Suspected drug-induced hypersensitivity reaction (DRESS Syndrome) following sitagliptin addition in a diabetic patient on glimepiride and metformin: A case report.

Background Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome is a rare, potentially life-threatening drug-induced hypersensitivity reaction characterized by skin eruptions, eosinophilia, and multi-organ involvement. While rare with antidiabetic drugs, sitagliptin has been implicated in a few reported cases. Objective : To report and analyze a suspected case of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome associated with sitagliptin initiation in a type 2 diabetic patient previously controlled on glimepiride and metformin, and to emphasize the importance of early recognition, appropriate management, and pharmacovigilance in rare but serious drug-induced hypersensitivity reactions.  Case Presentation We present a case of suspected DRESS syndrome in a 52-year-old male with type 2 diabetes mellitus, who developed facial and limb swelling, skin hyperpigmentation, and systemic laboratory abnormalities five days after sitagliptin initiation.  Management and Outcome Sitagliptin was discontinued, and supportive care was initiated. Laboratory abnormalities included leukocytosis, eosinophilia (10%, AEC 1,480 /µL), elevated liver enzymes, and mild renal dysfunction. Symptoms resolved within two weeks following drug withdrawal.  Conclusion This case highlights the need for vigilance in recognizing drug-induced hypersensitivity reactions in diabetic patients, even with relatively safe agents like sitagliptin. Recommendation Sitagliptin should be used cautiously after assessing hypersensitivity risk. Monitor for early DRESS signs (rash, facial swelling, eosinophilia) within 2–4 weeks. Educate patients, perform baseline and follow-up labs. Stop the drug at first suspicion; avoid rechallenge and other DPP-4 inhibitors. Report to pharmacovigilance. Skin biopsy and viral tests may aid diagnosis. Further research is needed

A cross-sectional environmental assessment of the ecological integrity of key driver components (Water Quality, Sediment, and Habitat) in the uMngeni, Thukela, Umvoti, Umdloti, and Umfolozi rivers, KwaZulu-Natal.

BackgroundFreshwater ecosystems in KwaZulu-Natal are increasingly threatened by urbanization, agriculture, and industrial activities. These pressures undermine ecological integrity by affecting water quality, sediment characteristics, and habitat structure. The uMngeni, Thukela, Umvoti, Umdloti, and Umfolozi Rivers hold critical ecological and socio-economic value, yet comprehensive assessments of their environmental condition remain limited.  MethodsA cross-sectional environmental assessment was conducted across five major rivers between March 2024 and October 2024, with sampling sites positioned upstream, midstream, and downstream to capture spatial variability. Water quality parameters (pH, dissolved oxygen, turbidity, nitrates, phosphates, and heavy metals) were measured using standard methods. Sediment samples were analysed for particle size distribution, organic content, and contaminants. Habitat integrity was assessed using the South African Scoring System (SASS5) and the Index of Habitat Integrity (IHI). Data were analysed using descriptive statistics and multivariate techniques.  ResultsThe assessment revealed varying levels of ecological degradation. Downstream sections of the uMngeni and Umvoti Rivers showed poor water quality, with elevated nutrient levels and low dissolved oxygen. Sediment contamination by organic matter and heavy metals was prominent near urban and industrial zones. Habitat integrity scores were lowest in areas affected by agricultural runoff and informal settlements. The Umdloti and Umfolozi Rivers showed relatively better ecological conditions, though signs of degradation were still evident.  ConclusionThe study highlights significant ecological stress in KwaZulu-Natal’s rivers, particularly due to declining water quality and habitat degradation. Spatial trends reveal a strong association between land use activities and ecosystem health, emphasizing the need for urgent intervention.  RecommendationTo protect freshwater ecosystems, authorities should enhance river monitoring programs, enforce pollution control measures, and implement habitat rehabilitation. A collaborative, catchment-based management approach involving communities, industries, and conservation stakeholders is essential for sustainable riverine ecosystem protection

UPTAKE OF INTRA-UTERINE CONTRACEPTIVE DEVICES AND ITS ASSOCIATED INDIVIDUAL FACTORS AMONG WOMEN AGED 15 – 45 YEARS ATTENDING SERVICES AT BWEYOGERERE HEALTH CENTRE III, WAKISO DISTRICT, CENTRAL UGANDA – A CROSS-SECTIONAL STUDY.

Introduction An Intra-Uterine Contraceptive Device (IUCD) is a reversible, long-acting, safe, and effective method of postponing childbirth for couples, but many women get unwanted pregnancies in fear of side effects associated with some methods. This study aimed at determining the uptake of IUCDs and its associated individual factors among women aged 15 – 45 years attending health services at Bweyogerere Health Center III, Wakiso District, Central Uganda.  Methods This cross-sectional study involved 391 women aged 15 – 45 years, attending services at Bweyogerere Health Center III, who voluntarily consented to participate in the study and were selected using systematic random sampling. Data was collected using a structured questionnaire. The data was analyzed in SPSS v.21 using mean, frequencies, percentages, chi-square, and binary logistic regression. Participants provided written informed consent for participation. Ethical approval was sought from the College Research and Scientific Committee, and administrative clearance was obtained from the District Health Office and the Health Facility In-Charge.   Results Data was collected from 391 participants with an average age of 26.2 years (S = 6.86) and 348 (89%) were married and 378 (96.65%) were employed with almost equal distribution in the highest education level attained as; 148 (37.9%) had primary or less, 141 (36.1%) secondary and 102 (26.7%) had a tertiary or higher qualification. The uptake of IUCD was 26.6% and was associated with participants’ age (aOR=0.271; p-value=0.000) and education level (aOR=90.090; p-value=0.000) as the significant individual factors. Conclusion The uptake of IUCDs among participants is 26.6%, which is low and is associated with one’s age and educational level as the significant individual factors. Recommendations Health workers need to provide targeted contraceptive methods that are tailored to clients’ characteristics, like age and educational background, to accelerate the uptake of methods like IUCDs.

A Study on the Impact of Smart Phone Use on Haematological and Cardiovascular Parameters in the Adult Population

Background: The increasing use of mobile phones has raised concerns about their potential health effects, particularly on cardiovascular, inflammatory and hematological parameters. This study investigates the impact of mobile phone usage on WBC count and blood pressure among adults. Methods: This study was conducted at IGIMS, Patna, to assess the effects of mobile phone radiation on cardiovascular, inflammatory and hematological parameters. Blood pressure was measured using a mercury sphygmomanometer, and WBC count was analysed using the hemocytometer method. Data on mobile phone usage were obtained from call logs, and statistical analysis was performed using SPSS with a significance level of p<0.05. Results: The study found that 76% of participants were aged 21-25 years, with males comprising 86% of the sample. Blood pressure analysis showed 47% had systolic BP >120 mmHg, and 51% had diastolic BP >80 mmHg. No significant correlation was found between mobile phone usage and blood pressure or leukocyte count (p>0.05). Conclusion: Prolonged mobile phone use showed a non-significant trend toward higher blood pressure, but no direct impact on leukocyte count. Further studies with larger samples are needed to explore potential health effects

Hepatic enzyme alterations as prognostic markers in neonates with hypoxic-ischemic encephalopathy: A hospital-based prospective cohort study.

BackgroundPerinatal asphyxia remains a significant contributor to neonatal morbidity and mortality, with hypoxic-ischemic encephalopathy (HIE) being a major sequela. Liver injury is a common systemic complication, and hepatic enzymes may serve as potential biomarkers for the severity of hepatic encephalopathy (HIE). Objectives: To assess the pattern of hepatic enzyme alterations in neonates with HIE and explore their prognostic value in stratifying disease severity.  MethodsThis prospective cohort study enrolled 100 term neonates with perinatal asphyxia. HIE staging was performed using the modified Sarnat and Sarnat criteria. Liver function tests, including serum glutamate oxaloacetate transaminase (SGOT), serum glutamate pyruvate transaminase (SGPT), and alkaline phosphatase (ALP), were measured on Days 1 and 3. Statistical analysis included ANOVA, post-hoc comparisons, and Chi-square tests to evaluate associations with clinical outcomes.  ResultsAmong the neonates, 33% had HIE Stage I, 39% Stage II, and 28% Stage III. Serial measurements showed significant increases in SGOT, SGPT, and ALP from Day 1 to Day 3 across all HIE stages (p<0.001). Enzyme elevations were most marked in Stage III. Cut-off values for predicting Stage III HIE were SGOT >77.4 U/L, SGPT >90.4 U/L, and ALP >257.1 U/L. Seizure activity (p<0.001) and mode of resuscitation (p<0.001) showed statistically significant associations with HIE severity, while maternal risk factors (p=0.72), mode of delivery (p=0.64), and place of delivery (p=0.59) did not.  ConclusionSerial hepatic enzyme levels are reliable biochemical indicators for assessing the severity of HIE. Their prognostic relevance supports early stratification and targeted management in neonatal intensive care units.Recommendations Regular monitoring of hepatic enzymes in neonates with perinatal asphyxia can aid early detection and management of HIE severity

IN VITRO STUDIES ON PHYTOCHEMICAL, ANTIOXIDANT, AND ANTIBACTERIAL PROPERTIES OF ADANSONIA DIGITATA L. FRUIT PULP AND LAWSONIA INERMIS L. LEAVES EXTRACTS.

Background Plant materials are widely used for their healing power, and many studies have shown that compounds isolated from plants exhibit variable biological properties. The present work was aimed to determine the preliminary phytochemical contents, evaluate the antioxidant capacities, and investigate the antibacterial activities of Adansonia digitata L (Bombacaceae) fruit pulp and Lawsonia inermis L (Lythraceae) leaves extracts. Methods Plant materials were first extracted (separately) by methanolic maceration, then the obtained extracts were utilized for preliminary phytochemical screening tests, in vitro DPPH antioxidant assay, and to determine their antibacterial activities against Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, and Pseudomonas aeruginosa using the plate hole diffusion assay. Results The preliminary phytochemical screening for L. inermis leaf extract revealed the presence of tannins, flavonoids, alkaloids, steroids, and saponins, while A. Digitata fruit pulp extract gave positive results for tannins, saponins, cardiac glycosides, terpenes, and flavonoids. Both plant materials exhibited concentration-dependent radical scavenging activity with relatively similar capacities, which is equivalent to the standard (quercetin) at all concentrations (5, 10, 50, 125, and 250 µg/ml). The recorded growth inhibition for A. digitata was 19mm against Klebsiella pneumoniae, 18mm for Staphylococcus aureus and Proteus mirabilis, 15mm for Pseudomonas aeruginosa, and 14mm against Escherichia coli. For L. inermis, the inhibition zone was 25mm against Staphylococcus aureus, 20mm for Escherichia coli, 19mm for Proteus mirabilis, 16mm for Pseudomonas aeruginosa, and 13mm against Klebsiella pneumonia. Conclusion The obtained findings could justify the pharmacological properties and may provide the rationale for some ethnomedicinal uses of these plant products. Recommendation Further investigations should be performed as they could enhance the medicinal importance and evaluate the traditional values of these plants

To Study Vitamin D, Uric acid along with C-REACTIVE Protein in patients of psoriasis in tertiary care hospital in Bihar

Background Psoriasis, a persistent severe skin disorder mediated by the immune system, affects two to three percent of individuals globally and is becoming recognized as a systemic disease. Emerging evidence suggests that vitamin D deficiency, hyperuricemia, and elevated C-reactive protein (CRP) may contribute to its pathogenesis and associated comorbidities. Despite India’s high prevalence of vitamin D deficiency, studies exploring the interplay of these biomarkers in psoriasis are limited. Methodology A prospective case-control study was conducted in IGIMS, Patna. from February 2020 to October 2021. Out of the 150 participants, 75 had chronic plaque psoriasis and the remaining 75 were healthy controls who were assigned for sex and age. Serum 25-hydroxyvitamin D [25(OH)D], uric acid, along with CRP was measured by chemiluminescent microparticle immunoassay, uricase–peroxidase enzymatic method, and latex-enhanced turbidimetric immunoassay, respectively. The statistical analyses included the t-test, the chi-square test, and Pearson's correlation; a p-value of less than 0.05 was taken to be significant. Results Psoriasis patients showed markedly reduced serum vitamin D levels compared to healthy controls. In contrast, the patient group's levels of uric acid and C-reactive protein (CRP) were noticeably higher. All individuals with psoriasis were vitamin D deficient, and nearly half had elevated CRP levels. Vitamin D demonstrated a strong inverse relationship with CRP and a moderate negative association with uric acid, while CRP positively correlated with uric acid. Conclusion Vitamin D deficiency is significantly linked to psoriasis, systemic inflammation, and hyperuricemia, reflecting its systemic nature rather than a skin-limited disorder. Recommendation Routine screening of vitamin D, CRP, and uric acid levels should be integrated into psoriasis management, particularly in regions with endemic vitamin D deficiency. Vitamin D supplementation and metabolic risk monitoring may improve clinical outcomes and reduce long-term comorbidities. Further longitudinal and interventional studies are warranted to establish causality and therapeutic benefits

Assessing knowledge and awareness about Chlamydia trachomatis among undergraduate students at a University of Technology in KwaZulu-Natal, South Africa

BackgroundChlamydia trachomatis (CT) is the leading bacterial cause of sexually transmitted infections (STIs) worldwide and represents a major public health problem. The World Health Organization estimated in 2020 that the global prevalence of CT infections had increased by 2.9%, with women disproportionately affected. Understanding knowledge and awareness levels of CT among young adults is essential to inform prevention strategies. The study aimed to assess the level of knowledge and awareness of CT among undergraduate students at a University of Technology in KwaZulu-Natal, South Africa. MethodsA cross-sectional survey was conducted among female students. Data was collected via a self-administered electronic questionnaire consisting of four sections: demographics and practices; awareness and knowledge of STIs; knowledge of CT; and awareness of CT risk factors and screening methods. Descriptive statistics were used to summarize responses. ResultsMost participants (90%) had heard of STIs, primarily through social media, school, clinics, and community sources. However, only 20% reported ever being tested for an STI. Awareness of CT specifically was low, with only 43% recognizing the infection and its mode of transmission. Furthermore, 83% lacked knowledge of CT prevention and management. Small proportions identified abstinence (7%), testing (11%), and education/awareness campaigns as preventive measures. ConclusionAlthough general awareness of STIs was high, knowledge of CT was limited. Targeted health education and campus-based interventions are needed to improve awareness, prevention, and screening practices for specific STIs. The study was limited by its small, single-institution sample and reliance on online survey distribution, which may not have fully represented the intended student population

A Prospective interventional study on the therapeutic potential of human placental extract in dermatological conditions.

Background Placental extract is known for its regenerative, anti-inflammatory, and antioxidant properties. It is increasingly used in dermatology for conditions such as melasma, alopecia, and chronic ulcers. Objective: To evaluate the clinical efficacy and safety of topical and intradermal human placental extract (HPE) in selected dermatological conditions.  Methods A prospective interventional study was conducted at a tertiary care dermatology outpatient clinic over 6 months (August 2023 to February 2024). Fifty patients were enrolled and grouped according to diagnosis: melasma (n=20), chronic non-healing ulcers (n=15), and alopecia areata (n=15). Topical application or intradermal injection of placental extract was administered over 6 weeks. Clinical improvement was assessed using the MASI (score melasma), ulcer area measurement, and SALT score (alopecia) at baseline, 3 weeks, and 6 weeks.  Results In the present study, age (mean±SD): B 47.3±8.4 > A 34.1±6.2 > C 29.8±5.6; females: A 90%, B 60%, C 40%. Significant improvement was observed in all groups. In melasma, the mean MASI score decreased from 12.6 ± 2.3 to 6.4 ± 1.9 (p < 0.01); in chronic ulcers, the mean area reduced by 68.2% (p < 0.01); and in alopecia areata, the SALT score improved from 35.2 ± 8.1 to 22.5 ± 6.7 (p < 0.05). No major adverse effects were reported.  Conclusion Human placental extract is effective and safe in the management of melasma, chronic ulcers, and alopecia areata. Further large-scale trials are recommended. Recommendations Use HPE adjunctively (melasma: weekly intradermal ×6; ulcers: daily topical; alopecia: intralesional q2w ×3 with standard co-therapies), standardize monitoring (photos, MASI/SALT/ulcer area at 0/3/6 weeks), enforce safety/asepsis with AE logs, implement SOPs/registry, and conduct ≥6–12-month RCTs (dose–response, subgroups/biomarkers, cost-effectiveness, PROs)

Factors post abortion care utilization and associated factors among women of reproductive age in Lira City. A cross-sectional study.

  Background PAC is an effective intervention for decreasing maternal mortality and morbidity owing to abortion. PAC Services are services offered by the healthcare professionals to women who have had an abortion to prevent complications related to Abortion. This study aimed to assess the factors influencing PAC service utilization among women of reproductive age in Lira City.  Methods This was a quantitative cross-sectional study done among women of reproductive age in Lira City. A total of 335 women were recruited by multistage sampling. The data was collected using a pre-tested structured questionnaire. Ethical approval was obtained. Data was analyzed using SPSS version 23.  Results The mean age of study participants was 26.09. (87%) Of the participants were Christians 54.3% (182) had heard about PAC, and the majority, 55.5% (186), had some knowledge about PAC. Most participants (63.9%) stay 1-5km away from the health facility. Stigma was the most common (59.1%) challenge women who had an abortion faced in the community. 26.6% of the participants said health providers of abortion services are kind. Only marital status remained statistically significant at multivariate analysis, P-value (0.009 OR 4.907[0.870-8.266]. Age, religion, and income level are significant in determining whether one will have an abortion or not at p-values of 0.004, 0.009, and 0.029, respectively.  Conclusion Education level, marital status, and knowledge increased utilization of PAC services, while factors like stigma and restrictive abortion laws decreased utilization of services.  Recommendations The restrictive abortion laws, which allow abortion only if the life of the mother and/or the fetus is in danger, should be adjusted to include adolescents and young women who are not ready for childbearing