Inflammation plays a very important role in the development of non-communicable diseases in the general population, while it remains the leading cause of morbidity and mortality among HIV-positive patients treated with HAART. We aimed to investigate the association between IL-6 and hs-CRP with the components of metabolic syndrome among HIV-positive patients on HAART. We conducted a prospective study among HIV-positive HAART naïve patients. Eighty-six HIV-positive HAART naïve patients and eighty-six HIV-negative subjects to serve as controls at baseline were recruited. The baseline data was taken and recorded before commencing the patients on HAART. Then, the patients were placed on lamivudine, tenofovir and dolutegravir (DTG) HAART regiment and followed up for 24 months. Both serum IL-6 and hs-CRP are higher among HIV-positive patients than healthy control and among patients with and without MetS. Both age, gender, anthropometric and blood pressure FBC and LDL-c show an inverse correlation with the development of MetS at baseline, but not IL-6 and hs-CRP. However, 24 months post-HAART hs-CRP shows a significant correlation with MetS (P= 0.010) but IL-6 has a weak positive correlation with MetS (P= 0.055). In regression model, IL-6 has a strong negative correlation with the development of MetS (r –0.085 p= 0.042), while hs-CRP have a strong positive correlation with the development of MetS (r 0.117 p= 0.008). Interleukin-6 and hs-CRP are found to be highly elevated among patients with HIV than healthy controls, as well as in patients with MetS than those without MetS. Both IL-6 and hs-CRC are associated with the development of MetS among HIV patients on HAART than HAART naïve.

The transition from pediatric to adult care is a critical period for young people with type 1 diabetes. In Djibouti, the Young Diabetic Center has implemented a structured therapeutic education program to support this transition. A one-year prospective study of 100 patients aged 16 to 21 evaluated the impact of this process on glycemic control (HbA1c), autonomy, and satisfaction among young adults. The results show a modest but significant improvement in HbA1c after 12 months, despite the persistence of imbalance in nearly half of the participants. Female gender, low autonomy, and insufficient medical follow-up appear to be vulnerability factors. This experience highlights the importance of a coordinated, multidisciplinary, and patient-centered transition.

Inappropriate long-term use of Proton Pump Inhibitors (PPIs) is a public health challenge. It is uncertain if this "implementation gap" is driven by knowledge deficits or other behavioural barriers. This study aimed to quantify systematic de-prescribing protocol (SDP) use and identify barriers to PPI de-prescribing among Internal Medicine (IM) and Gastroenterology (GI) physicians. A cross-sectional survey was conducted among 310 physicians (IM, GI) from three Indian states. A validated questionnaire assessed knowledge, self-efficacy, barriers, and use of an SDP (the primary outcome). A multivariable logistic regression model, robust for clustering, identified predictors of SDP use. Physician knowledge was high (mean 3.7/4.0), but a "knowledge–implementation gap" was evident: 85.2% agreed de-prescribing was "crucial," yet only 28.4% used an SDP. Gastroenterologists (40.0%) were twice as likely as IM physicians (20.0%; p=0.0002) to use an SDP. In the adjusted model, GI specialty (aOR 2.59) and higher self-efficacy (aOR 1.82) were the strongest predictors. The highest-rated barriers were 'Patient resistance/anxiety' (78.0%) and 'Consultation time constraints' (69.2%). In this cohort, PPI over-prescription appears driven by implementation failure and clinical inertia, not knowledge deficits. This is associated with low self-efficacy and barriers like patient anxiety and time pressure. The specialty disparity suggests confidence, not just knowledge, is key. Interventions must pivot from education to systemic solutions targeting these behavioural barriers.

Background: Lipids are essential in many facets of life, and the ABO system is the paramount system in the transfusion process. This research seeks to correlate serum levels of total cholesterol, triglycerides, HDL-C, LDL-C, and ABO blood type in healthy Sudanese adults. Methods: A cross-sectional community-based study was undertaken in Khartoum State, Sudan, from March 2020 to August 2021. Two hundred healthy people were enlisted, including 50 from blood group A, 50 from blood group O, 50 from blood group B, and 50 from blood type AB. The blood lipid profile was assessed using an auto chemistry analyzer, and statistical analysis was conducted using SPSS version 25. Results: A significantly elevated serum cholesterol level (p value = 0.004) and triglycerides (p value = 0.000) were seen across various blood types, with the AB blood group exhibiting the highest levels of both serum cholesterol and triglycerides. There exists a positive link between serum cholesterol levels and age in blood groups O, B, and AB, with correlation coefficients of r=0.399 (P=0.004), r=0.431 (P=0.002), and r=0.403 (P=0.004), respectively. A positive association exists between serum triglycerides and age in blood groups A and O, with coefficients r=0.463 (P=0.001) and r=0.408 (P=0.003), respectively. There exists a significant association between LDL-C and age in blood groups B and AB (r=0.385, P=0.006; r=0.463, P=0.001, respectively). Conclusion: Individuals with the AB blood group have elevated serum cholesterol and triglyceride levels compared to other blood groups, with a positive association shown between age and cholesterol, triglycerides, and LDL-C across various blood types.

Postoperative peritonitis (POP) is a serious complication of abdominal surgery, associated with high morbidity and mortality despite advances in diagnosis and treatment. The objective of this study was to describe the diagnostic, therapeutic, and outcome aspects of POP in the visceral surgery department of Avicenne Military Hospital in Marrakech. A retrospective study was conducted on 30 cases collected between January 2020 and December 2024. All patients included had undergone reoperation for confirmed peritonitis following abdominal surgery. The mean age was 47.9 years, with a balanced sex ratio. Major comorbidities included diabetes, obesity, and neoplastic diseases. The predominant causes were anastomotic leakage (43.3%) and visceral perforation (30%). Diagnosis was based on abdominal pain, fever, leukocytosis, and computed tomography (CT). Treatment involved early surgical reintervention, peritoneal lavage, and appropriate antibiotic therapy. Observed mortality remained significant, influenced by the timing of diagnosis, multiorgan failure, and patient condition. POP remains a major medico-surgical emergency requiring a multidisciplinary approach, early detection, and optimized treatment to improve survival.

Background: Pre-eclampsia and eclampsia remain significant causes of maternal and perinatal morbidity and mortality, particularly in developing countries. Emerging evidence suggests that micronutrient deficiencies, such as Vitamin D deficiency, may play an important role in their pathogenesis. Understanding the demographic, obstetric, and biochemical differences among healthy, pre-eclamptic, and eclamptic women can help identify risk factors and improve preventive strategies. Objective: To evaluate demographic and obstetric variables, blood pressure profiles, and serum Vitamin D levels among healthy, pre-eclamptic, and eclamptic pregnant women. Methods: This cross-sectional comparative study was conducted among 90 pregnant women attending the Department of Obstetrics and Gynaecology of a tertiary care hospital in Bangladesh. The study population was divided into three groups: healthy pregnant women (n = 30), pre-eclamptic women (n = 30), and eclamptic women (n = 30). Data were collected on demographic and obstetric characteristics, systolic and diastolic blood pressure. Statistical analysis was performed using appropriate tests, and p < 0.05 was considered significant. Results: Pre-eclamptic and eclamptic patients were younger, more likely to be primigravida, and had a lower socioeconomic and educational status compared to healthy controls (p < 0.05). Mean systolic and diastolic blood pressures were significantly higher in pre-eclamptic and eclamptic groups (p < 0.001). Serum Vitamin D levels were markedly lower among pre-eclamptic and eclamptic patients compared to healthy pregnant women, and the difference was statistically significant (p < 0.001). Conclusion: Pre-eclampsia and eclampsia are associated with younger maternal age, primigravidity, and low socioeconomic background. Significantly lower Vitamin D levels among affected women suggest that Vitamin D deficiency may contribute to the development or severity of these hypertensive disorders in pregnancy. Screening and supplementation strategies could therefore play a role in prevention and improved maternal outcomes.

Superficial Ewing sarcoma of the skin and dermis is extremely rare and may closely simulate benign adnexal tumors or neuroendocrine carcinomas, leading to major diagnostic pitfalls. We report the case of a 19-year-old woman presenting with a painful, rapidly enlarging 1.5 cm nodule at the cervico-occipital region. Histologically, the lesion exhibited a compact multilobulated architecture within the dermis, with a striking “blue ball in dermis” appearance suggestive of spiradenoma. Immunohistochemistry was misleading, showing focal dot-like AE1/AE3 staining, heterogeneous low-to-moderate synaptophysin and chromogranin expression, CD56 positivity, and CK20 dot-like staining, raising the possibility of Merkel cell carcinoma. Strong diffuse CD99 positivity and nuclear NKX2.2 expression supported a Ewing sarcoma family tumor. Molecular analysis confirmed an EWSR1 rearrangement. This case highlights the diagnostic challenges of superficial small round blue cell tumors and emphasizes the need for integrated histologic, immunohistochemical, and molecular assessment.

Non-alcoholic fatty liver disease (NASH) has become the most widespread liver disease in the world, mainly due to obesity and metabolic syndrome. We conducted a retrospective study, selecting the records of patients followed for obesity over a 2-year period. All patients over 18 years of age, with a BMI greater than 30kg/m2, without diabetes or hypertension were included. After eliminating patients with chronic liver disease, thrombocytopenia or elevated liver enzymes associated with other pathologies, notably muscular, drug or thyroid disease, we collected clinical and biological data. The FIB-4 score was calculated according to the formula: (age (years) × ASAT (U/L)/platelets (PLT) (109/L) × √ALAT (U/L)). We found that in 50 patients, a FIB-4 score below 1.30 was associated with a high negative predictive value, suggesting that severe fibrosis was unlikely in these cases. In the zone of uncertainty, corresponding to FIB-4 values between 1.30 and 2.67, we identified 18 cases, and which require further evaluation to accurately determine the level of fibrosis. Two cases had a positive predictive value for advanced fibrosis, underlining the need for early and specialized management. These results may help to improve clinical management by identifying patients at risk of severe fibrosis and providing them with the appropriate treatment.