International Journal of Medical Sciences and Pharma Research

Dental Caries Prevalence and Associated Factors Among Primary School Children in Kigali, Rwanda: A Cross-Sectional Study

2026-07-17T19:19:25+02:00

Background: Dental caries represents a significant public health challenge in low- and middle-income countries, yet epidemiological data from sub-Saharan Africa remain scarce.

Objective: To determine the prevalence of dental caries and identify associated risk factors among 5–11-year-old children attending public primary schools in Kimironko Sector, Kigali, Rwanda.

Methods: This cross-sectional study employed stratified random sampling to recruit 325 children from three public primary schools (G.S. Kimironko I & II, E.P. Kibagabaga) between November 2024 and June 2025. Data collection comprised clinical oral examinations by calibrated dental examiners using WHO diagnostic criteria and parent-completed structured questionnaires assessing sociodemographic characteristics, dietary habits, oral hygiene practices, and parental knowledge. Chi-square tests examined bivariate associations, with statistical significance set at α=0.05.

Results: Dental caries prevalence was 51.1% (95% CI: 45.7–56.5%), with significant inter-school variation. Significant associations emerged for residence (OR=1.75, 95% CI: 1.11–2.76, p=0.015), dental visit frequency (p=0.045), parental reminders to brush (OR=2.55, 95% CI: 1.35–4.81, p=0.003), parental tooth-checking behavior (p=0.002), and composite parental knowledge score (p=0.031). Fluoride treatment showed an inverse association that did not reach statistical significance (OR=0.42, 95% CI: 0.17–1.07, p=0.077). No significant associations were detected for age, gender, or dietary habits.

Conclusions: Dental caries prevalence among Kimironko primary school children exceeds both national and regional estimates and was significantly associated with modifiable environmental and behavioral factors rather than demographic characteristics in bivariate analyses. Our findings underscore the urgent need for school-based preventive interventions to reduce this substantial disease burden.

Keywords: dental caries; child oral health; epidemiology; risk factors; fluoride; parental involvement; Rwanda; East Africa

Implementing Enhanced Recovery After Surgery (ERAS) Protocols in Resource-Limited Environments: A Critical Review for Nigerian Surgical Patients

2026-07-16T05:38:25+02:00

Background: Enhanced Recovery After Surgery (ERAS) protocols have been shown to improve perioperative outcomes and reduce healthcare costs in various settings. However, their implementation in resource-limited environments, such as Nigeria, remains constrained due to infrastructural, economic, and sociocultural barriers.

Methods: This critical review synthesizes current literature on the application of ERAS protocols in resource-constrained environments, with a focus on Nigeria. A comprehensive search of PubMed, Scopus, and African Journals Online was conducted to identify relevant studies. Data were extracted regarding the clinical benefits, cost-effectiveness, challenges, and context-specific strategies for ERAS implementation.

Results: Evidence indicates that ERAS protocols can significantly reduce postoperative complications, length of hospital stay, and overall healthcare expenditure in resource-limited settings. Successful implementation requires adaptation of ERAS components to local realities, prioritization of low-cost and high-impact interventions, and active engagement of multidisciplinary stakeholders.

Conclusion: The adoption of ERAS protocols in Nigeria requires careful adaptation to address local challenges and cultural factors. By focusing on readily available, reproducible, cost-effective strategies and fostering collaboration among healthcare providers, ERAS protocols can enhance surgical outcomes and optimize resource utilization in low- and middle-income countries.

Keywords: Enhanced Recovery After Surgery (ERAS), perioperative care, resource-limited settings, Nigeria, surgical outcomes, healthcare optimization

Bone Marrow Infiltration in Breast Cancer: Diagnostic and Prognostic Perspectives- A Narrative Review

2026-07-16T05:39:44+02:00

Bone marrow infiltration (BMI) by breast cancer cells is an early and critical step in the metastatic cascade that significantly impacts patient prognosis. The bone marrow microenvironment serves as a sanctuary for disseminated tumor cells, allowing them to survive, evade treatment, and potentially lead to disease recurrence. Understanding the mechanisms and clinical significance of BMI is essential for improving detection and therapeutic strategies in breast cancer management. Diagnostic approaches for identifying BMI range from invasive techniques such as bone marrow biopsy with histopathological and immunocytochemical analysis, to emerging molecular assays that increase sensitivity for detecting isolated tumor cells. Conventional imaging modalities provide limited sensitivity for early marrow involvement, underscoring the need for more precise diagnostic tools. Advances in molecular diagnostics and liquid biopsy technologies hold promise for less invasive and more accurate detection of bone marrow micro metastases. The presence of BMI in breast cancer patients is strongly associated with poorer outcomes, including increased risk of relapse and reduced overall survival. As a marker of minimal residual disease, BMI assessment can inform prognosis and guide personalized treatment decisions, including the escalation of adjuvant therapies. Integrating bone marrow evaluation into clinical practice and further elucidating tumor-microenvironment interactions could enhance metastasis prevention and improve long-term patient outcomes.

Keywords: Bone marrow infiltration, breast cancer, metastasis, diagnostic methods, prognostic markers

Factors Affecting the Stability of Probiotics in Pharmaceutical Products: A Comprehensive Review

2026-06-25T05:36:58+02:00

Stability of probiotics in pharmaceutical formulations is an important factor in determining the efficacy, product quality and regulatory requirements. In pharmaceuticals, probiotics are now being included to improve gastrointestinal immunity, gastrointestinal health, and to prevent or treat a number of diseases. But, survival and activity of probiotics during processing, storage and shelf life is still a challenge. Various factors which affect probiotic stability are strain selection, formulation type, excipients, moisture content, exposure to oxygen, temperature, packaging materials and storage conditions. Moreover, if the processing conditions are not optimized, such as drying, encapsulation and compression, the survival of probiotics may be negatively impacted. This thorough review critically analyzes the most important physicochemical, technological and environmental parameters that impact the stability of probiotics in pharmaceutical formulations. The main strategies used to improve the stability of probiotics, such as microencapsulation, protective carriers, packaging and controlled storage conditions are presented. In addition, regulatory issues and quality control strategies concerning the stability testing of probiotics and label claims are emphasized. To ensure the development of stable, effective and high-quality probiotic pharmaceutical products with consistent probiotic health promoting benefits for consumers, particular emphasis is put on understanding and control of these factors

Keywords: Probiotics in Pharmaceutical Products, the stability of probiotics in pharmaceutical products, factors affecting probiotics products stability.