Objectives:This scoping review aims to methodically identify and analyse the determinants which influence maternal mortality and healthcare utilization in women of childbearing years in Nigeria.The review specifi-cally addresses the difficulties faced in assessing medical care,and the ongoing initiatives to lower the maternal mortality ratio.Methods:Primary studies(published after year 2000)focused on maternal mortality,health determinants,and the utilization of maternal healthcare services in Nigeria were retrieved following a systematic search across multiple databases,including Scopus,PubMed,Google Scholar,and Web of Science.These were screened using defined inclusion and exclusion criteria.Data from these studies were extracted and thematically analysed to identify common themes and trends.Results:A total of 21 publications were included in this review comprising 2 qualitative,17 quantitative,and 2 mixed study designs.Major health determinants identified in these studies include hypertensive disorders of pregnancy,haemorrhage,and sepsis/septicaemia,contributing as much as 29％,24％,and 14.2％of maternal deaths respectively in over 10％of the reviewed studies.Similarly,social-economic determinants including poverty,maternal education,health system issues and culture significantly impacted the utilization of maternal healthcare services,inadvertently impacting maternal mortality.Despite various maternal health interventions such as the"Abiye"Safe Motherhood Initiative,the Integrated Maternal,Newborn,and Child Health Strategy and strengthening emergency obstetric care by governmental and non-governmental agencies,early childbearing,unemployment,large family sizes,and dependence on male spouses continued to result in suboptimal utilization of services and adverse maternal outcomes.Conclusion:This scoping review comprehensively integrated existing data from published studies to provide a detailed picture of maternal mortality,its health determinants,and factors influencing care utilization among women of childbearing age in Nigeria and approaches to reduce maternal mortality in the country and possibly in the West African sub-region.

Objective:This review examined the co-morbidity of malaria and hypertension in Nigerian adults,with a focus on epidemiological trends,genetic and environmental risk factors,pathophysiological mechanisms,and systemic healthcare barriers.Methods:A qualitative synthesis of peer-reviewed literature,national health surveys,and institutional reports published between 2000 and 2025 was conducted using thematic analysis.While centered on Nigeria,the review incorporated comparative insights from global studies on renin angiotensin aldosterone system polymorphisms,co-infection dynamics,and health service inequalities.Results:The findings indicate overlapping risk factors including renin angiotensin aldosterone system gene poly-morphisms,urbanization,and poverty.Angiotensin Ⅱ demonstrates dual functions,contributing both to malaria suppression and to hypertension pathogenesis.Clinical challenges include diagnostic overlap,adverse drug in-teractions,and disparities in service delivery between rural and urban populations.These challenges particularly affect older adults and highlight systemic gaps in access,workforce distribution,and policy alignment.Conclusion:The dual burden of malaria and hypertension in Nigeria requires integrated disease management strategies that address both communicable and non-communicable disease risks.Urgent priorities include multi-sectoral policy reforms,expanded rural health investments,and the adoption of precision medicine approaches guided by genetic profiling.The implications extend to clinical practice through co-screening and tailored treat-ment protocols and to public health policy,where integrated frameworks are essential to reducing inequities and improving long-term outcomes.

Objectives:We systematically reviewed the rational use of medicines using the World Health Organiza-tion/International Network of Rational Use of Drugs(WHO/INRUD)core drug use indicators.We also assessed the impact of the coronavirus disease 2019 pandemic and the National Drug Policy(NDP)2005 on the rational use of medicines.Methods:Searches were conducted in PubMed,Scopus,and Google Scholar databases to identify studies that met our eligibility criteria.Assessment of the quality of studies was conducted using the Joanna Briggs Institute criteria for analytical studies.We reported and compared the median values of WHO/INRUD core drug use indicators with standard thresholds.Data were presented with median,interquartile range(IQR),and percentages.Mann-Whitney and Kruskal-Wallis tests were conducted to assess for statistical significance(P＜0.05)across variables.Results:Thirty-one studies were included in the review,comprising 50,931 patient encounters across 268 health facilities.Within prescribing indicators,average number of medicines per patient encountered[3.4(IQR:3.0 to 4.0)],percentage of medicines prescribed by generic[50.4％(IQR:47.4％to 65.0％)],percentage of en-counters with antibiotic prescribed[40.2％(IQR:30.5％to 52.7％)],percentage of encounters with injection prescribed[18％(IQR:3.2％to 30.0％)]and the percentage of medicines prescribed from essential medicines list[82.0％(IQR:66.4％to 89.3％)].The median percentage of encounters with antibiotics(P=0.04)and the median percentage of medicines prescribed by generics(P=0.03)increased during and after the COVID-19 pan-demic.Prescribing indicators were worse in primary and secondary health facilities,with significant differences in the median percentage of encounters with antibiotics(P=0.007)and injections(P=0.0002)across primary,secondary,and tertiary health facilities.There were improvements across all prescribing indicators after the implementation of NDP 2005.Conclusions:Core drug use indicators in Nigerian health facilities deviated from the WHO/INRUD thresholds,with noticeable improvement after the implementation of NDP 2005.More efforts are needed to improve rational drug use in Nigerian hospitals.

Background:Antimicrobial resistance(AMR)poses a significant and growing public health challenge in East and Southern Africa.Despite formal commitments to the National Action Plans,domestic financing for AMR remains critically limited,with most countries continuing to depend heavily on external donor funding.Objective:This narrative review examines the current extent to which domestic fiscal commitments align with national AMR policy goals across the two regions.Methods:Government websites for ministries of health and finance,donor platforms,and three academic databases(Scopus,JSTOR,Google Scholar)were searched for eligible articles.National budget statements and media reports were also reviewed where available.Three researchers independently screened titles and sum-maries,followed by full-text reviews to confirm eligibility.Results:The findings reveal that while several countries have developed National Action Plans,very few have allocated domestic funding to implement them.Only Malawi,Nigeria and Uganda reported modest domestic con-tributions,while in other countries such as Zambia,Ethiopia,and South Africa,AMR programs remain largely donor-financed or lack dedicated budget lines altogether.Veterinary and laboratory sectors are particularly un-derfunded,with minimal integration into broader AMR strategies.While this review has several limitations in-cluding restricted access to current,comprehensive national budget data and a reliance on secondary sources such as donor and World Health Organization reports,which may introduce bias,the patterns identified in this review still offer valuable insight into regional funding dynamics and can inform future policy and research efforts.Conclusion:We conclude that without dedicated domestic financing and accountability mechanisms,AMR efforts in the region may face significant sustainability challenges observed in other health responses such as human immunodeficiency virus.Strengthening AMR governance requires clear budgetary commitments,sustainable co-financing models,and policy instruments to reduce dependency on external support.

Objective:This study has the objective to offer a thorough overview of the current state and future research possibilities regarding the social stigma of tuberculosis(TB).Given the growing volume and variety of research in this field,a quantitative approach is essential for mapping existing themes and pinpointing potential areas for further investigation.To accomplish this,a bibliometric and content analysis was performed to explore the current literature and emphasize key themes and future directions.Methods:The study examines 770 bibliographic records from Scopus and visualizes the results of the biblio-metric analysis using co-occurrence and thematic map analyses with VOSviewer and Tableau Public software.Additionally,a content analysis was conducted based on the findings from the co-occurrence analysis.Results:The findings indicate a notable rise in publications and citations related to the social stigma of TB,with prominent research topics including healthcare workers,social support,mobile health technology(mHealth),nursing,and attitudes.Emerging areas of research encompass epidemiology,public health,patient delays,multidrug-resistant TB(MDR-TB),corona virus disease 2019,and mHealth.Future studies might concentrate on the factors leading to patient delays,as well as the development of diagnostic tools and effective treatment regimens for MDR-TB cases.Conclusion:This study offers important insights into the current state of social stigma in TB research and iden-tifies promising areas for future investigation.By addressing these research gaps and refining methodological approaches,researchers can strengthen initiatives to combat TB stigma,ultimately resulting in more effective treatments and improved adherence among TB patients.

Background:Long-term exposure to toxic substances increases the risk of their accumulation and triggering endocrine disruption.The ill-planned irrigation systems in Uzbekistan led to severe environmental disasters,resulting in aridization and the spread of organochlorine pesticides and toxic metals across the region.Objective:We investigate the influence of negative environmental factors on hormonal activities such as sex steroids,gonadotropic hormones,and growth factors,in addition to potential disruptions in growth rate and anthropometric indicators in prepubertal adolescents living in this region.Methods:This study included 405 prepubertal boys aged 11 to 13 years,residing in the cities of Muynak(un-favorable region)and Nukus(favorable region)of Uzbekistan.We measured 20 anthropometric parameters and assessed somatotype by the Heath-Carter method,peak height velocity(PHV),and maturity offset based on Mir-wald's equation.In addition,the endocrine profile of 8 hormonal parameters was assessed,which includes growth factors,gonadotropins,sex steroids,and thyroid status.Results:We observed a positive dependence of physique,rate of maturation,and level of androgens,stimulated by gonadotropin hormones.Children living in unfavorable environmental regions show a decrease in follicle-stimulating hormone,luteinizing hormone,total testosterone(the best predictor),and anthropometric signs of androgen deficiency.These resulted in an increase in maturity offset and PHV,combined with lower skeletal density and ectomorphic somatotype compared to their peers living in favorable environmental regions.Conclusion:Regional differences in stature,body weight,and anthropometric parameters of adipose tissue,growth factor axis,and thyroid hormones are the influencing indices in the regulation of growth in prepubertal children.We hypothesize that the inhibition of the gonadotropin-testosterone axis may result from endocrine disruption due to higher levels of toxic metals and pesticide exposure.

Background:Female fish farmers in coastal Bangladesh face significant reproductive health(RH)challenges due to occupational,nutritional,and sociocultural factors.However,their health burdens have been largely overlooked in labor and health policies.Objectives:This study aims to investigate the prevalence,severity,determinants,and emotional and relationship consequences of RH morbidities among female fish farmers in Shyamnagar,Satkhira,Bangladesh.Methods:A cross-sectional survey with structured questionnaires was conducted among 297 female fish farmers.Data were supplemented by rural appraisal activities.Descriptive statistics,chi-square tests,Poisson regression,and Structural Equation Modeling were used for analysis.Results:The study found that 59.60％(177/297)of participants suffered from moderate to severe uterine issues,remarkably menstrual irregularities(92.65％,164/177),backache(59.32％,105/177),pelvic and fatigue pain(42.37％,75/177),anemia(28.24％,50/177),with the"21-30"year age group bearing a higher physiological burden with greater relational and emotional disruptions than"31-40"year age group,and"41-50"year age group women.High exposure to occupational chemicals(81.82％,243/297)and lack of personal protective equipment(93.94％,279/297)were key contributors.Access to formal healthcare is limited due to financial hardships(85.86％,255/297),social stigma(51.52％,153/297),and inadequate health services(46.47％,138/297).Structural Equation Modeling results also revealed significant associations among RH morbidities,emotional distress,social isolation,and diminishing well-being.Conclusion:The study highlights the urgent need for integrated health policies addressing reproductive care,occupational safety,and mental health support for female fish farmers in coastal Bangladesh.Addressing these issues will improve their health,well-being,and resilience.

Clinical pharmacy is on the cusp of exponential change powered by artificial intelligence agents,automation,data analytics,and robotics.Blockchain will enhance data integrity and transparency,and Augmented and Virtual Reality technologies will revolutionise training,patient education,and simulation-based care planning.Clinical pharmacists need to be ready and upskill to prepare for emerging technologies.The ethical,regulatory,and educational frameworks surrounding artificial intelligence and precision medicine will require constant attention,but the potential benefits for patient outcomes are unprecedented.Clinical pharmacists are in a prime position to design a new era in precision medicine,where technology works hand in hand with humans to transform healthcare.

Despite a global decline in tobacco use,smoking remains a leading cause of preventable death,with rising vaping rates among adolescents and young adults further complicating nicotine cessation efforts.Digital interventions,particularly chatbots,have gained attention for their potential to support tobacco and vaping cessation by sim-ulating human-like conversations and providing instant feedback.However,evidence of their effectiveness is limited.The emergence of generative artificial intelligence(AI)chatbots,such as ChatGPT,offers a promising av-enue for more personalised and effective cessation support.This article reviews existing literature on traditional chatbot interventions for cessation services,explores the potential of AI chatbots,namely ChatGPT,in continuing to support tobacco and vaping cessation efforts,and identifies areas for future research.It highlights the need to further monitor the reliability and accuracy of AI-generated content and to develop frameworks ensuring health-care professionals receive adequate training in using these new tools effectively to support patients in quitting smoking and/or vaping.

Background:Low awareness of common pediatric eye conditions,such as amblyopia,conjunctivitis,and myopia in rural Chiang Rai,Thailand,prompted the development of a specialized curriculum.This curriculum aimed to provide individuals serving these areas with resources to educate and disseminate information within their communities.Methods:A one-hour curriculum covering the causes,signs,diagnosis,treatment,and prevention of amblyopia,conjunctivitis,and myopia was delivered virtually to public health students at a Thai university and in-person to students at this university and rural community members.The in-person seminar included hands-on activities and simulations of these eye conditions.Knowledge acquisition and retention were assessed using pre-tests,immediate post-tests,and one-month post-tests.Results:The seminar was attended by 87 virtual public health students,111 in-person public health students,and 40 in-person rural community members.All groups showed significant improvement in test scores from pre-test to immediate post-test(P＜0.001).In-person students had 1.57 times the odds of answering correctly on the immediate post-test compared to virtual students,despite no significant difference in baseline knowledge.However,the subset of in-person students who did not receive bilingual materials showed no significant difference in immediate post-test performance compared to virtual students(P＞0.05).Although public health students had more than twice the odds of answering correctly at pre-test compared to rural community members,there were no significant differences between groups on the immediate post-test(P＞0.05).Conclusion:A brief seminar significantly improved understanding and retention of pediatric eye conditions,achieving similar levels of understanding among public health students and rural community members,regard-less of initial knowledge on this topic.In-person,hands-on seminars with educational materials in participants'preferred language proved more effective than virtual ones in achieving these improvements.