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Research Article
Associations of Carotid Atherosclerosis in Type 2 Diabetic Out-Patients in a Tertiary Health Facility in South-Eastern Nigeria: A Cross-Sectional Study
Issue:
Volume 14, Issue 4, August 2025
Pages:
98-108
Received:
16 May 2025
Accepted:
29 May 2025
Published:
9 July 2025
Abstract: Background: Carotid atherosclerosis (CA) characterized by the thickening of the endothelium of the carotid arteries, is a reflection of generalized atherosclerosis and a surrogate for cardiovascular events. Objectives: To determine the prevalence and associated risk factors for CA in asymptomatic type 2 diabetes mellitus (T2DM) out-patients at NAUTH in Nnewi, Nigeria. Materials and Methods: This was a cross-sectional study that evaluated 142 T2DM out-patients. Relevant data was extracted with a researcher-structured questionnaire. Anthropometric measurements, glycated haemoglobin and fasting lipid profile were done. Carotid intima-media thickness was measured using ultrasongraphy. Ultrasonography of the brachial and pedal arteries was done using ultrasonic pocket doppler device and ankle brachial pressure index calculated. Lastly, the vibration perception threshold was determined using a digital biothesiometer. Data was analyzed using SPSS version 25. Results of categorical variables were presented in tables as frequencies and percentages. The mean values and standard deviation for the continuous variables were calculated. Chi-square test was used to assess the association between CA and categorical variables. The level of significance was set at p < 0.05. Results: The mean age of the 142 subjects was 59.15 ± 11.37 years and the gender distributions comprised 57.7% female and 42.3% male subjects, respectively. The prevalence of CA among the subjects was 49.3% and CA showed significant associations with educational level (X2 = 10.460; p = 0.015), exercise status (X2 = 5.060; p = 0.024), abdominal obesity in male (X2 = 4.659; p = 0.031) and the female subjects, respectively (X2 = 8.874; p = 0.003), and also with diabetic peripheral neuropathy (DPN) (X2 = 8.158; p = 0.004). Conclusion: The prevalence rate of CA was high and depicted a huge burden of cardiovascular morbidities in T2DM subjects. Equally, CA showed significant associations with educational level, exercise, diabetic peripheral neuropathy and abdominal obesity in subjects.
Abstract: Background: Carotid atherosclerosis (CA) characterized by the thickening of the endothelium of the carotid arteries, is a reflection of generalized atherosclerosis and a surrogate for cardiovascular events. Objectives: To determine the prevalence and associated risk factors for CA in asymptomatic type 2 diabetes mellitus (T2DM) out-patients at NAUT...
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Research Article
Reverse Hepatorenal Index: A New Parameter for Detection of Early Chronic Renal Parenchymal Changes
Atul Kapoor*
,
Aprajita Kapur
Issue:
Volume 14, Issue 4, August 2025
Pages:
109-114
Received:
14 June 2025
Accepted:
26 June 2025
Published:
18 July 2025
Abstract: Aim of the Study: Early detection of chronic kidney disease (CKD) remains a clinical challenge. Current diagnostic parameters often identify renal dysfunction only after significant parenchymal damage has occurred. This study introduces the Reverse Hepatorenal Index (RHI), a novel ultrasound-based parameter designed to detect early chronic renal parenchymal changes and evaluates the diagnostic accuracy of the Reverse Hepatorenal Index in detecting early chronic renal parenchymal changes compared to conventional parameters. Material and Methods: A prospective observational study was conducted on 150 participants (75 with early-stage CKD and 75 healthy controls) from January 2025 to May 2025. Ultrasound examinations were performed to measure renal and hepatic echogenicity. The RHI was calculated as the below normal values of the ratio of hepatic cortical echogenicity to renal cortical echogenicity. Serum creatinine, estimated glomerular filtration rate (eGFR), and urinary biomarkers were measured for comparison. Results: The mean RHI was significantly lower in patients with early CKD (0.78 ± 0.12) compared to healthy controls (1.15 ± 0.09) (p<0.001). RHI demonstrated a sensitivity of 86.7% and specificity of 90.7% for detecting early renal parenchymal changes at a cut-off value of 0.92. The area under the ROC curve for RHI (0.924) was superior to serum creatinine (0.756) and comparable to eGFR (0.889). Conclusion: The Reverse Hepatorenal Index represents a promising non-invasive parameter for early detection of chronic renal parenchymal changes. Its superior performance compared to traditional markers suggests potential clinical utility in CKD screening and monitoring.
Abstract: Aim of the Study: Early detection of chronic kidney disease (CKD) remains a clinical challenge. Current diagnostic parameters often identify renal dysfunction only after significant parenchymal damage has occurred. This study introduces the Reverse Hepatorenal Index (RHI), a novel ultrasound-based parameter designed to detect early chronic renal pa...
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Research Article
Role of Obesity and Diabetes in the formation of Thyroid Nodules - Analysis of Data from Bulgarian Population Screening in 2024
Anna-Maria Borissova,
Boyana Trifonova*,
Lilia Dakovska,
Mircho Vukov
Issue:
Volume 14, Issue 4, August 2025
Pages:
115-126
Received:
15 June 2025
Accepted:
3 July 2025
Published:
30 July 2025
Abstract: Thyroid nodules (TN), obesity and diabetes affect millions of people individually and in combination, which suggests the existence of pathogenetic link between them. Aim: To establish the current prevalence of TN in the country and its connection with some of the risk factors causing the disease - gender, age, obesity and diabetes. Material and methods: 936 subjects were divided into three age groups: 20-44 years - 342 (36.5%), 45-59 years - 301 (32.2%) and 60-79 years - 293 (31.3%); Body Mass Index (BMI) was calculated and normal, overweight, and obese groups were formed; TSH (ECLIA-sandwich method), FT4 (competitive ECLIA method) were tested; oGTT was performed to determine plasma glucose at 0 and 120 minutes; Ultrasound examination was applied. Results: Thyroid nodules were detected in 40.85% (382/935) of the subjects, with higher prevalence in women compared to men - 46.4% (222/478) vs. 35.0% (160/457), p < 0.05. The prevalence of TN increased with age: 60-79 years vs. 20-44 years - more significantly in the overall group (54.3%, 159/293 vs. 29.2%, 100/342, p < 0.001) and in women (59.9%, 103/172 vs. 30.2%, 48/259, p < 0.001), but less in men (46.3%, 56/121 vs. 28.4%, 52/183, NS). Out of the 382 individuals with TN, only 27.5% (105/382) had normal weight (BMI < 25 kg/m²), while 72.5% (277/382) were overweight or obese (BMI ≥ 25 kg/m²), p < 0.001. Among diabetics (n=155), 46.5% (72/155) had both type 2 diabetes (T2D) and TN. It was established that 38.1% (59/155) of them had BMI ≥ 25 kg / m², whereas only 8.4% (13/155) were with normal weight (BMI < 25 kg/m²), p < 0.02. In the group of patients with TN (n-382), 18.8% (72/382) had a combination of TN and T2D, with 15.4% (59/382) having a BMI ≥ 25 kg/m2 and only 3.4% (13/382) having normal weight (BMI < 25 kg/m2), NS. Among the individuals with BMI ≥ 25 kg/m² (n=637), TN was present in 43.5% (277/637), of whom 21.3% (59/277) had T2D as well. Thus, approximately one in five individuals with BMI ≥ 25 kg/m² and TN, also had T2D. Conclusion: The current data clearly demonstrate very strong connection between obesity, T2D and TN. When any of these conditions are present, we should be look for the other two in order to ensure early diagnosis and appropriate therapeutic intervention.
Abstract: Thyroid nodules (TN), obesity and diabetes affect millions of people individually and in combination, which suggests the existence of pathogenetic link between them. Aim: To establish the current prevalence of TN in the country and its connection with some of the risk factors causing the disease - gender, age, obesity and diabetes. Material and met...
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Research Article
Application of Modified Poisson Regression Analysis in Assessing Patients’ Satisfaction: Insights from SERVQUAL Data at KCMC Referral Hospital, Tanzania
Issue:
Volume 14, Issue 4, August 2025
Pages:
127-135
Received:
3 July 2025
Accepted:
24 July 2025
Published:
8 August 2025
Abstract: Patient satisfaction is a key indicator of healthcare service quality and an important component in evaluating health system performance, particularly within referral hospitals in low-resource settings like Tanzania. This interdisciplinary study was conducted at Kilimanjaro Christian Medical Centre (KCMC) Referral Hospital to assess outpatient satisfaction using the SERVQUAL framework. A stratified random sampling technique was employed to ensure proportional representation of patients across various outpatient clinics. Within each clinic stratum, participants were selected using simple random sampling. Outpatients were evaluated across five service quality dimensions: tangibility, reliability, responsiveness, assurance, and empathy. Modified Poisson regression analysis was applied to examine associations between patient satisfaction and selected demographic and service-related variables. The results revealed that effective communication with healthcare providers (RR = 1.246, p = 0.008) and the availability of prescribed medications (RR = 1.093, p = 0.009) were significantly associated with higher satisfaction. Conversely, patients aged 46 years and above reported lower satisfaction levels (RR = 0.903, p = 0.002). Additionally, more than half of the respondents expressed dissatisfaction with the waiting time for services. While overall satisfaction with outpatient services was generally positive, the findings underscore the need for targeted improvements, particularly in reducing waiting times. This study highlights the value of integrating robust statistical modeling and service quality frameworks to generate actionable insights for enhancing patient-centered care in sub-Saharan African referral hospitals.
Abstract: Patient satisfaction is a key indicator of healthcare service quality and an important component in evaluating health system performance, particularly within referral hospitals in low-resource settings like Tanzania. This interdisciplinary study was conducted at Kilimanjaro Christian Medical Centre (KCMC) Referral Hospital to assess outpatient sati...
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Review Article
AI-driven Innovations in Cardiology: A Comprehensive Review of Effectiveness and Challenges
Issue:
Volume 14, Issue 4, August 2025
Pages:
136-144
Received:
25 May 2025
Accepted:
19 June 2025
Published:
20 August 2025
DOI:
10.11648/j.cmr.20251404.15
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Abstract: Background: Cardiovascular diseases (CVD) are the leading cause of mortality in China, accounting for 40% of annual deaths and affecting over 290 million individuals. Rapid urbanization, lifestyle changes, and an aging population have exacerbated CVD risk factors such as hypertension, diabetes, and obesity. Artificial Intelligence (AI) technologies, including machine learning (ML) and deep learning (DL), offer transformative potential to address these challenges by enhancing diagnostic accuracy, risk stratification, and patient management. Objectives: This systematic review evaluates the effectiveness of AI in improving CVD diagnosis and treatment outcomes within the Chinese healthcare system. Secondary aims include assessing AI’s role in risk prediction, identifying implementation barriers, and exploring future directions. Methods: Following PRISMA guidelines, we conducted a comprehensive literature search (2021-2025) across PubMed, CNKI, IEEE Xplore, Scopus, and Web of Science. Inclusion criteria focused on peer-reviewed studies involving AI applications (ML/DL) in adult CVD care, while excluding non-empirical research or studies outside China. Results: Preliminary findings demonstrate that AI significantly enhances diagnostic precision (e.g., CNNs for ECG interpretation, DL for imaging analysis) and enables personalized treatment plans. Challenges include infrastructural limitations, data privacy concerns, and clinician resistance due to inadequate training. AI-driven predictive analytics show promise in early intervention but require robust validation and ethical oversight. Conclusion: AI holds immense potential to revolutionize CVD care in China, though its integration demands addressing technological, educational, and ethical barriers. Future research should prioritize longitudinal studies and standardized frameworks to ensure equitable, transparent AI deployment in cardiology.
Abstract: Background: Cardiovascular diseases (CVD) are the leading cause of mortality in China, accounting for 40% of annual deaths and affecting over 290 million individuals. Rapid urbanization, lifestyle changes, and an aging population have exacerbated CVD risk factors such as hypertension, diabetes, and obesity. Artificial Intelligence (AI) technologies...
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