Journal of Advances in Medicine and Medical Research

Blood Pressure Control and its Barriers among Adult Rural Dwellers Living with Hypertension in Ido-Osi Communities of Ekiti State, Southwest Nigeria

Thu, 05 Mar 2026 00:00:00 +0000

Adequate control of blood pressure (BP) remains a significant way to reduce the morbidity and mortality associated with hypertension. Barriers such as distance to facilities, affordability of healthcare services, and cultural beliefs have been shown to negatively impact rural populations' management of hypertension. Despite various health interventions in Nigeria, rural communities continue to experience an increasing rate of BP control. The study determined the prevalence of blood pressure control and its barriers among adult rural dwellers living with hypertension in Ido-Osi Communities of Ekiti State, Southwest Nigeria. A multistage sampling technique was employed to recruit 180 patients with hypertension in two rural communities of Ekiti State, Southwest Nigeria. Socio-demographic data and barriers to blood pressure control were collected using a structured questionnaire adapted from the WHO STEP-WISE approach to non-communicable disease surveillance. Blood pressure and body mass index were measured and recorded. Data were analysed using STATA version 16. Multivariate logistic regression analysis using the odds ratio at 95% confidence interval was used to identify factors contributing to blood pressure control. The mean age of respondents was 55.2 ± 9.5 years, with ages ranging from 36 to 74 years. The prevalence of blood pressure control was 40%. The associations between socio-demographic characteristics and blood pressure control in this study revealed that lower age (p<0.001), higher occupation (p<0.001), higher educational status (p<0.001) and higher income level (p<0.001) were statistically significantly associated with blood pressure control. Affordability of antihypertensive medication (p<0.001), the choice of healthcare providers (p=0.012) and awareness of normal blood pressure levels (p<0.001) were significantly associated with blood pressure control. Hypertensive patients who were of younger age group (AOR = 12.143, 95%CI: 2.178-28.636), could afford antihypertensive medications (AOR =8.573, 95% CI: 1.404-25.948) physically active (AOR =2.016, 95%CI: 1.007-3.699), consumed fruits/vegetables (AOR=2.646, 95% CI: 1.099-4.232), normal BMI (AOR=6.903, 95% CI: 2.013-17.614) and aware of normal blood pressure (AOR=4.556, 95%CI:1.035-8.665) were the determinants of blood pressure control. In contrast, the barriers to blood pressure control included hypertensive patients who were unemployed, (AOR=0.315, 95%CI: 0.001-0.843), no formal education (AOR=0.042, 95% CI: 0.034-0.763), low income (AOR=0.010, 95% CI: 0.001-0.239), and adding salt to the meal (AOR=0.084, 95%CI: 0.004-0.614). The findings would assist the stakeholders in recommending culturally-appropriate targeted interventions to improve the rate of blood pressure control in rural southwest Nigeria.

The Added Value of 18F-FDG PET/CT in Suspected Infective Endocarditis: A Retrospective Analysis of 21 Cases

O. Ait Sahel, M. Aboussaber, I. Zahfir, S. N. Oueriagli, Y. Benameur, A. Doudouh — Sat, 07 Mar 2026 00:00:00 +0000

Background: The diagnosis of infective endocarditis (IE) remains complex, and the modified Duke criteria have limitations, particularly in patients with prosthetic valves or cardiac devices. This study evaluates the diagnostic contribution and clinical impact of 18F-FDG PET/CT in patients with suspected IE and inconclusive initial evaluations.

Materials and Methods: We conducted a retrospective analysis of 21 18F-FDG PET/CT scans performed for suspected IE between January 2020 and December 2025 in 18 patients initially classified as Duke ± (possible) or Duke − (rejected). The final diagnosis of IE was established by multidisciplinary consensus during follow-up (minimum 3 months). PET/CT image analysis focused on the cardiac area and systematically searched for distant septic foci. Semi-quantitative parameters (SUVmax, target-to-background ratios) were recorded. Diagnostic performance was calculated with 95% confidence intervals, and clinical impact (reclassification rate and management changes) was quantified.

Results: Of the 21 scans, 15 were performed in patients with prosthetic cardiac material. PET/CT was positive in 9 of these 15 patients (60%), demonstrating periprosthetic valvular hypermetabolism in 6 patients and device-related hypermetabolism in 3 patients. Extracardiac infectious foci were identified in 6 patients (40%). One false-negative result occurred in a patient on prolonged antibiotic therapy for fungal endocarditis. In the 6 patients with suspected native valve IE, all PET/CT scans were negative, and IE was subsequently excluded. Diagnostic performance in the prosthetic material group showed: sensitivity 90% (95% CI: 54.1–99.5%), specificity 100% (95% CI: 46.3–100%), PPV 100% (95% CI: 62.9–100%), NPV 83.3% (95% CI: 36.5–99.1%). PET/CT reclassified 8 of 16 patients (50%) from "possible" to "definite" IE and influenced clinical management in 12 of 21 scans (57.1%), including treatment intensification, detection of extracardiac foci requiring intervention, avoidance of unnecessary procedures, and surgical planning guidance.

Conclusion: 18F-FDG PET/CT provides significant diagnostic value in suspected IE involving prosthetic valves or cardiac devices, with high sensitivity and specificity when echocardiography is inconclusive. The examination not only aids in confirming cardiac infection but also provides crucial whole-body assessment by detecting peripheral septic emboli and extracardiac foci. With a 50% reclassification rate and 57% impact on management, PET/CT should be performed early in the diagnostic pathway for appropriately selected patients according to 2023 ESC guidelines.

The Prevalence of Anaemia and Its Associated Risk Factors in Adult Saudis with Type 2 Diabetes Mellitus

Imad R Musa — Tue, 10 Mar 2026 00:00:00 +0000

Background: Type 2 diabetes mellitus (T2DM) is a growing health challenge worldwide and is associated with significant complications. Anaemia is another chronic medical condition that is associated with T2DM and adds to the complications associated with it. We conducted this study to evaluate the prevalence and the associated predictors of anaemia within a group of adult patients with T2DM at the Royal Commission Hospital (RCH) in the Kingdom of Saudi Arabia (KSA).

Methods: A retrospective study was conducted between 1 January 2024 and 31 December 2024, during which time the participants had regular follow-up visits at the RCH. All data required for the study were obtained from their electronic medical records at the RCH.

Results: A total of 4,311 patients diagnosed with T2DM were recruited for this study. The median (interquartile range (IQR)) age was 57.00 (17.0) years, and 2,186 (50.7%) of the participants were males. The median (IQR) value for the body mass index was 30.33 (7.91) kg/m² and 7.11% (1.64) for haemoglobin A1c (HbA1c). Anaemia was relatively high among this group of participants (22.1%), specifically among females (66.00% females vs. 34.00% males). In the multivariate analysis, we found significant associations between anaemia in adult patients with T2DM and age, “adjusted odds ratios” (AOR) of 1.003 (95% confidence interval (CI): 1.001–1.012), gender AOR of 2.443 (95% CI: 2.086‒2.861), obesity AOR of 0.735 (95% CI: 0.595‒0.908), overweight AOR of 0.725 (0.570‒0.921), diagnosis of hyperlipidaemia of AOR 0.792 (95% CI: 0.676 ‒ 0.929), diagnosis of hypertension AOR of 1.252 (95% CI: 1.052 ‒1.491) and lower diastolic blood pressure AOR, 0.988(95% CI:0.975‒0.988).

Conclusion: A higher prevalence of anaemia was reported in patients with T2DM, particularly among females. Older age, female gender, overweight and obesity, history of hypertension, history of hyperlipidaemia and lower diastolic blood pressure were significant predictors of anaemia in this group of patients.

Influence of Shade Tab Placement Position and Professional Background on Tooth Shade Selection Accuracy

Abiodun Olabisi Arigbede, Ayamma Udo Umanah — Fri, 13 Mar 2026 00:00:00 +0000

Aims: to assess the influence of shade tabs placement position on accuracy of tooth shade determination and to compare the shade selection ability of dental students, dental surgery technicians (DSTs), registrars and senior registrars (SRs).

Study Design: Cross-sectional

Place and Duration of Study: Department of Restorative Dentistry, University of Port Harcourt Teaching Hospital, between December 2005 and January 2026

Methodology: Six participants each from among: dental students, DSTs, registrars and SRs were requested to match shade A1, B2 and C2 in a bench setting using vita Classical. They were divided into two groups, A & B. In group A, the shade tab being matched is placed by the side of the reference shade tab on the shade guide while in group B the shade tab is placed parallel and close to the edge of the chosen shade tab. The percentage of correct response for each shade and the median for each group were obtained. The median (IQR) was compared between the two groups (Mann-Whitney t-test). P was set at 0.05.

Results: Two students in group A and none in group B correctly identified shade A1. One student in group A identified each of B2 and C2. Two DSTs (66.67%) in group A and 1 in group B, identified shade A1. One DST in group A identified shade B2. Two registrars in group B identified shade A1 and two in group A identified B2. In group B, all the SRs identified shade A1 and one identified shade B2. In group A, 1 identified C2 correctly. There was no statistically significant difference in the median percent score of correct response between the groups (P=0.378).

Conclusion: Shade tab placement position did not make a statistically significant impact on the final results. The students and SRs performed better in group A and B respectively.

Prevalence of Submicroscopic Plasmodium Falciparum Infection Across Age Groups and Gender at a General Hospital in a Fast-developing Town in South-South Nigeria

Fri, 13 Mar 2026 00:00:00 +0000

Submicroscopic Plasmodium falciparum infections pose significant challenges in malaria elimination efforts, particularly in endemic regions. This research aimed to investigate the prevalence of submicroscopic Plasmodium falciparum infection among patients at General Hospital Ikot Ekpene, Akwa Ibom State, Nigeria. The study included male and female participants aged 1 to 60 years, excluding pregnant women and individuals who had taken Artemisinin-based Combination Therapies (ACTs) or herbal treatment within the preceding two weeks. Malaria diagnosis was carried out using Malaria Rapid Diagnostic Test (mRDT), Microscopy and Real-time Polymerase Chain Reaction (qPCR). Submicroscopic malaria cases were determined by Real-time Polymerase Chain Reaction (qPCR), owing to its higher sensitivity. Out of 382 samples analyzed, a total of 132 true positive cases of Plasmodium falciparum infections were detected, among whom were 28 (7.3%,) cases of submicroscopic infections. The prevalence of Submicroscopic Plasmodium falciparum infection in the study population as detected by qPCR was 7.3%, and common across all ages represented in the following order:1-10years had a prevalence of 5.9%, 11-20years had 8.2%, 21-30years had 7.4%, 31-40years had 7.9%, 41-50years had 14.0%), while 51-60years had 2.8%, respectively. Regarding the prevalence of submicroscopic Plasmodium falciparum infection and gender detected by qPCR, females recorded 7.5% while males had 7.2%. The study revealed significant burden of submicroscopic Plasmodium falciparum infections across age groups in the study area with no bias to gender, which is crucial for guiding malaria control strategies and interventions.

Sexual Risk Behaviours amongst Unemployed Youth in Botswana

O. Kotlhao, K. Maripe — Mon, 16 Mar 2026 00:00:00 +0000

Sexual risk behaviours among youth in Botswana continue to pose a significant public health challenge, contributing to high rates of sexually transmitted infections (STIs), and unplanned pregnancies (Sinkamba & Moseki-Lowani, 2016). This study investigated how youth unemployment complicates engagement in risky sexual practices. A systematic desk review methodology was adopted, following PRISMA guidelines to ensure rigor and transparency. The findings demonstrate that at the individual level, unemployment constraints young people’s ability to engage in safe sexual decisions, while at the interpersonal level, dependency on financially supportive partners reduces negotiation power for safer sex.

Conservative Marsupialization of a Large Mandibular Odontogenic Keratocyst with CBCT Follow-Up: A Case Report

Wed, 18 Mar 2026 00:00:00 +0000

Background: Odontogenic keratocyst (OKC) is a developmental odontogenic cyst characterized by aggressive biological behaviour and a relatively high recurrence rate. Management of large lesions in young patients is challenging because radical surgical approaches may compromise mandibular integrity and functional outcomes. Conservative treatment strategies such as marsupialization have gained increasing attention for their ability to reduce intracystic pressure, promote gradual lesion shrinkage, and stimulate bone regeneration while preserving surrounding structures.

Case Presentation: A 19-year-old female patient presented with a bony hard swelling in the left mandibular region that had progressively increased in size over one year. Cone beam computed tomography (CBCT) revealed a well-defined radiolucent lesion measuring approximately 51.7 × 22.2 mm involving teeth 34, 35, and 36. Management included extraction of the involved teeth, creation of a bony window through the alveolar crest, and marsupialization of the cystic cavity. Straw-coloured fluid was aspirated intraoperatively, and a custom acrylic obturator was placed after 15 days to maintain patency of the surgical window. Weekly follow-up visits included irrigation and replacement of chlorhexidine-impregnated packing. After one year, CBCT imaging demonstrated a reduction in lesion size to 38.5 × 13.6 mm, with radiographic evidence of progressive bone regeneration. Histopathological examination confirmed the diagnosis of odontogenic keratocyst, showing a parakeratinized epithelial lining with palisaded basal cells and satellite cysts.

Conclusion: Marsupialization proved to be an effective conservative approach for managing a large mandibular odontogenic keratocyst while preserving mandibular integrity. The technique facilitated progressive lesion shrinkage and bone regeneration, preparing the site for definitive surgical management. Continued long-term clinical and radiographic follow-up is essential due to the recurrence potential of OKC.

Phenotypic Assessment of Bacterial and Fungal Colonization on Mobile Phone Earpieces of University Students in Port Harcourt, Nigeria

Giami Lynda Kadi, Ollor Amba Ollor — Fri, 20 Mar 2026 00:00:00 +0000

Background: Mobile phones are high-contact personal devices that may serve as reservoirs for pathogenic microorganisms. Accessories such as earpieces maintain prolonged contact with the ear canal and may facilitate microbial transmission.

Aim: This study investigated bacterial and fungal colonization of mobile phone earpieces used by university students and evaluated the antimicrobial susceptibility profiles of recovered bacterial isolates.

Methods: A cross-sectional descriptive study was conducted on twenty (n = 20) mobile phone earpieces collected from students at Rivers State University, Port Harcourt, Nigeria. Swab samples were cultured on selective bacteriological and mycological media. Isolates were identified using standard microbiological techniques. Antimicrobial susceptibility testing was performed using the Kirby–Bauer disk diffusion method following CLSI (2023) guidelines. A total of thirty-six (n = 36) bacterial isolates were recovered and tested.

Results: All earpieces (20/20; 100%) yielded microbial growth. Bacterial isolates included Staphylococcus aureus (15/20; 75%), Staphylococcus epidermidis (12/20; 60%), Escherichia coli (5/20; 25%), and Pseudomonas aeruginosa (4/20; 20%). Fungal isolates included Candida spp. (8/20; 40%) and Aspergillus spp. (5/20; 25%). Reduced susceptibility was highest against amoxicillin (13/36; 36.1%), erythromycin (11/31; 35.5%), and tetracycline (12/36; 33.3%). Multidrug resistance (MDR), defined as resistance to at least one agent in three or more antimicrobial classes, was observed in S. aureus (4/15; 26.7%) and P. aeruginosa (2/4; 50%). Ciprofloxacin (5 µg) demonstrated the highest sensitivity rates (30/36; 83.3%).

Conclusion: Mobile phone earpieces serve as reservoirs for potentially pathogenic and multidrug-resistant microorganisms. Regular disinfection and improved hygiene practices are recommended to reduce microbial transmission risks.

Pattern, Correlation and Outcome of Gastroenterological Care between Primary and Tertiary Care Setting of a Teaching Hospital

Sat, 21 Mar 2026 00:00:00 +0000

Background: Studies have compared care by generalists and specialists for variety of disorders; there is limited work done on gastroenterological disorders especially in our environment hence the study aimed to observe the pattern, the correlation and outcome of gastroenterological care between primary and tertiary care setting of a teaching hospital.

Methods: This study was a retrospective cross-sectional study that evaluated the records of patients referred from the Primary Care (general outpatient clinic) to the Tertiary Care (gastroenterology clinic) of a Teaching Hospital.

Results: The pattern of diagnosis observed among gastroenterological cases referred showed the most common indication for referral from primary care to tertiary care was chronic hepatitis B, 53.8% followed by Peptic Ulcer Disease (PUD), and Primary Liver Cell Carcinoma (PLCC), 14.2% and 4.7% respectively. This is comparable to that observed at the tertiary care with Chronic Hepatitis B being 51.0% followed by Acid Peptic Disorders and Chronic Gastritis, 6.7% each and followed closely by PLCC,4.7%.

The correlation of diagnosis at primary and tertiary care level was observed to have fair agreement, k = 0.35, p < 0.001. The study observed varying levels of agreement in investigations ordered that ranged from none-agreement to poor, and fair agreements.

Outcome of tertiary care gastroenterological consultations showed that majority, 78.3%, were lost to follow-up upon further investigative requests.

Conclusion: There was a fair correlation in the diagnosis made among gastroenterological cases referred at both primary and tertiary settings. Investigation requests showed some none, some poor and some fair agreements depending on the type of investigation requests. Majority of gastroenterological cases seen at tertiary care were lost to follow-up upon further investigative requests. Further studies are recommended to explore the high level of “loss to follow up” observed in this study.

White Matter Specifications in Different Secondary Vasculitic Lesions

Mon, 23 Mar 2026 00:00:00 +0000

Background: Vasculitis is characterized by vessel wall inflammation leading to a beaded appearance of the arteries with variable degrees of stenosis and ectasia.

Aim: The aim of this work was to clarify a systemic approach to differentiate some secondary vasculitic diseases through their white matter distribution and morphology.

Methods: This cross-sectional prospective study was carried out on 30 systemic vasculitis patients aged 18 years or more, of both sexes. All patients underwent detailed history taking, complete general and neurological examination, laboratory workup, rheumatoid factor when indicated, serological tests for vasculitis [antinuclear, anti–double stranded DNA, anti-Ro, anti–cyclic citrullinated peptide, anticardiolipin, anti-neutrophil cytoplasmic, and lupus anticoagulant antibodies], brain imaging [Magnetic resonance imaging (MRI) of the brain, with magnetic resonance venography and magnetic resonance angiography].

Results: Total WMH volume showed a moderate negative correlation with disease duration (r = -0.398, P = 0.029), indicating that longer disease duration was associated with slightly lower total WMH burden. Similarly, deep WMH volume was negatively correlated with disease duration (r = -0.393, P = 0.032), and periventricular confluent WMH volume demonstrated the strongest negative correlation (r = -0.480, P = 0.007).

Conclusions: MRI findings alone may not be specific enough to distinguish different secondary vasculitic lesions, and further clinical correlation and investigations are often required.

Prevalence of Dysmenorrhea and Its Association with Body Mass Index among Female College Students in Sulaymaniyah: A Cross-Sectional Survey Study

Wed, 25 Mar 2026 00:00:00 +0000

Background: Dysmenorrhea is a periodic, cramping pain sensation, typically experienced in the lower abdomen before or during menstruation. It is among the most common gynecologic issues affecting female students. It is a frequent cause of college absence in this age group and can negatively affect academic performance. In addition, overweight and obesity are common health concerns among females.

Objectives: The purpose of this study was to investigate the relationship between body mass index (BMI) and dysmenorrhea. Although previous studies suggest a possible association, the evidence remains inconclusive due to existing gaps in knowledge. Therefore, this study aims to determine the prevalence and severity of dysmenorrhea among female college students in Sulaymaniyah across different BMI categories and to evaluate the association between BMI, dysmenorrhea intensity, and related risk factors.

Methodology: A cross-sectional study was conducted from January 2024 to March 2024 among female college students aged 18–24 years (n = 362) from eight universities in Sulaymaniyah. Participants were assessed using a self-administered questionnaire to determine BMI, dysmenorrhea prevalence, intensity, and associated risk factors, with pain severity evaluated using the Visual Analog Scale (VAS). BMI levels and associated risk factors were compared according to the dysmenorrhea presence and severity.

Results: The overall prevalence of dysmenorrhea among participants was 91.2%. Regarding pain severity, 14.7% reported mild pain, 41.4% reported moderate pain, and 35.1% reported severe pain, while 8.8% reported no dysmenorrhea. The mean BMI demonstrated a decreasing trend with increasing pain severity. Participants with severe dysmenorrhea had the lowest mean BMI (22.57 ± 4.05 kg/m²; n = 150), followed by those with moderate dysmenorrhea (22.95 ± 3.78 kg/m²; n = 177) and mild dysmenorrhea (23.21 ± 3.76 kg/m²; n = 24). In contrast, participants without dysmenorrhea had the highest mean BMI (24.08 ± 3.89 kg/m²; n = 11). Statistical analysis revealed no significant association between BMI and the presence or severity of dysmenorrhea. However, significant associations were identified between dysmenorrhea (and its severity) and menstrual irregularity, heaviness of menstrual blood loss, and positive family history (p < 0.05).

Conclusion: Dysmenorrhea is highly prevalent among female college students in Sulaymaniyah, with greater severity observed in individuals with menstrual irregularities, heavy bleeding, or a positive family history. Body mass index (BMI) was not significantly associated with dysmenorrhea, suggesting that it may not be a major contributing factor. These findings highlight the importance of routine screening and targeted reproductive health education, and further research is needed to investigate other biological, genetic, and lifestyle contributors to menstrual pain.

Internet Addiction and Excessive Daytime Sleepiness among Adolescents Attending Secondary Schools in Rivers State, Nigeria

Nneka Gabriel-Job, Josephine. I. Onumaku — Sat, 28 Mar 2026 00:00:00 +0000

Background/Aim: Internet addiction is an emerging social problem which has been linked with psychosocial dysfunctions. Adolescents are more vulnerable with high rise of internet use globally. Excessive daytime sleepiness (EDS) is a common sleep disorder found in adolescents with associated social behavioural problems. The aim of this study was to determine the level of internet addiction and the effect it has on adolescent daytime sleepiness in Rivers State, Nigeria.

Materials and Methods: This was a cross-sectional study, conducted in January 2026 among adolescents. The internet addiction test, Paediatric Daytime Sleepiness Scale (PDSS) and a self-administered questionnaire were used to obtain data. The dependent variable was internet addiction rate while independent variable was excessive daytime sleepiness and sociodemographic and economic characteristics of participants. Inferential statistics was carried out with a p value of < 0.05 considered significant.

Results: A total of 600 adolescents aged 10-19 years participated in the study. Females were 334 (55.7%). One hundred and sixty-seven (27.8%) students were addicted to the internet. There was a sex difference in internet addiction (p=0.0001) with more males (32.3%) compared to females (23.5%) reporting internet addiction. The prevalence of EDS was 40.2% and was higher among females (n=145, 43.4%) than males (n= 96, 36.1%) p= 0.04. Those with internet addiction were 8 times more likely to have EDS compared to those without internet addiction. (p= 0.0001, OR; 8.50, CI; 5.62-12.83). There was also a significant positive correlation between internet addiction and EDS, as the Internet Addiction Test (IAT) scores increased, the PDSS scores also increased (Spearman Rho=0.184; p=0.0001).

Conclusion: The finding of this study highlights the negative impact of Internet addiction among adolescents. To address this issue, interventions that will enhance sleep hygiene as well as a greater offline participation with their peers both at school and at home is needed.

Modeling Agrochemical Contamination in Drinking Water and Chronic Disease Risk in U.S. Farmers

Mon, 09 Mar 2026 00:00:00 +0000

Agrochemical contamination of drinking water represents an underrecognized environmental health risk in agricultural communities, particularly among farmers who rely on private wells for long-term water consumption. Intensive use of pesticides, herbicides, and nitrogen-based fertilizers can lead to groundwater and surface water contamination through leaching, runoff, and subsurface transport, resulting in chronic low-level exposure. Existing monitoring and biomonitoring approaches are often insufficient to capture cumulative and historical exposure relevant to chronic disease development. This review synthesizes current modeling approaches used to estimate agrochemical contamination in drinking water and examines how these modeled exposures have been linked to chronic disease risk among farmers. Environmental fate and transport models, spatial and temporal exposure models, and emerging mixture-based frameworks are reviewed to illustrate how long-term drinking water exposure is reconstructed and applied in epidemiologic research. Evidence linking modeled exposure to cancer, neurologic, endocrine, metabolic, and renal outcomes is summarized, with attention to exposure duration, latency, and population-specific vulnerabilities. Overall, the literature indicates that drinking water is a critical and continuous exposure pathway contributing to chronic disease risk in farming populations, particularly where regulatory oversight of private wells is limited. Future research should prioritize integrated modeling–biomonitoring frameworks, improved mixture assessment, and the use of conceptual diagrams to clarify exposure mechanisms. Strengthening these approaches will support more effective surveillance, risk assessment, and preventive strategies aimed at protecting farmer health and reducing long-term disease burden.

Integrative Exposome Modeling of Agrochemical Risks in U.S. Farmers

Alex Nnanyelugo Egbuchiem, Felix Donkor, Gifty Dudzilah, Saerimam Nzunde Markus — Sat, 14 Mar 2026 00:00:00 +0000

Farmers in the United States experience sustained exposure to agrochemicals through occupational, environmental, residential, and dietary pathways. These exposures are typically low dose, cumulative, and heterogeneous, yet traditional risk assessment approaches continue to emphasize single chemicals and short-term exposure windows. Such paradigms are poorly suited to capture the complex, mixture-based exposure environments encountered in agriculture or to explain observed patterns of chronic disease, including cancer, neurodegenerative disorders, and cardiometabolic conditions, among farming populations. This review synthesizes current evidence on agrochemical-related chronic disease risk through the lens of the exposome, a framework that encompasses the totality of environmental exposures across the life course and their internal biological correlates. We examine major classes of agrochemicals used in U.S. farming systems, dominant exposure pathways, and disease outcomes characterized by long latency and multi-morbidity. Particular attention is given to integrative modeling approaches that combine spatial exposure estimation, biomonitoring, and mixture-aware statistical or computational methods to reconstruct cumulative exposure and internal dose. Our synthesis highlights that, while these integrative methods offer substantial promise for capturing real-world agricultural exposure complexity, their broader application remains constrained by persistent methodological challenges, including exposure misclassification, temporal mismatches between biomarkers and disease onset, confounding by co-exposures, and fragmented environmental and health data systems. Addressing these barriers is essential for translating exposome science into actionable public health evidence. By bridging environmental contamination with chronic disease risk through integrative exposome modeling, this review underscores the need to move beyond single-agent frameworks toward cumulative, life-course–informed risk assessment. Embedding these approaches into regulatory science and surveillance systems is critical for identifying exposure mixtures driving multi-morbidity patterns and for developing more equitable, preventive strategies to protect vulnerable agricultural communities.

A Comprehensive Review of Ligaplants: Biological Revolution in Dental Implantology

Tue, 17 Mar 2026 00:00:00 +0000

Conventional endosseous dental implants rely on osseointegration to achieve anchorage. Although clinically successful, they inherently lack a functional periodontal ligament (PDL), which in natural dentition provides shock absorption, proprioception, adaptive mobility and a dynamic soft‐tissue and bone interface. The concept of a “ligaplant,” defined as a tissue‐engineered implant incorporating PDL stem or progenitor cells (or PDL‐like scaffolds) around a biomaterial fixture, offers a promising biomimetic alternative. This review presents the biological rationale for PDL integration, surveys current methodologies for ligaplant fabrication, summarises pre-clinical and emerging clinical evidence, discusses advantages and barriers, and outlines future translational pathways. While animal and in-vitro studies demonstrate formation of PDL‐like fibres, cementum‐like tissue and mechanical behaviour closer to natural teeth, the technique remains largely experimental with limited human data. Rigorous translational research, standardisation of cell‐scaffold constructs, and long-term clinical trials are required to validate ligaplants as a clinically viable alternative to conventional implants.

Drug Dissolution Studies in Pharmaceutical Formulations: Mechanisms, Influencing Factors, and Regulatory Perspectives

Dickson Pius Wande — Wed, 18 Mar 2026 00:00:00 +0000

Assessing dissolution is essential for many pharmaceuticals that lack suitable solution forms. Drug dissolution testing plays a central role in pharmaceutical development, quality control, and regulatory evaluation of oral dosage forms. This review provides a comprehensive overview of the theoretical foundations, mechanistic principles, and practical considerations governing drug dissolution in pharmaceutical formulations. Fundamental mathematical models describing dissolution kinetics are discussed, including the diffusion-layer–based Noyes–Whitney equation, the Hixson–Crowell cube-root law, Dankert’s surface-renewal model, and the Takeru Higuchi model for matrix-based systems. These models provide critical insights into diffusion-controlled, interfacial, and matrix-mediated drug-release mechanisms.

Key physicochemical factors influencing dissolution—such as solubility, particle size, salt formation, polymorphism, and solid-state characteristics—are examined alongside formulation variables, processing parameters, and dissolution test conditions, including agitation, temperature, medium composition, and surfactant effects. The review addresses both immediate-release and modified-release dosage forms, highlighting differences in release mechanisms and the specific challenges associated with poorly soluble compounds, particularly those classified under the Biopharmaceutics Classification System.

Furthermore, the importance of establishing in vitro–in vivo correlation (IVIVC) is discussed. IVIVC models serve as predictive tools linking in vitro dissolution data to in vivo performance and support regulatory applications such as bioequivalence assessment, biowaivers, post-approval changes, and Quality by Design (QbD) strategies.

Overall, dissolution testing remains an indispensable tool in pharmaceutical sciences, bridging formulation development, mechanistic understanding, and regulatory decision-making to ensure the safety, efficacy, and quality of drug products.

Hospitalizations Due to Systemic Arterial Hypertension among Older Adults in Pará, Brazil: A Descriptive Study, 2020–2024

Sat, 14 Mar 2026 00:00:00 +0000

Objective: To analyze hospitalizations due to hypertension in elderly individuals in the State of Pará, Brazil, from 2020 to 2024.

Methods: This is an epidemiological, quantitative study using secondary data obtained from the Hospital Information System of the Unified Health System (SIH/SUS), available on DATASUS. Data referring to hospitalizations of elderly individuals with systemic arterial hypertension between 2020 and 2024 were analyzed.

Results: A total of 14,722 hospitalizations were recorded during the study period. The highest number of cases occurred in 2024 (3,644), followed by 2022 (3,045). The municipality of Belém presented the highest number of hospitalizations (1,574), followed by Santo Antônio do Tauá (1,044). Females accounted for the majority of cases (8,377), and the most affected age group was 60–69 years. The highest frequency was observed among individuals classified as brown (pardo).

Conclusion: Systemic arterial hypertension in the elderly represents a significant public health problem in the State of Pará. The findings highlight the need for strengthening prevention strategies and improving healthcare actions to reduce hospitalizations and improve the quality of life of this population.

Diagnostic Significance of Oral Signs in Gastrointestinal Syndromes: A Review of Clinicopathological Relationships

Fri, 06 Mar 2026 00:00:00 +0000

The oral cavity is anatomically contiguous with the gastrointestinal tract and biologically integrated with it through shared mucosal immunity, microbial exchange, and systemic inflammatory networks. For many gastrointestinal syndromes, oral findings are not merely coincidental comorbidities but may precede intestinal symptoms, mirror disease activity, or reflect complications such as malabsorption, anaemia, immune dysregulation, and medication effects. This review synthesises evidence on how oral lesions and dental changes can function as practical diagnostic gateways to major gastrointestinal conditions, emphasising inflammatory bowel disease, coeliac disease, reflux-related disorders, Helicobacter pylori–associated syndromes, chronic liver disease, and hereditary polyposis syndromes. Mechanistic pathways are discussed, including oral–gut microbial translocation, cytokine-driven mucosal injury, and acid–exposure–mediated hard-tissue damage. Clinical implications are highlighted for dentists, oral physicians, gastroenterologists, and primary-care clinicians, focusing on recognition of red-flag oral patterns that should trigger targeted gastrointestinal evaluation. The review also appraises limitations in the current literature, including heterogeneity of diagnostic criteria for oral lesions, confounding by oral hygiene and smoking, and the challenge of distinguishing disease-specific lesions from nutritional or drug-related changes.

Microscope Assisted Management of Symptomatic Internal Root Resorption in a Mandibular Premolar: 1 Year Outcome

Hazal Faiz Arslanparçası, Mehmet Ali Arslanparçası — Tue, 10 Mar 2026 00:00:00 +0000

Although rare, internal resorption is a pathology that can severely compromise the structural integrity of a tooth if not diagnosed and treated early. In this case report, symptomatic internal resorption detected in the mandibular right second premolar (#45) of an 18-year-old patient was managed with operating microscope-assisted endodontic treatment performed under high magnification. Following clinical and radiographic evaluation, thorough canal disinfection was performed under the operating microscope. The resorptive defect was carefully filled with mineral trioxide aggregate (MTA) using the micro-apical placement (MAP) system. Root canal obturation was completed with a thermoplastic gutta-percha technique. Post-treatment, the patient’s symptoms completely resolved, and 12-month follow-up radiographs revealed no pathological findings in the periapical tissues. This case demonstrates that endodontic treatment performed under an operating microscope, using MTA placed with the MAP system and thermoplastic obturation techniques, can achieve successful clinical and radiographic outcomes in cases of symptomatic internal resorption.

Radicular Cyst Associated with Maxillary Anterior Teeth: A Case Report and Literature Review on Combined Surgical Enucleation and Endodontic Management with One-Year Follow-Up

Thu, 19 Mar 2026 00:00:00 +0000

Background: Radicular cysts are the most common inflammatory odontogenic cysts arising from epithelial rests of Malassez secondary to pulpal necrosis and chronic periapical inflammation. They are frequently associated with non-vital teeth in the anterior maxillary region and may lead to progressive bone destruction if not managed appropriately.

Objective: The present study reports a multidisciplinary management approach for a large periapical lesion in the anterior maxilla using surgical enucleation followed by endodontic therapy and prosthetic rehabilitation, along with one-year clinical and radiographic follow-up.

Case Presentation: A 28-year-old female patient presented with mild swelling and pain in the anterior maxillary region with a history of trauma three months earlier. Clinical examination and radiographic evaluation revealed a well-defined unilocular radiolucent lesion measuring approximately 2.5 × 3 cm involving teeth 21, 22, and 23. All involved teeth were non-vital with expansion of the labial cortical plate. Surgical enucleation of the lesion was performed under local anaesthesia, followed by curettage of the surrounding bone. The excised tissue was submitted for histopathological examination.

Results: Histopathological analysis revealed fibrocellular connective tissue with chronic inflammatory infiltrate and cholesterol clefts, consistent with a periapical granuloma rather than a true radicular cyst. Postoperative healing was uneventful, and radiographic evaluation at six months demonstrated significant bone regeneration. Endodontic therapy was subsequently completed for teeth 21, 22, and 23, followed by prosthetic rehabilitation using zirconia crowns.

Conclusion: This case highlights the importance of a multidisciplinary approach combining surgical management, histopathological diagnosis, endodontic therapy, and prosthetic rehabilitation in the successful treatment of large periapical lesions. Long-term follow-up confirmed complete osseous healing and functional rehabilitation, emphasizing the importance of integrated treatment strategies in managing periapical pathology.

Radial Forearm Free Flap for Microvascular Reconstruction of Post-COVID Mucormycosis Maxillary Defect: A Case Report

Sat, 28 Mar 2026 00:00:00 +0000

Post-COVID mucormycosis has resulted in a significant increase in patients presenting with complex maxillary defects, necessitating exploration of effective reconstructive and rehabilitation strategies. This case report describes the microvascular reconstruction of an oroantral defect in a 52-year-old male following subtotal maxillectomy for rhino-maxillary mucormycosis. The patient initially underwent reconstruction using a patient-specific implant (PSI) to restore skeletal continuity; however, functional deficits persisted due to soft tissue deficiency. The defect measured approximately 8 × 4 cm and was subsequently reconstructed using a radial forearm free flap.

The surgical procedure involved flap harvesting with a long vascular pedicle, followed by microvascular anastomosis to the facial vessels and precise intraoral inset to re-establish palatal integrity. Postoperative recovery was uneventful, with no evidence of flap compromise. At the three-month follow-up, the patient demonstrated complete resolution of nasal regurgitation, significant improvement in speech articulation, and restoration of mastication.

This case highlights the limitations of PSI in addressing soft tissue defects and underscores the importance of microvascular reconstruction in achieving functional rehabilitation. Alternative rehabilitation options, including obturator prostheses, implant-supported prostheses, and regional flaps, should be considered based on defect size and patient factors. The radial forearm free flap remains a reliable and versatile option for restoring oral function and improving quality of life in patients with post-mucormycosis maxillary defects.