specific. Rehabilitation programmes should prioritise individualised PLYO protocols targeting advanced neuromuscular demands. Evidence certainty was 'very low' per GRADE, urging higher-quality RCTs.
Exploring the Relationship between Internet Use and Risky Sexual Behaviors among Unmarried Adolescents and Young Females in Sub-Saharan Africa: Insights from DHS Data.
Dansou J
Niger Postgrad Med J · 2025 Oct · PMID 41143382 · Publisher ↗
Adolescents and young women in sub-Saharan Africa (SSA) face disproportionately high rates of HIV infection and unintended pregnancy. As Internet access accelerates across SSA, its implications for adolescent sexual heal...
Adolescents and young women in sub-Saharan Africa (SSA) face disproportionately high rates of HIV infection and unintended pregnancy. As Internet access accelerates across SSA, its implications for adolescent sexual health demand urgent scrutiny. This correspondence examines the association between Internet use and risky sexual behaviours (RSBs) amongst 5920 unmarried, sexually active females aged 15-34, using Demographic and Health Survey (DHS) data from nine countries: Burkina Faso, Côte d'Ivoire, Ghana, Kenya, Lesotho, Madagascar, Mozambique, Rwanda and Tanzania. Data analysis employed logistic regression methods using R version 4.4.2. The prevalence of RSB was higher amongst Internet users (46.2% vs. 35.7%). It was as high as 72.2% in Lesotho, as low as 21% in Ghana. Internet users were 26% (adjusted odds ratio [aOR] = 1.26, 95% confidence interval [CI] = [1.09-1.45]) more likely to engage in RSBs. Additional drivers included age, media exposure, non-marital fertility, residence and country-specific factors. Relative to Kenya, elevated odds were found in Lesotho (aOR = 2.54, 95% CI = [1.88-3.46]), Burkina Faso (aOR = 2.13, 95% CI = [1.61-2.81]), Mozambique (aOR = 1.64 [1.26-2.13]) and Rwanda (aOR = 1.90, 95% CI = [1.35-2.70]). While digital platforms hold promise for expanding sexual education, these findings underscore the need for targeted content oversight and culturally responsive interventions to mitigate online health risks.
How the Summative Objective Structured Clinical Examination Can Support Learning in Post-graduate Ophthalmology Education in a Resource-constrained Context.
Onebunne EO, Ugalahi MO
Niger Postgrad Med J · 2025 Oct · PMID 41143381 · Publisher ↗
Objective structured clinical examination (OSCE) is a structured performance-based assessment of learners' competencies. These technical and non-technical competencies are evaluated by multiple examiners through uniforml...
Objective structured clinical examination (OSCE) is a structured performance-based assessment of learners' competencies. These technical and non-technical competencies are evaluated by multiple examiners through uniformly timed, multiple stations. OSCE has been adapted in the assessment and training of post-graduate medical doctors in Ophthalmology in Nigeria. Leaning on current practice and evidence-based pedagogy from the existing literature, we explore how OSCE can be adapted to support learning, in post-graduate ophthalmology in Nigeria. We describe initiatives to modify the existing OSCE assessment method to balance 'assessment of' with 'assessment for' learning.
Stress among Medical Students and Its Association with Mental Health Support to Reduce Stigma: A Critical Review of Programmes and Practices.
Chandankhede MS, Tiwade YR
Niger Postgrad Med J · 2025 Oct · PMID 41143380 · Publisher ↗
Stress is pervasive among medical students, driven by academic pressures, clinical responsibilities and personal challenges. This stress often leads to mental health issues such as anxiety, depression and burnout, exacer...
Stress is pervasive among medical students, driven by academic pressures, clinical responsibilities and personal challenges. This stress often leads to mental health issues such as anxiety, depression and burnout, exacerbated by the stigma surrounding mental health support. Addressing this stigma is critical to fostering well-being in future healthcare providers. Key themes include the prevalence and sources of stress, the impact of stigma on mental health help-seeking behaviours and innovative programmes integrating mental health education and stigma reduction. Insights are drawn from international practices and evidence-based interventions. Recommendations highlight the need for culturally sensitive and student-centric approaches to create an inclusive and supportive environment. By addressing stigma and enhancing mental health support, institutions can improve medical students' academic and personal outcomes.
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