ABSTRACT Background and Aims Doxorubicin‐cyclophosphamide (AC) chemotherapy induces hepatotoxicity through oxidative stress and inflammatory pathway activation, but prospective African data are lacking and conventional liver tests may miss subclinical injury. We evaluated changes in liver enzymes, hepatic synthetic markers, and high‐sensitivity C‐reactive protein (hs‐CRP) after AC chemotherapy in Ethiopian women with breast cancer. Methods This prospective cohort study enrolled consecutive women (≥ 18 years) with breast cancer scheduled for four cycles of adjuvant/neoadjuvant AC (doxorubicin 60 mg/m2 + cyclophosphamide 600 mg/m2) at Tikur Anbessa Specialized Hospital (Addis Ababa, Ethiopia) from January 2024 through December 2025. Exclusion criteria included chronic liver disease, viral hepatitis, diabetes, and pregnancy/lactation. Serum AST, ALT, ALP, total protein, albumin, and hs‐CRP were measured at baseline and 2–4 weeks following the fourth cycle. Paired t‐tests/Wilcoxon tests, multivariable regression, and interaction testing were performed with Benjamini–Hochberg adjustment. Results Among 43 enrolled patients, 39 (90.7%) completed paired assessments (mean age 43.5 ± 12.3 years; 43.6% premenopausal; 53.5% stage I–II). AC chemotherapy induced an 81% hs‐CRP increase (baseline: 3.2 ± 2.1 mg/L; post‐AC: 5.8 ± 3.4 mg/L; Δ = +2.6 mg/L; p < 0.001; d = 0.92). Also, 46% experienced significant albumin decline (≥ 0.3 g/dL), and 18% developed frank hypoalbuminemia (< 3.5 g/dL), despite stable AST, ALT, and ALP. ΔHs‐CRP correlated inversely with Δalbumin (r = −0.34, p = 0.04). Age ≥ 56 years predicted greater hs‐CRP increase (β = +1.8 mg/L; p = 0.03); postmenopausal status predicted lower post‐AC albumin (β = −0.3 g/dL; p = 0.04). No grade ≥ 3 hepatotoxicity occurred. Conclusion AC chemotherapy was associated with marked systemic inflammation and biomarker changes consistent with subclinical hepatic synthetic impairment in nearly half of patients, not captured by conventional liver panels. Because albumin is also influenced by nutritional and inflammatory factors, this finding is a signal warranting closer monitoring, particularly in older and postmenopausal women, rather than proof of hepatocellular injury. These inexpensive biomarkers should be incorporated into monitoring protocols in resource‐limited settings.
ABSTRACT Background and Aims Dengue, a mosquito‐borne viral infection, poses a significant public health challenge in Bangladesh, with a recent surge in reported dengue cases and fatalities at the national level. This paper aims to investigate the association between climatic factors and the 2023 dengue outbreak in Bangladesh, with a particular focus on Dhaka City. It also explores factors contributing to the surge in cases and atypical features observed. Methods A structured narrative review was conducted alongside an ecological analysis of secondary data. The study utilized epidemiological data on reported dengue cases and climate variables, including climate data from 2019 to 2023. Relevant scientific literature on dengue and climate change was also reviewed. Monthly trends were analyzed, and associations between dengue incidence and temperature variables were assessed. Findings were interpreted descriptively in the context of existing literature. Results There was a concerning rise in dengue cases and fatalities in Bangladesh during 2023. Notably, Dhaka City experienced a surge in cases from June to December despite a slight decrease in average temperatures compared to previous years. This surge suggests a possible shift in transmission dynamics under changing environmental conditions. However, when data from all 5 years were aggregated and analyzed using average monthly temperature values, a statistically significant correlation was observed between dengue cases and minimum temperature (p = 0.04), whereas no statistically significant correlation was observed with maximum temperature. Reports from selected clinical studies suggest atypical presentations and a decrease in the characteristic skin rash were observed in hospitalized children, although these findings are not based on nationally representative data. Conclusion The 2023 dengue outbreak in Bangladesh highlights a complex and multifactorial relationship between climate factors and dengue transmission. This highlights the need to prioritize climate change research, developing a tetravalent dengue vaccine, and implementing proactive vector control measures. Collaborative efforts involving health agencies, researchers, and policymakers are essential to combat this evolving public health challenge.
ABSTRACT Background and Aim Infertility is a significant global health concern affecting couples worldwide, with male factors contributing to approximately half of all cases. Given regional variations in reproductive determinants, location‐specific evidence from clinic‐based populations is essential to inform targeted clinical assessments and local public health strategies. The primary objective of this study was to evaluate the statistical associations between demographic characteristics, clinical history, and lifestyle factors with sperm quality parameters in men attending a regional infertility referral center. Methods This descriptive‐analytical cross‐sectional study was conducted on 200 men who were referred to Lorestan University of Medical Sciences. The data collection tool included a researcher‐made checklist consisting of four sections on individual demographic information, information and clinical records, one's lifestyle information, and information on the results of sperm testing that were collected from the individual's file. The information was then entered into SPSS 22 and was analyzed. Results The average age of participants was 34.12 ± 6.45 years, ranging from 23 to 55 years. Among them, 60.5% were employed, 84.5% lived in cities, and 42% had an undergraduate education. Twenty percent had a history of chemical exposure or factory work, 25.5% smoked, 7% consumed alcohol, and 8% had sexual disorders. A significant inverse association was observed between age and age at marriage with sperm morphology (p = 0.004 and p = 0.022, respectively), indicating lower sperm morphology with increasing age and later age at marriage. Significant associations were also observed between certain clinical history variables (heart disease, diabetes, medication use, sexual dysfunction) and lifestyle factors (chemical exposure, alcohol consumption, smoking) with sperm parameters, particularly sperm forward motility (p < 0.05). These findings represent statistical associations and should not be interpreted as causal effects due to the cross‐sectional study design. Conclusions Therefore, this study concludes that older age at marriage negatively impacts sperm quality. This study suggests that a later age at marriage is associated with lower sperm morphology and that certain clinical and lifestyle factors are associated with statistical differences in sperm parameters, particularly motility. These exploratory patterns underscore the necessity of accounting for demographic and behavioral variables during clinical assessments.
ABSTRACT Background Adolescence is a critical period for the formation of health behaviors, yet composite lifestyle data from rural districts of Pakistan are scarce. We described the healthy lifestyle profile of school‐going adolescents in Bahawalpur, South Punjab, and its association with socio‐demographic factors. Methods This descriptive cross‐sectional study enrolled 319 adolescents aged 11–19 years from four public schools in one randomly selected tehsil during August 2024. Two over‐age records were excluded, leaving 317 eligible participants for descriptive tabulation; three of these had a missing item and were further excluded, leaving 314 participants for the complete‐case composite analysis. Lifestyle was measured with a nine‐item behavioral composite informed by the Adolescent Lifestyle Profile. We treated the composite as a formative index with a possible range of 0–38 and analyzed it mainly as a continuous score. We assessed associations with Mann–Whitney U tests (reporting rank‐biserial effect sizes), Spearman correlation, χ2 tests with Cramér's V, and multivariable linear regression with heteroscedasticity‐consistent (HC3) standard errors. Results The mean composite score was 21.36 (SD 3.79; median 22, IQR 19–24; observed range 11–31). When scores were grouped into pragmatic descriptive bands, most adolescents fell in the middle of the distribution, and none reached the highest band. Girls scored modestly higher than boys (21.83 vs. 20.81; Mann–Whitney p = 0.0075; rank‐biserial r = 0.175). In multivariable regression (R2 = 0.073), grade was the only independent predictor of a higher score (β = 0.78, 95% CI 0.34–1.22, p < 0.001). Age, sex, parental education, family size, and household income were not. Conclusion Adolescents attending these four schools reported largely mid‐range lifestyle behaviors. Screen time was high, fruit and vegetable intake low, sugary‐drink consumption frequent, and vigorous physical activity limited. School‐based health promotion that targets these specific behaviors and accounts for grade‐ and sex‐related differences is warranted. The findings apply to students of the four sampled schools and should not be generalized to all adolescents in the district.
