ABSTRACT
Vascular abnormalities are very prevalent in type 2 diabetes mellitus (T2DM) and are the major causes of morbidity and mortality in this setting. This study aimed at determining the prevalence and associated risk factors for diabetic peripheral neuropathy (DPN) and peripheral artery disease (PAD) in T2DM subjects at NAUTH, Nigeria. This was a cross-sectional study that evaluated 142 stable T2DM out-patients. Anthropometric and blood pressure measurements were done. Glycated haemoglobin and fasting lipid profile were assayed. Biothesiometry of the feet and Doppler ultrasonography of the brachial and pedal arteries were done for diagnosis of vascular complications. Data was analysed 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 determine the association between the vascular abnormalities and the categorical variables. The level of significance was set at p ˂ 0.05. The prevalence rate of DPN and PAD was 50.7% and 18.3%, respectively. DPN showed significant association with age (X2 = 14.059; p = 0.001), sex (X2 = 6.630; p = 0.010), education level (X2 = 12.286; p = 0.006), duration of DM (X2 = 5.246; p = 0.022), global obesity (X2 = 5.494; p = 0.019), DM treatment (X2 =11.821; p = 0.003), dyslipidaemia (X2 = 9.767; p = 0.002), lipid-lowering drugs use (X2 = 4.036; p = 0.045) and PAD (X2 = 8.158; p = 0.004). Similarly, PAD showed significant association with systolic hypertension (X2 = 10.942; p = 0.001), diastolic hypertension (X2 = 24.026; p = 0.000), DM treatment (X2 = 7.262; p = 0.026) and DPN (X2 = 8.753; p = 0.003). The prevalence of DPN and PAD from the study was high and depicted a high burden of vascular abnormalities in T2DM subjects.

ABSTRACT
Air pollution, particularly fine particulate matter (PM2.5), is a significant health hazard, particularly for urban natives and teenagers. The purpose of this study was to assess the relationship between daily PM2.5 exposure and respiratory symptoms in 132 high school students in Nonthaburi Province, Thailand. From January to February 2025, Daily PM2.5 and students' self-reported respiratory symptom questionnaires obtained online. Results showed a clear relationship between elevated PM2.5 stages and worse respiratory symptoms. The mean PM2.5 concentration during the course of study was 36.2 µg/m³, significantly higher than the recommended safe exposure limit of the World Health Organization. In particular, symptom prevalence increased by 27.6% on days with PM2.5 was exceeding 40 µg/m³ compared to days ≤25 µg/m³. The logistic regression model indicated that PM2.5 concentration was related to 52% higher risk of the occurrence of respiratory symptoms (OR=1.52, 95% CI: 1.26–1.79, p<0.001). The results highlight the urgent requirement for instant air pollution controlling policies, such as school-based monitoring systems, public health education and active intervention to safeguard the development of adolescents in high polluted metropolis.

ABSTRACT
Abstract: Introduction: Macrophage activation syndrome (MAS) secondary to visceral leishmaniasis is a rare clinical entity. We report the case of a 4-year-old boy with no prior medical history, who had presented with fever and pallor for three weeks. Clinical examination revealed a temperature of 39°C, hepatomegaly, and splenomegaly. Laboratory tests showed bicytopenia, hypertriglyceridemia, and elevated lactate dehydrogenase (LDH). Bone marrow examination revealed Leishman bodies and hemophagocytic images. The patient was hospitalized and received treatment. The clinical and biological course was favorable. Conclusion: Visceral leishmaniasis associated with hemophagocytic syndrome is severe and may be life-threatening. Physicians should consider this diagnosis in children presenting with fever and splenomegaly. Urgent complementary investigations are needed to confirm this association and initiate appropriate treatment.

ABSTRACT
Background: The optimal rate of feeding advancement in preterm LBW infants remains uncertain, especially in low-resource settings. This study aimed to compare feeding intolerance and nutritional outcomes between rapid and gradual feeding protocols. Aim of the Study: The aim of the study was to compare feeding intolerance and nutritional outcomes in preterm low birth weight neonates receiving rapid versus gradual advanced feeding protocols. Methods: This randomized controlled trial at the Department of Neonatology, Bangladesh Shishu Hospital & Institute (BSH&I), Dhaka, from July 2022 to June 2024, included 88 low birth weight preterm neonates. Neonates were randomized to receive either rapid or gradual feeding advancement. Primary outcomes included feed intolerance, sepsis, NEC, hospital stay, and mortality. Data were analyzed using SPSS with a significance level of p < 0.05. Results: The study compared two feeding protocols in preterm low birth weight neonates. There were no significant differences in gestational age or birth weight between the groups. Feed intolerance was more common in group A (29.5%) than in group B (15.9%), but not significantly (p = 0.127). Group A reached full feeds faster (7.0 vs. 8.5 days, p = 0.004) and required less parenteral nutrition (5.0 vs. 7.5 days, p = 0.001). Group B had a longer hospital stay (10.0 vs. 7.0 days, p = 0.002), but no difference in weight at discharge (p = 0.740). Conclusion: Rapid enteral feeding in low-birth-weight preterm neonates improves nutritional outcomes without increasing feed intolerance.

ABSTRACT
The present review is designed to integrate recent developments in the diagnosis and treatment of heart failure (HF), a worldwide medical challenge associated with substantial morbidity and mortality. A systematic search of the literature published from 2015 up to October 2024 was performed using PubMed, Scopus and Web of Science. The search used the keywords “heart failure diagnosis,” “heart failure management,” and “novel therapies.” The studies were included when relevant, methodologically robust and of importance. Important findings of the review are diagnostic novelties as the natriuretic peptide testing and the advanced imaging, as well as therapeutic novelties as the SGLT2 inhibitors and the personalized medicine. Non-pharmacological interventions, including cardiac rehabilitation and device therapies, have also contributed to improvement in outcome. Yet, inequities in quality of care and heterogeneous guideline uptake remain. This review highlights the importance of integrated care paradigms and ongoing research in precision medicine to manage the multifaceted pathophysiology of HF. This review integrates the evidence to offer clinicians and researchers a complete resource for practice and future studies.

ABSTRACT
Background: Sweet syndrome or acute febrile neutrophilic dermatosis is a recurrent and rare skin disease caused by the release of cytokines, with diverse possible etiologic causes mainly being associated with infections, malignancy and drugs, with a reported incidence of 0.08 pediatric cases Historically, the Von den Driesch diagnostic criteria has been used to diagnose sweet syndrome. Case Presentation: We report a 6 month-old African female infant who presented with features of sweet syndrome. This case illustrates the typical presentation, diagnosis, and treatment outcome of this highly misdiagnosed condition. Conclusion: Due to the limited resources and knowledge about this under-reported disease in resource –constrained settings, the characteristic manifestation of sweet syndrome can be easily missed and thus requires a high index of suspicion for earlier diagnosis and management.

ABSTRACT
Median nerve neuropathy, which is characterized by pain, reduced muscular strength, and restricted nerve movement, is increasingly associated with long-term computer use. This study investigated in symptomatic computer users the effect of muscle strengthening exercises alone vs a combination of strengthening exercises and median nerve manipulation in 30 symptomatic computer users. Before conducting the four-week experiment, volunteers in Group A were split into two groups and had been selected out of 90 individuals to receive conservative treatment (muscle strengthening exercises) whilst Group B received both muscle strengthening and Butler's median nerve mobilization procedure. Pain and muscle strength were assessed using Visual Analog Scale (VAS) and Medical Research Council (MRC) grading respectively. Both groups separately showed significant improvement (p < 0.001) though Group B had a relatively more reduction in discomfort and gain in muscle strength than Group A and recommends that in computer users, a synergy of neural mobilization with usual strengthening exercises is more effective in moderating median nerve neuropathy signs. They recommend larger scale studies with objective evaluations in the future.