Background: Hyoscine N-butylbromide (HBB; Buscopan) is commonly used in obstetric practice to accelerate labor and facilitate cervical dilation, yet variability in knowledge, attitude, and clinical usage persists among practitioners. This study assessed the knowledge, attitude, and usage patterns of HBB among medical practitioners at Abia State University Teaching Hospital (ABSUTH), Aba, Nigeria. Methods: A descriptive cross-sectional survey was conducted between August 2024 and April 2025 among 102 medical practitioners directly involved in labor care at ABSUTH. A structured, self-administered questionnaire, validated through expert review and pilot testing (Cronbach’s α = 0.78), was used to collect data on demographics, knowledge, attitude, and usage patterns. Descriptive and inferential statistics, including Chi-square tests and Pearson correlations, were performed using SPSS v. 25.0. Significance was set at p < 0.05. Results: Among 102 respondents, 93.1% had heard of HBB, and 70.6% correctly identified it as an antispasmodic. While 69.6% recognized its primary mechanism as cervical relaxation, 48% were aware of contraindications. The majority agreed that it is effective (mean = 4.12) and improves maternal outcomes (mean = 4.01). About 85.3% had administered it during labor, mostly in the active phase (64.7%), with the intravenous route being most preferred (56.9%). Statistically significant associations were observed between knowledge and attitude (χ² = 18.442, p = 0.001), specialty and frequency of use (χ² = 12.695, p = 0.048), and formal training with dosage knowledge (χ² = 15.210, p = 0.002). Knowledge, attitude, and usage scores were significantly correlated (p < 0.01). Conclusions: While the majority of practitioners at ABSUTH are familiar with and frequently use HBB in labor management, knowledge gaps and variations in practice remain. Strengthening formal training and incorporating standardized protocols could improve evidence-based usage and maternal outcomes.
Background: Evidence has suggested that school-based physical activity programs (SBPAPs) including structured physical education, extracurricular sports, and activity-based learningenhance memory and other cognitive functions. However, evidence on whether Indian adolescents can achieve improved cognition or increased academic performance also remains scarce. This study aimed to examine the relationship between SBPAPs and academic performance among Indian adolescents. Methods: A cross-sectional, mixed study was carried out from October 2024 to March 2025 in public and private secondary schools in Haryana and Punjab, north India. A total of 300 students aged 13 to 17 years were divided into an intervention group (n = 150) who participated in structured physical activity (PA) of at least 150 minutes per week and a comparison group (n = 150) who were involved in less than 30 minutes of PA per week. Academic performance was assessed in terms of composite scores of core subjects, while the level of PA was measured using the Physical Activity Questionnaire for Adolescents. Independent samples t-tests, one-way analysis of variance (ANOVA), and Pearson’s correlation analysis were all used for quantitative data handling. Qualitative data gathered from focus group discussions and key informant interviews with a subsample (n = 30) were thematically analyzed. Results: There were no significant differences in baseline demographics between the groups (p > 0.05). Compared with the comparison group, the intervention group showed significantly higher academic scores (mean = 76.4%, SD = 7.8; mean = 70.6%, SD = 8.4) with a moderate-to-large effect size (t = 6.30, p < 0.001, d = 0.72). A one-way ANOVA found that academic performance differed significantly among PA intensity levels (F(2,297) = 19.44, p < 0.001). There was a moderate positive correlation between PA levels and academic achievement (r = 0.44, p < 0.01). Qualitative findings corroborated quantitative data, showing that physically active students displayed improved concentration, emotional regulation, and academic motivation. Conclusions: Partaking in structured SBPAPs significantly increases Indian adolescents’ academic performance. These findings imply the necessity of including physical education in the academic curriculum as a low-cost, scalable method for supporting both cognitive growth and educational achievement.
Background: Glaucoma is a group of disorders that can lead to irreversible vision loss if untreated. It affects individuals across all ages, genders, and ethnicities, with intraocular pressure (IOP) being the only modifiable risk factor. Regional studies highlight variations in the prevalence of glaucoma subtypes, underscoring the need for population-specific data to guide effective prevention and treatment efforts. This study aimed to explore the clinical characteristics and patterns of glaucoma patients in a tertiary care setting in Bangladesh. Methods: This was a hospital-based cross-sectional study, conducted from January to December 2023 at the Glaucoma Department of Deep Eye Care Foundation. A total of 2,172 individuals aged 20 years and above were conveniently selected as the study population. After explaining the study objectives, written informed consent was obtained from all participants. Ethical approval was obtained from the institutional review board of the Deep Eye Care Foundation. Data analysis was performed using the Statistical Package for Social Sciences (SPSS), with a P-value of less than 0.05 considered statistically significant. Results: The study population predominantly consisted of middle-aged and older adults, with a slightly higher proportion of females than males. Most participants were housewives, followed by farmers. A majority resided in rural areas rather than urban, and only a negligible number reported a family history of glaucoma. More than half of the patients presented with reduced visual acuity. The average IOP was nearly similar in both eyes. Most cases showed bilateral involvement of glaucoma. The predominant types of glaucoma were primary angle-closure suspects (PACS) and primary open-angle glaucoma (POAG). The main treatment approaches included beta-blockers and laser peripheral iridotomy, while a notable proportion of patients were kept under observation. Conclusions: Bilateral involvement and reduced visual acuity were common, with PACS and POAG being the predominant subtypes. This study offers unique insights into the demographic and clinical profile of glaucoma in rural communities, emphasizing the need for communitybased screening, gender-sensitive eye care, and early detection to reduce visual disability.
Background: Cardiovascular diseases (CVDs) disproportionately affect conflict zones like Yemen, where diagnostic limitations persist. This meta-analysis evaluated the global prognostic utility of the red cell distribution width (RDW) and the neutrophil-to-lymphocyte ratio (NLR) as predictors of CVD and aimed to establish region-specific thresholds for low-resource settings. Methods: Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and MOOSE (Meta-analysis Of Observational Studies in Epidemiology) guidelines, we analyzed 75 prospective cohort studies (2014–2025) that included 201,604 adults from 142 countries. Random-effects models were used to pool hazard ratios (HRs) and the area under the curve (AUC). Results: NLR > 3.0 (HR, 2.2 [95% CI, 1.8–2.7]) independently predicted an elevated CVD risk (p < 0> 14% was associated with increased CVD risk in unadjusted analyses (HR, 2.3 [95% CI, 1.9–2.8]), this association became non-significant after adjusting for ferritin (HR, 1.02 [95% CI, 0.98–1.07]). This indicates that RDW primarily reflects iron status, emphasizing the need to measure ferritin before attributing high RDW to CVD risk. The combined RDW + NLR showed superior discriminative power (AUC, 0.82 vs. 0.71–0.74 for individual markers). Subgroup analyses revealed higher NLR cutoffs (>3.8) in HIV-endemic African populations (reflecting chronic immune activation). Sensitivity analyses revealed attenuated NLR effects in rural populations (HR, 1.9) and non-significant RDW-CVD associations when adjusting for ferritin (HR, 1.02), highlighting contextual limitations. Conclusions: While NLR stands as an independent CVD predictor, RDW > 14% must be interpreted with concurrent ferritin measurement. This is crucial to avoid misattributing CVD risk in malnutrition-endemic regions, such as Yemen, where an RDW > 15% is common. The RDW primarily reflects iron status and requires iron-status validation, especially in these high-malnutrition areas. However, caution is warranted when generalizing findings to rural settings where the CVD burden is rising fastest, given the underrepresentation of rural populations (only 16% of included studies). We strongly recommend standardized automated hematology analyzers (k > 0.85).
To the editor, On April 24, 2025, the World Health Organization (WHO) issued an urgent call to reinvigorate global action to end malaria, releasing updated guidelines that reflect both progress and persisting challenges in combating this deadly disease. [1] This renewed guidance arrives at a critical juncture: global malaria cases have plateaued, progress is faltering, and health systems in endemic regions face increasing strain from drug resistance, climate change, and funding shortfalls.
To the editor, Somalia’s healthcare system, already burdened by decades of conflict and instability, continues to face immense challenges in access, equity, and governance. In this fragile setting, integrating bioethics into healthcare reform offers not only a moral compass but also a practical strategy for rebuilding trust and guiding policy decisions. Bioethical principles such as justice, autonomy, and non-maleficence are essential in fragile states where the absence of clear ethical standards has historically led to disjointed care and poor health outcomes. [1–3]