Prosthetic joint infection caused by Mycobacterium tuberculosis is extremely rare. It can mimic aseptic loosening or chronic infection with common bacteria, delaying diagnosis. We report a case of tuberculous infection in a total hip arthroplasty in a 55-year-old immunocompetent patient, revealed by prosthetic loosening. The diagnosis was confirmed by histology, culture, and molecular biology (GeneXpert). This case highlights the need to consider tuberculosis in the differential diagnosis of chronic prosthetic infections, particularly in endemic areas.

Background: Healthcare workers face high levels of stress, long hours and demanding workloads, which can impair sleep, mental health and job performance. Aerobic exercise has been shown to improve these outcomes by enhancing mood, reducing stress and promoting better sleep. Exploring the effects of aerobic exercise on sleep quality, mental health, and job performance among healthcare professionals is necessary. Aim of the Study: To determine the effects of aerobic exercises on job performance, mental health and sleep quality among interns in Federal Medical Centre, Owo. Material and Methods: This pretest-protest study design involved 40 physically fit healthcare interns at Federal Medical Centre, Owo selected through consecutive sampling. Participants engaged in supervised aerobic exercise sessions; three times weekly for six week, each lasting 40 minutes. Pre and post intervention data were collected using the Werwick-Edinbugh Mental well-being Scale (WEMWBS), Pittsburgh sleep quality index (PSQI), and the Minnesota Job Satisfaction Questionnaire (MJSQ). Data were analyzed using Statistical Package for Social Sciences (SPSS) version 26 with Wilcoxon signed-rank test applied to assess pre-and post- intervention differences at a 0.05 significance level. Results: A total of 37 interns (mean age= 25.54 ± 2.40 years) completed this study. Pre and post intervention comparison of results showed no significant difference in mental well-being (p=0.219) and job satisfaction (p=0.158). However, a significant difference was observed in sleep quality of participants (p=0.001), indicating better sleep quality. Conclusion: Aerobic exercise significantly improved sleep quality, with positive trends (though not significant) in mental well-being and job satisfaction.

Introduction: Prosthetic joint infection (PJI) is a serious complication of arthroplasty, associated with significant morbidity and therapeutic challenges, particularly due to biofilm formation and the emergence of multidrug-resistant (MDR) bacteria. In Morocco, where osteoarticular trauma and resistant nosocomial pathogens are frequent, a local assessment of PJIs is warranted. The objectives of our study are to determine the frequency of infections in prostheses, specify the epidemiology and resistance profile of isolated strains to antibiotics. Methods: This is a retrospective study conducted in the bacteriology laboratory of the Mohammed V Military Teaching Hospital in Rabat over a 4-year period (2015–2018), involving 572 arthroplasties. Samples were processed using standard microbiological techniques, and antimicrobial susceptibility testing was performed by the disk diffusion method and interpreted according to CA-SFM/EUCAST guidelines. Results: Out of 53 samples received, 37 (69.8%) were culture-positive. Twenty-four cases of PJIs were confirmed, representing an infection rate of 4.19%, predominantly affecting hip prostheses (3.49%). Delayed infections (3–24 months post-surgery) were the most frequent (87.5%). Gram-positive cocci accounted for 59.5% of isolates, followed by Enterobacterales at 31.7%. Staphylococcus aureus was 100% methicillin-susceptible, while 26% of coagulase-negative staphylococci were methicillin-resistant. Resistance rates among Enterobacterales were 32% for cefotaxime and 4% for imipenem. Conclusion: PJIs represent a major issue in our setting, with a predominance of staphylococci and an alarming emergence of multidrug-resistant Gram-negative bacilli. These findings highlight the need for rigorous diagnostic protocols, strengthened preventive measures, and antibiotic policies tailored to the local microbiological ecology.

Background: Female sexual health is often underexplored in the context of chronic liver diseases, despite its key role in overall quality of life. Sexual dysfunction in this population is rarely addressed during hepatology consultations, even though it may be aggravated by clinical complications such as cirrhosis. Methods: This was a cross-sectional, descriptive, and analytical study conducted between January and December 2024, including 106 female patients (53 with chronic liver disease, 53 controls). All completed the FSFI questionnaire. A score < 26 indicated sexual dysfunction. Data were analyzed using Jamovi version 2.2.5. Results: Sexual dysfunction (FSFI score < 26) was observed in 60.4% of patients with chronic liver disease, versus 28.3% in the control group (p < 0.001). The most affected domains were lubrication (84.4%), satisfaction (75%), and desire (65.6%). Cirrhosis was significantly associated with dysfunction (OR = 6.8; p = 0.046). Conclusion: Sexual dysfunction is frequent in women with chronic liver disease, especially in those with cirrhosis. Despite its high prevalence, it remains neglected in routine hepatology practice, underscoring the need for integrated sexual health assessment.

Background: Dilated cardiomyopathy (DCM) poses a significant health risk in pediatric populations, yet its pathophysiological mechanisms remain unclear. This study aims to explore new biomarkers as potential predictors in pDCM. Methods: A total of 84 pediatric patients diagnosed with dilated cardiomyopathy (DCM) and 34 age-matched healthy controls were prospectively recruited. Inclusion criteria were based on clinical diagnosis, echocardiographic findings, and relevant exclusion criteria for other cardiac or systemic conditions. Serum levels of total carnitine, procollagen type III N-terminal propeptide (PIIINP), cystatin C (Cys-C), β2-microglobulin (β2M), and haptoglobin (Hp) were quantitatively assessed using enzyme-linked immunosorbent assay (ELISA). Expression of acylcarnitine was assessed via qRT-PCR. Results: There were significantly higher plasma levels of total carnitine (p=0.001), PIIINP (p=0.016), Cys-C (p=0.001), β2M (p=0.009), and haptoglobin (p=0.001) in pDCM compared to matched controls. Total carnitine, PIIINP and β2M at cut-off points 65 umol/ml &3 & 2 mg/L showed 73&79% & 75% sensitivity and 91& 56% & 81% specificity respectively for predicting risk of pDCM. Haptoglobin at cutoff point 164 mg/L has highest specificity (100%) but with low sensitivity 56%). Combined β2M, PIIINP, and total carnitine demonstrated the best accuracy (83.5%) with 75% sensitivity, 92% specificity, 90% PPV, and 79% NPV for the presence of pDCM. A significant upregulation of the acylcarnitine expression gene was also observed in the DCM group compared to controls. Conclusion: Acylcarnitine, PIIINP, Cys-C, β2M and heptoglobin are potential emerging predictors for pDCM and might have a pathogenic role in pDCM with mechanistic associations.

The global imperative to decarbonize energy systems and mitigate climate change has catalyzed intense research and development into alternative energy carriers. Hydrogen, the most abundant element in preconceived universe, is emerging as a pivotal vector in this transition, offering a versatile, high-energy-density fuel that can be produced from various sources. This paper explores the burgeoning "Hydrogen Horizon," focusing on the technical innovations driving its advancement, particularly within the renewable energy paradigm. It critically compares blue hydrogen (produced from fossil fuels with carbon capture) and green hydrogen (produced from renewable electricity via electrolysis), examining their respective production processes, economic viabilities, and environmental implications using relevant data. The pros and cons of different hydrogen production pathways are discussed, alongside a comparative analysis with the incumbent oil and gas industry. The paper concludes that while blue hydrogen may serve as a transitional technology, green hydrogen, propelled by continuous technical innovation, holds the ultimate promise for a truly sustainable energy future.

A key global concern that relates to Intellectual Capital and Financial Performance of Listed Manufacturing Companies is that the measurement and disclosure models relating to intellectual capital are not standardized in various international markets. This paper has looked at the influence of intellectual capital on financial performance of publicly traded manufacturing firms in Nigeria. In particular, it examined the impact of structural capital, human capital and capital used on financial performance of these firms. The research utilized ex-post facto research design, which made it possible to analyze secondary financial data in detail. The subject of the research included thirty-three (33) listed manufacturing firms in Nigeria that were selected to include both industrial and consumer goods firms, as of December 31, 2024, listed on the Nigerian Exchange Group (NGX). Descriptive statistics and Random-effects Generalized Least Squares (GLS) regression were applied to analyze data. Results showed that both the components of intellectual capital are not statistically significant predictors of financial performance at a significant level, as the value of the Wald chi-square was insignificant. The regression results showed poor explanatory ability with a negligible contribution to financial performance variance. The findings imply that firm-specific heterogeneity, as opposed to intellectual capital revaluations across time, are the significant sources of financial performance variation. Though the intellectual capital has theoretical significance, its output as far as the financial performance of the Nigerian manufacturing sector is concerned, seems minimal. The research advocates that manufacturing firms ought to do a better job of recognizing and reporting on the components of intellectual capital; and policymakers need to come up with uniform reporting regimes to enhance financial transparency, comparability and strategic thinking in emerging markets.

The study examined the impact of some macroeconomic variables of food inflation in Nigeria. Exchange rate (ExR), broad money supply (BMS), interest rate (InR), and food production index (FoPI) were employed as dependent variables, while food price inflation was employed as the dependent variable. Data on the variables from the period 1996 to 2023 were sourced from the Central Bank of Nigeria (CBN) Statistical bulletin, and the World Bank, World Development Indicators for Nigeria. The Augmented Dickey-Fuller unit root test was used to test for stationarity of the variables, which revealed that the variables were integrated of order I and order II, which necessitated the adoption of the Autoregressive Distributed Lag (ARDL) bounds test for long run relationship. Result of the bounds test confirmed that the variables have long run relationship. Outcome of the ARDL estimates revealed that an increase in exchange rate resulted to an increase in food price inflation in the country, while an increase in broad money supply, interest rate and food production index all had significant impacts in reducing food price inflation in the country. The study therefore, recommends among others that the Nigerian government through the monetary authorities should avoid devaluation of the currency given that exchange rate worsens food price inflation in the country.

Barriers to effective mental health problems management by family doctors in primary health care settings often stem from systemic and structural issues. One significant barrier is the lack of time during patient consultations. Family doctors frequently have heavy caseloads, which limits their ability to conduct thorough assessments and engage in meaningful discussions about mental health. Additionally, many practitioners may feel ill-equipped to handle mental health issues due to insufficient training during their education. Despite the high prevalence of mental health conditions, primary care training programs have historically emphasized physical health, leaving physicians underprepared to identify and treat psychological disorders. Furthermore, stigma surrounding mental health can further complicate patient interactions in primary care settings. Family doctors may experience their own latent biases about mental health, which can influence the quality of care they provide. Patients, too, may be hesitant to disclose mental health concerns due to fear of being judged or misunderstood, leading to underreporting of symptoms. Financial and resource limitations also play a role; many family practices lack access to mental health specialists for referrals or collaborative care, constraining doctors' ability to offer comprehensive treatment plans. As a result, these barriers can lead to inadequate management of mental health issues, potentially exacerbating the overall health outcomes for patients in primary care environments.

Background: Physical activity plays a vital role in maintaining physical and mental well-being thereby reducing the risk of numerous chronic conditions and certain musculoskeletal disorders. Despite its importance, many women struggle to engage in regular physical activity due to a range of barriers. This study aimed at assessing physical activity levels and potential barriers among women working in Federal Medical Center, Owo. Materials and Method: The cross-sectional survey recruited 100 female staff who had worked for at least one year at Federal Medical Center, Owo. Ondo state, Nigeria. Data were collected using the IPAQ-Short Form and the Barriers to Being Physically Active Quiz. Ethical approval and informed consent were obtained. Data were analyzed using SPSS (version 21) with chi-square and logistic regression tests at a 0.05 significance level. Results: Most participants were aged 45-54, married, and had university-level education. 39% had low physical activity levels, 45% moderate, and 16% high. The most reported barriers were lack of time (64%), lack of energy (63%), and lack of willpower (59%). Other barriers like social influence, fear of injury, and lack of resources were less frequently cited. Chi-square analysis showed no significant association between physical activity level and socio-demographic factors or reported barriers. Logistic regression also revealed no significant predictors of activity level. Conclusion: Participation in physical activity remains low among women at in this study. Key barriers such as time, energy, and willpower were prevalent but not statistically predictive.

The study examines the impact of macroeconomic aggregates on stock price in Nigeria. The study employs secondary data extracted from the Central Bank of Nigerian (CBN) Statistical Bulletin of 2023 and the international financial statistics (IFS). The methods of data analyses include the ordinary least squares multiple regression and the error correction mechanism on a time series data covering the period of thirty years (1994-2023). The findings of the study are that, the current level of money supply (DM2) has a positive and insignificant impact on All Share Index (ASI) in the short-run while the money supply (M2) in the long run has a negative relationship and a statistically significant impact on All Share Index (ASI), the current level of Interest Rate (DINTR) has a negative and insignificant impact on All Share Index (ASI) in the short run while interest rate (INTR) has negative relationship with the all share index (ASI) and not statistically significant, the current year of inflation rate (DINFR) has a negative and a statistically significant impact on All Share Index (ASI) in the short run while inflation rate (INFR) has a negative and a statistically significant impact on All Share Index (ASI), and the current level of consumer confidence index (DCCI) has a negative and statistically significant impact on All Share Index (ASI) in the short-run while consumer confidence index has a positive and statistically significant impact on All Share Index (ASI). A major recommendation of the study is that Government should reduce its participation in direct importation so as to enhance stock market indices in the Nigerian capital market.

This research area is to measure the dimensions of flower of services that affect the patients’ satisfaction in the hospitals. A systematic questionnaire was used to collect quantitative data for survey method. Objective: The purpose of the study is an attempt to assess the level of satisfaction from the perspective of different dimensions. Materials and Methods: The study was conducted in several renowned secondary level hospitals in Laksham Upazilla, Cumilla, Bangladesh. A questionnaire was designed based on 42 items based on the outcome-based literature review. SPSS is used to measure the result. Results: Consultation; one of the vital dimensions have great influence on patient satisfaction. Conclusions: The current study is specifically useful for the assessment of the health care system in tertiary areas of Bangladesh. The purpose of the study is an attempt to assess the perception and overall satisfaction of patients towards flower of services. The findings of the survey will be helpful for doctors and nurses to upgrade the level of satisfaction in hospitals.

Labour pain is among the most intense forms of physiological pain a woman can experience. Epidural analgesia is widely accepted as the most effective method for managing labour pain. This article reviews the procedure, pharmacology, maternal and neonatal outcomes, advantages, limitations, and the latest updates in epidural pain management.

Background: Anemia in pregnancy is widespread and poses risks to both mother and fetus. This study aims to compare the efficacy of injection ferric carboxymaltose and oral iron supplementation in treating iron deficiency anemia during pregnancy. Aim: To compare the injection ferric carboxy maltose and oral iron in treating iron deficiency anaemia during pregnancy. Methods: This randomized control trial was conducted at department of Obstetrics & Gynecology, Institute of Child and Mother Health, for 9 months, following ethical clearance. A total of 156 pregnant women (16 to 34 weeks of gestation) diagnosed with anemia (Hb < 11 g%, low serum ferritin, and peripheral blood smear findings of IDA) were included after getting informed written consent and divided into Group-A (oral Ferrous Sulphate, n=78) and Group-B (Injection Ferric carboxy maltose, n=78). Data was collected in separated case-record form and analyzed by SPSS 26 version. Result: Demographic characteristics were similar across the two groups in terms of age and residence (p>0.05 in all cases). In both group-A and group-B, significant rise of Hb (mean difference= 1.018 and 1.664, respectively) and serum ferritin (mean difference= 205.22 and 227.37, respectively) were noted. However, TIBC was significantly decreased only in group-B (mean difference= -47.06, p=0.013), while group-A showed no significant improvement in TIBC (p>0.05). Overall, Hb≥ 11 gm% after 6-weeks of treatment was significantly higher in group-B than group-A (65.4% vs 44.9%, p=0.010). Besides, group-B patients had significantly lower gastrointestinal adverse events than group-A patients (p<0.05). Conclusion: Ferric carboxymaltose demonstrates superior effectiveness and safety compared to oral ferrous sulfate for treating anemia in pregnant women. However, further study is warranted.

This study provides an overview of the consequence of the use of oral corticosteroid in the treatment of severe asthma in adults; it also identified recent evidence based alternative drug regimen for asthma management to prevent long term negative effect of oral corticosteroids. Asthma is a chronic inflammatory airway disease affecting about 300 million people globally. Approximately 4% to 8% of asthma patient’s symptoms remain uncontrolled and exacerbations occur frequently despite high-intensity treatment, hence the need for corticosteroid treatment for sustain symptom control and to prevent flare-ups. Oral corticosteroids are powerful anti-inflammatory medicine which helps by quickly reducing the swelling in the lungs. There is no doubt that the use of oral corticosteroids (OCS) plays a vital role in the management of asthma, particularly in the management of acute exacerbations and severe asthma. However, there is clinical evidence that both long- and short-term use of corticosteroids in asthma has complicated relationship with some referring to them as a ‘frenemy, as side effect of oral corticosteroids has detrimental effect on quality of life of asthma patients. The study utilized literature review of web-based articles and journals using multiple databases. Studies both on short term and long- term use of OCS was reviewed to have better understanding of the subject matter. Studies in children populations were excluded as the focus of this study is on adult patients living with asthma. Following the literature search, ten articles met the inclusion criteria and were selected. The study concluded that due to widely acknowledged side effects, and advances in care, there is clinical support for a shift away from a reliance on OCS in the treatment of severe asthma to other alternative management.