Tumor-Specific Critical Intraoperative Findings Influence Multidisciplinary Therapy.

Background: Local control strategies in pediatric oncology are guided by disease-specific considerations. Effective communication of the goals of surgical procedure and associated intraoperative events plays a crucial role in shaping subsequent treatment decisions. However, accurately and comprehensively documenting these findings remains challenging, with considerable variability across different tumor types.

Reducing post-cesarean sepsis: Current best practice in prevention and treatment.

Cesarean section is the most common surgical procedure performed worldwide. It is associated with good perinatal and maternal outcomes when indicated. The rising global cesarean birth rate has coincided with an increase in post-cesarean sepsis - specifically site infections, which have an incidence of 7% worldwide.

Health literacy, multimorbidity and its effect on mental health in South African adults: a repeated cross-sectional nationally representative panel study.

Objective And Methods: Health literacy is a key determinant of physical and mental health outcomes, particularly in low- and middle-income settings like South Africa, where multimorbidity is increasingly common. Limited health literacy may hinder effective management of multiple chronic conditions and worsen mental health. Using repeated cross-sectional nationally representative data, this study examined the relationship between health literacy and multimorbidity, with a specific focus on mental health among South African adults (18 years and older).

Arbovirus surveillance detects mosquito-borne viruses in central South Africa.

Surveillance plays an important role in early detection of circulating arboviruses with potential to cause outbreaks of disease. In South Africa (SA) there are several endemic mosquito-borne viruses of medical and veterinary importance associated with outbreaks of disease in humans and domestic animals (livestock and horses) usually occurring after heavy rainfall. In addition, there are historical reports of viruses that were isolated from mosquitoes during vector surveillance studies with demonstration of antibodies in human populations during serosurveys.

Head and face dimensions of Black South African respirator users.

Objectives: Many South African workers rely on respirators for protection from airborne hazards. To our knowledge, there is no public head and face anthropometric database for Black South African respirator users to inform the design of respirators for these individuals. The objective of our study was to determine the facial dimensions of Black South African respirator users using the 13 facial dimensions recommended by the United States National Institute for Occupational Safety and Health (NIOSH).

Patterns of patent and sub-patent Plasmodium falciparum infections in household members of children under seasonal malaria chemoprevention coverage in the health district of Nanoro, Burkina Faso.

Background: Seasonal Malaria Chemoprevention (SMC) has been adopted since 2014 in Burkina Faso to reduce malaria burden in children under 5 years. However, the intervention's expected potential has not yet been achieved in real-life conditions, suggesting other factors may influence its effectiveness. Asymptomatic carriers, including patent and sub-patent Plasmodium falciparum infections in household members seems to be a potential factor maintaining the high malaria burden in children under SMC coverage.

What's new in the critical care management of acute liver failure: a focus on global accessibility.

Introduction: Acute liver failure (ALF) is a rare syndrome characterized by acute severe liver dysfunction and hepatic encephalopathy. The etiology of ALF varies according to age and geographical distribution and hence management depends on the etiology and clinical condition.

Areas Covered: While high-income-countries (HIC) most often see acetaminophen (APAP) and drug-induced liver injury (DILI) as causes of ALF, low-middle-income countries (LMIC) face a higher burden of viral hepatitis (particularly hepatitis A and E virus) and herbal/traditional/toxin medicine-related ALF transplant-free survival from ALF continues to improve with corresponding reduced rates of intracranial hypertension and cerebral edema particularly in APAP-ALF.

Does palliative care improve the quality of life for cancer patients in three tertiary hospitals in South Africa?

Background: Quality of life (QoL) is a crucial treatment outcome for cancer patients, who often experience significant symptom burden and distress. Despite its benefits, access to palliative care remains limited in many settings, including South Africa. This study assessed changes in QoL before and after palliative care interventions and examined factors associated with QoL improvements.

Integrating the Perspectives of Youth, Women, and Marginalised Communities in Addressing Global Environmental Management Challenges.

Globally, environmental mismanagement, overconsumption, population growth, and lifestyle changes disproportionately impact society, particularly affecting marginalized and vulnerable groups in developing nations. Despite progress in raising awareness and funding, many initiatives, including Youth Engagement Programs, Capacity Building, Gender (women) Mainstreaming, and Community-Based Approaches, have been limited or ineffective due to demographic variability. This study employed qualitative and quantitative methods to examine institutional factors that hinder the effective use of demographic variables in addressing global environmental challenges.

Barriers to and strategies for diagnosis of cryptococcal meningitis in people living with HIV in low-income countries.

Introduction: Cryptococcal meningitis (CM) is the second leading cause of AIDS-related mortality where the burden of advanced HIV disease is concentrated. Advances in diagnostics and treatment, including cryptococcal antigen (CrAg) screening and short-course antifungal regimens, have improved clinical outcomes in trials, but replicating these same benefits in routine care has proven more difficult.

Areas Covered: This review outlines the biological rationale for CrAg screening and examines the major operational barriers to effective CM diagnosis in low-income countries.

Serum metabolic profiling in rheumatic heart disease and degenerative aortic stenosis.

Metabolomics enables the characterisation of pathogenic and diagnostic biomarkers in cardiovascular disease (CVD). Given the high prevalence of rheumatic heart disease (RHD) and degenerative aortic stenosis (AS) in Africa, we investigated potential discriminant metabolic biomarkers in individuals with severe RHD and AS undergoing valve replacement and compared them to those in matched controls. Untargeted metabolomics of serum samples showed that seven metabolites that were differentially expressed in RHD patients were independent of the patients' baseline characteristics (covariates) and could differentiate RHD patients from healthy controls (AUC > 0.

Exploring the Acceptability of Web-Based Health Modalities in Individuals With Hypertension: Qualitative Study.

Background: Hypertension is a significant public health concern in low- and middle-income countries, where access to care is crucial for effective treatment and control. Web-based health modalities provide a promising solution to overcome barriers to care, particularly in underresourced communities, if those communities engage with the technology.

Objective: This study aims to examine the past experiences, perceptions, and preferences of using web-based health modalities for health care access among community members with or at high risk for hypertension.

Malaysian assistant medical officers: The profession's history, education, practices, and future.

Malaysia's healthcare system features a dual-tier structure with government and private sectors rooted in its colonial history. Assistant medical officers (AMOs) play a crucial role within this system, constituting the third largest group of healthcare professionals. The profession has evolved over 230 years, originating with the introduction of medical assistants to Malaysia by the British East India Company in 1786.

Penetrating cardiac injuries of the left ventricle - a case series and review of literature.

Background: Penetrating cardiac injuries (PCIs) remain a significant surgical challenge, characterized by high mortality rates, particularly in young adult males. The mechanism of injury (gunshot wound vs. stab wound) significantly influences outcomes.

Contributions of a community health worker program in improving district health system performance in South Africa, using routine health service variables in a quasi-experimental study design.

Background: Globally low- and middle-income countries are investing in community health worker (CHW) programs. These programs are viewed as fundamental to ensuring universal health coverage for all. Where CHW programs are doing what they should be doing and doing it adequately, they should make a difference in population health outcomes, reflecting health system changes.

A systemic risk assessment methodological framework for the global polycrisis.

Human societies and ecological systems face increasingly severe risks, stemming from crossing planetary boundaries, worsening inequality, rising geo-political tensions, and new technologies. In an interconnected world, these risks can exacerbate each-other, creating systemic risks, which must be thoroughly assessed and responded to. Recent years have seen the emergence of analytical frameworks designed specifically for, or applicable to, systemic risk assessment, adding to the multitude of tools and models for analysing and simulating different systems.

The Exposome Perspective: Environmental and Infectious Agents as Drivers of Cancer Disparities in Low- and Middle-Income Countries.

Cancer disparities in low- and middle-income countries (LMICs) arise from multifaceted interactions between environmental exposures, infectious agents, and systemic inequities, such as limited access to care. The exposome, a framework encompassing the totality of non-genetic exposures throughout life, offers a powerful lens for understanding these disparities. In LMICs, populations are disproportionately affected by air and water pollution, occupational hazards, and oncogenic infections, including human papillomavirus (HPV), hepatitis B virus (HBV), (), human immunodeficiency virus (HIV), and neglected tropical diseases, such as schistosomiasis.

Preventing multidrug resistant tuberculosis: the dawn of a new era.

Multidrug resistant tuberculosis (MDR-TB) remains a global health threat and accounts for a quarter of deaths due to antimicrobial resistance. Individuals infected with MDR-TB are at risk of progressing to TB disease. Treatment of drug-resistant TB infection to prevent progression to disease and avert the associated morbidity and mortality is a global priority.

Is South Africa ready for point-of-care, non-sputum tests for TB diagnosis? An assessment of end-user perceptions on a novel urine test and tongue swab for TB testing.

Background: Sputum collection continues to limit TB testing, resulting in undiagnosed TB. Innovative interventions are needed to expand point-of-care TB diagnosis particularly in low-to-middle income countries (LMICs). Novel non-sputum sample types currently under development can increase TB testing, however there is limited knowledge on end-user perceptions on these tests.

Plasmodium falciparum Genomic Surveillance Reveals a Diversity of Kelch 13 Mutations in Zambia.

Antimalarials are central to Zambia's strategies for malaria control and elimination. Antimalarial drug resistance poses a significant threat to the effectiveness of artemisinin-based combination therapies and preventive strategies such as sulfadoxine-pyrimethamine chemoprevention in pregnant women. In this genomic surveillance study, dried blood spots and epidemiological data were collected from confirmed Plasmodium falciparum cases at 61 health facilities across all 10 Zambian provinces from March to July 2023.

High Prevalence of Molecular Markers Associated with Artemisinin, Sulfadoxine, and Pyrimethamine Resistance in Northern Namibia.

Artemisinin-based combination therapies are a cornerstone of Namibia's efforts to eliminate malaria. Namibia has experienced a greater than 90% reduction in malaria cases since the introduction of these therapies in 2005. However, their efficacy has not been routinely monitored, with malaria outbreaks regularly reported since 2016.

Prevalence of anxiety and depression among pharmacy students at a University in South Africa: A cross-sectional survey.

Introduction: With approximately one-third of university students reporting symptoms consistent with at least one mental disorder at some point during their academic journey, mental health has become a global public health issue. The implications of these mental health statistics are grave, as anxiety and depression affect student well-being and correlate significantly with academic performance and retention rates. Students afflicted with mental health concerns are recognised to demonstrate lower engagement in their studies and higher dropout rates, which poses challenges for educational institutions aiming to support student success and development.

Optometry Students' Mental Health at a University in South Africa: Investigating the Links Between Anxiety, Depression, and Key Variables.

Introduction: Anxiety and depression in optometry students are becoming acknowledged as critical concerns, especially given the rigorous demands of their academic curricula. This study aimed to identify the severity of anxiety and depression and their association with socio-demographic, academic, and clinical variables among optometry students in South Africa.

Methods: This study was a descriptive, quantitative, and cross-sectional study involving 171 optometry undergraduate students at a university in South Africa.

In Vitro Evaluation of Antimicrobial Synergy Against Multidrug-Resistant Gram-Negative Paediatric Bloodstream Pathogens in South Africa.

: In vitro synergy testing (ST) is a useful means to gauge the performance ofantibiotic combinations against multidrug-resistant (MDR) Gram-negative bacteria (GNB). This study aimed to determine synergy of antibiotics against paediatric bloodstream (BS) carbapenem-resistant Enterobacterales (CRE) and extremely drug-resistant (XDR) species. : This cross-sectional study was conducted at a public tertiary hospital in South Africa, from January 2023 to December 2023.