Background: Chronic kidney disease (CKD) can be specified as a significant health issue around the world, with considerable level of cardiovascular mortality and morbidity. Cardiovascular complications in patients with CKD include cardiac arrhythmias caused by structural cardiac abnormalities, autonomic dysfunction, electrolyte imbalance, uremic toxin accumulation. There is some emerging evidence that renal biomarkers especially cystatin C can offer useful information on cardiovascular risk assessment in CKD patients. Nonetheless, the correlation between renal dysfunction, electrolyte imbalances, and cardiac arrhythmias and cystatin C levels is not fully established. Objective: In this work, the aim was studying the relations between cardiac arrhythmias, in addition to chronic kidney disease, assessing epidemiological patterns, clinical manifestations, serum cystatin C, and electrolyte biomarkers in CKD patients. Methods: A total of 120 participants (60 CKD patients with reported cardiac arrhythmias and 60 age- and sex-matched CKD patients without arrhythmias (control group)) were involved in a case-control study. Structured interviews and review of the medical records were used to collect demographic data, medical history, and clinical characteristics. Serum cystatin C levels and electrolyte levels, such as potassium (K+), magnesium (Mg2+), calcium (Ca 2+), sodium (Na+), and phosphate (PO43-), were determined by routine laboratory tests. Electrocardiographic tests were conducted to diagnose and categorize arrhythmia. Results: Patients with cardiac arrhythmias had significantly elevated serum cystatin C levels in comparison to controls (p < 0.001). Among patients with arrhythmias in CKD, electrolyte abnormalities, especially hyperkalemia, hypocalcemia, and hyperphosphatemia were more common (p < 0.05). Also, multivariate logistic regression analysis indicated that cystatin C, serum potassium increased and calcium decreased were independent predictors regarding cardiac arrhythmias in the CKD patients. Furthermore, the most common arrhythmias were atrial fibrillation and ventricular premature complexes. Conclusion: Cardiac arrhythmias extremely common in CKD patients as well as strongly linked to compromised renal functionality, high levels of cystatin C and electrolyte disturbances. Cystatin C seems to be a potentially valuable biomarker in distinguishing CKD patients at higher risk of arrhythmias. Renal function monitoring and electrolyte disorders correction at an early stage could enhance cardiovascular outcomes and decrease the number of complications with arrhythmia in this population at risk.

Immunization remains one of the most cost-effective public health interventions for reducing childhood morbidity and mortality. The aim of the study was to assess the immunization coverage and dropout rates among children aged 0–23 months attending a tertiary hospital in Otukpo, Benue State, Nigeria. A retrospective descriptive study reviewed routine immunization data extracted from the National Health Management Information System (NHMIS) register from January to December 2021 at the Federal University of Health Sciences Otukpo Teaching Hospital (FUHSO-TH). Data were collated and analyzed using descriptive statistics to determine frequencies, coverage percentages, and dropout rates. A total of 1,344 records were analyzed. The mean immunization coverage across all scheduled vaccines was 77.9%. The Bacillus Calmette-Guérin (BCG) vaccine had the highest coverage (87.9%), while the second dose of the Measles-Containing Vaccine (MCV2) had the lowest (65.4%). The highest dropout rate occurred between BCG and MCV1 (18.1%), followed by MCV1 and MCV2 (9.2%). The study concluded that, while early infant vaccine uptake is encouraging, overall immunization coverage remains suboptimal and falls short of the WHO 90% target. Strengthening community sensitization, defaulter tracking, and implementing reminder systems are essential to improve coverage, particularly for vaccines administered later in infancy.

Background: Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition characterized by persistent difficulties in social communication and interaction together with restricted or repetitive patterns of behavior. Aim: A study of changes in total carnitine levels was associated with clinical improvement after oral carnitine supplementation in children with autism spectrum disorder. Methodology: 120 treatment-naive children aged 3–7 years with Childhood Autism Rating Scale (CARS) scores of 35–50 were allocated equally to L-carnitine syrup (50 mg/kg/day in two divided doses) or matching placebo for six months. Results: CARS and serum total carnitine were assessed at baseline and month 6, and all participants completed follow-up. CARS decreased from 40.83±5.19 to 34.05±5.45 in the L-carnitine group and from 41.12±4.14 to 39.85±4.29 with placebo. The between-group difference in change was −5.52 points (95% CI −6.72 to −4.31; p<0.001; Cohen’s d = −1.66). Serum total carnitine increased from 29.10±9.25 to 50.22±7.24 µmol/L with L-carnitine but remained unchanged with placebo (28.82±6.20 to 28.98±6.19 µmol/L); the between-group difference in change was 20.96 µmol/L (95% CI 19.03 to 22.89; p<0.001). Within the active group, greater carnitine elevation was strongly associated with greater CARS reduction (Pearson r= −0.86, p<0.001). A predefined response of at least a 4-point CARS reduction occurred in 73.3% versus 5.0% of participants. Adverse events were mild and no participant discontinued treatment. Conclusion: Six months of L-carnitine improved serum total carnitine and autism severity relative to placebo, with a strong exposure-response association. Larger multicenter trials are required.