Kateb Journal of Medical Science & Biotechnology
Kateb Journal of Medical Sciences and Biotechnology, affiliated with Kateb University, is a peer-reviewed, double-blind, open-access scientific research journal published semi-annually, focusing on the fields of medical sciences and biotechnology. With a commitment to the advancement of specialized knowledge, the journal regularly publishes articles in diverse areas, including cellular and molecular biology, biotechnology, medical biology, pharmacology, genetics, clinical research, and other related disciplines. The primary objective of this journal is to enhance the production and exchange of knowledge within the realms of medical sciences and biotechnology through the regular publication of high-quality scientific research. It aims to facilitate research collaborations and address health and biotechnological challenges, particularly within the context of Afghanistan—an approach pursued to expand the frontiers of knowledge and provide scientific solutions for sustainable development. This publication welcomes original research and review articles from researchers addressing significant and contemporary issues in the field, presenting innovative and original findings within their respective areas of expertise. Manuscripts must be original, previously unpublished, and not under simultaneous consideration for publication in any other journal. General Information Title (English): Kateb Journal of Medical Sciences and Biotechnology Title (Persian): مجله علمی-تحقیقی علوم طبی و بیوتکنولوژی کاتب Publisher/Owner: Kateb University Publishing Body: Kateb University Scope: medical sciences and biotechnology Peer-Review Model: Double-Blind Review Year of Establishment: 2013 (originally launched as Kateb Scientific Quarterly) Date of National Accreditation: 13/05/2021 Accreditation/Rank: Recognized as a National Scientific-Research Journal (Ministry of Higher Education, Afghanistan) Average Time for Initial Review: Approximately 10 days Average Peer-Review and Acceptance Period: 2–3 months (minimum of two referees) Publication Frequency: Biannual (two issues per year) Languages of Publication: Persian (Dari) and English Format: Electronic and limited print edition Access Policy: Free and Open Access (full text) Print ISSN: 2789-1178 Online ISSN: 2789-1186 Citation Style: Vancouver
Prevalence and Associated Factors of Genetic Disorders and Congenital Abnormalities in Consanguineous Marriages in Afghanistan
Background: Consanguineous marriage, the union between two individuals closely related, is a prevalent practice in Afghanistan, with an estimated 46.2% of all marriages being consanguineous. This practice is driven by various factors, including cultural traditions, beliefs in strengthening familial bonds, and ease of finding a suitable spouse within the extended family. However, consanguineous marriages have been associated with an increased risk of genetic disorders in offspring. This study aimed to investigate the prevalence and associated factors of genetic disorders and congenital abnormalities in a group of couples with consanguineous marriage in Afghanistan. Methodology: A cross-sectional study design was employed to recruit 131 couples with consanguineous marriage from various hospitals in Kabul, Afghanistan. Participants were selected on questionnaire from registered patients admitted to the hospitals based on their marital status, consanguinity, and reasons for visiting the doctor, including marital problems, childlessness, repeated abortions, congenital and genetic diseases in their children. Data were collected on demographic characteristics, medical history, physical examination findings, and genetic testing results and descriptive statistics (mean, median, mode, standard deviation, variance, frequency) conducted. Results: The study findings revealed that 30% of the participating couples had children with genetic disorders. Among these couples, 59% of the cases were associated with first cousin marriages. The most common type of consanguineous marriage was first cousin marriage, accounting for 61.8% of all consanguineous marriages. These findings highlight the significant association between consanguineous marriage and the prevalence of genetic disorders in Afghanistan. Conclusion: This study delves into Afghanistan's common practice of consanguineous marriage, particularly first cousin unions (over 60%). Worryingly, it reveals a stark link between this practice and an increased risk of children with genetic disorders. While details require further exploration, these findings highlight the crucial need for accessible genetic counseling and education to empower couples to make informed choices regarding their reproductive health and future generations.
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Prevalence and Associated Factors of Chronic Kidney Disease Patients in Wazir Mohammad Akbar Khan Hospital in Kabul, Afghanistan
Background: Chronic Kidney Disease (CKD) is a global health issue affecting a significant portion of the world's population, with diabetes and hypertension as its prime causes. The disease's incidence varies within countries by ethnicity and social determinants, and it contributes substantially to noncommunicable diseases. Accurate assessment and staging of CKD are crucial for appropriate management. This study investigated the prevalence and associated factors of CKD among patients referred to Wazir Mohammad Akbar Khan Hospital in Kabul, Afghanistan. Methodology: The study utilized a case series-based descriptive design, and the study population comprised 87 CKD patients out of 33,836 patients who visited the hospital's emergency department. Data were collected through multi-stage sampling method, with demographic details and clinical findings analyzed using Excel 2016. All ethical guidelines were strictly adhered to, ensuring participants' voluntary participation and confidentiality. Result: The results revealed that diabetes mellitus was the primary cause of CKD in 60% of cases, followed by hypertension in 34%. Females comprised 65.5% of CKD patients, with diabetes mellitus being the most common cause in both genders. The majority of patients were between the ages of 41 and 60, and 34.5% of patients had associated anemia. The disease stages varied, with the majority of patients in stage 2. The majority of patients (80%) were managed with medical therapy, while 20% required referral to a dialysis center. The majority of CKD patients (79.3%) were from the Central zone. These findings underscore the need for targeted interventions to manage the burden of CKD effectively.
Prevalence of Corneal Trauma among Patients Attending Noor Hospital in the Second Half of 2019
Corneal trauma is a common ocular injury that leads to vision loss and disability in individuals. This study aims to investigate the prevalence of corneal trauma among patients attending Noor Hospital in Kabul in the second half of 2019. According to the results, the most common cause of corneal trauma is domestic accidents, with men being three times more affected than women. Furthermore, children and adolescents under the age of 20 are more prone to corneal trauma. In terms of the affected eye, the right eye is more commonly affected than the left eye, and iris prolapse is the most frequent associated complication with corneal trauma. Based on these findings, increasing community awareness through education, universities, and families can reduce the risk of corneal trauma.
The prevalence of glaucoma cases at the Teaching Eye Hospital in the year 1401 AH
Glaucoma, also known as "black water," is a chronic and progressive disease that damages the optic nerve and leads to loss of vision. One of the main risk factors for this disease is elevated intraocular pressure. Disruption in the eye's fluid drainage system can result in fluid accumulation and increased pressure, which damages the optic nerve. The optic nerve is a bundle of nerve fibers that connects the retina to the brain. Damage to this nerve leads to vision loss. Vision loss initially begins with peripheral vision and gradually affects central vision. When the optic nerve damage occurs, it may take months or years for symptoms to manifest, and once vision is lost, it is irreversible. Methodology: In this study, a descriptive-cross-sectional research method was employed using a retrospective review of the medical records of 26,000 patients who visited the ophthalmology clinic between 1 Hamal 1401 and 29 Hoot 1401. The purpose was to investigate the prevalence of glaucoma. All the information was collected from the patients' files. Results: Overall, 138 cases of glaucoma were recorded in the eye clinic during the year 1401. The current research results indicate that the highest number of glaucoma cases occurs in individuals over 60 years old, while the lowest cases are observed in individuals aged 0-20. In terms of gender, the majority of cases were observed in males (60.78%) and fewer cases in females (39.13%). Regarding the type of glaucoma, primary open-angle glaucoma (POAG) accounted for the highest number of cases, while primary closed-angle glaucoma (PCAG) accounted for the fewest cases. Conclusion: Early diagnosis and treatment of glaucoma are crucial as untreated glaucoma can lead to vision loss. Regular eye examinations and measurement of intraocular pressure are vital for early detection of glaucoma. The treatment of glaucoma includes the use of eye drops, medications, and in severe cases, surgery. Additionally, correcting risk factors such as controlling blood pressure, making dietary changes, and adopting a healthy lifestyle can also be effective in reducing the risk of developing glaucoma.
intraocular pressure, primary open-angle glaucoma (POAG)
Investigation of Leishmaniasis Events in Afghanistan
Leishmaniasis is a disease caused by parasites of the Leishmania type. It species spreads by the bite of certain types of sandflies. The disease can present in three main ways: cutaneous, mucocutaneous, or visceral leishmaniasis. It’s a common parasitic disease of human and some animals, the incidence of secondary infection in cutaneous lesions, can cause serious problems and even death. The rate of its Incidence is high in developing countries including Afghanistan. The World Health Organization reports more than three hundred and fifty million people at risk of leishmaniasis, as many as 12 million people are believed to be currently infected, and an estimated of 2 million new cases every year. NMLCP the National Malaria and Leshmainia program of Afghanistan reports the highest number of Leishmaniasis in Kabul (14,940 cases) and the lowest in Zabul province (11 cases) in 2021. The 13 district of Kabul city indicate the most number of the disease. The incidence of leishmaniasis is not significant between man and women, but slightly increased in female in 2012 and 2021. The high rate of leishmaniasis according to NMLCP in Afghanistan was in 2009 (41072) and low in 2004 (9203). Kabul city has the highest rates of leishmaniasis then other provinces in Afghanistan, as indicated that the high rate was in 2012 (15862) and the low rate in 2014 (6488). This study will guide further practical studies in different region of Afghanistan. More practical studies regarding the prevalence of the parasite and molecular studies for differentiation of different kind of lieshmania in the country are recommended.
The Impact of an Educational Intervention Program on Malaria Prevention among Students in Rural Areas, Iranshahr, Iran
Malaria, as a global health problem, continues to be a significant challenge in Iran. The southern and southeastern regions of Iran, particularly Sistan and Baluchestan, Hormozgan, and Kerman provinces, are known as areas affected by malaria. Despite control and prevention programs, malaria remains a serious threat to the community, especially in rural areas with limited access to health information and services. This article examines the impact of an educational intervention program on malaria prevention among students in rural areas of Iranshahr. The main objective of this educational program is to increase students' knowledge and awareness about the causes, symptoms, prevention methods, and treatment of malaria. By providing targeted health messages, students are empowered with the necessary knowledge and resources to identify and manage malaria-related health issues. The educational intervention program in this study employed a non-experimental research method. By selecting a sample of students from rural areas of Iranshahr and implementing the educational program, the impact of this program on enhancing students' knowledge and awareness of malaria was evaluated. The results of this study demonstrate that the educational intervention program can play an effective role in reducing the prevalence of malaria among students in rural areas. Increasing knowledge and awareness about malaria, understanding its symptoms and prevention methods, and strengthening community and teacher collaboration in implementing malaria control programs can be instrumental in controlling this disease.
The Capacity of Health Research in Afghanistan: Bibliometric Analysis
Background: Credible evidence appropriate to the setting and accessible is fundamental to providing quality health services and education. Therefore, we aim to evaluate Afghanistan's health research capacity. Method: Bibliometric analysis was done in four databases by keywords of “Afghanistan” including the PubMed, Web of Sciences, Scopus, and Science Direct to see how many articles have been published on Afghanistan people's health problems and to determine the contribution of indigenous institutions and scientists. Result: Out of 1075 articles that met our inclusion criteria, just 140 (13.02%) articles were written by scholars with affiliation with Afghanistan institutions (n = 34 org). Afghanistan Universities account for 25 articles out of 140. Ministry of public health, with 52 articles, French Institute for Children with 16 articles, and Kabul University of Medical Sciences with 11 articles were leading the organizations in Afghanistan in terms of publication numbers. Conclusion: There are few numbers of publications considering the health of Afghanistan people. The indigenous health research system's capacity is low, and dependency exists in different perspectives to the other countries. The universities of Afghanistan have not paly its role in producing knowledge.
Non-Invasive diagnosis of Hemolytic disease of fetus and newborn by cff DNA
Introduction: The most common cause of HDFN (Hemolytic Disease of the Fetus and Newborn) is Rh incompatibility between mother and fetus. The result of the incompatibility in the mother's body is the creation of allo-antibodies which can pass through the placenta and lead to lysis of embryo's red blood cells. HDFN may cause anemia, jaundice, hepatosplenomegaly, Kernicterus, encephalopathy and also abortion. Aim: Conventional methods including cordocentesis and amniocentesis, which are used to detect HDFN, are invasive and may lead to abortion, so the importance of NIPT (Non-Invasive Prenatal Testing) is revealed as this methodology does not have the risks of earlier methods and has high accuracy and sensitivity. Methods: Data collections have been done using databases: PubMed, Nature and Science Direct. To compare and summarize the different diagnostic methods of HDFN, books and articles that have been published by 2018 are studied. Result: Incompatibility in maternal and fetal blood groups may cause irreversible damage to the fetus, so an early diagnosis can prevent these problems. Discussion and Conclusion: NIPT can be done from the 10th week of pregnancy. The specificity and sensitivity of this method is high and the risk of abortion does not exist. It is strongly suggested to do NIPT on mothers with Rh- blood in order to accurately detect fetal Rh type and reduce excessive Rhogam use.
Investigating the relationship between mental health and academic achievement in students of Shahid Ostad Rabbani University of Education and Training
Objective: The objective of this research is to study the relationship between mental health and educational achievement among students of Ustad Rabbani University. Research Methodology: This paper is based on Cross-Sectional Descriptive study and the statistics are based on the evaluations gathered from students of Ustad Rabbani University. In addition, the probability sampling method used in this paper is Simple Random Sampling with 400 samples. Moreover, research tools for this study are Goldberg 28-Item General Health Questionnaire (GHQ28) and students’ educational achievement records. Results: The output derived from this research depicts that there is no significant difference between mental health and educational achievements among students of Ustad Rabbani University. Despite noticeable differences in subscales of mental health like body language, anxiety and depression among students of different gender, no significant difference was noticed with other socially dysfunctional disorders. Discussion: Based on the results of this study, it is recommended to open psychotherapy and consultancy service centers in universities to help students suffering from mental health problems. Considering most of the students in this survey were single and staying in hostels with having fewer responsibilities and little life struggles, they were more focused on their studies.
Investigation on the age of menarche and its related factorsinsecondary school girl students in Birjand-Iran
Introduction: menarche is a remarkable phenomenon during the stages of female puberty. Predicting the correct time of puberty in girls makes it possible to provide them with the necessary knowledge in this field. Method: This cross-sectional study was performed on 400 middle school girls 11 to 14 years of age in Birjand using interviews and anthropometric measurement methods. Samples were selected by two-stage random sampling. The data collection tool was a questionnaire including demographic characteristics, the age of menarche, and anthropometrics. The content validity of the questionnaire was confirmed by several faculty members and its reliability was confirmed using retesting and calculating Cronbach's alpha coefficient. Data were analyzed using SPSS software and independent t-test, analysis of variance and Pearson correlation coefficient were used, and p≤0.05 was considered as a significant level. Results: Based on the findings of this study, the mean age of menarche in Birjand was 12.13±1.19 years. The mean body mass index was 20.3±3.8 kg/m2 . A significant relationship was found between menarche age and body mass index (p≤0.001). In other words, girls with normal body mass experience menarche age later than girls who are overweight and obese. Conclusion: The average age of menarche in Birjand is lower than other regions of the country which is the result of different climatic conditions, improving health and social conditions, and improving nutritional status.
First report of infants of diabetic mothers frequency in Afghanistan
Background: Diabetes is a chronic metabolic disease. It affects about 0.5 – 5% of all pregnancies, diabetes during pregnancy divided in tow pre gestational diabetes and gestational diabetes. 81% cases were gestational diabetes and 19% cases were pre gestational diabetes. Goals: the purpose of the present study was to evaluate complication of IDM(infants of diabetic mothers) in Afghanistan. Methods: we conducted descriptive hospital based study in IGICH(Indira Gandhi institute of child Health) during one year from june 2017 to may 2018 to assess the outcome in IDMs and association of various complication to glycemic status of mothers. Result: 5912 patient hospitalized in neonatal department that 59 patient was Infant of diabetic mothers. These 59 patient were descriptively studied, 63% were boys and 37% were girls, among them hypoglycemia was the most commonly observed complication with frequency 60% followed by macrosomia (50%), other complications were prematurity, hypocalcemia, polycythemia, hyperbilirubinemia, respiratory distress, birth asphyxia and neonatal seizure. Conclusions: high frequency of complication is seen in infants born to diabetic mothers. Strict glycemic control in mother and proper monitoring in babies is required to prevent morbidity and mortality in infants of diabetic mothers.
COVID-19 situation in Indonesia: Efforts and challenges
More than a year has passed since the emergence of Coronavirus Disease 2019 (COVID-19) pandemic. However, Indonesia still tussles to flatten the curve. To curb the infection rate, the Government of Indonesia passed public health policies to increase its healthcare system capacity and Indonesians’ awareness about COVID-19. However, existing health disparities between its regions, funding and political concern, and misinformation continue to hinder the effectiveness of these policies. This paper aims to provide a critical commentary on the current efforts against the COVID-19 pandemic and the challenges facing it’s in responses in Indonesia.
Somaliland: a self-declared country’s fight against COVID-19
Somaliland despite having a weak health system, managed COVID-19 better than some well-resourced countries in the continent by establishing a National Task Force to direct efforts in early detection, surveillance, risk communication and infection control of the virus. The Ministry of Health has been able to garner personnel with medical skills to increase the response workforce and also supervise the activities of medical facilities across the country. However, these measures have shown unfavorable effect on the economy. Somaliland is in active trade with other African countries and neglecting the impact of the virus can greatly affect the trade partner countries. Appropriate relief funds should be offered by capable countries to lessen the economic impact of the pandemic in the country. In the meantime, it is time to reframe the health system of Somaliland and improve sectors that have been underfunded like emergency, intensive care units and the surgical departments.
The Low and Slow COVID-19 Pandemic of Timor-Leste
COVID-19 is a highly contagious disease that has penetrated many countries including Timor-Leste. Being relatively new with frail healthcare system, lack of access to water and sanitation facilities, and high poverty level in addition to its proximity to Indonesia—a country with increasing number of infections and fatalities, it was expected that this country would be conquered by this public health threat. Conversely, it has managed to prevent community transmission, maintain low infection rate, and record zero deaths since the first case was confirmed on 21 March 2020. The country’s feat against this public health threat appears to be attributable to the immediate action of the government, support from international organizations, effective communication strategies, involvement of the church, and importance given to water, sanitation, and hygiene programs. The pandemic further emphasized the need of the country for more investments on the healthcare system. Nevertheless, despite the limitations on resources, the current tally of COVID-19 cases in TimorLeste manifests how a neophyte and small country with limited resources could respond to a global health dilemma. As the country slowly lifts restrictions, vigilance must be kept to sustain its initial success especially that new and more infective strains of the disease are being discovered.
Comparison of IQ between 4-16 year-old children after cochlear implantation in the left or right ear
Purpose: Hemispheric dominance is associated with more activity in one half of the body, which is very important in the presence of a relationship between the intelligence and brain lateralization. Delayed language development in the children undergoing cochlear implantation can have deleterious effects on their growth, academic performance, adaptation, and social interactions. Regarding this, the present study aimed to determine the relationship between the dominant hand and intelligence in the 4-16 year-old children undergoing cochlear implantation in the left or right ear. Methods: This cross-sectional study was conducted on the records of the patients aged within 4-16 years who had undergone cochlear implantation during 2008-2011. The subjects’ IQ was measured using Wechsler test by a neuroscience specialist. Then, the IQ of the children with the right cochlear implant was compared to that of those with left implant. The data were analyzed using the t-test, Fisher’s exact test, Mann-Whitney U test, and Chi-square test in SPSS version 18. Results: According to the results, there was no significant difference between the children with right and left cochlear implants in terms of the mean IQ score (P=0.54). Furthermore, no significant association was observed between IQ score and right-handedness or left-handedness in the children undergoing cochlear implantation (P=0.17, P=0.8, respectively). Conclusion: As the findings indicated, there was no relationship between the dominant hand and IQ score in the children undergoing cochlear implantation.
The Role of Mothers’ Intentions for Physical Activity Education in Children: A Test of Theory of Planned Behavior
Background: One of the important agents in the development of children physical activity is mothers. Objective: The present study aimed to assessing the role of socio-cognitive determinants in mothers’ intention to physical activity education for children based on the theory of planned behavior. Methods: This cross-sectional study was conducted among a sample of mothers who have 3 to 6 old child in the west of Iran, 2018. Participants were randomly selected to participate voluntarily in the study. A structured questionnaire was applied for collecting data and data were analyzed by SPSS version 20 using correlations, and linear regression statistical tests. Results: Mean age of the mothers was 31.68 [95% CI: 31.17, 32.19]. Attitude, subjective norms and perceived behavior control variables predictors accounted for 42% of the variation in the intention of physical activity education for children by mothers. Perceived behavior control (Beta=-0.654 and P≤ 0.001) was the more influential predictor on physical activity education intention. Conclusion: It seems that designing and implementation of educational programs to increase perceived behavior control of mothers regarding the physical activity education for children may be the usefulness of the results in order to the promotion of physical activity among their children.
urpose: we reviewed that the mental fatigue is influenced by dopamine depletion, and we assume that increasing DA level can increase athletic stamina and promote athletic performance after prolong exercise. Methods: The search strategy was according to key words contain, Mental fatigue, Decision making, Dopamine, Stroboscope training through the Google scholar, PubMed, and Elsevier. Among the literatures, 100 papers include review and original articles were studied. Finally, we decided to select 49 papers based on similarity and recent studies so more than 50 percent of papers were excluded, because of they were out of date or irrelevant to key words. Results: Based on many studies, it was found dopamine has an essential role on athletic performance and his stamina. Conclusion: The stroboscope vision training in sports could enhance the dopaminergic neurons and associated visuo-motor skills.
Determination of the Course of COVID-19 Pandemic Using Modified Mathematical Modeling
Introduction: COVID-19 appeared in China at the end of 2019. It then spread all over the world very quickly. The new type of corona virus COVID-19, which causes respiratory tract infection, is destructive with its high rate of transmission and mortality rate Aim: In this study, previously applied to literature in Turkey and Iran, to determine the course of epidemics with the help of a specially modified mathematical modeling to calculate the course of the pandemic in Afghanistan and COVID-19 is intended to reveal. Method and Results: If the normal course of the disease continues, the number of cases after 4 months is expected to reach the limit of 135,000. However, depending on the severity of increasing public, social and individual measures, it is predicted that the total number of cases may fall below 100,000. If the disease continues to spread in its current form, it is possible to reach more than 2000 new cases daily by reaching the maximum level, like the end of June-early July. However, it is understood from the graph that this number will fall much further if the measures are followed. According to our modified mathematical modeling results, the COVID-19 pandemic will spread very rapidly in Afghanistan. However, it is possible to reduce the number of cases and deaths very effectively with easy measures.
Real Time PCR; A new, fast and accurate technique in diagnosing the severe type of hemophilia A patients
Introduction: Hemophilia A (HA) is one of the most deleterious X-linked bleeding disorders in male patients. Early and rapid detection could provide management strategies for this disease. This study aims to improve the classic method for detection of important intron 22 inversion mutations (INV22). Materials and Methods: Whole blood samples were taken from 21 male children with a history of severe HA, referred to the Iranian comprehensive hemophilia care center. Two groups were involved for detection of INV22 and two methods were examined in a double-blind manner. The first method used a classical method, inverse PCR, and the second method was Real-time inverse PCR. Results: Results showed that both methods could separately detect the INV22 in 11 out of 21 patients with severe HA (52%) in the same accuracy, but with this difference that only one day was needed for detecting of INV22 by Real-time inverse PCR and on other hand 3 days were needed for the classical methods. Concusion: Because of the medical importance of early detection or prenatal/postnatal diagnosis of this disease, this study recommends the Real-time inverse PCR technique for the rapid detection of this mutation in well-equipped genetic laboratories everywhere.
Type 2 Diabetes Mellitus in Afghanistan (2015–2025): A Systematic Review of Prevalence and Determinants
Background: Type 2 Diabetes Mellitus (T2DM) is a rapidly growing public health concern in Afghanistan, reflecting global trends in the increase of non-communicable diseases. However, the country’s fragile healthcare infrastructure, prolonged socioeconomic instability, and limited preventive strategies make a unique epidemiological context that may worsen disease burden and outcomes. Objective: This systematic review aims to synthesize available evidence on the prevalence, temporal trends, and key determinants of T2DM in Afghanistan between 2015 and 2025. Methods: A systematic review with narrative synthesis was conducted using studies retrieved from PubMed, Google Scholar, Scopus, Web of Science, and relevant grey literature. Eligible studies included observational studies on adult populations in Afghanistan that reported T2DM prevalence and associated risk factors. Due to methodological heterogeneity, findings were synthesized thematically rather than through meta-analysis. Results: Evidence indicates a rising and consistently high prevalence of T2DM, generally ranging from approximately 9% to over 20%, with higher rates observed in urban populations. Major determinants include physical inactivity, dietary transitions toward high-calorie and low-fiber foods, obesity, and socioeconomic constraints. Health system limitations—particularly inadequate screening, delayed diagnosis, and poor continuity of care—contribute substantially to undiagnosed and poorly controlled cases. Additionally, gender disparities and rural–urban differences significantly affect disease distribution and management outcomes. Conclusion: T2DM in Afghanistan is a growing and multifactorial health challenge driven by both modifiable lifestyle factors and systemic healthcare weaknesses. Addressing this burden requires integrated national strategies focused on early detection, strengthening primary healthcare systems, improving public awareness, and promoting preventive interventions. Without coordinated action, the prevalence and complications of T2DM are likely to continue increasing.
Awareness of Cerebrovascular Accident (CVA) and Associated Risks Among Youths in West Kabul: A Cross-Sectional Study
Background: Cerebrovascular accident (CVA), also known as stroke, is a leading cause of death and disability in the world. Although more common in older people, its causative factors—hypertension, cigarette smoking, obesity, and lack of exercise—are fast becoming common in young individuals. Understanding stroke warning signs and prevention is of primary importance. Objective: To assess the level of awareness of cerebrovascular accident (CVA), including risk factors, warning signs, and complications, among youths aged 18–25 years in West Kabul. Methods: 1,800 young people (900 men and 900 women) aged 18–25 years were surveyed using convenience sampling from schools, universities, public spaces and community centers. Data was collected using a validated questionnaire on demographics, CVA awareness, risk factors, and warning signs. SPSS was used for descriptive analysis of response. Informed consent was obtained from all participants, and ethical principles for human research were observed. Results: Among males (n=900), 79% were aware of CVA; however, only 29% correctly identified major risk factors. Among females (n=900), 67% reported overall awareness, but only 34% accurately identified causes and risk determinants. A significant majority held misconceptions about lifestyle risks and warning signs, such as sudden weakness or speech difficulty. Good knowledge of CVA complications, including paralysis and permanent disability, was observed in only 24% of males and 30% of females. Conclusion: While most of the youths in West Kabul have a good understanding of CVA, proper awareness of risk factors, warning signs, and complications is not widespread. Less than one-third had high awareness, and this necessitates education specifically to this population. School programs and community outreach should be utilized to roll out stroke prevention programs to promote healthier lifestyles.
A Narrative Review on the Biochemical Effects of Drugs of Abuse on Liver and Kidney
Background: Chronic abuse of opioids, stimulants, and analgesic drugs is associated with significant biochemical, immunological, and oxidative stress–related alterations in liver and kidney function. Although the toxic effects of these substances have been widely documented, available evidence remains fragmented and largely substance-specific, with limited comparative analysis and insufficient focus on recovery following drug withdrawal. This review aimed to synthesize current evidence regarding chronic drug-induced organ toxicity and post-withdrawal biochemical recovery patterns. Methods: This narrative review analyzed findings from twenty peer-reviewed studies, predominantly preclinical animal-based investigations, with limited inclusion of available human clinical data. The review evaluated the effects of chronic exposure to opioids (tramadol, morphine, heroin), stimulants (amphetamine, cocaine, ketamine), and analgesics (acetaminophen and Tramacet). Biochemical and immunological parameters assessed included hepatic enzymes (ALT, AST, LDH), renal biomarkers (BUN and creatinine), oxidative stress markers (GSH, SOD, CAT, MDA), and pro-inflammatory cytokines (IFN-γ and IL-1β). Results: Acetaminophen exhibited the most severe hepatotoxic and nephrotoxic effects, primarily mediated through its reactive metabolite N-acetyl-p-benzoquinone imine (NAPQI). Opioids and stimulants produced moderate but clinically significant hepatic and renal injury, mainly through reactive oxygen species (ROS) generation and mitochondrial dysfunction. Oxidative stress biomarkers demonstrated reduced antioxidant defense and increased lipid peroxidation across most studies. Post-withdrawal findings revealed only partial normalization of biochemical and inflammatory parameters, indicating persistent and drug-specific toxic effects despite cessation of exposure. Conclusion: Chronic abuse of opioids, stimulants, and analgesics can cause significant liver and kidney damage through oxidative and inflammatory mechanisms. Persistent abnormalities after withdrawal highlight the need for long-term monitoring and targeted therapeutic interventions.
Substance Abuse in Kabul, Afghanistan: Clinical Patterns, Comorbidities, and Healthcare Challenges
Background: Substance abuse represents a major public health problem in Afghanistan, with its high prevalence among adults aged 18 to 40 years. Besides social complications, there are physical and psychological complications. Consequently, it places a high burden on the healthcare system. Patterns, comorbidities, and healthcare challenges posed by substance use must be understood in order to intervene effectively. Methods: A cross-sectional survey was conducted among 1,500 adults (aged 18–40 years) using convenience and snowball sampling in community and public settings across Kabul. Data were collected using a structured questionnaire adapted from previously published instruments and administered in local languages (Dari and Pashto). The questionnaire captured demographic characteristics, substance use patterns, clinical symptoms, and healthcare access. Descriptive statistics and cross-tabulations were performed using SPSS. Results: 68% of men reported substance use, primarily opioids (35%) and methamphetamines (25%). Malnutrition accounted for 45% of physical complications, infections for 12%, and anxiety for 25% and depression for 48% of mental health issues. 42% of women reported using cannabis and opioids, with fewer health issues. Misconceptions regarding the dangers of drugs were widespread, and only 30% had access to healthcare services. Conclusion: Substance misuse among Afghan adults constitutes a serious health problem in the 18-40-year-old age group, for whom access to healthcare itself is very challenging. Urgent interventions through community-based programs, awareness programs, and policy initiatives are required to reduce harms and improve public health outcomes.
A Novel Approach to Mitigating the Systemic Health Impacts of Postprandial Hyperglycemia
Introduction: Postprandial hyperglycemia (PPHG) is a common metabolic disorder in both type 1 and type 2 diabetes and plays a significant role in the development of microvascular and macrovascular complications. Elevated blood glucose levels after meals, through mechanisms such as oxidative stress, inflammation, and pancreatic beta-cell dysfunction, can lead to vascular damage and progression of chronic diabetic complications. Materials and Methods: This study was conducted as a narrative review. Scientific literature was searched in PubMed, Scopus, Web of Science, and Google Scholar databases. Studies related to non-pharmacological and pharmacological interventions effective in controlling postprandial hyperglycemia including post-meal physical activity, consumption of fiber or vegetables before meals, vinegar intake, low glycemic index diets, insulin therapy, and GLP-1 receptor agonists were reviewed and qualitatively analyzed. Results: The reviewed studies indicated that inadequate control of PPHG is associated with an increased risk of microvascular complications such as retinopathy, nephropathy, and neuropathy, as well as macrovascular complications including cardiovascular diseases. Lifestyle interventions, particularly low–glycemic index diets and regular physical activity, play an effective role in reducing postprandial blood glucose levels. However, pharmacological treatments alone are not sufficient to achieve complete control of PPHG in all patients. Conclusion: Effective control of postprandial hyperglycemia requires a multifaceted approach that includes dietary modification, increased physical activity, appropriate pharmacological therapy, and careful blood glucose monitoring. Given the limited long-term evidence, future studies are needed to evaluate the sustained effectiveness of these interventions and to explore the use of novel continuous glucose monitoring technologies.
Prevalence of Bacterial Meningitis Among Children Under 13 Years of Age Attending Kabul Child Health Hospital in 1403: A Descriptive Cross-Sectional Study
Background: Bacterial meningitis is a serious central nervous system infection in children. Delayed diagnosis can lead to severe complications and death. Epidemiological data are limited in Afghanistan. Objective: This study aimed to determine the prevalence, common bacterial pathogens, age and gender distribution, geographic residence, and treatment patterns among children under 13 years admitted to Sehat-e-Tifl Hospital in 1403. Methods: A descriptive cross-sectional study was conducted on 1,700 children suspected of meningitis. Data were collected retrospectively from medical records and analyzed using SPSS version 26. The Chi-square test was applied (P < 0.05). Results: Of 1,700 suspected cases, 84 (4.9%) were confirmed as bacterial meningitis. The highest prevalence was in the 0 2 years age group (35.7%) and among males (55.9%). The most common pathogens were Streptococci (48.8%), Haemophilus influenzae (35.7%), and Neisseria meningitidis (11.9%). Vancomycin, alone or with ceftriaxone, was the most common first-line therapy. Conclusion: Bacterial meningitis remains a major health concern in children under 13 years, especially in early childhood. Early diagnosis, accurate documentation, and improved access to healthcare services are essential to reduce complications and mortality.
Prevalence of Chronic Dacryocystitis at the Teaching Eye Hospital in 1402
Background: Chronic dacryocystitis is a persistent inflammation of the lacrimal sac, usually caused by obstruction and infection of the nasolacrimal duct. It commonly presents with epiphora and mucopurulent discharge, especially in women and older adults. Objective: To determine the prevalence of chronic dacryocystitis according to age, gender, and laterality among patients attending a teaching eye hospital. Methods: This descriptive cross-sectional retrospective study was conducted using medical records of patients who attended Kadri Eye Hospital in 2023. A census sampling method was applied, including all diagnosed cases of chronic dacryocystitis. Data were analyzed using descriptive statistics (frequency and percentage) and inferential statistics (Chi-square test). A p-value < 0.05 was considered statistically significant. Results: Out of 26,000 patients, 153 cases of chronic dacryocystitis were identified (prevalence: 0.59%). The highest frequency was observed in the fifth decade of life (26.8%), followed by the third decade (23.5%). Females were more commonly affected (73%) compared to males (27%), showing a statistically significant association (p < 0.05). The left eye was more frequently involved (40.5%) compared to the right eye (32.7%), while bilateral involvement was seen in 26.8% of cases. Conclusion: Chronic dacryocystitis showed a prevalence of 0.59% in this study, with higher occurrence among females and middle-aged individuals. Significant associations were observed between gender and disease occurrence.
The Global Impact of Preeclampsia on Maternal Mortality: A Comparative Analysis of Healthcare Accessibility and Outcomes in Low and Middle-Income Countries Comparing High-Income Countries
Background: Preeclampsia is a leading cause of maternal mortality, particularly in low- and middle-income countries (LMICs) where access to healthcare services is limited. Despite significant advancements in prenatal care in high-income countries, preeclampsia continues to challenge healthcare systems globally, especially in regions with limited resources. Methodology: This analytical study examined recent literature and epidemiological data to assess the incidence, prevalence, and impact of preeclampsia on maternal mortality. Data were collected from studies spanning high- and low-income regions to identify risk factors, complications, and regional disparities in healthcare access. Results: Preeclampsia affects approximately 3-10% of all pregnancies worldwide, with higher rates observed in LMICs. Advanced maternal age, obesity, hypertension, and diabetes are significant risk factors, exacerbated by socioeconomic constraints in resource-poor settings. Preeclampsia accounts for 10-15% of maternal deaths, with LMICs experiencing higher mortality due to limited emergency obstetric care and delayed treatment. Preventive strategies such as routine screenings and early interventions have reduced complications and improved maternal outcomes in high-income settings but remain underutilized in LMICs. Conclusion: The findings emphasize the urgent need for expanded prenatal care accessibility, targeted training for healthcare providers, and community-based preventive strategies in LMICs. Addressing healthcare inequalities and implementing early detection programs are critical steps toward reducing preeclampsia-related maternal mortality globally.
Low- and Middle-Income Countries (LMICs)
Artificial Intelligence and Medicine: Threats and Opportunities
Background: Artificial intelligence (AI) is transforming healthcare by advancing diagnostic accuracy, optimizing treatment pathways, and enabling personalized medicine and efficient administrative processes. Despite these advancements, its adoption raises ethical, legal, and operational challenges. This review critically examines AI’s dual impact on healthcare by assessing its applications in diagnostics, robotic-assisted surgery, predictive analytics, drug discovery, and telemedicine while addressing key concerns like data privacy, algorithmic bias, workforce implications, and technological dependency. Methodology: A systematic review of peer-reviewed literature published between 2018 and 2024 was conducted using databases such as PubMed, Web of Science, and Google Scholar. Search terms included "artificial intelligence in clinical practice," "machine learning ethics in medicine," "AI-driven diagnostics," and "healthcare predictive analytics." Articles were selected based on their relevance to AI's clinical applications and ethical implications, emphasizing qualitative evaluations and real-world case studies in diagnostic imaging, minimally invasive surgery, pharmacological innovation, and virtual healthcare delivery. Results: AI has shown significant promise in enhancing healthcare outcomes, particularly in achieving diagnostic accuracies on par with or exceeding human expertise in imaging and pathology. It has accelerated drug development pipelines, improved surgical precision, and streamlined clinical workflows. However, the review highlights persistent challenges, including algorithmic bias, insufficient transparency in AI systems, and ethical concerns regarding patient data security. The findings also underscore risks of workforce displacement and over-reliance on automated systems in decision-making processes. Conclusion: AI is poised to revolutionize healthcare, yet its integration must be carefully managed to address ethical and practical concerns. Ensuring that AI systems are transparent, unbiased, and designed to augment—rather than replace—clinical expertise is essential. Future progress should prioritize ethical AI design, rigorous regulatory frameworks, and fostering synergy between AI technologies and healthcare professionals to maximize patient outcomes and system efficiency.
Artificial intelligence (AI) in medicine
Interconnected Impacts of COVID-19: A Meta-Analysis on Public Health and Economic Disparities
Background: The COVID-19 pandemic had profound and wide-reaching impacts on global public health and economies, with significant regional variations. This meta-analysis examines these impacts, focusing on mortality, long-term health effects such as Long COVID, and the pandemic's economic consequences, especially in vulnerable sectors. Methodology: This meta-analysis systematically reviewed 45 peer-reviewed studies from 2020 to 2023, examining the pandemic's public health and economic impacts globally. Studies were sourced from databases such as PubMed, Web of Science, and Scopus. Data on mortality rates, healthcare system strain, mental health disorders, and economic performance were extracted, analyzed, and synthesized. Special attention was given to disparities between high-income countries (HICs) and low- and middle-income countries (LMICs), particularly regarding healthcare access, fiscal responses, and economic recovery. Results: Public health systems were overwhelmed worldwide, with the highest mortality rates recorded in the Americas and Europe. Long COVID affected 10–30% of recovered individuals, contributing to ongoing healthcare burdens. Mental health disorders, including depression and anxiety, increased by 25–30% globally. Economically, global GDP contracted by 3.5% in 2020, with the most severe declines in tourism, hospitality, and retail sectors. Job losses were concentrated in vulnerable groups, especially in LMICs, where recovery was slower due to limited fiscal resources and vaccine access. Conclusion: The COVID-19 pandemic revealed the interconnectedness of health and economic stability. While developed economies rebounded quicker, LMICs faced prolonged public health crises and deeper economic contractions. Strengthening healthcare infrastructures and fostering inclusive economic recovery are crucial for future resilience. Enhanced global cooperation is essential to mitigate disparities and ensure preparedness for future pandemics.
AStudy on the Role of In-Silico Methods in the Development and Discovery of New Drugs for the Treatment of COVID-19
Introduction: the rapid spread of the SARS-CoV-2 virus and the extensive global impact of COVID-19 have underscored the urgent need for discovering and developing new drugs. In silico methods, utilizing molecular simulations and computational techniques, have emerged as effective tools for identifying potential therapeutic compounds. These methods allow for the rapid assessment of drug effects before proceeding to laboratory and clinical testing. Objective: this study aims to investigate the role of in silico methods in simulating and evaluating potential therapeutic compounds for the treatment of COVID-19, with a particular focus on identifying drugs such as Remdesivir as effective treatment options. Methodology: this research was conducted using a library-based and systematic review approach. Data were collected from reputable scientific databases such as PubMed, Scopus, and Web of Science. The analysis of existing data from these sources was used to better understand the application of in silico methods in discovering new drugs. Results: the findings of this study indicate that in silico methods have been highly effective in identifying drugs like Remdesivir. These methods have successfully reduced the time and cost of drug research and have facilitated the identification of potential therapeutic compounds prior to clinical trials. Conclusion: this study highlights that in silico methods are powerful tools in the drug discovery process. However, the final validation of their effectiveness requires clinical and laboratory testing. These methods can serve as rapid and efficient solutions in global crises like COVID-19, aiding in the identification of effective drugs and combating emerging diseases.