An Overview of Disease and Health Research Vol. 8

Paediatric Multisystem Inflammatory Syndrome Associated with COVID-19: Advances, Controversies, and Future Perspectives

Juan Pablo Martínez-Becerra — 2026-01-10

Paediatric multisystem inflammatory syndrome (MIS-C), temporally linked to SARS-CoV-2 infection, emerged in 2020 as a condition of significant clinical concern due to its potential to cause multiorgan dysfunction and severe outcomes. It is a post-infectious phenomenon characterised by a dysregulated immune response and intense systemic inflammation. This review analyses scientific findings from the past decade, with emphasis on advances in pathophysiology, updated diagnostic criteria, epidemiological changes over the course of the pandemic, diversity of clinical manifestations, therapeutic strategies, and future perspectives. In 2020, the first cases of MIS-C were diagnosed as Kawasaki disease, and after changes, like Kawasaki disease. The documented experience of a second-level hospital in Guanajuato, Mexico, is also incorporated, allowing reflection on diagnostic and therapeutic challenges in middle-resource settings. Although incidence has decreased following the circulation of recent variants and the implementation of vaccination, MIS-C continues to represent a challenge for global paediatrics.

A Mini-Review of the Relationship between Diet and Cancer Risk

Ying Yang — 2026-01-10

Background: Despite significant advances in the basic research and clinical practice, treatments such as surgery and chemoradiotherapy have side effects. And the research on minimum food uptake to supplement curative roles in among critical chronic cancer cases using food and cancers are important, and has grown exponentially over the decades. Diet plays a major role in preventing many types of cancer and also in the supporting the intervention, thus it is very good to have a chapter on nutrition in cancer.

Objective: The purpose of this minireview is to summarize the relationship between various food and cancers.

Methods: The search strategy uses the keywords “cancer AND food consumption AND diet” in Title/Abstract part from 2014 to 2025 years in Pubmed papers written in English.

Results: This minireview summarized the latest findings on the relationship between various food and cancers including cancer incidence / mortality / treatment. The foods such as fermented foods benefit cancers, while ultra-processed foods worsen cancers. The cancers include breast cancer, lung cancer, gastrointestinal cancer, hepatocellular cancer, and obesity-related cancer so on. The mechanism of diet influencing gut microbiota related to cancer is that bioactive metabolites such as lactic acid from fermented foods may impact immune, metabolic status and disease severity.

Conclusion: Food can both prevent and cause cancer, and may either worsen or mitigate its progression. This minireview should help develop dietary strategies for public health regarding cancers.

Hypertension and Cognitive Decline in Older Adults: A Comprehensive Review

Ana Cristina Salgado-Sauz — 2026-01-10

Hypertension is the leading risk factor contributing to the global burden of all-cause morbidity and mortality. Account for 9.4 million deaths per year and result in 212 million disability-adjusted life years lost in the affected population. Additionally, the prevalence of hypertension in individuals older than 60 years is approximately 60%, and this figure is expected to increase due to population ageing. Clearly, there exists a harmful association between hypertension and cognitive function. Mild Cognitive Impairment (MCI) refers to the alteration of cognitive functions without significantly impairing instrumental activities of daily living.

Its clinical significance lies in its role as the initial manifestation of Alzheimer’s disease. Persistent exposure to elevated blood pressure triggers microcirculatory damage, promoting cerebral atrophy and blood-brain barrier dysfunction. It is estimated that older adults with hypertension have up to a 40% increased relative risk of MCI and a 70% increased relative risk of dementia. Clinically, older adults with MCI may present with an insidious onset of memory loss and impairment of executive function, also referred to as abstract reasoning, involving frontal and subcortical brain structures.

These deficits manifest as difficulties in task planning, time management, self-care activities, and decreased cognitive processing speed. These observations underscore the importance of intensive and sustained blood pressure control, as hypertension is the most extensively studied modifiable factor for slowing the progression of cognitive decline.

Paraurethral Leiomyoma as a Rare Cause of Lower Urinary Tract Symptoms in a Female of Reproductive Age

Sanjula Jethwani — 2026-01-10

Leiomyomas are generally benign lesions originating from smooth muscle cells. However, paraurethral leiomyomas are a rare occurrence, with only a few cases being reported in the literature till date. In view of the scarce existing literature regarding paraurethral leiomyoma, their diagnosis and management pose a peculiar challenge.

Case Report: A case of a 43-year-old female, who presented with obstructive voiding symptoms of moderate severity for 4 months, is described. A mass of size 2.5 x 2 cm was palpable along the anterior wall of the vagina and the posterior wall of the urethra. The patient underwent surgical excision of the mass by the transvaginal route. This was confirmed to be leiomyoma on histopathology.

Conclusion: Paraurethral leiomyoma is an infrequent tumour arising from the periurethral smooth muscle and is an important differential diagnosis for paraurethral masses in females of reproductive age. In view of the limited experience with this entity, every case provides a significant insight for its diagnosis and management.

Role of Oil Pulling on Oral Health: An Overview

Ngwu Justina Nnenna — 2026-01-10

Oil pulling is a powerful and detoxifying Ayurvedic technique. It is an alternative medical practice in which an edible oil is swished around the mouth for a period of time and then spat out, similar to mouthwash. This chapter presents the role of oil pulling in oral health. Chronic use of mouth rinses containing phenol and other agents, such as chlorohexidine gluconate, used in taking care of the oral cavity, stains the teeth. Also, microorganisms in the oral cavity consist of a single cell covered with a lipid membrane, which, when it comes in contact with some of the oil used in oil pulling, adheres to it to achieve its oral cleansing. The results of studies conducted show that some of the oils, such as coconut oil, sesame oil, and sunflower oil, used in oil pulling therapy can reduce dental plaque, prevent gingivitis, halitosis, dental caries and other dental conditions. This is due to its antibacterial, antifungal, antiviral and antioxidant properties. Outside of offering several oral health benefits, it also contributes positively to overall health with minimal side effects when practised as recommended. Being one of the cheapest, cost-effective, safe, easy and efficient ways to control oral diseases, it should be used as a supplemental oral hygiene aid. It was recommended that oral health professionals should incorporate some of these products into patients’ oral hygiene materials. Additionally, these products should be made in a form that will be handy for patients.

Evaluation of the Knowledge, Practices and Barriers to Peak Flow Meter Use among Nurses in a Ghanaian Tertiary Hospital

Afua Wirekowaa Adjei Yeboah — 2026-01-10

Background: Chronic respiratory diseases, including asthma and chronic obstructive pulmonary disease (COPD), are among the most common non-communicable diseases globally and contribute substantially to morbidity, mortality, and health system costs. In asthma and COPD management, objective assessment of lung function is essential for diagnosis, monitoring exacerbations, and guiding therapy. Asthma and COPD are rising causes of morbidity and mortality in Ghana, yet objective tools for monitoring airflow limitation remain underused. Peak flow meters (PFMs) offer a simple, low-cost method for assessing airway obstruction, but their utilisation by nurses has not been well documented.

Objective: The primary objective of this study is to assess nurses’ knowledge, practices, and perceived barriers to PFM utilisation in the management of respiratory disorders at Komfo Anokye Teaching Hospital (KATH), Ghana.

Methods: A descriptive cross-sectional survey was conducted among 335 registered nurses selected through proportionate stratified sampling from medical, surgical, and emergency units of KATH. Data were collected using a pretested structured questionnaire. The instrument comprised four sections: demographic characteristics (age, sex, rank, years of practice, unit of work); knowledge of PFM use (purpose, calibration units, colour zones, clinical indications); practice of PFM use (experience, patient instruction, documentation); and perceived barriers to PFM utilisation. All the collected data were analysed with descriptive statistics (SPSS version 26).

Results: Knowledge of PFM use was poor, as only 55 nurses (16.4%) correctly identified the PFM as a device for measuring airflow limitation, and 28 (8.4%) recognised litres per minute as the standard calibration unit. Across the seven scored knowledge items, the estimated mean correct score was 2.36 ± 0.9 (out of 7), reflecting limited knowledge overall. Practical use was similarly limited, with 93 (27.8%) reporting ever using a PFM to assess a patient and 20 (6.0%) documenting peak flow values after bronchodilator administration. Major barriers included work overload (329, 98.2%), high device cost (315, 94.0%), lack of time to teach patients (305, 91.0%), and administrative unavailability of PFMs (304, 90.7%).

Conclusion: Nurses at KATH demonstrated substantial gaps in both knowledge and practice of PFM use despite acknowledging its clinical importance. Integrating PFM training into pre-service nursing curricula, providing regular in-service education, and ensuring consistent device availability are critical to strengthening respiratory care in Ghana. This study is limited by its cross-sectional design and single-site setting, which constrain generalizability. Future research should therefore involve multiple centres, include observational or audit data on PFM use, and examine both the effects of structured training interventions and the contextual factors influencing PFM utilisation in different clinical areas.

Making Decentralised Health Systems Work: Insights from Sierra Leone

Alhassan Fouard Kanu — 2026-01-10

Background: A decentralised health system is the cornerstone of a country’s health sector. However, for this system to perform effectively, it requires good leadership and management practices, in addition to the requisite inputs, notably finances and human resources, among others.

Aim: The present study aimed to investigate the factors that influence the performance of the district health management team (DHMT) in Sierra Leone.

Methods: This was a cross-sectional study with a mixed-method design conducted in four (4) DHMTs (Bo, Kailahun, Kenema, and Kono). A self-administered questionnaire was used to rate the leadership and management practices of District Medical Officers (DMOs), while an interview guide was used to explore the perceived factors that influence the performance of the DHMTs. SPSS version 25 was used to analyse the quantitative data, and a thematic analysis was carried out for the qualitative data.

Results: The leadership and management practices of the DMOs are rated as democratic by the majority of the subordinates. While leadership was mainly viewed as democratic, qualitative interviews uncovered underlying issues of domineering behaviour and perceived favouritism, indicating a disconnect between formal management styles and interpersonal dynamics. Despite the geographic variation across the four districts, the influence of leadership on performance remained consistent (p > .05).

On the perceived factors that influence the performance of DHMTs, the notable issues are the inadequate and late disbursement of funds to the district. This affects the implementation of planned activities. Further, the lack of adequate and capable staff within the DHMTs was highlighted. Other concerns were the poor coordination between national and district levels, and the poor working conditions (for example, poor office spaces, unreliable power supplies, and internet connectivity).

Conclusions: To make district health management teams work in Sierra Leone and in similar contexts, addressing the human resource gaps; ensuring a better flow of funds to the districts; and improving the coordination in health program planning and implementation between the national and the districts are promising measures that will optimise the performance of the decentralised health system.

Influence of Supply-side Factors on Access to Healthcare: An Empirical Analysis of Service Delivery in Sierra Leone

Alhassan Fouard Kanu — 2026-01-10

The capacity of the health system to respond timely and adequately to the health needs of the people is critical to averting deaths, especially in vulnerable populations such as pregnant women and children. The robustness and responsiveness of a country’s health system predict access to a range of health services, including maternal and child health (MCH) services. The purpose of this cross-sectional study was to examine the influence of five (5) health system characteristics (i. type of health provider, ii. level of facility, iii. availability of essential medicines, iv. availability of basic equipment, and v. type of facility) on access to MCH services in Sierra Leone. This study was guided by Bryce, Victora, Boerma, Peters, and Black’s framework for evaluating the scale-up to millennium development goals for maternal and child survival. The study was a secondary analysis of the Sierra Leone 2017 Service Availability and Readiness Assessment (SARA) dataset, which comprised 100% (1,284) of the country’s health facilities. Data analysis included bivariate and multivariate logistic regressions. In the bivariate analysis, all the independent variables showed statistically significant association with access to MCH services and achieved a p-value < .001. In the multivariate analysis, however, only 3 predictors explained 38% of the variance (R² = .380, F (5, 1263) = 154.667, p<.001). The type of health provider significantly predicted access to MCH services (β =.549, p <.001) as did the availability of essential medicines (β= .255, p<.001) and the availability of basic equipment (β= .258, p <.001). According to the study findings, the availability of the right mix of health providers, essential medicines, and basic equipment significantly influenced access to MCH services, regardless of the level and type of health facility. The study has highlighted the relative influence of health system access to MCH services. The findings would inform efforts towards broadening strategies to address weak health system blocks to optimise access to quality MCH services, which ultimately can contribute towards the reduction of maternal and child mortality rates in Sierra Leone and similar contexts.