An Overview of Disease and Health Research Vol. 6

Smokers' Awareness of the Effects of Smoking on Oral Health at the Military Dental Hospital, Omdurman, Sudan

Dalia Ahmed Gasm El Seed — 2025-10-11

Background: Smoking remains a highly prevalent addiction in many populations worldwide despite the increasing awareness of its harmful effects on general health. Smoking is considered a risk factor for the initiation and progression of oral and periodontal diseases. Periodontal diseases affect the quality of life of patients by affecting the function and appearance of their dentition.

Aim: The aim of this study was to assess the awareness of smokers about the effects of smoking on periodontal and oral health.

Methods: A descriptive, hospital-based, cross-sectional study was conducted among male smokers at the Military Dental Hospital in Omdurman, Sudan. A pretested and revised self-administered questionnaires were used to collect data from study participants. Demographic data, such as age, occupation and educational level, were recorded. Factors related to smoking awareness, the effect of the number of cigarettes and the duration of smoking on oral periodontal health and the oral symptoms (complaints) associated with smoking were also assessed. A simple random sampling technique was used to select study participants. Data were analysed using SPSS version 23, and the results were presented as frequencies and proportions.

Results: A total of 385 smoking males, with a mean age of 27.8, participated in this study. The mean number of cigarettes smoked per day was 10 cigarettes, and the mean duration since starting smoking was 8 years. The majority of smokers (85.5%) were not aware of the effect of the number of cigarettes on periodontal and oral health. Also, 93 % of them were not aware of the effects of the duration of smoking on oral and periodontal health. Among the participants, 63% of smokers complained of color change of oral mucosa, 35% about staining of the teeth, 19.2% of bad breath and 17% delay in wound healing (with statistically significant difference at p-vale <0.01) More than half (58.20%) of smokers were aware that smoking could cause oral cancer and 76.10% held favorable attitudes toward smoking (i.e., they believed “smoking was cool”). Most of the study participants (89.10 %) didn’t receive adequate information about the risk of smoking on their health from their dentists, and 88.60% of them didn’t hear about Nicotine Replacement Therapy (NRTs).

Conclusion: This study demonstrates that a high percentage of smokers were not aware of the harmful effects of smoking on oral and periodontal health. This study recommends increasing awareness among smokers through advertisements, audiovisual aids, and print media to show the benefits of smoking cessation for oral and systemic health.

Surgical Management in Autoimmune Thyroidal Disorders: A Review

Eirini Avgoustou — 2025-10-11

Graves’ disease (GD) and Hashimoto’s thyroiditis (HT) are autoimmune thyroid disorders, with patients experiencing mild to debilitating symptoms. GD is characterised by hyperthyroidism, which can lead to functional disturbances, compressive symptoms and orbitopathy. HT is often associated with hypothyroidism, localised painful symptoms, and has a stronger link to differentiated thyroid cancer. While both diseases are primarily managed medically, surgery becomes the definitive treatment option in cases where either other treatments are ineffective or poorly tolerated, or when compressive symptoms, pain, or coexisting malignancy are present. Total thyroidectomy, which is obligatory for coexisting malignancy, has proven to be the most effective intervention for symptomatic relief in both diseases. Although excision of the thyroid gland in these cases can be technically challenging, the rate of permanent complications remains acceptably low when the operations are performed by experienced surgeons in high-volume centres.

This review explores the indications for surgical intervention in autoimmune thyroid disease, highlighting both the clear benefits and potential risks of surgery, as well as emphasising the need to enhance access to high-quality surgical care.

The Effects of Lead Exposure on Pediatric Oral Health

Tannu Kumari — 2025-10-11

Lead exposure is a major environmental concern with significant implications for pediatric oral health. This chapter reviews sources of exposure, mechanisms of toxicity, and oral manifestations such as enamel hypoplasia, caries, periodontal changes, and Burton’s line. Diagnostic approaches and preventive strategies are discussed, emphasising the role of pediatric dentists in screening and education. Future directions highlight advanced diagnostic tools, public health interventions, and policy actions needed to reduce risks and protect children worldwide.

Penile Tuberculosis: A Rare Manifestation of Extrapulmonary Tuberculosis

Harikrishna R — 2025-10-11

Introduction: The 2024 WHO Global Tuberculosis report labelled Tuberculosis as the leading cause of mortality amongst infectious diseases, surpassing COVID-19. Extrapulmonary manifestations account for almost 20% cases. Penile tuberculosis is a rare variant of genital tuberculosis in males, accounting for less than 1% of all cases.

Case: The case of a 65-year-old man, who presented with several painful ulcerative lesions on the glans penis that had developed over the span of 1 year, was presented. Histopathological examination from a wedge biopsy of the lesion revealed granulomatous inflammation, which, being the diagnostic hallmark, confirmed the diagnosis of penile tuberculosis. Thus, the patient was enrolled under the RNTCP program and received Anti-Tuberculous Treatment (ATT).

Conclusion: Penile tuberculosis is a rare clinical entity. Therefore, maintaining a high level of clinical suspicion is crucial for achieving a timely and accurate diagnosis, which facilitates the initiation of appropriate therapy.

The Role of Leptin in Pathology of Polycystic Ovary Syndrome (PCOS)

Sushitha ES — 2025-10-11

Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder with significant impacts on women’s health. This intricate condition affects the endocrine and metabolic systems, characterised by features such as anovulation, infertility, obesity, insulin resistance, and the presence of polycystic ovaries. The aim of this review is to investigate the diagnostic potential of leptin in PCOS. The objective is to contribute to the existing body of knowledge by examining the relationship between leptin, the leptin receptor gene, obesity, and the various metabolic and hormonal irregularities associated with PCOS. In this regard, a comprehensive review of the literature from the past decade was conducted using databases such as Google Scholar, PubMed, and Scopus. The search strategy was aimed at gathering relevant studies on the relationship between leptin and PCOS, including genetic aspects. All the reviewed studies unanimously confirm the diagnostic potential of leptin in PCOS, emphasising its relevance in metabolic disorders associated with PCOS. Leptin is a fat cell-derived hormone that promotes a shift from carbohydrate to fat oxidation and regulates glucose homeostasis. Leptin, classified within the “tumour necrosis factor” family as a cell factor, is an amino peptide consisting of 167 amino acids. Leptin plays a crucial role in relaying metabolic signals to the brain and modulating the hypothalamic-pituitary-ovarian axis. PCOS involves hyperandrogenism, inappropriate luteinizing hormone secretion, insulin resistance, and hyperinsulinemia. The relationship between leptin and key factors in PCOS, such as gonadotropins, androgens, and insulin, remains a subject of ongoing research and discussions. The evidence gathered highlights elevated leptin levels, particularly in obesity, as a consistent characteristic of PCOS. The positive correlation between leptin and fat cell quantity underscores its potential role in PCOS pathogenesis. Leptin extends its impact beyond weight regulation, influencing oocyte maturation and activating ovarian enzymes involved in steroid production. Genetic studies on Leptin Receptor Gene (LEPR) polymorphisms indicate associations between specific genetic variants and PCOS susceptibility. Combining leptin with markers like Anti-Mullerian Hormone (AMH) shows high diagnostic accuracy, offering potential utility in clinical assessments. The multifaceted impact of leptin on both reproductive and metabolic aspects is evident. The findings support the integration of leptin with other markers for enhanced diagnostic accuracy, providing a promising avenue for future clinical applications in PCOS assessments.

Chronotypes and Health: Biological and Social Implications

Sambid Sunamajhi — 2025-10-11

Chronotypes represent an individual’s natural preference for sleep and activity timing within the 24-hour day, governed by circadian rhythms and the suprachiasmatic nucleus (SCN). This review explores how chronotypes categorised as morning, evening, and intermediate affect various dimensions of health and behaviours. It examines the biological underpinnings of chronotype, including hormonal and genetic mechanisms, and the tools used for its assessment, such as the Morningness-Eveningness Questionnaire, Munich Chronotype Questionnaire, actigraphy, and sleep diaries. The study highlights significant associations between chronotype and physical health outcomes, including sleep quality, metabolic disorders, cardiovascular health, and immune function. In terms of mental health, evening chronotypes are particularly vulnerable to depression, anxiety, and stress-related disorders, often due to misalignment between biological rhythms and societal demands. Furthermore, chronotype influences cognitive functioning, academic performance, and the impact of shift work, particularly among working adults. Understanding and aligning daily routines with an individual’s chronotype can lead to improved well-being, enhanced productivity, and reduced health risks. The findings underscore the importance of recognising chronotype differences to improve health outcomes, optimise daily functioning, and tailor interventions in educational, clinical, and occupational settings. Future research should continue to explore chronotype-based interventions and policies that respect biological diversity in human functioning.

Cryptic Co-Infection by Strongyloides stercoralis and Helicobacter pylori Mimicking Gastrointestinal Malignancy: A Case Report

Shruti Varshney — 2025-10-11

Background: Strongyloidiasis is an infection caused by Strongyloides stercoralis, a globally prevalent nematode. It is estimated to infect about 600 million people globally mainly from tropical and subtropical regions of Africa, Asia, South America, and the Southeastern United States. India, being a tropical country, is prone to many such infections, but there is limited availability of data showing the prevalence of Strongyloides stercoralis infection.

Aim: This case report aims to emphasise the importance of keeping parasitic infections as a differential diagnosis in cases clinically suspicious for gastrointestinal malignancies.

Case Presentation: This chapter reports a case of a 60-year-old male with a co-infection by Strongyloides stercoralis and Helicobacter pylori. The patient presented with the non-specific symptoms of epigastric discomfort, fatigue and unintentional weight loss over several months with no significant past medical history. This led to a suspicion of malignancy for which routine investigations, along with upper gastrointestinal endoscopy with biopsy, were performed. Subsequently, rhabditiform larvae of Strongyloides stercoralis and Helicobacter pylori were identified on gastric and duodenal biopsies. The patient was treated with Amoxicillin 1 g twice daily, Clarithromycin 500 mg twice daily, Proton pump inhibitor (Omeprazole) 20 mg twice daily for Helicobacter pylori infection, and Ivermectin at a dose of 200 µg/kg/day for Strongyloides stercoralis infection. Follow-up evaluations after 4 weeks showed normalisation of the patient’s haemoglobin levels, stool examination and a significant improvement in overall health and nutritional status.

Discussion: Strongyloidiasis usually targets immune-compromised hosts owing to hyperinfestation, but remains asymptomatic in healthy individuals. Moreover, there is limited availability of diagnostic modalities for such parasitic infections which hinders the way for early diagnosis, therefore leading to poor prognosis. In selected cases with non-specific symptoms like that in this case, early upper gastrointestinal endoscopy with histopathology can help in early diagnosis and prompt treatment.

Conclusion: Due to the non-specific nature of the symptoms, it is difficult to reach a diagnosis, though it is necessary to have a high degree of suspicion and make an early diagnosis to have better outcomes.

Bioactive Treasures of Crotalaria multibracteata: Cultivating Sustainable Medicine for Tomorrow

Divya Prajapati — 2025-10-11

This chapter aims to provide a comprehensive overview of Crotalaria multibracteata within the framework of sustainable therapeutics. It explores the species’ botanical characteristics, ethnomedicinal significance, phytochemical profile, pharmacological properties, and potential applications through green technologies. Traditional medicine has long employed species of Crotalaria for treating a wide range of ailments, from fever and wounds to skin infections and digestive disorders. These uses, documented in several ethnobotanical surveys across Africa and South Asia, suggest the presence of pharmacologically active constituents, although many species, including C. multibracteata, remain underexplored in modern research. Various parts of these plants leaves, roots, seeds, and flowers are employed in poultices, decoctions, infusions, and pastes, often in combination with other herbs. Common ailments addressed include skin infections, ulcers, fever, gastrointestinal disorders, wounds, and inflammatory conditions. Integrating green science principles is critical to unlocking this potential responsibly. Eco-friendly extraction technologies such as supercritical CO₂ and subcritical water extraction can maximise yield and purity while preserving environmental integrity. By embracing interdisciplinary collaboration among ethnobotanists, chemists, pharmacologists, biotechnologists, and conservationists, Crotalaria multibracteata can transition from a largely underexplored plant to a model for sustainable phytotherapeutics. This journey exemplifies the fusion of ancestral wisdom and modern science toward healthier populations and a healthier planet.

Frontline of Lassa Fever: Clinical Predictors and Outcomes from Primary Health Care Centres in Rivers State, Nigeria

Briggs, Nduye Christie Tobin — 2025-10-11

Introduction: Lassa fever, a viral haemorrhagic illness endemic to West Africa, remains a significant public health concern more than half a century after its discovery. Globally, annual estimates suggest a burden of approximately 300,000 to 500,000 cases, resulting in about 5,000 deaths each year.

Within West Africa, Nigeria, Sierra Leone, and Liberia bear the heaviest Lassa fever burden. A recent meta-analysis of regional epidemiological data reported a pooled attack rate of 21% and a case fatality rate (CFR) of 27%. Notably, Nigeria’s CFR was lower at 16%, although hospitalised patients and vulnerable groups (children, pregnant women) experienced much higher mortality.

Early detection at Primary Health Centres (PHCs) is essential for reducing diagnostic delays and enhancing patient outcomes.

Aims: This study aimed to identify the clinical signs that predict Lassa fever and evaluate the outcomes of patients attending PHCs in Rivers State, Nigeria.

Methods: A retrospective cross-sectional study was conducted in 15 PHCs in Rivers State from January 2023 to March 2025. A simple random sampling was used to select 5 Local Government Areas (LGAs) from the 23 LGAs of Rivers State by balloting. Also, simple random sampling using computer-generated random numbers was used to select 3 PHCs from each LGA to make the 15 PHCs.

A total of 312 suspected Lassa fever presentations were included. Data were abstracted using a structured proforma on demographics, presenting symptoms, laboratory confirmation (RT-PCR), management (referral, initial care), and outcomes (recovery, referral, death).

Bivariate analysis (Pearson chi-square) compared symptoms in confirmed and non-confirmed cases; variables with p<0.20 were entered into multivariable logistic regression to estimate adjusted odds ratios (AORs) for predictors of confirmed Lassa fever.

Results: Of 312 suspected cases, 78 (25.0%) were laboratory-confirmed by RT-PCR. Persistent fever (>7 days) was present in 52.6% confirmed cases versus 20.1% of non-confirmed cases (p<0.001). Other symptoms disproportionately represented among confirmed cases included bleeding tendencies (30.8% versus 3.4%; p<0.001), sore throat (23.1% versus 11.5%; p=0.008), and hearing loss (9.0% versus 1.3%; p=0.002). Multivariable logistic regression identified persistent fever (AOR 3.12; 95% CI 1.62-5.98), bleeding (AOR 4.85; 95% CI 2.11-11.12), sore throat (AOR 2.77; 95% CI 1.32-5.79), and hearing loss (AOR 6.41; 95% CI 1.90-21.59) as independent predictors. Outcomes among confirmed cases were recovered 49 (62.8%), referred 13 (16.7%), and died 16 (20.5%).

Conclusion: In PHC settings in Rivers State, presentation of clinical features such as persistent fever, bleeding, sore throat, and hearing loss strongly raises the probability of RT-PCR confirmed Lassa fever. Though less frequent, hearing loss had the highest AOR and should be regarded as an important clinical red flag. The observed fatality rate among confirmed cases (20.5%) is an indication of persistent fatality where timely diagnostics and referrals are limited. Strengthening PHC capacity for syndromic recognition, specimen collection and rapid referral to diagnostic centres, together with community education and strengthened surveillance, is essential to reduce morbidity and mortality from Lassa fever.

A Rare Case of Autoimmune Hemolytic Anaemia in a 3-Year-Old Male Child with Associated Complications

Abhirami Rajasekhar — 2025-10-11

Autoimmune haemolytic anaemia (AIHA) is an uncommon cause of antibody-induced haemolytic anaemia in children. It involves a rapid breakdown of red blood cells, leading to a decrease in haemoglobin and hematocrit levels. In pediatric patients, it is less of a rare condition. Pediatric AIHA often presents with clinical features such as pallor, jaundice, fatigue, and splenomegaly, and it can be triggered by viral infections like Epstein-Barr virus or Mycoplasma pneumoniae, or as part of an underlying autoimmune condition. In this study, a 03 year old male patient was admitted to a tertiary care hospital with complaints of fever since the last day morning, vomiting since previous day of 5 episodes, containing mostly mucus material, abdominal pain, decreased appetite for 2 days, yellowish discolouration of eyes and dark colored urine noted, and decreased urine output. The patient had a recent travel history to Dubai and had consumed cheese for the first time. The serology showed positive in the Direct Coombs Test (DCT) with a decrease in Haemoglobin, Hematocrit, MCH, MCHC, with a Blood Picture showing features of Hemolytic Anaemia. CRP, Bilirubin, AST, ALP, and Serum LDH levels were increased. This confirmed Autoimmune Hemolytic Anaemia associated with liver enzyme elevation, potentially due to severe hemolysis, a rare condition with an estimated incidence of 0.2 per one million individuals younger than 20 years. Plan of care was primarily with IV corticosteroids, blood transfusion, and folate supplements. Other supportive medications were also given. The condition improved during the course of time in the hospital and was discharged with oral medications. This rare case of AIHA in a pediatric patient highlights the importance of a comprehensive approach to diagnosis and management, particularly when secondary causes are suspected.

Dietary Interventions for Managing Vitamin D Deficiency in Children in the UK

Foluso Bamidele Afelumo — 2025-10-11

Until recently, the burden of Vitamin D deficiency among UK children had largely depended on anecdotal reports and single-centre studies, leaving the epidemiological references by clinicians and scholars to mere conjectures. However, new studies on a national scale have shown the enormity of vitamin D deficiency among UK children and have spurred concerted efforts towards addressing the problems associated with the deficiency of this all-important vitamin. In children, vitamin D deficiency is a notable problem that should arouse the interest of public health physicians, nutritionists, and governments all over the world, and its prevalence is high. This review explores the dietary interventions tackling vitamin D deficiency among children in the UK. Different studies have been conducted to highlight the many clinical problems associated with vitamin D deficiency among UK children and to highlight some efforts to correct them. Some of the studies form the thrust of this write-up. The findings revealed that the prevalence of vitamin D deficiency differs widely among many European countries and regions, and it is of grave concern. Vitamin D deficiency among children will continue to be a serious concern for public health practitioners, paediatricians, nutritionists and governments at all levels in the world due to inadequate exposure of children to sunlight; inadequate intake of vitamin D-rich foods; and many governments’ inertia and reticence in frontally confronting the challenge. Vitamin D deficiency can occur in children if they are made to consume strict vegetarian diets. Supplementation entails adding nutrients to someone’s diet to tackle a perceived deficiency and improve the wellness of the person in relation to Sustainable Development Goal 3. Monitoring and evaluating the improvement in Vitamin D levels in each population shows how effective the fortification intervention is. Early screening, diagnosis, and management of vitamin D deficiency holistically will have positive effects in the long run. Prevention of Vitamin D deficiency has numerous benefits, both on an early, middle, and long-term basis, in drastically reducing vitamin D deficiency worldwide.

From Confusion to Clarity: A Case of Kikuchi-Fujimoto Disease Misdiagnosed as Space Infection

SUNIL VASUDEV — 2025-10-11

Kikuchi-Fujimoto disease (KFD), also known as Histiocytic Necrotising Lymphadenitis, is a benign and self-limited disease that mainly affects young women. Patients present with localised lymphadenopathy, fever, and leukopenia in up to half of the cases. It was first described by Dr Masahiro Kikuchi in 1972 and independently by Y. Fujimoto. This study describes a case of KFD, which was earlier misinterpreted as a space infection and its diagnosis and management. The study reports the case of a 45-year-old female who presented with pain and swelling in the right lower jaw region for two weeks. General examination revealed Mild cervical lymphadenopathy noted on the right side. Orthopantomogram (OPG) showed deep dentinal caries with respect to 47 and a horizontally impacted 48 with surrounding bone loss. MRI revealed multiple conglomerate necrotic lymph nodes in the right side of the neck from level 2 to level 5 with significant peripheral fat stranding and oedema- likely infective aetiology like tuberculosis. Although the exact cause of KFD is not well understood, viral infections and autoimmune mechanisms are believed to play a role. In most cases, KFD disease resolves spontaneously within a few months, and no specific antiviral or antimicrobial treatment is required. Early recognition is essential to avoid unnecessary invasive interventions or prolonged antimicrobial therapy.