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A detailed, unbiased perspective of the inter-relations among medical fields could help students make informed decisions on their future career plans. Using a data-driven approach, the inter-relations among different medical fields were decomposed and clustered based on the similarity of their working environments.Publicly available, aggregate databases were merged into a single rich dataset containing demographic, working environment and remuneration information for physicians across Canada. These data were collected from the Canadian Institute for Health Information, the Canadian Medical Association, and the Institute for Clinical Evaluative Sciences, primarily from 2018 to 2019. The merged dataset includes 25 unique medical specialties, each with 36 indicator variables. Latent Profile Analysis (LPA) was used to group specialties into distinct clusters based on relatedness.The 25 medical specialties were decomposed into seven clusters (latent variables) that were chosen based on the Bayesian Information Criterion. The Kruskal-Wallis test identified eight indicator variables that significantly differed between the seven profiles. These variables included income, work settings and payment styles. Variables that did not significantly vary between profiles included demographics, professional satisfaction, and work-life balance satisfaction.The 25 analyzed medical specialties were grouped in an unsupervised manner into seven profiles via LPA. These profiles correspond to expected and meaningful groups of specialties that share a common theme and set of indicator variables (e.g. procedurally-focused, clinic-based practice). These profiles can help aspiring physicians narrow down and guide specialty choice., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)

Background: Interest in mixed methods methodology within medical education research has seen a notable increase in the past two decades, yet its utilization remains less prominent compared to quantitative methods. This study aimed to investigate the application and integration of mixed methods methodology in medical education research, with a specific focus on researchers' perceptions, strategies, and readiness, including the necessary skills and expertise. This study adheres to the COREQ guidelines for reporting qualitative research., Methods: Faculty members from King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Saudi Arabia, across its three campuses in Riyadh, Jeddah, and Al Ahsa, participated in this study during the 2021-2022 academic year. We conducted 15 in-depth, one-on-one interviews with researchers who had previously used mixed methods in their medical education research. Theoretical saturation was reached with no refusals or dropouts. Data were collected using a semi-structured interview guide developed from literature review and mixed methods guidelines. Thematic analysis was employed to analyze the data, enabling a comprehensive understanding of the participants' perspectives., Results: The thematic analysis of the interviews yielded three key themes. The first theme, 'Understanding and Perceptions of Mixed Methods in Medical Education Research,' delved into researchers' depth of knowledge and conceptualization of mixed methods. The second theme, 'Strategies and Integration in Mixed Methods Implementation,' explored how these methodologies are applied and the challenges involved in their integration. The final theme, 'Mastery in Mixed Methods: Prerequisites and Expert Consultation in Research,' highlighted the gaps in readiness and expertise among researchers, emphasizing the importance of expert guidance in this field., Conclusion: Findings indicate a varied understanding of mixed methods among participants. Some lacked a comprehensive grasp of its application, while others perceived mixed methods primarily as a means to enhance the publication prospects of their studies. There was a general lack of recognition of mixed methods as a guiding methodology for all study aspects, pointing to the need for more in-depth training and resources in this area., (© 2024. The Author(s).)

Background: Artificial intelligence (AI) has the potential to revolutionize the way medicine is learned, taught, and practiced, and medical education must prepare learners for these inevitable changes. Academic medicine has, however, been slow to embrace recent AI advances. Since its launch in November 2022, ChatGPT has emerged as a fast and user-friendly large language model that can assist health care professionals, medical educators, students, trainees, and patients. While many studies focus on the technology's capabilities, potential, and risks, there is a gap in studying the perspective of end users., Objective: The aim of this study was to gauge the experiences and perspectives of graduating medical students on ChatGPT and AI in their training and future careers., Methods: A cross-sectional web-based survey of recently graduated medical students was conducted in an international academic medical center between May 5, 2023, and June 13, 2023. Descriptive statistics were used to tabulate variable frequencies., Results: Of 325 applicants to the residency programs, 265 completed the survey (an 81.5% response rate). The vast majority of respondents denied using ChatGPT in medical school, with 20.4% (n=54) using it to help complete written assessments and only 9.4% using the technology in their clinical work (n=25). More students planned to use it during residency, primarily for exploring new medical topics and research (n=168, 63.4%) and exam preparation (n=151, 57%). Male students were significantly more likely to believe that AI will improve diagnostic accuracy (n=47, 51.7% vs n=69, 39.7%; P=.001), reduce medical error (n=53, 58.2% vs n=71, 40.8%; P=.002), and improve patient care (n=60, 65.9% vs n=95, 54.6%; P=.007). Previous experience with AI was significantly associated with positive AI perception in terms of improving patient care, decreasing medical errors and misdiagnoses, and increasing the accuracy of diagnoses (P=.001, P<.001, P=.008, respectively)., Conclusions: The surveyed medical students had minimal formal and informal experience with AI tools and limited perceptions of the potential uses of AI in health care but had overall positive views of ChatGPT and AI and were optimistic about the future of AI in medical education and health care. Structured curricula and formal policies and guidelines are needed to adequately prepare medical learners for the forthcoming integration of AI in medicine., (©Saif M I Alkhaaldi, Carl H Kassab, Zakia Dimassi, Leen Oyoun Alsoud, Maha Al Fahim, Cynthia Al Hageh, Halah Ibrahim. Originally published in JMIR Medical Education (https://mededu.jmir.org), 22.12.2023.)

Importance: Diversity in the physician workforce improves patient care and decreases health disparities. Recent calls for social justice have highlighted the importance of medical school commitment to diversity and social justice, and newly established medical schools are uniquely positioned to actively fulfill the social mission of medicine., Objective: To identify diversity language in the mission statements of all medical schools accredited since 2000 and to determine whether the presence of diversity language was associated with increased diversity in the student body., Design, Setting, and Participants: Cross-sectional study of public websites conducted between January 6, 2023, and March 31, 2023. Qualitative content analysis of mission statements was conducted using a deductive approach. Eligible schools were identified from the 2021-2022 Medical School Admission Requirements and American Medical Colleges and American Association of Colleges of Osteopathic Medicine websites. Each school's publicly available website was also reviewed for its mission and student body demographics. All United States allopathic and osteopathic medical schools that have been accredited and have enrolled students since 2000., Exposure: Content analysis of medical school mission statements., Main Outcomes and Measures: Prevalence of diversity language in medical school mission statements and its association with student body racial diversity. Data were analyzed in 5-year groupings: 2001 to 2005, 2006 to 2010, 2011 to 2015, and 2016 to 2020)., Results: Among the 60 new medical schools (33 [55%] allopathic and 27 [45%] osteopathic; 6927 total students), 33 (55%) incorporated diversity language into their mission statements. In 2022, American Indian or Alaska Native individuals accounted for 0.26% of students (n = 18), Black or African American students constituted 5% (n = 368), and Hispanic or Latinx individuals made up 12% (n = 840). The percentage of schools with diversity language in their mission statements did not change significantly in schools accredited across time frames (60% in 2001: mean [SE], 0.60 [0.24] vs 50% in 2020: mean [SE], 0.50 [0.11]). The percentage of White students decreased significantly over the time period (26% vs 15% students in 2001-2005 and 2016-2020, respectively; P < .001). No significant differences were observed in student body racial or ethnic composition between schools with mission statements that included diversity language and those without., Conclusions and Relevance: In this cross-sectional study of US medical schools accredited since 2000, diversity language was present in approximately half of the schools' mission statements and was not associated with student body diversity. Future studies are needed to identify the barriers to increasing diversity in all medical schools.

This article explores experiences of teaching qualitative research (QR) broadly, and qualitative methods (QM) more specifically in medicine, highlighting the challenges faced, and offering recommendations for overcoming them. Using collective online interviews, collaborative autoethnography (CAE) was employed to generate data comprising educator's reflective accounts of teaching QM in medical schools across two continents. Three main themes were identified through collaborative thematic analysis: making meaningful contributions from a marginalized position; finding our pedagogical feet; and recognizing the translational applicability and value of QR. We reflected on the marginalized positioning of QM in medical curricula and the underestimation of the value of QR to understanding pressing health issues. Analysis of these reflections pointed to a lack of formal training for educators and curriculum space for qualitative approaches. Our teaching pedagogies, developed through our own research experiences, self-reflection and student feedback, were primarily student-centered employing a range of novel approaches designed to foster skills and interest in the craft of QR, and introduce a greater appreciation of the significance of QR approaches to medicine. CAE further allowed us to identify some key recommendations that could help medical educators plan for teaching QM and other research methods more effectively in medicine. Future curriculum development should consider the benefits of exposing learners to a range of methods and approaches from across the qualitative-quantitative spectrum., (© 2023. The Author(s).)

Tayādhūq, also known as Theodocus/Théodoros (d. early 8th century AD), was educated in the Gondēs̲h̲āpūr School and served the Sassanid kings. During this period, he contacted the Umayyad court and became the physician of Hajjāj ibn Yūsuf (d. 715 AD), the general governor of the Eastern regions of the caliphate. In addition to his knowledge on the Sassanid scientific tradition, Tayādhūq had a significant role in transferring this tradition to the Islamic world. His ideas were later followed by polymath physicians such as Rhazes (Abū Bakr al-Rāzī, d. 925 AD), Avicenna (Ibn Sīnā, d. 1037 AD), and others who lived after him. His medical works were of great importance to the development of early Islamic medicine. Therefore, this study will attempt to illuminate this forgotten scholar's medical knowledge, the works he produced, and finally illustrate his influences on later Muslim physicians., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Robot-assisted surgical methods are a development and supplement to conventional laparoscopy. Thus, appropriate training of surgeons in this specialty is indispensable. Especially for the initial phase, simulation programs - similar to those used in aviation - are ideally suited to introduce surgeons to the technically challenging surgical procedure. Later on, but still at the beginning of the learning curve, proctoring has proven its worth in order to allow the surgeon to be trained on site, to train him individually and to introduce him to more complex cases. An essential component of successful training concepts is the feedback: after some time and in written form, the surgeon to be trained receives a summary or a guideline, which describes the existing situation as well as suggestions for improvement and future potential. The implementation of such feedback allows the surgeon, in addition to the number of cases completed, to put his self-assessment into perspective and adjust development goals. Thus, feedback is the crucial interface between the beginning of a learning curve and advanced surgical skills, including the possibility of realistic self-assessment., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

Background: The medical profession is one of the most highly respected and desired professions among students worldwide, most likely because it provides opportunities for both a financially and socially rewarding career. However, while it has been quite established that factors such as self-interest, family pressure, friend pressure, and socioeconomic status do influence the choice of medicine among students worldwide, the exact reasons for an individual to join a medical school may actually vary worldwide. The aim of this study was to comprehensively explore factors influencing medical students to opt in/out medical careers in Sudan., Methods: An institutional based descriptive cross-sectional study was conducted at University of Khartoum in the year 2022 with a random sample of 330 students that was obtained from the medical students at the The University of Khartoum, Faculty of Medicine using stratified random sampling., Results: Self-interest was the most common factor influencing opting in (choosing) medical profession (70.6%) (n = 233), followed by getting a very high score in high-school that qualifies into the faculty (55.5%) (n = 183). Regarding the factors affecting medical students' choices, parental pressure was the main factor (37.0%) (n = 122), followed by other relatives' pressure (12.4%) (n = 41), and 4.2% (n = 14) chose Peer pressure. 59.7% (n = 197) of the participants stated that they were not affected by any of these factors. Most of the participants felt that the general perception of the medical profession by society is that it is prestigious and has good career opportunities, only 5.8% (n = 19) believed that it is "Not appreciated at all" by the society. A statistically significant association was found between the type of admission & parent pressure (p value 0.01). out of 330 participants, (56.1%) (n = 185) have opted out i.e. lost their interest or regretted their choice of medical career. Academic difficulties was the most common factor causing students to opt-out of the medical career (37%) (n = 122) followed by Multiple suspensions of education (35.2%) (n = 116), Current political & security conflicts in Sudan (29.7%) (n = 98), Poor quality of education (24.8%). The proportion of students having regrets for the medical profession was significantly higher among females. Over one third of the participants reported having depressive symptoms more than half days of the week. No statically significant correlation was established between the academic level and having these depressive symptoms and no statistically significant correlation was established between the decision to opt-out and the academic level (class) of the individuals (P = 0.105)., Conclusions: Over half of Sudanese medical students at the University of Khartoum have already lost their interest or regretted their choice of medical career choice. Whether these future doctor chose to drop out or continue their path in the medical career suggests that they are more prone to serious hardships in their future careers. A careful comprehensive approach should further explore and try to offer solutions for problems like "Academic difficulties", "multiple suspension of education", and "poor quality of education" for they were the most common factors that caused medical students to opt out of the medical career., (© 2023. The Author(s).)

Phenomenon: Program director ( PD)-resident relationships are important in shaping resident experiences and educational outcomes. Yet, there is limited literature on the development or meaning of these relationships, particularly from the PD perspective. Through qualitative interviews, we explore how PDs navigate their role to develop and maintain relationships with their trainees, and elucidate how these relationships impact the PDs personally and professionally., Approach: Qualitative study using individual semi-structured interviews of former and current PDs (n = 33) from multiple specialties and hospitals in accredited residency programs in Qatar, Singapore, and the United Arab Emirates. We used attachment theory and narrative analysis to investigate how PDs perceive and describe relationship building with their residents amidst tensions of familiarizing themselves with their new role., Findings: PD-resident relationships are complex and multidimensional, shifting over time, changing patterns and evolving to respond to different contexts. PDs initially negotiate their own roles, while navigating their relationships with residents and other stakeholders to create their professional identities. PDs develop professional alliances, defining for the resident the profession and its expectations. As residents negotiate the various challenges of their training, the role of the PD emerges into one of providing emotional support and advocacy. The support and attachment are often enduring and extend beyond the period of residency training., Insights: Our study examines the experiences of program directors as they negotiate complex educator-learner relationships. The PDs described roles that extended beyond their job description. Although all interviewees reported that the PD position was challenging, they focused on the rewarding aspects of the job and how their relationships helped sustain them through the difficulties. Through their reflections, the PDs described the personal satisfaction and benefits of their interactions with the residents, and how the engagement contributed to personal and professional success.

A detailed, unbiased perspective of the inter-relations among medical fields could help students make informed decisions on their future career plans. Using a data-driven approach, the inter-relations among different medical fields were decomposed and clustered based on the similarity of their working environments. Publicly available, aggregate databases were merged into a single rich dataset containing demographic, working environment and remuneration information for physicians across Canada. These data were collected from the Canadian Institute for Health Information, the Canadian Medical Association, and the Institute for Clinical Evaluative Sciences, primarily from 2018 to 2019. The merged dataset includes 25 unique medical specialties, each with 36 indicator variables. Latent Profile Analysis (LPA) was used to group specialties into distinct clusters based on relatedness. The 25 medical specialties were decomposed into seven clusters (latent variables) that were chosen based on the Bayesian Information Criterion. The Kruskal-Wallis test identified eight indicator variables that significantly differed between the seven profiles. These variables included income, work settings and payment styles. Variables that did not significantly vary between profiles included demographics, professional satisfaction, and work-life balance satisfaction. The 25 analyzed medical specialties were grouped in an unsupervised manner into seven profiles via LPA. These profiles correspond to expected and meaningful groups of specialties that share a common theme and set of indicator variables (e.g. procedurally-focused, clinic-based practice). These profiles can help aspiring physicians narrow down and guide specialty choice.

Background: Birth injury is defined as impairment of neonate’s body function that occur due to mechanical forces during the process of delivery. Incidence of birth injury varies from place to place, with place of delivery, experience of birth attendants, and mode of delivery. Objective: To determine the incidence, characteristics of birth injury in the Special Care Baby Unit of the University of Maiduguri Teaching Hospital (UMTH). Subjects and methods: This is a prospective observational study that was conducted in a Special Care Baby Unit (SCBU) of the University of Maiduguri Teaching Hospital. The subjects were recruited between 1st January, 2016 and 31st December, 2016. Neonatal birth injury was diagnosed based on paediatrician or senior registrar examination. Demographic variables: maternal age, maternal weight, and height, reproductive and labour variables: prenatal care, parity, gestational age, presence and duration of PROM, duration of labour, type of delivery, and skill of delivery attendance, while neonatal variables, includes: neonatal age, sex, birth weight, length, Apgar score, and type of birth injury. The treatment administered to the patients were either medical management such exchange blood transfusion in case of severe Jaundice complicating cephalhaematoma and/or simple transfusion for anaemia without complication, phototherapy, antibiotics, among others, or surgical/orthopaedic treatment in the presence of surgical injury. Statistical analysis was done using SPSS version 16 (SPSS Inc., Illinois, Chicago USA). A P-value < 0.0001. Soft tissue injury constituted the majority accounting for 37/61 (60.7%), closely followed by sub- conjunctival haemorrhages 25/61 (41.0%). Severe perinatal asphyxia also constituted significant proportion of the birth injury 24/61 (39.3%). Other central nervous system (CNS) birth injuries includes facial nerve palsy and Erb’s palsy 13.1% each. The commonest of the fractures was femoral bone fracture 9/61 (14.8%), followed by clavicular fracture 5/61 (8.2%). It was revealed that urea 2.5 mmol/L, total serum bilirubin (TSSB) 12.4 μmol/L and random blood sugar 2.6mmol/L were deranged in those neonates with three or more birth injuries and all the three parameters were statistically significant p0.05. Four patients died, two with internal organ injury were, of which one with splenic rupture and the other one with liver damage in addition to severe perinatal asphyxia died while the remaining two patients with severe perinatal asphyxia also died with mortality rate of 6.6%. Conclusion: The incidence of birth injury has decreased overtime especially in the affluent economy where obstetric and perinatal diagnosis has remarkably improved, but in the developing economy like ours as demonstrated in this study CC –BY 100 such an improvement is yet to be achieved. However education of the general populace especially the pregnant women so that they attend antenatal care and deliver at health facility with skilled health personnel will remarkably reduce birth injury.

Abstract Risks in the supply chain can damage many companies and organizations due to sustainability risk factors. This study evaluates the supply chain risk assessment and management and then selects the best supplier in a gas company in Egypt. A comprehensive methodology can use the experts' opinions who use the linguistic variables in the spherical fuzzy numbers (SFNs) to evaluate the criteria and suppliers in this study based on their views. Selecting the best supplier is a complex task due to various criteria related to supply chain risk assessment, such as supply risks, environmental risks, financial risks, regularity risks, political risk, ethical risks, and technology risks and their sub-criteria. This study suggested a new combined model with multi-criteria decision-making (MCDM) under a spherical fuzzy set (SFS) environment to overcome uncertainty and incomplete data in the assessment process. The MCDM methodology has two methods: the Entropy and COmbinative Distance-based Assessment (CODAS) methods. The SFS-Entropy is used to compute supply chain risk assessment and management criteria weights. The SFS-CODAS method is used to rank the supplier. The main results show that supply risks have the highest importance, followed by financial and environmental risks, and ethical risks have the lowest risk importance. The criteria weights were changed under sensitivity analysis to show the stability and validation of the results obtained from the suggested methodology. The comparative analysis is implemented with other MCDM methods named TOPSIS, VIKOR, MARCOS, COPRAS, WASPAS, and MULTIMOORA methods under the SFS environment. This study can help managers and organizations select the best supplier with the lowest sustainability risks.

Abstract Background Educational settings in professional health education establishments significantly shape students' academic, social, and emotional experiences. These environments encompass physical, psychological, and social infrastructures of programs or institutions, which jointly influence learning and development. This study analyzed the educational environment at Prince Nora University in Saudi Arabia, a renowned institution in health education. Aim The primary aim of this study was to evaluate the perceptions of the educational environment among students at Prince Nora University using the Dundee Ready Education Environment Measure (DREEM) inventory. The DREEM inventory is a renowned and validated tool designed to gauge students' perceptions across various dimensions of their educational experience. Methods Employing a cross-sectional survey design, the research gathered data from a sample of 321 students enrolled in the College of Health and Rehabilitation Sciences at Prince Nord University. The DREEM inventory, which measures the academic, social, and emotional aspects of the learning environment from the student's perspective, was utilized to collect the information. Results The findings from the study indicated a positive perception of the educational environment among the students, with an overall mean score of 113.84 out of 200 on the DREEM inventory. Analysis of the subscales revealed that the Student Perceptions of Atmosphere (SPoA) received the highest scores, indicating a favourable environment, while Student Social Self-Perceptions (SSSP) scored the lowest, suggesting areas that may require attention and improvement. Conclusion The study successfully showed the utility of the DREEM inventory in assessing the educational environment at Prince Nora University, highlighting its effectiveness as a tool for understanding student perceptions. The positive overall score suggests a conducive learning atmosphere, though the disparity in subscale scores points to potential areas for enhancement. Recommendation: The research suggests that Saudi Arabian universities should implement the DREEM inventory to assess and enhance their educational settings, ultimately delivering a comprehensive and nurturing learning experience for students.

Abstract Terahertz (THz) wireless communication is a promising technology that will enable ultra-high data rates, and very low latency for future wireless communications. Intelligent Reconfigurable Surfaces (IRS) aiding Unmanned Aerial Vehicle (UAV) are two essential technologies that play a pivotal role in balancing the demands of Sixth-Generation (6G) wireless networks. In practical scenarios, mission completion time and energy consumption serve as crucial benchmarks for assessing the efficiency of UAV-IRS enabled THz communication. Achieving swift mission completion requires UAV-IRS to fly at maximum speed above the ground users it serves. However, this results in higher energy consumption. To address the challenge, this paper studies UAV-IRS trajectory planning problems in THz networks. The problem is formulated as an optimization problem aiming to minimize UAVs-IRS mission completion time by optimizing the UAV-IRS trajectory, considering the energy consumption constraint for UAVs-IRS. The proposed optimization algorithm, with low complexity, is well-suited for applications in THz communication networks. This problem is a non-convex, optimization problem that is NP-hard and presents challenges for conventional optimization techniques. To overcome this, we proposed a Deep Q-Network (DQN) reinforcement learning algorithm to enhance performance. Simulation results show that our proposed algorithm achieves performance compared to benchmark schemes.

Abstract This study introduces an innovative approach to fabricate aluminum matrix composites strengthened with biochar, derived from renewable biomass sources. A systematic investigation of varying biochar weight percentages (0, 2.5, 5, 7.5, and 10 wt%) reveals substantial improvements in mechanical properties and corrosion resistance. Mechanical assessments, including compressive strength and hardness, demonstrate a significant enhancement in mechanical strength with biochar incorporation. In this study, it was discovered that the composite with 7.5 wt% biochar exhibits an optimal balance, displaying an 8.83% increase in compressive strength and a 15.15% rise in hardness compared to the base aluminum matrix. The study further evaluates corrosion behavior through electrochemical analyses and immersion tests in 3.5% NaCl corrosive environments, highlighting the superior corrosion resistance of biochar-reinforced composites. Corrosion rates decrease by 73% in the composite with 10 wt% biochar for the 24 h immersion time, affirming its protective barrier against corrosive agents. This research provides quantitative insights into tailoring mechanical and corrosion properties in aluminum matrix composites through biochar reinforcement, offering a promising avenue for sustainable material development. The resulting materials exhibit not only an 8.83% increase in mechanical strength but also a 73% reduction in corrosion rates, offering valuable uses in industries that need strong, eco-friendly solutions.

Abstract This research introduces an advanced finite control set model predictive current control (FCS-MPCC) specifically tailored for three-phase grid-connected inverters, with a primary focus on the suppression of common mode voltage (CMV). CMV is known for causing a range of issues, including leakage currents, electromagnetic interference (EMI), and accelerated system degradation. The proposed control strategy employs a system model that predicts the inverter’s future states, enabling the selection of optimal switching states from a finite set to achieve dual objectives: precise current control and effective CMV reduction, a meticulously designed cost function evaluates the potential switching states, balancing the accuracy of current tracking against the necessity to minimize CMV. The approach is grounded in a comprehensive mathematical model that captures the dynamics of CMV within the system, and it utilizes an optimization process that functions in real-time to determine the most suitable control action at each interval, Experimental validations of the proposed FCS-MPCC scheme have demonstrated its effectiveness in significantly improving the performance and durability of three-phase grid-connected inverters, Experimental validations of the proposed (MPC with CMV) scheme have demonstrated its effectiveness in significantly improving the performance and durability of three-phase grid-connected inverters. The proposed method achieved substantial reductions in CMV, notable improvements in current tracking accuracy, and extended system lifespan compared to conventional control methods.

Abstract Mosquitoes, one of the deadliest animals on the planet, cause millions of fatalities each year by transmitting several human illnesses. Synthetic pesticides were previously used to prevent the spread of diseases by mosquitoes, which was effective in protecting humans but caused serious human health problems, environmental damage, and developed mosquito pesticide resistance. This research focuses on exploring new, more effective, safer, and environmentally friendly compounds to improve mosquito vector management. Phytochemicals are possible biological agents for controlling pests and many are target-specific, rapidly biodegradable, and eco-friendly. The potential of extracts of Lantana camara, Melia azedarach, Nerium oleander, Ricinus communis, and Withania somnifera against 3rd instar Culex pipiens (Common house mosquito) larvae was evaluated. Methanol extracts had more toxic effects against Cx. pipiens larvae (95–100%, 24 h post-treatment) than aqueous extracts (63–91%, 24 h post-treatment). The methanol extracts of Nerium oleander (LC50 = 158.92 ppm) and Ricinus communis (LC50 = 175.04 ppm) were very effective at killing mosquito larvae, 24 h after treatment. N. oleander (LC50 = 373.29 ppm) showed high efficacy in aqueous plant extracts. Among the different extracts of the five plants screened, the methanol extract of R. communis recorded the highest ovicidal activity of 5% at 800 ppm concentration. Total developmental duration and growth index were highly affected by R. communis and M. azedarach methanol extracts. In field tests it was clear that plant extracts decreased mosquito larval density, especially when mixed with mosquito Bti briquette, with stability up to seven days for N. oleander. GC–MS results showed that the methanol extract had a higher number of chemical compounds, particularly with more terpene compounds. A high-performance liquid chromatography (HPLC) technique was used to detect the existence of non-volatile polyphenols and flavonoids. All five methanol extracts showed high concentrations of active ingredients such as gallic acid, chlorogenic acid (more than 100 μg/ml) and the rosmarinic acid was also found in all the five extracts in addition to 17 active polyphenols and flavonoids presented at moderate to low concentrations. Molecular modeling of 18 active ingredients detected by the HPLC were performed to the vicinity of one of the fatty acid binding proteins of lm-FABP (PDB code: 2FLJ). Rutin, Caffeic acid, coumaric acid and rosmarinic acid which presented densely in R. communis and N. oleander showed multiple and stable intermolecular hydrogen bonding and π–π stacking interactions. The inhibition ability of the fatty acid binding protein, FABP4, was evaluated with remarkable receptor inhibition evident, especially with R. communis and N. oleander having inhibitory concentrations of IC50 = 0.425 and 0.599 µg/mL, respectively. The active phytochemical compounds in the plants suggest promising larvicidal and ovicidal activity, and have potential as a safe and effective alternative to synthetic insecticides.

Abstract To obtain high efficient elimination of ammonia (NH4 +) from wastewater, Cu(II), Ni(II), and Co(II)) were loaded on Dowex-50WX8 resin (D-H) and studied their removal efficiency towards NH4 + from aqueous solutions. The adsorption capacity of Cu(II)-loaded on D-H (D-Cu2+) towards NH4 + (qe = 95.58 mg/g) was the highest one compared with that of D-Ni2+ (qe = 57.29 mg/g) and D-Co2+ (qe = 43.43 mg/g). Detailed studies focused on the removal of NH4 + utilizing D-Cu2+ were accomplished under various experimental conditions. The pseudo-second-order kinetic model fitted well the adsorption data of NH4 + on D-Cu2+. The non-linear Langmuir model was the best model for the adsorption process, producing a maximum equilibrium adsorption capacity (qmax = 280.9 mg/g) at pH = 8.4, and 303 K in less than 20 min. The adsorption of NH4 + onto D-Cu2+ was an exothermic and spontaneous process. In a sustainable step, the resulting D-Cu(II)-ammine composite from the NH4 + adsorption process displayed excellent catalytic activity for the degradation of aniline blue (AB) and methyl violet 2B (MV 2B) dyes utilizing H2O2 as an eco-friendly oxidant.

Abstract This study examines the spatiotemporal variability of drought and associated physical processes over the Arabian Peninsula (AP). For this purpose, we computed the standardized precipitation evapotranspiration index (SPEI) for the period 1951–2020 using the Climate Research Unit and fifth generation ECMWF atmospheric reanalysis datasets. By applying rotated empirical orthogonal function analysis on the SPEI data, we identified four homogeneous and coherent drought regions. The droughts in the northern regions follow a relatively similar temporal evolution as compared to those in the southern region. All four sub-regions of the AP exhibit a significant drying trend (p

Abstract Background Socioeconomic status (SES) is a social classification factor that takes into account income, parental education and occupation. SES has been shown to play an important role in shaping students’ academic performance, including in medical schools, but there still remains significant variation in findings around SES and academic achievement worldwide. We aim to assess and explore socioeconomic disparities and their effects on medical school performance at Sudanese public and private universities. Objectives The objective of our study was to assess the effects of age, sex, living conditions, parental education and income level on the academic achievement of medical students from universities in Sudan. Methods This cross-sectional study was conducted among undergraduate medical students at ten public universities in Sudan between September and December 2023. Participants were included if they were older than 18 years and were studying in their 2nd year or older. The data were collected using an online questionnaire with open- and closed-ended questions measuring age, living conditions, parental income level and education. A convenience sampling method was used to recruit participants from universities. The data were analyzed using SPSS v28.0.0, and a p value less than 0.05 was used to indicate statistical significance. Results We received 832 responses, 516 (62%) from females and 307 (36.9%) from males. The median age was 23 years. Most students lived with their families (61.1%), followed by student housing (28.2%). This study revealed age (p = .024) (95% Cl: 0.025- 0.023) andhigh family income (p = .019) (95% Cl: 0.018- 0.02) are associated with academic achievement in the long term, as demonstrated through cumulative grade point average (cGPA). Conclusion The findings underscore the importance of targeted support systems to bridge the socioeconomic gaps that exist among medical students, allowing all students to thrive academically regardless of their background. Clinical trial number None.

Abstract Self-reported physical activity questionnaires (e.g., International Physical Activity Questionnaire, IPAQ) are a cost-effective, time-saving, and accessible method to assess sedentary behaviour and physical activity. There are conflicting findings regarding the validity of self-reported questionnaires in comparison to accelerometer-measured data in a free-living environment. This study aimed to investigate the concurrent validity between self-reported Arabic–English IPAQ short form (IPAQ-SF) and Fibion (Fibion Inc., Jyväskylä, Finland) accelerometer-measured sedentary and physical activity time among young adults. One hundred and one young healthy adults (mean age 20.8 ± 2.4 years) filled in the IPAQ short form (IPAQ-SF) and wore the Fibion device on the anterior thigh for ≥ 600 min per day for 4–7 days. Concurrent validity between the IPAQ-SF and Fibion accelerometer for sitting, walking, moderate activity, and vigorous activity time was assessed using the Spearman correlation coefficient ( $$\rho$$ ρ ) and Bland–Altman plots. Significant weak associations between IPAQ-SF and Fibion measurements were found for total activity time ( $$\rho$$ ρ = 0.4; P

Abstract This is an interim analysis of the Beta-blocker (Propranolol) use in traumatic brain injury (TBI) based on the high-sensitive troponin status (BBTBBT) study. The BBTBBT is an ongoing double-blind placebo-controlled randomized clinical trial with a target sample size of 771 patients with TBI. We sought, after attaining 50% of the sample size, to explore the impact of early administration of beta-blockers (BBs) on the adrenergic surge, pro-inflammatory cytokines, and the TBI biomarkers linked to the status of high-sensitivity troponin T (HsTnT). Patients were stratified based on the severity of TBI using the Glasgow coma scale (GCS) and HsTnT status (positive vs negative) before randomization. Patients with positive HsTnT (non-randomized) received propranolol (Group-1; n = 110), and those with negative test were randomized to receive propranolol (Group-2; n = 129) or placebo (Group-3; n = 111). Propranolol was administered within 24 h of injury for 6 days, guided by the heart rate (> 60 bpm), systolic blood pressure (≥ 100 mmHg), or mean arterial pressure (> 70 mmHg). Luminex and ELISA-based immunoassays were used to quantify the serum levels of pro-inflammatory cytokines (Interleukin (IL)-1β, IL-6, IL-8, and IL-18), TBI biomarkers [S100B, Neuron-Specific Enolase (NSE), and epinephrine]. Three hundred and fifty patients with comparable age (mean 34.8 ± 9.9 years) and gender were enrolled in the interim analysis. Group 1 had significantly higher baseline levels of IL-6, IL-1B, S100B, lactate, and base deficit than the randomized groups (p = 0.001). Group 1 showed a significant temporal reduction in serum IL-6, IL-1β, epinephrine, and NSE levels from baseline to 48 h post-injury (p = 0.001). Patients with severe head injuries had higher baseline levels of IL-6, IL-1B, S100B, and HsTnT than mild and moderate TBI (p = 0.01). HsTnT levels significantly correlated with the Injury Severity Score (ISS) (r = 0.275, p = 0.001), GCS (r = − 0.125, p = 0.02), and serum S100B (r = 0.205, p = 0.001). Early Propranolol administration showed a significant reduction in cytokine levels and TBI biomarkers from baseline to 48 h post-injury, particularly among patients with positive HsTnT, indicating the potential role in modulating inflammation post-TBI. Trial registration: ClinicalTrials.gov NCT04508244. It was registered first on 11/08/2020. Recruitment started on 29 December 2020 and is ongoing. The study was partly presented at the 23rd European Congress of Trauma and Emergency Surgery (ECTES), April 28–30, 2024, in Estoril, Lisbon, Portugal.

Abstract The main focus of this study was on using radiation to make an ultra-absorbent hydrogel (UAH) from sodium alginate (SA) and gelatin (GL) biopolymers. This UAH can effectively handle water and nitrogen in wheat farming during drought stress. The hydrogel was synthesized by gamma irradiation-induced SA/GL/polyacrylamide crosslinking at 10–40 kGy. Varying SA/GL ratios affected swelling and the gel fraction of SA/GL/PAm hydrogels. The (SA/GL 17/83) hydrogel exhibited a 40.03 g/g swelling degree, while increasing SA content resulted in higher swelling, peaking at 75.5 g/g for (SA/GL 83/17). This indicated a synergistic interaction between SA and GL. The gel fraction also increased from 76.8 to 90.3%, with a higher GL content reflecting increased crosslinking. After multiple hydrolysis cycles, the hydrogel achieved 1293 (g/g) swelling and 36 days of water retention. When applied to wheat (Triticuma estivum) under drought stress, it significantly improved shoot length (18%), root length (43%), shoot fresh weight (49%), and shoot dry weight (51%) under extreme drought. The significant increases in protein and carbohydrate content in both shoots (up to 32% and 19%, respectively) and grains (up to 21% and 24%, respectively), along with the reduction in proline content (up to 38%), demonstrate that ultra-absorbent hydrogel (UAH) effectively enhances nitrogen content, photosynthesis, and overall plant health in wheat under varying drought stress levels. This novel SA/GL-based UAH holds promise for addressing water scarcity and agricultural challenges, offering a sustainable solution for water and nitrogen management under drought stress.

Interest in naturally occurring phytochemicals has been on the increase, they are believed to reduce the risk of brain disorders. Hispidulin (HN) is a phenolic flavonoid compound with various pharmacological and biological effects on the central nervous system. It belongs to the flavone class of flavonoids. It can be found in different plant materials, especially fruits and vegetables. The literature used in this review was collected from credible scientific databases including ScienceDirect, Scopus, PubMed, Google Scholar, and Hindawi without time restriction, using relevant keywords, such as HN, brain, central nervous system, flavonoids, and flavones. HN was discovered to possess pro-apoptotic properties, act as an antioxidant, inhibit cytokine production and toll-like receptor 4 expression, as well as impede nuclear factor kappa beta and mitogen-activated protein kinase B. HN was also found to inhibit lipid peroxidation in vitro and reduce brain edema in mice. These pharmacological potentials suggest that HN is a promising candidate for neuroprotection in CNS disorders like depression and epilepsy. This review provides an update on the scientific literature concerning how these activities could help provide various forms of neuroprotection in the CNS. Additional experimental data on the effects of HN in models of neurological disorders and neuroprotection should be explored further. Based on the current study, HN is a promising candidate for neuroprotection of the CNS.

Abstract The number of birds or their total live weight in relation to a given area is known as stocking density; higher stocking densities will cause more stress to the birds, which may have an impact on their physiological state, productivity, carcass quality, growth performance, immunity, metabolism, and meat quality. The present study aimed to investigate the potential impact of 2 different stocking densities on growth performance, carcass characteristics, meat quality, serum, and expression of Insulin like growth factor-1 (IGF-1), muscle regulatory genes expression and serum biochemical indicators of broilers supplemented with essential oils (EO). In total, 784-day-old chicks of Ross 308 were randomly assigned into 4 different groups with 7 replicates for each: Normal feed (no essential oils [EO] added) and normal stocking as 9 bird/m2, (NSD). Normal feed (no essential oils [EO] added) and high stocking as 14 bird/m2, (HSD). Feed with essential oils (Digestarom DC® 150 g/Ton of feed) and normal stocking as 9 birds/m2, (NSD + EO). Feed with essential oils (Digestarom DC® 150 g/Ton of feed) and high stocking as 14 birds/m2, (HSD + EO) for 35 days. Bodyweight was recorded at the beginning of the trial and then at the end of each week, feed intake was recorded at the end of each week as well. A total of 28 birds (7 birds per treatment) birds were slaughtered at 35 days of age to evaluate each parameter. The HSD group had the lowest (P

Abstract Quantitative structure relationships linked to a chemical structure that shed light on its properties and chemical reactions are called topological indices. This structure is upset by the addition of silicon (Si) doping, which changes the electrical and optical characteristics. In this article, we examine the connection between a chemical structure’s Gibbs energy (GE) and K-Banhatti indices. In this article, we compute the K-Banhatti indices and then show the correlation between the indices and Gibb’s energy of the molecule using curve fitting. Through the curve fitting, we see that there is a strong correlation between indices and Gibb’s energy of a molecule. We use the polynomial curve fitting approach to see the correlation between indices and Gibb’s energy.

Abstract Heart failure (HF) is a global epidemic with a prevalence of over 64.3 million cases worldwide. Several factors account for the increase in the prevalence of HF. The most significant factor is the growing population of older adults. Other factors include improved treatment and survival after myocardial infarction, poorly controlled hypertension (HTN), and diabetes mellitus (DM). As a modifiable construct, perceived control can be improved to promote healthier lifestyle choices, such as self-care, and consequently better health outcomes. A person’s perception of control is their conviction that they have the power to deal with adverse circumstances, like receiving an HF diagnosis, and produce favorable results, such as an improvement in symptom status. The objective of this study was to evaluate the factors influencing perceived control attitudes among patients with heart failure in Oman. In this sample of HF patients (N = 180), the mean perceived control attitude was 16.97 ± 2.25. Certain factors had higher effects than others. For example, females (p = 0.006), old age (p

Abstract Colorectal cancer (CRC) is the third most common cancer in the United States. Recent epidemiological evidence demonstrates an increasing incidence of young-onset CRC cases, defined as CRC cases in individuals 50 years old or younger. Studies have established that alterations in both the WNT and TGF-Beta signaling pathways have contributed to CRC development. While this is well understood, the comprehensive analysis of WNT and TGF-Beta pathway alterations in young-onset CRC cases has yet to be investigated. Here, we conducted a comprehensive bioinformatics analysis of mutations associated with each of the WNT and TGF-Beta signaling pathways according to age (≤ 50 years old versus > 50 years old) utilizing published genomic data from the cBioPortal. Chi-square results demonstrated no significant difference in WNT alterations between young-onset CRC and those > 50 years old. However, across all age groups, WNT alterations were frequently found in rectal cancers. We also found that WNT alterations were associated with better outcomes. The mutations associated with TGF-beta were observed at a higher rate in older CRC patients when compared to those ≤ 50 years old. Additionally, these mutations were found more frequently in colon primaries.

Vaccines are arguably the most important public health tools available today. Since the successful eradication of smallpox with the use of the vaccine, many vaccines have become available to man. Of great importance to public and child health are the vaccines against the so-called six killer diseases of childhood- measles, pertussis, diphtheria, tetanus, tuberculosis and poliomyelitis. In the last 2 decades, effective vaccines against the major causes of pneumonia, another childhood killer, have become available. Data from many parts of the world including African countries have shown the benefits of the and vaccines. pneumococcal Haemophilus influenzae type b The scientific world is still searching for appropriate candidate vaccines for malaria and HIV infection. Despite the availability and effectiveness of many vaccines, the benefits to a country is highly dependent on a viable and sustainable health system which include adequate f inancing, dynamic and motivated workforce, strong partnerships and effective community participation. If well deployed, available vaccines as elucidated in this discourse can accelerate the achievements of the Millennium Development Goals in Nigeria and many other developing countries.

Summary: A case of Juvenile dermatomyositis (JDM) in a 10 year old Nigerian girl is herein reported to discuss some of the features of the disease and challenges in management of such a rare but crippling autoimmune vasculopathy of childhood. She was referred to the University of Maiduguri Teaching Hospital (UMTH) with an eight-month history of recur rent fever, abdominal pain, and a four-onth history of body rash and inability to walk or sit. Muscle biopsy and clinical findings consistent with JDM were found. Her condition improved with steroids, cytotoxic therapy and physiotherapy. Some invest igat ion and t reatment modalities could not be accessed for the benefit of the patient. Although, the outcome of patients with JDM has improved with the discovery of steroids, the disease is shown to have a variable course, with attendant social and financial implications especially to the immediate family.

Background: Pneumonia remains a leading cause of U-5 morbidity and mortality in developing countries like Nigeria. This study was conducted to determine the clinical presentation, complications and factors contributing to mortality in the hospitalized children with community acquired pneumonia (CAP) in Maiduguri, Nigeria. Methods: Children younger than 14 years admitted into the Emergency Paediatric Unit of the University of Maiduguri Teaching Hospital (UMTH), Maiduguri, in 2011 with the diagnosis of community acquired pneumonia were followed up until discharge or death. Chest radiographs were read by radiologists. Results: Eighty nine children aged two months to 14 years were studied. The commonest clinical features were fever, cough, tachypnoea and dyspnoea. Radiographic evidence of pneumonia was found in 84 (94.4%) of cases. Dehydration and congestive cardiac failure (CCF) were the commonest complications encountered. Eight (9.0%) children died, seven of whom had complications of pneumonia. The rate of occurrence of complications, radiographic pattern of pneumonia and outcome of treatment did not significantly differ statistically in the different age groups; p = 0.135, 0.622 and 0.167 respectively. Conclusion: While dehydration and CCF were found to be commonest complications, mortality was commoner among the male infants hospitalized for pneumonia.

Acute Kidney Injury (AKI) previously known as acute renal failure (ARF) is a common problem in the paediatric emergency wards with infections like sepsis and malaria being the commonest causes in Nigeria. It has been known by various nomenclatures with a lack of standardised definition. This has made comparison of data very difficult. In the last decade, attempts have been made to standardize the definition by developing a classification criterion termed “RIFLE”. This is in turn undergoing various modifications with the most recent classification system developed by the Kidney Disease: Improving Global Outcomes (KDIGO). Despite these interesting developments, the basis of these classifications which is the use of serum creatinine measurements is fraught with its own limitations. This has led to discovery of various urinary and serum biomarkers like the cystatin C and neutrophil gelatinase associated lipocalin (NGAL) which appear to have very promising advantages over the well known creatinine measurements. Management of AKI continues to be anticipatory with appropriate fluid therapy and adequate treatment of infections. The benefits of furosemide and dopamine in management are still a constant source of debate. Treatment of life threatening complications like hyperkalaemia and hypertension as well as maintaining the kidney through the period of non-function can lead to remarkable recovery of renal homeostatic function.

Background: Cancer is a public health problem worldwide affecting all categories of persons. It is the second common cause of death in developed countries and among the three leading causes of death in developing countries. Objective: To compare the patterns of malignant childhood tumours in two tertiary hospitals in the north- Western and South western Nigeria. Methods: Retrospective studies of childhood malignancies diagnosed at Aminu Kano Teaching Hospital (AKTH), Kano and Obafemi Awolowo University Teaching Hospital Complex (OAUTHC) (Ife Hospital Unit, Ile-Ife and Wesley Guild Hospital Unit, Ilesa, Osun state) were undertaken from January, 2001 to December, 2010. The patterns of childhood cancers in these hospitals were compared. Results: Four hundred and ten children aged 7 months to 15 years were admitted at AKTH with malignancies of which 236 were males and 174 females with male to female ratio of 1.4:1. At OAUTHC, 568 children aged two months to 15 years were admitted with malignancies over the ten year period. There were 401 males and 167 females, with male to female ratio of 2.4:1. Lymphomas were the commonest type of malignancy in both centers, which accounted for 47.3% and 59.7% at AKTH and OAUTHC respectively. Retinoblastoma was the second commonest tumour at AKTH constituting 14.9% of all malignancies followed by nephroblastoma and acute leukemias. In contrast, acute leukemias were the second commonest malignancy at OAUTHC accounting for 12.7% of all malignancies followed by retinoblastoma and nephroblastoma. Tumours of central nervous system were observed to be commoner at AKTH, while bone tumours were commoner at OAUTHC. Conclusion: The pattern of childhood cancer varies rather little between different regions in Nigeria, with malignant lymphomas being the most common as is the case in most developing countries. However, the findings in this study suggest that there is variation in prevalence of leukemia, CNS and bone tumours in northern and southern Nigeria.

Introduction: In Africa alone, between 1000 – 4000 children are blinded annually by conjunctivitis. In view of the changing aetiological agents documented in other parts of the world and evolving resistance of infective agents to therapeutic agents, the present study was designed to define the bacterial agents, their antibiotic sensitivity pattern seen in AKTH, Kano, Nigeria. Patients and methods: This was a cross sectional prospective study done over a period of 3 months. Consecutive neonates who satisfied the inclusion criteria were recruited until the sample size of 175 was obtained. samples were transported to the laboratory within one hour. Gram staining and antibiotic sensitivity were determined using standard technique. Results: The mean age at presentation was 5.7 ± 4.6days. Results of the eye swabs showed that 97 (55.4%) were bacteriologically positive while 78 (44.6%) yielded no growth. Staphylococcus aureus was the most frequently isolated organism and was most sensitive to ceftriaxone, (73.1%). Escherichia coli was most sensitive to gentamicin (78.3%). Pseudomonas aeruginosa and Neisseria gonorrhea showed 100% sensitivity to ceftazidime and ceftriaxone respectively. Conclusion: Staphylococcus aureus is the commonest bacterial agent responsible for neonatal conjunctivitis. Staphylococcus aureus was most sensitive to ceftriaxone.

Background: HIV infection affects virtually all systems of the body including the haematological system. Objective: To determine the prevalence of anaemia in HIV infected children and compare with apparently healthy HIV negative age-sex matched controls. Design: Case control hospitalbased study. Methods: A total of 60 confirmed HIV infected antiretroviral naïve children and 60 HIV negative children were enrolled in a case control study of baseline haematological indices. In all cases, haemoglobin, total white blood cell count, neutrophils, lymphocytes and platelet counts were determined using SYSMEX XT- 2000i Haematologic auto-analyser. Children with HIV/AIDS were classified according to clinical disease stages using the 2006 World Health Organization (WHO) staging criteria. Data was analysed using MINITAB 12.21 Atlanta USA statistical software. Result: Anaemia (˂110 g/L) was present in 88.0% of the HIVinfected children, compared to 15.0% of controls (p = 0.001). Mild anaemia (70 – 109 g/L) was observed in 85.0% of HIVinfected children, compared to 15.0% of controls. Moderate anaemia (50 – 69 g/L) was present in 3.3% of HIV-infected children, but in none of the control. Leucopenia (˂4 × 109 /L) was seen in 11.6% of HIV-infected children and in 5.0% of controls. Neutropenia (˂1.5 × 109/L) affected13% of infected children and 5% ofcontrols. Lymphocytopenia (˂1.2 × 109/L) was observed in 3.3% of infected children but in none ofcontrols. Corresponding figures for thrombocytopenia (˂100 × 109/L) were6.7% of HIV infected children and 1.7% of controls. Conclusion: All cells lines arereduced in HIV/AIDS and anaemia is the most frequent haematological manifestation seen in HIV/AIDS infection.

Background: Acute post infectious glomerulonephritis (APIGN) describes a wide range of glomerulonephritis characterized by an immunologic response of the kidney to varieties of infectious agent commonly bacteria. It is characterized by an abrupt onset of haematuria, moderate oedema, hypertension and proteinuria usually < 2g/dl. However, between 2013 and 2015, we managed two children who had histological diagnosis of post infectious glomerulonephritis but presented with full complement of features of nephrotic syndrome including nephrotic range proteinuria in addition to the features of nephritis. Case reports: A 5year old boy and an 8 year old girl were admitted to our Paediatric Unit with history of generalized body swelling, reduction in the volume of urine and cough. There was no antecedent sorethroat or skin rash. At presentation, both patients had mild dyspnea, anasarca, massive ascitis, and hypertension (130/80mmHg and 150/100mmHg respectively) both systolic and diastolic blood pressure were greater than 99 percentile. Laboratory investigations revealed massive proteinuria of 4+ and 3+ respectively, haematuria, hypoalbuminemia, and hyperlipidemia. The histology of their renal tissues revealed features in keeping with acute glomerulonephritis. Conclusion: Acute glomerulonephritis may present with features of nephrotic syndrome including nephrotic range proteinuria. Hence in the event of the presentation of a mixed feature of nephrotic-nephritis as obtained in the case of these two children, management should first be in the line of AGN while awaiting the renal hisotology outcome before considering the commencement of steroid.

Introduction: Hepatitis B virus infection is a major public health problem worldwide. It is more infectious and more in Nigeria than the Human Immunodeficiency Virus (HIV). It is a major risk factor for the development of liver cirrhosis and hepatocellular cancer in hyperendemic areas. This study was carried out between 8th January and 7th March, 2012, to assess the prevalence of Hepatitis B virus infection among apparently healthy primary school pupils in Batagarawa Local Government, Katsina state. Methods: Hepatitis B surface antigen was tested for in 240 apparently healthy primary school pupils in Batagarawa Local Government, Katsina state in North- Western Nigeria using commercial recombinant enzyme-based HBsAg test strip. Results: Of the 240 samples screened, 56 (23.3%) were seropositive. HBsAg seroprevalence was higher among children aged 7 – 9 years (7.9%), and among male (15.8%) than female (7.8%) subjects. Of the predisposing factors for HBV infection studied, traditional circumcision among the male subjects recorded the highest prevalence of 30%. Conclusion: The high prevalence of HBV infection amongst the subjects studied strongly suggests that urgent preventive measures, particularly health education of the general public on HBV infection and provision of universal HBV vaccination should be given urgent priority.

Introduction: Glucose- 6-phosphate dehydrogenase deficiency is the most common enzymatic disorder of the red cell and an important risk factor for neonatal jaundice. Methodology: The aim of the study was to determine the incidence of G-6-PD deficiency among jaundiced neonates, and describe the associated morbidity and mortality pattern in them. A prospective cross sectional study was conducted and we studied one hundred consecutive jaundiced neonates (55 males, 45 females) presenting at Aminu Kano Teaching Hospital from between 2004 and August 2005. G-6-PD activity was assayed by Quantitative spectrophotometric method of Kornberg; serum bilirubin and haemoglobin levels were estimated by standard techniques. Exposure to possible Icterogenic agents, clinical features of kernicterus and the outcome were noted. Results: The incidence of G-6-PD deficiency was found to be 46% with male to female ratio of 3:1 (Χ 2 = 15, p = 0.001). A higher proportion (60.6%) of the inborn neonates had G-6-PD deficiency (x2 = 5.5, p = 0.06). Jaundice was noticed significantly earlier in the G-6-PD deficient neonates (mean = 2.0, SD = 1 days) compared to (mean = 2.7, SD = 1.6 days) in the sufficient neonates (t = 2.3, p = 0.02). Sixteen (16%) neonates developed kernicterus, of these 10 (63%) were G-6-PD deficient. The mortality rate among G-6-PD deficient neonates was 15% (7 of 46) twice as much as in the sufficient neonates 7% (4 of 54). Only six neonates 0.6% ware exposed to naphthalene of whom three were G -6PD deficient. Five babies were given traditional medicine two of which were G6-PD deficient. Conclusion: G-6-PD deficiency is an important risk factor for neonatal jaundice. Jaundice appeared early in the deficient neonates. There is high incidence of kernicterus and mortality among them. Low admission weight significantly contributed to the mortality.

Background: Burkitt lymphoma (BL) is highly chemotherapy-sensitive tumor and one of most common childhood cancers in Nigeria. Unlike in high income settings where cure rate is very high, the outcome of children with BL is still poor in low income countries like Nigeria. The main contributing factor to disparity in survival rate is treatment abandonment (TA). This study aimed to determine treatment outcomes and TA rates in a retrospective cohort of Nigerian children admitted with BL. Methodology: We conducted retrospective charts review of all children (

BACKGROUND: The role of endocervical curettage (ECC) in the diagnosis of cervical intraepithelial neoplasia (CIN) is a controversial topic. OBJECTIVES: Investigate the role of ECC in the diagnosis of CIN in human papillomavirus (HPV) positive patients. DESIGN: Retrospective SETTING: A tertiary training and research hospital PATIENTS AND METHODS: This study included patients who were referred for colposcopy between 2018-2022 because of abnormal screening results. ECC results, age, cytology, HPV status, and colposcopic impression of the patients were extracted from the medical records. Multinomial logistic regression analyses were performed to identify factors that could predict CIN on ECC. MAIN OUTCOME AND MEASURES: The likelihood of high-grade squamous intraepithelial lesions (HSIL) in ECC in patients with cervical biopsy results of normal and low-grade squamous intraepithelial lesion (LSIL). SAMPLE SIZE: 2895 women RESULTS: In patients with normal and LSIL cervical biopsy results, HSILs were detected in 6.7% of ECC results. There was no difference in the detection rates of CIN in ECC among groups with smear results negative for intraepithelial lesions or malignancy (NILM), atypical squamous cells of undetermined significance (ASC-US), and LSIL. The likelihood of HSIL being observed in ECC was 2.2 times higher in patients with HPV16. The probability of LSIL disanois was 2.3 times higher in women aged 50-59 years and 2.8 times higher in women ≥ 60 years compared to the reference group of

Abstract Background Smart phone technology including different instant messaging applications like, WhatsApp, can be used for the development of radiological skills, reporting, and performance. To determine the utility, attitude, and outcome of WhatsApp for augmenting education in FCPS radiology residency program. To assess the opinion of radiology residents regarding WhatsApp as a tool to enhance postgraduate training. Methodology A mixed method (qualitative and quantitative) was conducted at Dow Institute of Radiology, Karachi, Pakistan. All FCPS Radiology residents were given a radiological case by principal investigator followed by residents’ response in 24 h. Key findings were shared by the mentor. Before and after the intervention of WhatsApp, all residents were evaluated with written and radiological imaging reporting exam. For quantitative analysis, a closed ended questionnaire was used containing information about total number of messages, images, webpage links shared, level of contribution (active/non-active), and utility (contribution in education related topic only). A feedback form with Likert scale was also got filled by all residents. For qualitative research, semi structured interviews (SSIs) were conducted. Results Median number of total images shared were 293 (IQR 1002 images), messages shared 110 (IQR), webpages shared were 54 webpages (61 webpages) and total contents shared by participants was 243 (544 contents). Active contributors showed better performance in utility, competency of contents and attitude towards using social media as a medium for learning. Comparison of written and OSCE results showed better performance after the intervention. Feedback form with Likert scale revealed that students responded positively regarding the shared learning content. Thematic analysis showed 52 codes and 16 themes. Conclusion In this research we have observed that WhatsApp is highly efficient and productive academic tool which can amplify postgraduate radiology education. Student’s narrative reflects that residents have found the missing link which can take them to radiological professional excellence through targeted high-profile learning outside lecture hall in time and place convenient motivational environment. Once it will be blended with existing teaching strategy, it can prove to be a game changer.