An Overview of Disease and Health Research Vol. 12

In-vivo Hematotoxic Effects of Copper Oxide Nanoparticles and the Protective Role of Giloy

2026-05-16T08:21:09+00:00

Copper oxide nanoparticles (CuONPs) are widely applied in various modern technological, medical, and cosmetic industries due to their excellent optical and electrical properties, along with antimicrobial and antioxidant abilities. In line with the growing industrial applications of copper oxide nanoparticles (CuONPs) in various fields, concerns about their potentially harmful consequences on the environment and public health are increasing. Giloy is considered an alternative medicine to treat various ailments. It is deemed beneficial for promoting liver health and potentially impacting heart health. This study aimed to evaluate the hematotoxicity of CuONPs and the alleviating effect of giloy in adult rats. In this experiment, 28 laboratory rats were used, set to four groups (7/group), as follows: control group without any dose; CuONPs group administered copper oxide nanoparticles at 300 mg/kg/day; CuONPs + giloy group dosed with CuONPs at 300 mg/kg/day plus giloy at 100 mg/kg/day; giloy group treated only with giloy at 100 mg/kg/day. All treatments were given by gastric gavage and continued for 28 uninterrupted days. Dosing laboratory rats with CuONPs led to significant negative changes in the examined blood profile, with a marked decrease (P<0.05) in red blood cell count (RBC), hemoglobin (HB), hematocrit (HTC), mean corpuscular volume (MCV), and platelets (PLT), along with an increase in white blood cell count (WBC), compared to the control group. In contrast, when the rats were co-administered with giloy, restoring the disturbed blood levels was observed. Copper oxide nanoparticles at a high dose had notable hematotoxicity in laboratory rats and, supplemented with giloy, could reduce this haematological toxicity. Further research is needed to assess its protective effects on other tissues and organs.

Microsomal Epoxide Hydrolase (EPHX1) in Lung Carcinogenesis: A Narrative Review

2026-05-16T08:23:43+00:00

Microsomal epoxide hydrolase (mEH), encoded by the EPHX1 gene, represents a critical enzyme in xenobiotic metabolism, functioning at the interface between detoxification and metabolic activation of environmental carcinogens. In addition to its role in metabolising environmental xenobiotics, mEH regulates endogenous epoxide-containing compounds involved in various physiological processes. This review aims to discuss the role of microsomal epoxide hydrolase in lung cancer. mEH plays a pivotal role in the pulmonary metabolism of carcinogenic compounds derived from tobacco smoke and environmental pollutants. By converting reactive epoxide intermediates into more stable dihydrodiols, the enzyme contributes to cellular protection; however, it may also facilitate the formation of highly reactive dihydrodiol-epoxides, thereby promoting carcinogenesis. Thus, mEH activity reflects a complex balance between detoxification and bioactivation pathways. Accumulating epidemiological and molecular evidence indicates that genetic polymorphisms within the EPHX1 gene significantly influence individual susceptibility to lung cancer. Functional variants such as Tyr113His and His139Arg alter enzyme activity and affect the metabolic processing of carcinogenic compounds. The relationship between EPHX1 polymorphisms and lung cancer risk also appears to vary according to ethnic background and tumour histology. Reduced microsomal epoxide hydrolase activity has been proposed as an important factor influencing susceptibility to carcinogen-induced lung damage, and given the central role of xenobiotic metabolism in lung carcinogenesis, preventive strategies that reduce exposure to environmental carcinogens are the most effective approach to lowering disease risk. Electronic databases such as PubMed, Scopus, and Google Scholar were systematically searched to compile the information, but current evidence is restricted by small, ethnically homogeneous cohorts and inconsistent experimental designs. Advances in molecular genetics and multi-omics approaches, including genomics, transcriptomics, proteomics, and metabolomics, offer new opportunities to better understand xenobiotic metabolic networks and identify individuals at increased risk. Such insights may support the development of targeted prevention strategies, early screening programs, and personalised interventions to reduce lung cancer incidence.

Risk Factors Influencing Treatment Outcomes in Patients with Drug-resistant Tuberculosis in Puducherry, India

2026-05-16T08:27:37+00:00

Drug-resistant tuberculosis remains a major global public health challenge. Multidrug-resistant TB (MDR-TB), caused by Mycobacterium tuberculosis resistant to rifampicin and isoniazid, poses a significant threat to Tuberculosis (TB) control. Improving treatment outcomes for drug-resistant tuberculosis remains a critical global priority for tuberculosis control programs. India reports the highest number of MDR-TB cases worldwide; however, no longitudinal studies have evaluated factors influencing treatment outcomes in public sector settings. This study evaluated factors associated with unsuccessful treatment outcomes among patients with MDR-TB receiving outpatient care under the National Tuberculosis Elimination Programme in Puducherry, India, from January 2020 to December 2023. Suspected TB patients were initially screened at NAAT sites using Xpert MTB/RIF or TrueNat assays, and confirmed rifampicin-resistant cases were referred to PMDT centres. Samples were further analysed for drug susceptibility testing. Genetic mutations associated with rifampicin resistance (RR) were identified using the GenoType MTBDRplus version 2 assay. Patients received standardised MDR-TB treatment regimens as per national guidelines, and treatment outcomes were classified into favourable (cure, completion) and unfavourable (death, failure, loss to follow-up). Multivariate regression methods were used to estimate odds ratios with 95% confidence intervals to identify determinants of unsuccessful treatment outcomes. From 2020 to 2023, 192 MDR/RR-TB patients were enrolled, including 61 (31.8%) RR-TB and 131 (68.2%) MDR-TB cases; most were new cases (150), and 148 (77.1%) received shorter regimens with a higher treatment success rate (63.2%) compared to longer regimens (56.8%). Clinical data indicated an overall treatment success rate of 60.42%. Patients undergoing retreatment were more likely to experience unsuccessful outcomes. Co-infection with HIV and the use of alcohol or tobacco further increased the odds of treatment failure. Patients exhibiting heteroresistant patterns had 2.72 times the odds of an unsuccessful outcome compared with those with inferred or true-resistant patterns. Additionally, patients residing in rural areas experienced poorer treatment outcomes and higher rates of loss to follow-up than those in urban areas. Longer treatment regimens were associated with greater loss to follow-up than shorter regimens. True resistance due to rpoB gene mutations accounted for 65.9% (29 out of 44) of total deaths, with mutations at codon S450L contributing to 47.7% of these fatalities, a novel finding. The study demonstrated a strong association between heteroresistance in the rpoB gene and poor treatment outcomes. These results underscore the need for detailed molecular-level investigations to optimise drug selection for MDR/RR tuberculosis. Further research is warranted to clarify the impact of heteroresistance on individual patient outcomes.

Prevalence and Vaccination Patterns of Human Papillomavirus among Female Medical Sciences Students at Rivers State University, Port Harcourt, Nigeria

2026-05-16T08:30:37+00:00

Cervical cancer remains a major cause of morbidity and mortality among women globally, with a disproportionate burden in low- and middle-income countries such as Nigeria. Persistent infection with high-risk human papillomavirus (HPV) is the primary etiological factor. Although effective vaccines are available and Nigeria commenced national HPV vaccination in 2023, uptake among older adolescents and young adults, particularly university students, remains suboptimal. This study assessed the prevalence, patterns, and determinants of HPV vaccination among female medical sciences students at Rivers State University, Port Harcourt, Nigeria. A descriptive cross-sectional study was conducted among 214 female undergraduate students selected using a multistage sampling technique. Data were collected using a pretested, structured, self-administered questionnaire. Data was analysed using IBM SPSS version 27. Descriptive statistics were used to summarise variables, while associations were assessed using Chi-square and Fisher’s exact tests. Variables significant at bivariate analysis were entered into a binary logistic regression model to identify independent predictors. Statistical significance was set at p < 0.05. The mean age of participants was 20.8 ± 2.8 years. HPV vaccination initiation (≥1 dose) was 21.0%, while only 9.8% had completed the three-dose series. Among vaccinated respondents, 84.4% initiated vaccination during the catch-up age range (15–26 years), and 45.7% completed all three doses. The most common vaccination site was school or university health services (44.4%). 64.0% of participants demonstrated good knowledge of HPV infection; however, only 38.3% demonstrated adequate knowledge of the HPV vaccine. Factors significantly associated with vaccination initiation included age group, level of study, sexual activity, HPV vaccine knowledge, and willingness to pay (p < 0.05).

On multivariate analysis, independent predictors of vaccination were final-year status (aOR = 8.94; 95% CI: 3.21–24.91), good HPV vaccine knowledge (aOR = 4.56; 95% CI: 1.89–11.02), and sexual activity (aOR = 2.87; 95% CI: 1.21–6.80).

Among unvaccinated participants, major barriers included cost (45.0%), low perceived risk (40.2%), uncertainty about access (30.2%), and lack of awareness (22.5%). HPV vaccination uptake among female medical sciences students in this setting is low, with delayed initiation and suboptimal completion rates. Vaccine knowledge, academic level, and perceived risk significantly influence uptake. Targeted interventions—including subsidised vaccination, campus-based delivery strategies, and strengthened health education—are urgently needed to improve coverage among young adults and support national cervical cancer prevention efforts.

Addressing Malnutrition and Nutrient Deficiencies in Nigeria: Strategies for Advancing the Zero Hunger

2026-05-23T10:27:34+00:00

Shortage of animal product supply owing to absence of protein sources, regular increase in cost of feed ingredients, and climate change has affected developing countries like Nigeria. This study explores the potential of donkeys’ blood meal (DBM), donkeys’ caecal meal (DCM) and donkeys’ blood-caecal meal (DBCM) as animal protein feed ingredients to increase the amount of feed offered to animals, improve animal products, and therefore improve animal nutrient scarcity in order to address malnutrition in Nigeria. The parameters examined were the proximate composition of the three test ingredients, essential amino acid profiles and non-essential amino acids of the test ingredients. The results of the proximate composition of the test ingredients showed that the values of crude protein ranged from 78.09% DBM to 26.57% DBCM and DCM 19.42% respectively. The results revealed that DBM is the best test ingredient as an alternative animal protein source. Fibre fraction indicated that DBM has the least value of 0.00%, followed by DBCM 6.01%, but DCM had the highest value of 7.00% crude fibre. Macro and micro minerals showed that DCM has the highest value of nitrogen free extract, Gross Energy followed by DBCM and DBM, making it a superior test ingredient. Essential and non-essential amino acids revealed that DBM had the highest values, followed by DBCM and DCM among the test ingredients. This study evaluates the three feed ingredients, namely: DBM, DBCM and DCM, as an approach to overcome hunger and enhance nutrient shortage and malnutrition recommended that DBM be the best possible protein feed source, that has 78.09 crude protein.

Optimizing Growth and Development in Preterm Infants: Evidence-Based Nutritional Strategies in Neonatal Care

2026-06-02T08:54:44+00:00

Preterm infants face significant nutritional challenges due to the premature interruption of placental nutrient transfer and the immaturity of multiple organ systems. Nutrition is a major determinant of survival, growth, metabolic stability, immune competence, and long-term neurodevelopmental outcomes in this vulnerable population. Inadequate early nutrition is associated with postnatal growth failure, impaired brain development, increased morbidity, and adverse health consequences that may persist into later childhood and adulthood. This chapter presents a comprehensive, evidence-based overview of nutritional management in preterm neonates, focusing on physiological principles, nutrient requirements, and practical strategies for enteral and parenteral nutrition. Special emphasis is placed on the role of human milk, milk fortification, feeding advancement protocols, and structured clinical monitoring. Common nutritional complications, including feeding intolerance, necrotising enterocolitis, postnatal growth restriction, and metabolic bone disease, are discussed along with preventive and management strategies.

To support translation of evidence into clinical practice, integrated frameworks and clinical algorithms are included to guide individualised nutritional care in neonatal intensive care units. The overarching aim of this chapter is to provide clinicians, neonatologists, nurses, and allied health professionals with a practical reference that supports optimal growth, organ development, and neurodevelopmental outcomes in preterm infants.

Bridging Retention Gaps in Pediatric HIV Care: Insights from a One-Year Intervention in Taraba State, Nigeria

2026-06-02T08:56:45+00:00

Background: Despite significant progress toward achieving the Joint United Nations Programme on HIV/AIDS 95–95–95 targets, retention in pediatric HIV care remains a major challenge in Nigeria, particularly in underserved and hard-to-reach communities. Children living with HIV (CLHIV) often experience delayed diagnosis, poor linkage to treatment, treatment interruptions, caregiver-related barriers, stigma, and inadequate psychosocial support, all of which contribute to poor treatment outcomes. In Taraba State, gaps in pediatric HIV case finding, retention in care, and viral suppression continue to threaten efforts toward epidemic control.

Aim: This study assessed the effectiveness of a one-year community-based intervention aimed at improving HIV case identification, linkage to treatment, retention in care, and viral suppression among children living with HIV, adolescents and young people, caregivers, and the general population in selected communities in Taraba State, Nigeria.

Methods: A comprehensive community-based HIV intervention was implemented across three Local Government Areas (LGAs)—Karim Lamido, Sardauna, and Ussa—to address persistent gaps across the HIV treatment cascade. The intervention adopted targeted risk screening, index case testing, home-based HIV testing services, community outreach campaigns, and promotion of HIV self-testing to improve HIV case detection while reducing stigma and improving access in underserved populations.

Individuals diagnosed with HIV were promptly linked to treatment and supported through differentiated service delivery approaches designed to improve long-term retention. These included community pharmacy-based antiretroviral therapy (ART) refill systems, community ART support groups, nurse-led community clinics, treatment navigation services, active follow-up mechanisms, and integrated mental health and psychosocial support services. Capacity strengthening was conducted for multidisciplinary healthcare workers, case managers, community volunteers, and persons with lived HIV experience to enhance stigma-free, family-centred, and patient-centred service delivery. Programmatic data collected over a one-year implementation period were analysed across the HIV care continuum, including HIV testing and diagnosis (first 95), linkage to treatment (second 95), retention in care, and viral suppression (third 95).

Results: A total of 8,990 children, adolescents, caregivers, and members of the general population were tested for HIV across the three LGAs, with nearly equal representation of males (49.5%) and females (50.5%). Overall, 233 individuals tested HIV-positive, yielding an overall positivity rate of 2.6%, with females accounting for 69.5% of all positive cases.

Children aged 0–14 years represented the largest testing cohort (n=2,675) but recorded the lowest positivity rate (0.8%), highlighting persistent challenges in pediatric case identification. Higher positivity rates were observed among caregivers (4.7%) and the general population (4.5%), reinforcing the importance of family-centred testing approaches for identifying pediatric HIV risks.

Among the 233 individuals who tested positive, 168 were newly identified and referred for treatment, while 65 were previously known HIV-positive clients already receiving ART. Of those referred, 163 were successfully linked and enrolled in HIV treatment services, representing a linkage rate of 97%.

Among individuals enrolled on treatment, 143 remained actively engaged in care during the implementation period, resulting in an overall retention rate of 88%. Pediatric retention outcomes improved significantly through caregiver engagement and decentralised treatment delivery models. Retention rates varied across LGAs, with Karim Lamido recording the highest retention rate (95%), followed by Ussa (81%) and Sardauna (73%).

Among clients receiving ART, 91 had valid viral load test results, of whom 88 achieved viral suppression, resulting in a viral suppression rate of 97%. This demonstrates strong treatment adherence outcomes among retained clients.

Conclusion: The intervention demonstrated that community-driven, family-centred HIV programming can effectively address retention gaps in pediatric HIV care while improving broader treatment outcomes among adolescents, caregivers, and community members. High linkage rates, improved retention outcomes, and excellent viral suppression highlight the effectiveness of combining community-based case finding, differentiated service delivery models, and integrated psychosocial support in resource-limited settings. Scaling up similar interventions across high-burden communities in Nigeria could significantly strengthen pediatric HIV retention outcomes and accelerate national progress toward achieving sustainable HIV epidemic control.

Viral Infections among Kidney Transplant Recipients: A Clinical Review

2026-06-08T09:37:21+00:00

Kidney transplantation is the most effective treatment for patients with end-stage kidney disease. However, post-transplant viral infections remain a major cause of morbidity and mortality due to immunosuppression required to prevent graft rejection. The risk of infection is influenced by the type of virus, intensity of immunosuppression, and host factors. The frequently identified viruses as agents that may cause infection in case of recipients of kidney transplantation throughout the world are varicella-zoster virus, herpes simplex virus, cytomegalovirus (CMV), adenovirus, Epstein-Barr virus, BK polyoma virus (BKV) and hepatitis B. The distribution of these viruses is widespread worldwide. These microorganisms can reactivate, as these are DNA viruses, when immunosuppressive medications are given to afflicted patients. Particularly during the first six months following transplantation, these DNA viruses can result in systemic illnesses or allograft malfunction. Pretransplant evaluation, immunisation, adequate prophylaxis, and preventive measures following transplant can be adopted as effective means of reducing the frequency of these viral infections. Early detection through pretransplant screening, vaccination, prophylaxis, and post-transplant monitoring is essential to reduce complications. The primary objective of the review is to discuss viral infections that commonly occur in kidney transplant recipients, with particular focus on their origin (pathogenesis), diagnosis, prevention (prophylaxis), and management. The study reveals that CMV and BKV remain significant barriers to long-term graft survival and are associated with an increased risk of graft rejection and post-transplant malignancy. Future research should focus on improving viral surveillance strategies, developing safer immunosuppressive regimens, and exploring novel antiviral therapies and vaccines to reduce infection-related complications in transplant recipients.

Risk Management of Hazardous Medical Waste among Healthcare Workers in Sub-Saharan Africa: A Systematic Review

2026-06-16T08:20:09+00:00

Background: During the healthcare delivery process, hazardous wastes can be generated from health facilities. Improper healthcare waste management is responsible for the transmission of dangerous bloodborne pathogens to health workers.

Aim: This systematic review aimed to evaluate the risk management of medical waste among health care workers in sub-Saharan Africa.

Methodology: Literature review employed the Preferred Reporting Items for Systematic Reviews (PRISMA). The systematic identification, screening and inclusion of relevant literature was conducted using PubMed, ScienceDirect and Google Scholar. The review was conducted among sub-Saharan countries on the risk management of hazardous medical waste among health care workers.

Results: Electronic databases from PubMed, ScienceDirect and Google Scholar yielded 4942 articles. The duplicates removed from the records were 2321. Full-text articles assessed were 127, from which 25 studies met the inclusion criteria. It was identified that activities taking place in healthcare facilities produce high-risk types of waste. Waste treatment methods and technologies pose a risk to healthcare workers in sub-Saharan Africa. In sub-Saharan Africa, there are ineffective practices, resource limitations and regulatory deficiencies in the management of healthcare waste. Also, there is illegal dumping and poor medical waste disposal systems.

Conclusion: The existing healthcare waste management framework and management systems must be re-examined to fill functional gaps and allocate the required resources.

Effect of a Controlled Final Irrigation Protocol on Acute Pain after Single-versus Two-visit Root Canal Treatment in Necrotic Teeth with Apical Periodontitis

2026-07-02T08:31:33+00:00

Background: Postoperative acute pain and flare-ups remain important complications following root canal treatment (RCT), particularly in teeth with necrotic pulp and apical periodontitis. Controlled final irrigation protocols have been proposed to improve canal disinfection and reduce postoperative complications.

Objective: This study aimed to determine whether a controlled final irrigation protocol after cleaning and shaping procedures would reduce acute pain after single- versus two-visit RCT of teeth with necrotic pulp and apical periodontitis.

Methodology: A prospective multicentre randomised controlled trial was conducted involving 90 patients. Working length was established with an electronic device and confirmed radiographically. For mechanical enlargement, Twisted File Adaptive and ProTaper Next instruments were used in a brushing rotary movement and reciprocating mode, respectively. For the control group, the Balanced Force technique was employed. A controlled final irrigation protocol was used in all groups. The same clinical protocol was used in three different cities in Mexico.

Results: Clinical samples were distributed as 45 teeth in the one-visit group and 45 teeth in the two-visit group. Two cases (2.5%) experienced acute pain in teeth that received RCT. In previously asymptomatic/symptomatic teeth, treatment eradicated pain in 83.33% of cases. Statistical analysis of healing results showed no significant difference between groups (p = 0.05). The controlled final irrigation protocol was associated with a low incidence of postoperative acute pain and flare-ups across all treatment groups.

Conclusions: This study provided clinical evidence that properly instrumented single-visit RCT can be as effective as two-visit treatment in managing teeth with necrotic pulp and apical periodontitis. The use of a controlled final irrigation protocol incorporating sodium hypochlorite, EDTA, irrigant activation, and cold distilled water was associated with a low incidence of postoperative acute pain and flare-ups. The use of antibacterial irrigants and effective irrigation strategies appears to be a valuable adjunct for controlling endodontic infection and improving patient comfort.