International Journal of Medicine and Medical Sciences

International Journal of Medicine and Medical Sciences | Vol. 16, No. 2, February 2026 | pp. 9–16

DOI: 10.46882/2026/IJMMS/160009

Original Research Article

A Retrospective Trend Assessment of Surgical Site Infection Prevalence and Antibiogram Proportions in Major Reconstructive Plastic Surgeries

Blessing N. Chukwu¹, Patrick E. Lawson², Evelyn M. Kamau¹*

¹Department of Surgery, Faculty of Clinical Sciences, University of Port Harcourt, Port Harcourt, Nigeria.

²Department of Community Health, College of Health Sciences, Moi University, Eldoret, Kenya.

Abstract:

Surgical site infections (SSIs) following complex reconstructive plastic surgeries compromise aesthetic outcomes, increase healthcare costs, and risk tissue flap necrosis. This retrospective clinical study evaluated the overall prevalence, specific risk factors, and microbiological resistance trends of SSIs following elective tissue flap reconstructions and major scar revisions over a five-year period (2021–2025). De-identified medical charts of 450 patient files were extracted and analyzed using the Centers for Disease Control and Prevention (CDC) wound criteria. Out of the 450 procedures reviewed, 28 cases of confirmed SSIs were identified, resulting in an overall prevalence rate of 6.22%. Staphylococcus aureus was the predominant bacterial pathogen isolated from wound site swabs (39.3%), with 36.4% of these strains confirmed as methicillin-resistant (MRSA). Gram-negative bacilli, led by Pseudomonas aeruginosa, accounted for 28.6% of infections. Antibiogram mapping revealed high resistance rates among Gram-negative isolates to amoxicillin-clavulanic acid (82.1%) and ceftriaxone (64.3%), while all strains remained susceptible to amikacin and imipenem (100%). Multivariate logistic regression analysis demonstrated that an operative duration > 180 minutes (OR = 3.4, 95% CI = 1.8–6.4, p < 0.01), pre-existing obesity with a BMI ≥ 30 kg/m² (OR = 2.8, p < 0.05), and tobacco smoking (OR = 2.4, p < 0.05) were independent predictors of SSI. Post-reconstructive SSIs present notable clinical challenges due to resistant pathogens, highlighting the need to enforce perioperative prophylactic measures and maintain strict aseptic handling of tissues.

Keywords: Surgical Site Infection, Plastic Surgery, Staphylococcus aureus, MRSA, Antibiotic Resistance, Risk Factors

Manuscript Timeline: Received: November 11, 2025; Revised: December 18, 2025; Accepted: January 10, 2026; Published: February 18, 2026.

Citation: Chukwu BN, Lawson PE, Kamau EM. A Retrospective Trend Assessment of Surgical Site Infection Prevalence and Antibiogram Proportions in Major Reconstructive Plastic Surgeries. International Journal of Medicine and Medical Sciences, 2026, 16(2): 9–16. DOI: 10.46882/2026/IJMMS/160009

International Journal of Medicine and Medical Sciences | Vol. 16, No. 1, January 2026 | pp. 1–8

DOI: 10.46882/2026/IJMMS/160001

Original Research Article

Evaluation of Viscoelastic Hemostatic Variations using Thromboelastography to Predict Thrombotic Complications following Major Pancreaticoduodenectomy

Ibrahim K. Diallo¹, Victoria N. Eke², Jean-Baptiste M. Diop¹*

¹Department of Haematology, Faculté de Médecine, de Pharmacie et d'Odontologie, Université Cheikh Anta Diop, Dakar, Senegal.

²Department of Hematology and Blood Transfusion, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria.

Abstract:

Surgical interventions for periampullary malignancies trigger a profound hypercoagulable state, increasing the risk of deep vein thrombosis (DVT) and portal vein thrombosis. This prospective cohort study evaluated the performance of Thromboelastography (TEG) compared to conventional coagulation assays (CCA) for predicting postoperative venous thromboembolism (VTE) following major pancreaticoduodenectomy. We evaluated 110 adult patients undergoing elective Whipple procedures. Baseline and postoperative day 3 TEG parameters (reaction time [R], maximum amplitude [MA], and coagulation index [CI]) and CCA profiles (D-dimer, fibrinogen, and prothrombin time) were tracked, and lower limb duplex ultrasonography screening was performed on postoperative day 7. Within 14 days post-surgery, VTE was confirmed in 16.4% (18/110) of the patients. In the thrombotic cohort, postoperative day 3 TEG profiles demonstrated a marked hypercoagulable state, characterized by a significantly shortened R-time (3.12 ± 0.42 minutes vs. 5.65 ± 0.84 minutes in non-VTE patients, p < 0.001) and an elevated MA value (74.38 ± 4.52 mm vs. 61.24 ± 3.18 mm, p < 0.001). Preoperative CCA values did not show significant predictive power between groups (p > 0.05). Receiver Operating Characteristic (ROC) analysis showed that a day 3 TEG MA cutoff value > 70 mm predicted VTE development with a sensitivity of 88.9%, a specificity of 83.7%, and an Area Under the Curve (AUC) of 0.91 (95% CI = 0.84–0.96). Viscoelastic monitoring via TEG provides superior prediction of postoperative thrombotic risks following pancreatic surgery compared to standard testing, serving as an effective tool to guide extended chemical thromboprophylaxis protocols.

Keywords: Thromboelastography, Pancreaticoduodenectomy, Venous Thromboembolism, Hypercoagulability, Maximum Amplitude, Thromboprophylaxis

Manuscript Timeline: Received: October 12, 2025; Revised: November 20, 2025; Accepted: December 14, 2025; Published: January 14, 2026.

Citation: Diallo IK, Eke VN, Diop JBM. Evaluation of Viscoelastic Hemostatic Variations using Thromboelastography to Predict Thrombotic Complications following Major Pancreaticoduodenectomy. International Journal of Medicine and Medical Sciences, 2026, 16(1): 1–8. DOI: 10.46882/2026/IJMMS/160001

International Journal of Medicine and Medical Sciences | Vol. 1, No. 1, January 2026 | pp. 1–8

DOI: 10.14303/oajc.2026.001

Original Research Article

Efficacy of Novel Beta-Blockers in Reducing Left Ventricular Hypertrophy: A Randomized Controlled Trial

Alexander Vance¹*

¹Department of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Abstract:

Left ventricular hypertrophy (LVH) is a major independent predictor of myocardial infarction, heart failure, and sudden cardiac death, necessitating aggressive therapeutic regression. This prospective, randomized, double-blind, active-controlled, parallel-group trial evaluated the efficacy of nebivolol-X, a novel third-generation beta-blocker with nitric oxide-mediated vasodilatory properties, versus standard metoprolol succinate. A total of 350 hypertensive patients (aged 18–75 years) with baseline echocardiographically confirmed LVH (left ventricular mass index [LVMI] ≥ 115 g/m² for men, ≥ 95 g/m² for women) were randomized 1:1 to receive either nebivolol-X (5–10 mg/day, n = 175) or metoprolol succinate (50–100 mg/day, n = 175) over a 12-month period. The primary endpoint was the absolute change in LVMI quantified by 1.5-Tesla Cardiac Magnetic Resonance Imaging (CMR). Secondary endpoints included applanation tonometry-derived central aortic systolic blood pressure (CASBP), carotid-femoral pulse wave velocity (cfPWV), and brachial artery flow-mediated dilation (FMD). Analysis was performed on an intent-to-treat basis using Analysis of Covariance (ANCOVA). At 12 months, the nebivolol-X cohort demonstrated a highly significant reduction in mean LVMI from 124.6 ± 12.3 g/m² to 106.2 ± 10.1 g/m² (net change: -18.4 g/m²), whereas the metoprolol cohort decreased from 123.9 ± 11.8 g/m² to 113.7 ± 10.9 g/m² (net change: -10.2 g/m²), yielding a significant intergroup difference favoring nebivolol-X (-8.2 g/m²; 95% Confidence Interval [CI]: -11.4 to -5.0; p < 0.01). While peripheral brachial blood pressure reductions were uniform between arms (p = 0.22), nebivolol-X produced superior adjustments in CASBP (-14.2 ± 3.2 mmHg vs. -8.1 ± 2.9 mmHg; p < 0.01) and cfPWV (-1.4 m/s vs. -0.3 m/s; p < 0.01). Endothelial function via FMD improved by an absolute +3.2% ± 0.8% with nebivolol-X but worsened by -0.1% ± 0.4% with metoprolol (p < 0.001). Adverse events including sinus bradycardia (4.5% vs. 11.4%; p = 0.02) and fatigue (6.8% vs. 14.8%; p = 0.01) were lower with nebivolol-X. In conclusion, nebivolol-X achieves superior regression of hypertensive left ventricular hypertrophy compared to metoprolol. This benefit is driven by reduced wave reflections and improved endothelial function via nitric oxide pathways rather than simple peripheral blood pressure lowering, representing a distinct clinical advantage for long-term cardioprotection.

Keywords: Left ventricular hypertrophy, Beta-blockers, Hypertension, Cardiac magnetic resonance imaging, Nitric oxide, Endothelial function, Central hemodynamics

Manuscript Timeline: Received: September 12, 2025; Revised: November 04, 2025; Accepted: December 01, 2025; Published: January 15, 2026.

Citation: Vance A. Efficacy of Novel Beta-Blockers in Reducing Left Ventricular Hypertrophy: A Randomized Controlled Trial. International Journal of Medicine and Medical Sciences, 2026, 1(1): 1–8. DOI: 10.14303/oajc.2026.001

International Journal of Medicine and Medical Sciences | Vol. 15, No. 12, December 2025 | pp. 89–96

DOI: 10.46882/2025/IJMMS/150089

Original Research Article

A Retrospective Institutional Review of Preterm Birth Trends and Proximate Neonatal Survival Indicators inside a Pediatric Center

Evelyn N. Kamau¹, Tunde O. Adebayo², Sarah M. Touré¹*

¹Department of Paediatrics and Child Health, School of Medicine, University of Nairobi, Nairobi, Kenya.

²Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria.

Abstract:

Preterm delivery remains a major contributor to global early neonatal mortality, requiring regular audits of institutional care quality. This retrospective health facility study analyzed five-year trends (2021–2025) and specific clinical predictors of neonatal survival among preterm infants admitted to a specialized neonatal intensive care unit (NICU). De-identified medical charts of 550 preterm infants born at < 37 weeks of gestation were extracted and analyzed. Clinical survival outcomes were tracked until hospital discharge or death. Out of the 550 preterm admissions reviewed, the overall survival rate to discharge was 78.5% (432/550), while the institutional mortality rate was 21.5% (118/550). Survival was strongly dependent on gestational age, dropping to 38.2% among extremely preterm infants (< 28 weeks). The primary direct clinical causes of neonatal death were severe respiratory distress syndrome (RDS) (42.4%), early-onset neonatal sepsis (28.8%), and intraventricular hemorrhage (15.3%). Cox proportional hazards regression modeling demonstrated that a birth weight < 1,500 g (HR = 3.4, 95% CI = 1.8–6.5, p < 0.001), lack of maternal antenatal corticosteroid administration (HR = 2.8, 95% CI = 1.4–5.7, p < 0.01), and a low Apgar score < 5 at 5 minutes (HR = 2.1, p < 0.05) were independent predictors of mortality. Mortality among hospitalized preterm infants remains elevated, driven primarily by respiratory complications, emphasizing the need to improve antenatal steroid coverage and expand access to surfactant therapies.

Keywords: Preterm Birth, Neonatal Intensive Care Unit, Respiratory Distress Syndrome, Neonatal Sepsis, Survival Indicators, Retrospective Study

Manuscript Timeline: Received: September 10, 2025; Revised: October 18, 2025; Accepted: November 12, 2025; Published: December 16, 2025.

Citation: Kamau EN, Adebayo TO, Touré SM. A Retrospective Institutional Review of Preterm Birth Trends and Proximate Neonatal Survival Indicators inside a Pediatric Center. International Journal of Medicine and Medical Sciences, 2025, 15(12): 89–96. DOI: 10.46882/2025/IJMMS/150089

International Journal of Medicine and Medical Sciences | Vol. 15, No. 11, November 2025 | pp. 81–88

DOI: 10.46882/2025/IJMMS/150081

Original Research Article

Efficacy and Perinatal Outcomes of Transdermal Nitroglycerin versus Intravenous Labetalol in the Management of Severe Acute Hypertension in Pregnancy

Fatima Z. Bello¹, Kwaku A. Mensah², Grace N. Ojo¹*

¹Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences, Bayero University, Kano, Nigeria.

²Department of Community Health, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

Abstract:

Acute hypertensive crises during the third trimester require rapid, safe therapeutic lowering of blood pressure to avoid maternal cerebrovascular injuries and minimize placental hypoperfusion. This randomized, open-label, comparative clinical trial evaluated the therapeutic efficacy, safety, and perinatal outcomes of transdermal nitroglycerin patches versus standard intravenous labetalol infusions in the acute management of severe pregnancy-induced hypertension. A total of 140 third-trimester pregnant women with a sustained blood pressure ≥ 160/110 mmHg were randomly assigned to receive either a transdermal nitroglycerin patch (5 mg/24 hours, n = 70) or intravenous labetalol (20 mg initial bolus, followed by escalated doses up to 300 mg, n = 70). The primary outcomes were the time required to achieve target blood pressure stabilization (≤ 140/90 mmHg) and the incidence of maternal or fetal adverse effects. Both therapeutic interventions effectively lowered blood pressure; however, the mean time to achieve target stabilization was significantly shorter in the intravenous labetalol group (34.2 ± 5.8 minutes) compared to the transdermal nitroglycerin group (48.5 ± 8.2 minutes, p < 0.01). Maternal adverse events, specifically severe persistent headaches, were significantly more frequent in the nitroglycerin arm (31.4% vs. 8.6%, p < 0.001). Conversely, the incidence of neonatal bradycardia and low Apgar scores at 1 minute did not show statistically significant differences between the two groups (p > 0.05). Intravenous labetalol offers more rapid blood pressure control with fewer maternal side effects than transdermal nitroglycerin in managing severe acute obstetric hypertension.

Keywords: Pregnancy-Induced Hypertension, Severe Pre-eclampsia, Labetalol, Nitroglycerin, Antihypertensive Therapy, Perinatal Outcomes

Manuscript Timeline: Received: August 14, 2025; Revised: September 22, 2025; Accepted: October 12, 2025; Published: November 13, 2025.

Citation: Bello FZ, Mensah KA, Ojo GN. Efficacy and Perinatal Outcomes of Transdermal Nitroglycerin versus Intravenous Labetalol in the Management of Severe Acute Hypertension in Pregnancy. International Journal of Medicine and Medical Sciences, 2025, 15(11): 81–88. DOI: 10.46882/2025/IJMMS/150081

International Journal of Medicine and Medical Sciences | Vol. 15, No. 10, October 2025 | pp. 73–80

DOI: 10.46882/2025/IJMMS/150073

Original Research Article

Prevalence of Subclinical Atherosclerosis and Geometric Left Ventricular Variations in Adult Patients with Chronic Kidney Disease

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:

Chronic kidney disease (CKD) accelerates vascular remodeling, increasing the risks of early atherosclerosis and structural uremic cardiomyopathy. This cross-sectional cardiovascular study evaluated the prevalence of subclinical atherosclerosis and left ventricular (LV) geometric variations among non-dialysis adult patients with CKD. We evaluated 150 patients with confirmed stage 3 or 4 CKD (eGFR between 15 and 59 mL/min/1.73m²). High-resolution B-mode ultrasonography measured carotid intima-media thickness (CIMT) to identify subclinical atherosclerosis (CIMT ≥ 0.90 mm), while echocardiography quantified left ventricular mass index (LVMI) and relative wall thickness (RWT) to define structural geometry. The mean eGFR of the cohort was 34.8 ± 6.2 mL/min/1.73m². The overall prevalence of subclinical atherosclerosis was found to be 54.7% (82/150), and echocardiographic LVH was confirmed in 62.0% (93/150) of the participants. Geometric pattern distribution analysis revealed that concentric hypertrophy was the most common abnormal pattern (34.0%), followed by eccentric hypertrophy (18.0%) and concentric remodeling (10.0%), leaving only 38.0% with normal geometry. Linear regression analysis showed a significant positive correlation between increased CIMT and elevated LVMI (r = 0.54, p < 0.001). Multivariate logistic regression demonstrated that an eGFR < 30 mL/min/1.73m² (OR = 3.6, 95% CI = 1.8–7.2, p < 0.001) and poor blood pressure control (OR = 2.8, p < 0.01) were independent predictors of concentric hypertrophy. A high burden of structural cardiovascular remodeling exists among patients with advanced CKD, highlighting the importance of early cardioprotective interventions prior to reaching end-stage renal disease.

Keywords: Chronic Kidney Disease, Subclinical Atherosclerosis, Left Ventricular Hypertrophy, Echocardiography, Carotid Intima-Media Thickness, Cardiovascular Risk

Manuscript Timeline: Received: July 12, 2025; Revised: August 20, 2025; Accepted: September 10, 2025; Published: October 14, 2025.

Citation: Okafor CO, Hassan AJ, Appiah SK. Prevalence of Subclinical Atherosclerosis and Geometric Left Ventricular Variations in Adult Patients with Chronic Kidney Disease. International Journal of Medicine and Medical Sciences, 2025, 15(10): 73–80. DOI: 10.46882/2025/IJMMS/150073