International Journal of Medicine and Medical Sciences

International Journal of Medicine and Medical Sciences | Vol. 16, No. 9, September 2026 | pp. 1–5

DOI: 10.46882/2026/IJMMS/160066

Original Research Article

Altered Plasma Hexose Metabolism in Sickle Cell Anemia: A Metabolic Profiling Study

Chidi G. Osuagwu¹, Chika U. Mbeyi²*

¹School of Health Technology, Federal University of Technology, PMB 1526, Owerri, Imo State, Nigeria.

²School of Medical Laboratory Sciences, Imo State University, Owerri, Imo, Nigeria.

Abstract:

This study investigated altered hexose metabolism (glucose and fructose) in 135 participants, comparing normal (HbAA) with sickle cell states (HbAS, HbSS, HbSSc) using enzymatic and spectrophotometric methods. Findings revealed significant differences in plasma sugar levels: glucose was highest in HbSSc (84.80 ± 4.10 mg/dl) and lowest in HbAA (70.10 ± 0.05 mg/dl) (p < 0.05). Conversely, fructose was lowest in HbSSc (0.99 ± 0.05 mg/dl) and highest in HbAA (1.32 ± 0.08 mg/dl). Regression analysis indicated a positive glucose-fructose correlation in HbAA, no correlation in HbAS, and negative correlation in HbSS. The marked, significant differences in the 'Glucose-to-Fructose Ratio' suggest its potential as a biomarker for assessing the intensity of sickle cell anemia (p < 0.001).

Keywords: Hexose, energy metabolism, sickle cell anaemia, glucose, fructose, biomarker, glucose-to-fructose ratio.

Manuscript Timeline: Accepted: July 18, 2026.

Citation: Osuagwu CG, Mbeyi CU. Altered Plasma Hexose Metabolism in Sickle Cell Anemia: A Metabolic Profiling Study. International Journal of Medicine and Medical Sciences, 2026, 16(9): 1–5. DOI: 10.46882/2026/IJMMS/160066

International Journal of Medicine and Medical Sciences | Vol. 16, No. 9, September 2026 | pp. 65–72

DOI: 10.46882/2026/IJMMS/160065

Original Research Article

Subclinical Hypothyroidism and its Relationship with Lipid Parameters and Arterial Stiffness in Adult Patients

Chidi O. Okafor¹, Amina J. Hassan², Samuel K. Appiah¹*

¹Department of Medicine, College of Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria.

²Department of Medicine and Therapeutics, Korle Bu Teaching Hospital, Accra, Ghana.

Abstract:

Subclinical hypothyroidism (SCH) is characterized by elevated thyroid-stimulating hormone (TSH) levels despite normal circulating free thyroid hormones, but its impact on macrovascular structures remains under evaluation. This cross-sectional analytical study evaluated the prevalence of atherogenic dyslipidemia and explored its relationship with structural arterial stiffness in adult patients with SCH. We evaluated 150 patients presenting with persistent SCH (defined by TSH between 5.1 and 15.0 mIU/L with normal free T4) and compared them with 150 euthyroid controls matched for age and gender. Cardiovascular risk profiling included serum lipid fractions, while arterial stiffness was evaluated via carotid-femoral pulse wave velocity (cfPWV) using automated applanation tonometry. The mean TSH of the SCH cohort was 8.4 ± 1.5 mIU/L. Patients with SCH exhibited significantly higher mean levels of low-density lipoprotein cholesterol (LDL-C) (3.82 ± 0.45 mmol/L vs. 2.65 ± 0.32 mmol/L in controls, p < 0.01) and elevated serum triglycerides (p < 0.05). Macrovascular mapping revealed that the mean cfPWV was significantly increased in the SCH group (9.8 ± 1.2 m/s) compared to the euthyroid control cohort (7.2 ± 0.8 m/s, p < 0.001), indicating advanced subclinical arterial stiffness. Pearson correlation modeling confirmed a significant positive correlation between serum TSH levels and cfPWV structural values (r = 0.54, p < 0.001). Multivariate logistic regression demonstrated that a serum TSH level > 10 mIU/L was an independent predictor of advanced arterial stiffness (OR = 3.4, 95% CI = 1.8–7.2, p < 0.001). Subclinical hypothyroidism is strongly linked to pro-atherogenic lipid changes and increased arterial stiffness, elevating long-term cardiovascular risks.

Keywords: Subclinical Hypothyroidism, Thyroid-Stimulating Hormone, Dyslipidemia, Arterial Stiffness, Pulse Wave Velocity, Cardiovascular Risk

Manuscript Timeline: Received: June 12, 2026; Revised: July 20, 2026; Accepted: August 11, 2026; Published: September 15, 2026.

Citation: Okafor CO, Hassan AJ, Appiah SK. Subclinical Hypothyroidism and its Relationship with Lipid Parameters and Arterial Stiffness in Adult Patients. International Journal of Medicine and Medical Sciences, 2026, 16(9): 65–72. DOI: 10.46882/2026/IJMMS/160065

International Journal of Medicine and Medical Sciences | Vol. 16, No. 8, August 2026 | pp. 89–96

DOI: 10.46882/2026/IJMMS/160089

Original Research Article

Cardiovascular Event Reductions and Lipid Remodeling Metrics following Early Initiation of PCSK9 Inhibitors in Post-Myocardial Infarction Patients

Emily R. Bellingham¹, Arthur G. Pendelton², Ian K. Macallister³*

¹Nuffield Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford, UK.

²Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.

³Department of Medicine, McGill University Health Centre, Montreal, QC, Canada.

Abstract:

Achieving ultra-low low-density lipoprotein cholesterol (LDL-C) targets rapidly after an acute coronary syndrome is critical to stabilize vulnerable atheromatous plaques and mitigate early recurrent cardiovascular event risk. This prospective, randomized, double-blind, active-controlled trial evaluated the efficacy, safety, and vascular remodeling parameters of early evolocumab initiation (a PCSK9 inhibitor) combined with high-intensity statin therapy versus statin monotherapy. We evaluated 150 adult patients hospitalized with an acute myocardial infarction who presented with a baseline LDL-C ≥ 1.8 mmol/L despite background statin intake. Participants were randomized 1:1 within 72 hours of percutaneous coronary intervention to receive either subcutaneous evolocumab (140 mg every 2 weeks, n = 75) or a matching placebo (n = 75), alongside daily atorvastatin (80 mg) for 12 months. At 12 months, the evolocumab combination arm achieved a profound 74.5% reduction in mean LDL-C, collapsing from 2.45 ± 0.42 mmol/L to an absolute nadir of 0.62 ± 0.11 mmol/L (p < 0.001). The control group fell to 1.42 ± 0.28 mmol/L. Recurrent major adverse cardiovascular events (MACE) occurred in 4.0% of the evolocumab group compared to 12.0% in the monotherapy arm (p < 0.05). High-resolution intravascular ultrasound imaging confirmed significant plaque regression and an increase in fibrous cap thickness (+21.4 ± 3.5 μm, p < 0.01) favoring early combination intervention. Early initialization of PCSK9 inhibitors drives exceptional LDL-C clearance and directly modifies plaque structural geometry, offering superior secondary prevention post-infarction.

Keywords: Myocardial Infarction, PCSK9 Inhibitor, Evolocumab, Lipid Remodeling, Low-Density Lipoprotein, Plaque Regression

Manuscript Timeline: Received: May 15, 2026; Revised: June 20, 2026; Accepted: July 12, 2026; Published: August 18, 2026.

Citation: Bellingham ER, Pendelton AG, Macallister IK. Cardiovascular Event Reductions and Lipid Remodeling Metrics following Early Initiation of PCSK9 Inhibitors in Post-Myocardial Infarction Patients. International Journal of Medicine and Medical Sciences, 2026, 16(8): 89–96. DOI: 10.46882/2026/IJMMS/160089

International Journal of Medicine and Medical Sciences | Vol. 16, No. 8, August 2026 | pp. 81–88

DOI: 10.46882/2026/IJMMS/160081

Original Research Article

Diagnostic Utility of Next-Generation Sequencing vs. Conventional Liquid Biopsy for Early Detection of Epidermal Growth Factor Receptor T790M Mutations in Non-Small Cell Lung Cancer

David A. Kensington¹, Alistair M. Vance², Charles E. Sterling³*

¹Department of Oncology, Royal Marsden Hospital, Imperial College London, London, UK.

²Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

³Department of Laboratory Medicine and Pathobiology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.

Abstract:

The emergence of the epidermal growth factor receptor (EGFR) T790M gatekeeper mutation drives secondary resistance to first- and second-generation tyrosine kinase inhibitors in non-small cell lung cancer (NSCLC), demanding ultra-sensitive diagnostic detection tools. This prospective diagnostic accuracy study evaluated the sensitivity and clinical precision of droplet digital polymerase chain reaction (ddPCR) next-generation sequencing (NGS) platform versus conventional plasma-derived cell-free DNA (cfDNA) cobas assays for tracking emerging T790M variants. We evaluated 110 adult patients with advanced EGFR-mutant NSCLC showing clinical or radiological disease progression on erlotinib or gefitinib. Paired blood and tumor tissue biopsy specimens were processed. Sieve analysis of tumor tissue served as the reference standard baseline, which confirmed T790M mutations in 58.2% (64/110) of the participants. The NGS assay demonstrated a sensitivity of 92.2%, a specificity of 95.7%, a positive predictive value (PPV) of 96.7%, and a negative predictive value (NPV) of 89.8% for identifying the resistance mutation. In comparison, the conventional cobas liquid biopsy assay achieved a sensitivity of only 73.4% and an NPV of 72.1% (p < 0.01). The Area Under the Curve (AUC) was significantly larger for liquid NGS (AUC = 0.94, 95% CI = 0.88–0.98) than for standard assays (AUC = 0.78, p < 0.01). Next-generation sequencing of plasma cfDNA offers superior diagnostic precision and avoids invasive repeat tissue sampling, permitting early therapeutic switching to third-generation inhibitors.

Keywords: Non-Small Cell Lung Cancer, Next-Generation Sequencing, Liquid Biopsy, EGFR T790M Mutation, Droplet Digital PCR, Therapeutic Resistance

Manuscript Timeline: Received: May 14, 2026; Revised: June 22, 2026; Accepted: July 10, 2026; Published: August 14, 2026.

Citation: Kensington DA, Vance AM, Sterling CE. Diagnostic Utility of Next-Generation Sequencing vs. Conventional Liquid Biopsy for Early Detection of Epidermal Growth Factor Receptor T790M Mutations in Non-Small Cell Lung Cancer. International Journal of Medicine and Medical Sciences, 2026, 16(8): 81–88. DOI: 10.46882/2026/IJMMS/160081

International Journal of Medicine and Medical Sciences | Vol. 16, No. 8, August 2026 | pp. 73–80

DOI: 10.46882/2026/IJMMS/160073

Original Research Article

Efficacy of Targeted CFTR Modulators on Pulmonary Function and Sweat Chloride Metrics in Pediatric Cystic Fibrosis Patients

Sarah J. Corelli¹, Robert L. Sinclair², Fiona M. Gallagher³*

¹Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.

²Department of Pulmonology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.

³Institute of Cellular Medicine, Great Ormond Street Hospital, University College London, London, UK.

Abstract:

Small-molecule cystic fibrosis transmembrane conductance regulator (CFTR) modulators have transformed the management of cystic fibrosis, but their continuous efficacy on early-stage pancreatic and pulmonary alterations requires structured pediatric evaluation. This prospective, multi-center cohort study evaluated the clinical efficacy and safety of elexacaftor-tezacaftor-ivacaftor therapy in children possessing at least one F508del allele mutation. We evaluated 120 pediatric patients (aged 6 to 11 years) across three international tertiary centers who completed 24 weeks of targeted triple-combination therapy. The primary endpoints were absolute changes in ppFEV1 (percent predicted forced expiratory volume in 1 second) and sweat chloride concentrations, alongside nutritional indices monitored via body mass index (BMI) Z-scores. Data synthesis showed that by week 24, ppFEV1 increased significantly by a mean of +11.4 ± 2.8 percentage points from baseline markers (p < 0.001). Concurrently, mean sweat chloride concentrations demonstrated a substantial decrease of -42.4 ± 5.1 mmol/L (from 98.2 ± 8.4 mmol/L to 55.8 ± 4.2 mmol/L, p < 0.001), reflecting restoration of systemic ion channel functionality. Nutritional recovery was evidenced by a significant mean increase in BMI Z-scores (+0.34 ± 0.12, p < 0.01). Reported adverse events were primarily mild, with transient elevations in liver transaminases (ALT/AST) observed in 6.7% of the cohort, which resolved without drug discontinuation. Targeted triple-combination CFTR modulators achieve profound, rapid clinical improvements in lung function, clear sweat electrolyte markers, and enhance nutritional velocity in pediatric patients with cystic fibrosis.

Keywords: Cystic Fibrosis, CFTR Modulators, ppFEV1, Sweat Chloride, Pediatric Pulmonology, Nutritional Recovery

Manuscript Timeline: Received: May 10, 2026; Revised: June 18, 2026; Accepted: July 11, 2026; Published: August 11, 2026.

Citation: Corelli SJ, Sinclair RL, Gallagher FM. Efficacy of Targeted CFTR Modulators on Pulmonary Function and Sweat Chloride Metrics in Pediatric Cystic Fibrosis Patients. International Journal of Medicine and Medical Sciences, 2026, 16(8): 73–80. DOI: 10.46882/2026/IJMMS/160073

International Journal of Medicine and Medical Sciences | Vol. 16, No. 8, August 2026 | pp. 57–64

DOI: 10.46882/2026/IJMMS/160057

Original Research Article

Ameliorative Potential of Nauclea latifolia Stem-Bark Extract against Cadmium-Induced Hepatotoxicity and Oxidative Stress in Rats

Mustapha T. Gidado¹, Rose C. Obi², Elizabeth W. Wanjiku¹*

¹Department of Pharmacology and Toxicology, Faculty of Pharmaceutical Sciences, University of Maiduguri, Maiduguri, Nigeria.

²Department of Pharmacology and Pharmacognosy, School of Pharmacy, University of Nairobi, Nairobi, Kenya.

Abstract:

Environmental exposure to heavy metals like cadmium induces severe hepatic tissue degradation through accelerated lipid peroxidation and depletion of cellular antioxidant defenses. This experimental animal study examined the hepatoprotective and antioxidant potential of a crude ethanolic extract of Nauclea latifolia stem-bark (EENL) against cadmium chloride-induced hepatotoxicity in male Wistar rats. Thirty-five adult rats were randomly assigned to 5 equal groups: Normal Control, Toxicity Control (cadmium chloride 5 mg/kg body weight orally), Silymarin standard reference control (100 mg/kg), and two treatment groups receiving EENL (200 and 400 mg/kg) orally for 21 consecutive days alongside cadmium administration. Liver structural integrity was evaluated via diagnostic serum enzymes, tissue malondialdehyde (MDA) tracking, and histopathological architecture. Oral administration of cadmium caused extensive liver damage, indicated by significant elevations in serum alanine aminotransferase (ALT) (124.6 ± 12.3 U/L vs. 34.2 ± 3.8 U/L in controls, p < 0.01) and aspartate aminotransferase (AST) (215.8 ± 18.4 U/L vs. 68.2 ± 6.1 U/L, p < 0.01). Cadmium also significantly increased hepatic tissue MDA concentrations and reduced superoxide dismutase (SOD) and catalase activities (p < 0.01). Daily oral treatment with 400 mg/kg EENL significantly protected against liver injury, lowering serum ALT to 46.2 ± 5.1 U/L and AST to 98.2 ± 8.4 U/L (p < 0.01 vs. toxicity control). Furthermore, EENL reduced tissue lipid peroxidation and preserved endogenous antioxidant defenses. Histopathology confirmed these results, showing minimal hepatocyte necrosis and reduced inflammatory cell infiltration. Nauclea latifolia stem-bark possesses potent antiperoxidative properties that protect hepatic tissue from heavy-metal-induced injury.

Keywords: Nauclea latifolia, Cadmium Chloride, Hepatotoxicity, Oxidative Stress, Lipid Peroxidation, Hepatoprotection

Manuscript Timeline: Received: May 12, 2026; Revised: June 20, 2026; Accepted: July 14, 2026; Published: August 14, 2026.

Citation: Gidado MT, Obi RC, Wanjiku EW. Ameliorative Potential of Nauclea latifolia Stem-Bark Extract against Cadmium-Induced Hepatotoxicity and Oxidative Stress in Rats. International Journal of Medicine and Medical Sciences, 2026, 16(8): 57–64. DOI: 10.46882/2026/IJMMS/160057