Vol 14 Issue 1 April 2026-September 2026

Abstract: Background: Soil-transmitted helminths (STHs) remain a leading cause of morbidity among school-aged children in sub-Saharan Africa. Rwanda has implemented national mass drug administration (MDA) programmes, yet persistent hotspots remain. Mudende Sector, Rubavu District a high-altitude, predominantly rural area bordering the Democratic Republic of the Congo with documented WASH infrastructure deficits  has never been characterised by sector-specific STH data. This study aimed to determine the prevalence, infection intensity, and independent risk factors for STH infection among school-aged children in this setting.

Methods: A retrospective cross-sectional analysis was conducted using secondary data from a community survey carried out by the Rwanda Biomedical Center (RBC) in 2023. All 1,093 school-aged children (aged 5–14 years) with complete stool examination results and household WASH data were included. Infection was diagnosed using the duplicate Kato-Katz technique; intensity was classified per WHO criteria. Bivariate chi-square analysis and multivariate logistic regression identified independent predictors of STH infection (significance threshold p < 0.05).

Results: Overall STH prevalence was 95.3% (n = 1,042). Ascaris lumbricoides (86.0%) and Trichuris trichiura (85.9%) were the predominant species; hookworm was rare (0.5%). Dual Ascaris–Trichuris co-infections affected 76.7% of children. Moderate-intensity infections predominated for both Ascaris (85.1%) and Trichuris (83.4%). In multivariate analysis, only two variables independently predicted infection: absence of a household handwashing facility (adjusted odds ratio [aOR] = 6.57; 95% confidence interval [CI]: 1.77–19.8; p = 0.002) and reliance on unimproved water sources (aOR = 3.20; 95% CI: 1.23–7.32; p = 0.009). Gender, age, parental education and literacy, religion, latrine cleanliness, and knowledge-attitude-practice scores were not independently significant.

Conclusions: STH infections are hyper-endemic in Mudende Sector a prevalence that has not declined despite years of national MDA and are driven entirely by structural deficits in WASH infrastructure rather than individual behavioral or demographic factors. High STH knowledge coexisting with near-universal infection demonstrates that awareness cannot substitute for physical infrastructure in hyper-endemic settings. Mudende Sector should be formally designated a priority hotspot within Rwanda's national NTD control programme, with deworming frequency increased to at least three rounds per year and investment in household handwashing facilities and safe water access accelerated through multi-sectoral collaboration.

Keywords: soil-transmitted helminths; Ascaris lumbricoides; Trichuris trichiura; Rwanda; school-aged children; WASH; handwashing; hyper-endemic; Kato-Katz; neglected tropical diseases.

Title: Prevalence, Intensity and Factors Associated with Soil Transmitted Helminths among School Aged Children in Mudende Sector, Rubavu District, 2023

Author: Uwayezu Leonard, Amanuel Kidane Andegiorgish

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 153-163

Research Publish Journals

Website: www.researchpublish.com

Published Date: 01-June-2026

Abstract: Background: For neurosurgery patients on antiplatelet or anticoagulation, there is a critical balance to be struck between the risks of bleeding and thromboembolic complications. A crucial distinction must be made, as the effects of even a small amount of over-bleeding are irreversible and fatal.

Key Findings: Aspirin can safely be continued for certain types of cranial or spinal procedures. P2Y12 inhibitors will need to be discontinued 5-10 days before operation. For Warfarin patients, the goal is an INR <1.4, and bridging is only recommended in extreme situations of thrombotic risk. All DOACs should be discontinued 48-72 hours before procedure, but emergency reversal is available if necessary (idarucizumab and andexanet alfa). Routine bridging anticoagulation should generally not be utilized.

Conclusion: Multidisciplinary, individualized decision making is necessary in each perioperative neurosurgical case; by accounting for the risks of bleeding from specific procedures versus individual thrombotic risks to a specific patient, one can provide adequate care. This review aims to offer a systematic evidence based approach to such a dilemma.

Keywords: anticoagulants; antiplatelet; neurosurgery; perioperative management; intracranial haemorrhage; bridging anticoagulation; DOAC reversal.

Title: Perioperative Management of Antiplatelet and Anticoagulant Therapy in Neurosurgical Patients: A Practical Review with Evidence-Based Flow Chart

Author: Dr. Rathikinda Srinivasulu, Dr Saurabh Patel

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 145-152

Research Publish Journals

Website: www.researchpublish.com

Published Date: 01-June-2026

Abstract: Background: Postpartum weight retention is a major contributor to the long term obesity and related health problems in women, Despite being a critical period for health promotion, postpartum phase is often neglected in routine maternal care. Addressing lifestyle practices, mental health, sociocultural factors through comprehensive postpartum interventions can improve maternal health outcomes and long term well being.

Objectives: This study aims to estimate the prevalence of postpartum weight retention and assess its association with lifestyle, psychosocial, dietary, sociodemographic factors as well as weight management interventions among postpartum women in Chennai.

Methods: A cross-sectional study was conducted among 100 women, 6 months to 1 year postpartum, attending primary health centres in Chennai between June and August 2025. Data were collected using a pretested semi-structured questionnaire covering sociodemographic details, obstetric history, sleep, diet, physical activity, psychosocial perceptions, and weight loss intentions. Anthropometric measurements were obtained, and associations were analysed using Chi-square and Fisher’s exact tests.

Results: The prevalence of PPWR was high (79%). Significant associations were observed with shorter sleep duration, household and childcare responsibilities, mismatched family eating habits, limited dietary awareness, bodyweight perception, and occupation. Weight loss intentions were strongly influenced by confidence, media exposure, social comparison, physical activity, dietary efforts, and motivation to initiate lifestyle changes.

Conclusion: Postpartum weight retention is common and influenced by modifiable behavioural and psychosocial factors. The postpartum period is a key opportunity for preventing long term obesity and cardiometabolic risk by integrating structured lifestyle and psychosocial counselling into routine maternal care.

Keywords: Postpartum weight retention (PPWR); Maternal health; Psychosocial determinants; Dietary behaviours; Physical activity; Body image perception; Urban primary health centres; Public health intervention; Obesity prevention; Cardiometabolic risk.

Title: Postpartum Weight Retention and Weight Loss Intentions among Women Attending an Urban Primary Health Centre in Chennai: A Cross-Sectional Study

Author: M.H.Akshaya, N.Alagusankar, Dr. Sathishkumar, Dr.Arunmurugan

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 138-144

Research Publish Journals

Website: www.researchpublish.com

Published Date: 01-June-2026

Abstract: Introduction: Neonatal mortality remains a critical public health challenge in Rwanda, where neonates account for 44% of all under-five deaths and the Northern Province reports a neonatal mortality rate (NMR) of 22 deaths per 1,000 live births. Despite national progress in maternal and child health, facility-specific predictors of neonatal mortality in Gicumbi District have not been previously published. This study aimed to determine the prevalence and independent predictors of neonatal mortality at Byumba Level II Teaching Hospital.

Methods: A retrospective cross-sectional study was conducted at Byumba Level II Teaching Hospital, Northern Province, Rwanda. A total of 234 neonatal records (from a systematically sampled frame of 239) were reviewed for the period April to September 2023. Data were extracted using a validated structured tool (reliability coefficient 0.92; content validity index [CVI] 0.78). Bivariate chi-square analysis identified variables significantly associated with neonatal mortality (p < 0.05), which were entered into multivariate binary logistic regression to calculate adjusted odds ratios (aOR) with 95% confidence intervals (CI), controlling for potential confounders.

Results: The prevalence of neonatal mortality was 6.7% (16/239). Most mothers (95.3%) were enrolled in Mutuelle de Santé health insurance, yet 57.1% attended only 1–3 antenatal care (ANC) visits. Remarkably, 61.6% of neonates had very low birth weight (≤1,500 g). Multivariate analysis identified five independent predictors of neonatal mortality: inadequate ANC attendance of 1–3 visits versus ≥4 (aOR = 3.806; 95% CI: 1.203–12.046; p = 0.019); placenta abruption (aOR = 7.719; 95% CI: 1.260–47.326; p = 0.047); home birth compared to hospital delivery (aOR = 21.283; 95% CI: 1.718–263.628; p = 0.017); respiratory distress (aOR = 3.886; 95% CI: 1.091–13.834; p = 0.036); and congenital anomalies (aOR = 5.538; 95% CI: 1.121–27.350; p = 0.023). Marital status, maternal age, neonatal gender, and birth weight category were not independently significant.

Conclusion: Neonatal mortality at Byumba Level II Teaching Hospital is predominantly driven by modifiable factors. Targeted interventions to increase ANC attendance beyond four visits, eliminate home births among high-risk pregnancies, and strengthen neonatal respiratory care and congenital anomaly management are urgent priorities. These findings fill a critical evidence gap for Northern Province Rwanda and provide a foundation for district-level programme planning aligned with Rwanda's Sustainable Development Goal 3.2 targets.

Keywords: Neonatal mortality; Rwanda; Antenatal care; Home birth; Respiratory distress; Congenital anomalies; Sub-Saharan Africa.

Title: Prevalence and Predictors of Neonatal Mortality at Byumba Level II Teaching Hospital, Northern Rwanda: A Retrospective Cross-Sectional Study

Author: Claudine Ingabire, Charles NSANZABERA

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 128-137

Research Publish Journals

Website: www.researchpublish.com

Published Date: 29-May-2026

Abstract: Background: Diabetes mellitus is a growing global health challenge strongly associated with obesity. While both elevated fasting blood sugar (FBS) and increased Body Mass Index (BMI) are independently linked to type 2 diabetes mellitus, evidence regarding a direct relationship between BMI and FBS remains inconsistent. Urban elite populations, characterized by affluence, sedentary lifestyles, and dietary transitions, may exhibit unique metabolic patterns. This study assessed the relationship between BMI and FBS among an adult urban elite population in Onitsha, Nigeria.

Methods: A cross‑sectional study was conducted among 96 consenting Knights and Ladies of the Anglican Communion, at Onitsha. Sociodemographic data, anthropometric measurements, blood pressure, and fasting blood sugar were obtained using standardized procedures. BMI was calculated from measured height and weight, and FBS was assessed using a Double G glucometer. Data were analyzed using SPSS version 27. Independent samples t‑tests compared mean values by gender, while Pearson’s correlation coefficient evaluated the relationship between BMI and FBS. Statistical significance was set at p < 0.05.

Results: Participants had a mean age of 61.35 ± 10.3 years; 54.2% were female. The mean BMI was 30.4 ± 3.87 kg/m², indicating obesity, and the mean FBS was 114.2 ± 29.71 mg/dl, reflecting impaired fasting glucose. Males had significantly higher FBS than females (123.7 vs. 106.19 mg/dl, p = .003), while females had significantly higher BMI (31.85 vs. 28.68 kg/m², p < .001). Pearson’s correlation analysis showed no significant relationship between BMI and FBS (r = –.095, p = .357).

Conclusion: Despite high levels of obesity and impaired fasting glucose in this urban elite population, BMI did not correlate with fasting blood sugar. These findings suggest that BMI alone may not be a reliable predictor of glycaemic status in older, socioeconomically advantaged adults. Measures of central obesity may offer better predictive value and should be prioritized in future research.

Keywords: Body Mass Index, Fasting Blood Sugar, type 2 Diabetes mellitus, urban population, obesity.

Title: A Cross-Sectional Analysis of Body Mass Index and Fasting Blood Sugar Levels among Urban Elite Adult Population

Author: Onyekwelu J, Njelita IA.

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 121-127

Research Publish Journals

Website: www.researchpublish.com

Published Date: 14-May-2026

Abstract: Background: Postpartum women commonly experience upper back and periscapular pain due to hormonal changes, muscle weakness, and prolonged faulty postures during breastfeeding and infant care, leading to postural deviations, functional limitations, and reduced quality of life. However, evidence regarding the effectiveness of structured physiotherapy interventions such as GPR and MET in this population remains limited.

Objective: To determine the impact of Global Postural Re-education (GPR), Muscle Energy Technique (MET), and conventional therapy on pain, posture, functional ability, and quality of life in postpartum women with upper back and periscapular pain.

Methods: A total of 84 females aged 20 – 40 years with postpartum duration of 6 weeks to 12 months were selected using convenient sampling method. Participants were randomly divided into three groups; Group A received GPR, Group B received MET, and Group C received conventional management, including ergonomic counseling and posture education, with 28 participants each. Outcome measures included NPRS, MAPP-QOL, NDI, SPADI, and CVA. All groups received treatment sessions 3 times per week for a duration of 4 weeks.

Results: All three groups showed significant improvement in NPRS, MAPP-QOL, NDI, SPADI, and CVA after interventions (p < 0.001). Between-group analysis showed no significant differences in pain and quality of life outcomes. However, significant differences were observed in disability, shoulder function, and postural alignment (p < 0.001), with Group A demonstrating greater improvement.

Conclusion: All three interventions were effective in managing postpartum upper back and periscapular pain. However, GPR was more beneficial in improving functional ability and postural alignment.

Keywords: Postpartum women, Upper back pain, periscapular pain, Muscle energy technique, Global postural re-education, Quality of life.

Title: Effect of Global Postural Re-education Versus Muscle Energy Technique on Periscapular and Upper Back Pain Along with Quality of Life Among Postpartum Women: A Randomized Controlled Trial

Author: Jasmeen Kaur, Varinder Kaur

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 109-120

Research Publish Journals

Website: www.researchpublish.com

Published Date: 12-May-2026

Abstract: Background: Knee osteoarthritis is a degenerative disorder affecting postmenopausal women, frequently resulting in pain, reduced muscle strength, stiffness and limitation in joint range of motion. Bilateral knee osteoarthritis presents with asymmetrical involvement between the left and right knee, leading to functional imbalance and altered gait mechanics. Multimodal physiotherapy interventions including manual therapy and therapeutic exercises are commonly used in the management. However, limited studies have investigated side-to-side differences in knee range of motion and muscle strength following multimodal physiotherapy interventions in postmenopausal women with bilateral knee osteoarthritis.

Objective: To compare the effectiveness of Maitland Mobilisation combined with Isometric exercises and Dynamic Quadriceps and Maitland Mobilisation combined with Multiple-Angle Isometrics and Mini-squats on left and right knee range of motion and muscle strength in postmenopausal women with bilateral knee osteoarthritis.

Methods: Sixty postmenopausal women aged 40-60 years diagnosed with bilateral knee osteoarthritis (Kellgren Lawrence grade II-III) were randomly allocated into two groups. Group A received Maitland Mobilisation with Isometric exercises and Dynamic Quadriceps whereas Group B received Maitland Mobilisation with Multiple-Angle Isometrics and Mini-squats. Interventions were administered for three sessions per week for four weeks. Outcome measures included Range of Motion (Active and Passive) and Manual Muscle Testing (MMT).

Results: Both groups showed significant improvements in, increase in range of motion and muscle strength. However, the interventions used in Group B demonstrated comparatively greater improvement in both the outcome measures. Although improvements were observed bilaterally, the right knee demonstrated slightly better outcome in range of motion parameter as well as muscle strength improvements.

Conclusion: The study provides evidence regarding the effectiveness of multimodal physiotherapy interventions in improving side-specific knee range of motion and muscle strength in postmenopausal women with bilateral knee osteoarthritis. The findings guide clinicians to design targeted protocols for patients presenting with asymmetrical and bilateral involvement.

Keywords: Knee osteoarthritis, Postmenopausal Women, Maitland Mobilisation, Isometric Exercise, Multiple-Angle Isometrics.

Title: Effect of Multimodal Physiotherapy on Side-to-Side Differences in Knee Range of Motion and Strength in Postmenopausal Women with Bilateral Knee Osteoarthritis

Author: Sehajleen Kaur, Varinder Kaur

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 99-108

Research Publish Journals

Website: www.researchpublish.com

Published Date: 11-May-2026

Abstract: Contemporary warfare is increasingly defined by artificial intelligence (AI), yet its implications for population health remain insufficiently theorized. Existing scholarship is fragmented across security, governance, and public health domains, with limited integration of the mechanisms through which technological warfare produces health outcomes. This study addresses this gap by advancing the Technological Warfare Disruption–Public Health (TWD–PH) framework (Bull, 2026) as a novel mid-range explanatory theory. Grounded in complex adaptive systems theory and the structural determinants of health, the framework conceptualizes AI-enabled warfare as a structural driver of population health outcomes through cascading system disruption. The TWD–PH framework identifies key constructs, including AI warfare capability, technological dominance and strategic asymmetry, health system vulnerability, cascading disruption, and population health outcomes, while incorporating ethical governance and regulatory oversight as moderating and mediating influences. Central to the theory is cascading disruption, defined as the nonlinear and amplifying failure of interconnected systems following an initial technological shock. The framework advances a set of theoretically grounded propositions (P1–P6) that explain how technological inputs propagate through health systems and infrastructure to produce emergent outcomes such as increased morbidity, mortality, displacement, and psychological trauma. By integrating technological, structural, and governance dimensions into a unified explanatory model, the TWD–PH framework extends existing literature beyond descriptive and governance-centered approaches. The theory contributes by introducing cascading disruption as a central mechanism, conceptualizing health system vulnerability as a dynamic mediating construct, and embedding governance within system-level interactions. These contributions provide a coherent foundation for future empirical testing and offer critical insights for policy development aimed at mitigating the public health consequences of AI-enabled conflict.

Keywords: Artificial intelligence warfare; theory development; population health; cascading disruption; health system vulnerability; technological asymmetry; complex adaptive systems; governance.

Title: Technological Warfare Disruption and Public Health (TWD–PH): A Systems-Based Framework for Cascading Health Impacts in AI-Enabled Conflict

Author: Dr. David Bull

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 86-98

Research Publish Journals

Website: www.researchpublish.com

Published Date: 11-May-2026

Abstract: Telemedicine has become a central component of contemporary healthcare delivery, yet limited research has examined how distinct telemedicine delivery modes influence patient-perceived access to care and satisfaction within an integrated framework. This study investigated the extent to which telemedicine delivery modes (video, audio, and asynchronous) predict patient-perceived access to care and satisfaction, as well as the mediating role of access and the moderating role of digital literacy. Grounded in the Technology Acceptance Model and the Donabedian Model, a cross-sectional, predictive quantitative design was employed using a sample of N = 200 adults with prior telemedicine experience. Results indicated that telemedicine delivery modes significantly predicted both patient-perceived access to care (χ²(5) = 28.74, p < .001, R² = .31) and patient satisfaction (χ²(5) = 32.91, p < .001, R² = .34), with video visits emerging as the strongest predictor across models. Audio visits demonstrated moderate effects, while asynchronous messaging showed smaller but significant associations with satisfaction. Patient-perceived access to care significantly predicted satisfaction (β = .42, p < .001) and partially mediated the relationship between telemedicine delivery modes and satisfaction (indirect effect β = .15, p < .001). Additionally, digital literacy and prior telemedicine experience significantly influenced both outcomes, and digital literacy moderated the relationship between video visits and patient outcomes (β = .17, p = .015). These findings support a modality-specific and mechanism-based understanding of telemedicine effectiveness, demonstrating that both delivery mode and user capability shape patient outcomes. The study contributes to the literature by integrating telemedicine modalities, access, and satisfaction within a unified predictive framework and underscores the importance of multimodal strategies and digital equity in optimizing telehealth delivery.

Keywords: telemedicine, telehealth, access to care, patient satisfaction, digital literacy, healthcare delivery, health services research.

Title: Telemedicine Delivery Modes as Predictors of Patient-Perceived Access to Care and Satisfaction: A Quantitative Study

Author: Dr. David Bull

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 72-85

Research Publish Journals

Website: www.researchpublish.com

Published Date: 11-May-2026

Abstract: Accelerating orthodontic tooth movement, within its acceptable limits, can prevent damage to the teeth and its surrounding structures that are usually caused by prolonged treatment. Recent studies have investigated new methods and techniques that can reduce treatment time. It has been reported that Glutathione can induce osteoclastic differentiation, potentially accelerating tooth movement. Thus, this study aimed to determine the effect of reduced glutathione (GSH) on orthodontic tooth movement in rabbits. This in-vivo study utilized twenty-six (26) 10-12 week old male rabbits that were divided into 3 groups: Control Group A (without treatment), Control Group B (with tooth movement only) and Experimental Group C (with tooth movement and GSH). A nickel-titanium (Ni-Ti) closed coil spring with a 56.7g force was inserted between the maxillary incisors and the first molar to allow tooth movement. Reduced glutathione (GSH) 100 mg was orally administered daily, one week prior to and after the installation of the appliance. After 14 days, the distance of tooth movement was measured. H&E staining was performed to determine osteoclastic activity and observed under a scanning electron microscope at 10X and 40X magnification. Results showed that the mean distance of orthodontic tooth movement (mm) among subjects without GSH was at 0.20mm while for those with GSH was at 0.41mm. The number of osteoclasts also differed between those without GSH which had 1-2 osteoclasts and those with GSH which had 3-4 osteoclasts. The correlation using Spearman Rho’s test regardless of the groups was strongly positive at Spearman’s rank correlation coefficient (rs)= 0.95. Among those without GSH, it was found to be lower but still moderately positive at rs = 0.67. Lastly, those treated with GSH also had a strongly positive correlation at rs =0.84. All of the results were statistically significant at alpha =0.01. It can be concluded that there was an increase in tooth movement in the group that received 100mg GSH compared to the group without GSH.

Keywords: orthodontic tooth movement, reduced glutathione, osteoclastic activity.

Title: Increased orthodontic tooth movement using 100mg Reduced Glutathione (GSH) on rabbits

Author: Patricia Nicole C. Macalintal, Cecilia Angela C. Clemente

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 64-71

Research Publish Journals

Website: www.researchpublish.com

Published Date: 27-April-2026

Abstract: This study assessed medication knowledge and self-medication behaviors among secondary school students, focusing on antibiotics and anti-inflammatory drugs. A total of 200 students completed an online questionnaire, and data were analyzed using descriptive statistics. Students demonstrated moderate knowledge. While 56.5% correctly identified that anti-inflammatory drugs are not antibiotics and 49.0% checked expiration dates, key misconceptions persisted: 63.0% did not recognize that antibiotics are unnecessary for viral infections, and only 34.5% understood the risk of antimicrobial resistance from incomplete use. Medication practices were generally appropriate. Most students did not discontinue medication prematurely (66.0%) or self-medicate without consultation (52.5%). Pharmacists (97.0%) and physicians (94.5%) were the primary information sources. These findings highlight persistent knowledge gaps despite generally appropriate behaviors, underscoring the need for targeted education on rational antibiotic use.

Keywords: Antibiotics; Anti-inflammatory drugs; Self-medication; Secondary school students; Drug use behavior; Antimicrobial resistance.

Title: Medication Knowledge and Behaviors Related to Antibiotic and Anti-Inflammatory drug among Secondary School Students

Author: Mr. Natthapong Petdannue

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 58-63

Research Publish Journals

Website: www.researchpublish.com

Published Date: 24-April-2026

Abstract: Persistent demographic imbalance in U.S. clinical trials continues to undermine external validity, equity in treatment outcomes, and regulatory confidence in therapeutic efficacy across heterogeneous populations. This study proposes a novel Constrained Multi-Objective Fair Representation Optimization (CMOFRO) framework designed to simultaneously maximize predictive performance and demographic fairness in clinical trial recruitment and cohort construction. The framework integrates constrained optimization theory with advanced machine learning techniques to address representation bias across protected attributes such as race, gender, age, and socioeconomic status.

The proposed model formulates trial cohort selection as a multi-objective optimization problem, where competing objectives include (i) maximizing statistical power and predictive accuracy of clinical outcomes, (ii) minimizing demographic disparity metrics such as Demographic Parity Difference (DPD) and Equal Opportunity Gap (EOG), and (iii) ensuring regulatory-compliant representation thresholds. A hybrid architecture combining Pareto-efficient optimization, fairness-aware gradient boosting, and a constraint-regularized deep neural network (CR-DNN) is developed. The system leverages real-world datasets including synthetic EHR-derived cohorts and publicly available trial registries from ClinicalTrials.gov. To benchmark performance, CMOFRO is compared against established fairness-aware algorithms including FairBatch, Adversarial Debiasing, Reweighing, and Pareto Multi-Task Learning (PMTL). Experimental results demonstrate that CMOFRO achieves a 23–31% reduction in demographic disparity metrics while maintaining or improving predictive performance (AUC: 0.87–0.92) relative to baseline models. Notably, the proposed model reduces underrepresentation of minority subgroups by up to 28% in simulated enrollment scenarios without compromising statistical robustness. Graph-based visualizations, including Pareto frontiers and fairness–accuracy trade-off curves, reveal that CMOFRO consistently operates in the optimal efficiency region compared to competing methods. Furthermore, the framework incorporates a dynamic constraint adaptation mechanism that adjusts fairness thresholds in response to evolving recruitment patterns, enabling real-time optimization in decentralized and hybrid clinical trial environments. Sensitivity analysis confirms the robustness of the model across varying population distributions and missing data conditions. The results suggest that integrating constrained multi-objective learning into clinical trial design can significantly enhance inclusivity while preserving scientific rigor. This research contributes a scalable and interpretable solution for regulatory-compliant, fairness-aware clinical trial optimization, with implications for FDA-aligned diversity initiatives and precision medicine advancement.

Keywords: Algorithmic Fairness; Clinical Trial Optimization; Multi-Objective Learning; Demographic Representation; Fairness-Constrained Machine Learning.

Title: Algorithmic Fairness and Demographic Representation Optimization in U.S. Clinical Trials Using Constrained Multi-Objective Learning

Author: Ifiala Agwu Ifiala, Onuh Matthew Ijiga, Emmanuel Igba

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 40-57

Research Publish Journals

Website: www.researchpublish.com

Published Date: 20-April-2026

Abstract: The rapid integration of artificial intelligence (AI) into military operations has transformed the conduct of warfare, raising significant ethical, legal, and public health concerns. However, existing scholarship has largely examined AI warfare and public health in isolation, with limited attention to the governance mechanisms linking these domains. The purpose of this study was to examine how ethical governance and regulatory frameworks shape the public health implications of AI-enabled warfare and to develop a governance-centered conceptual framework connecting AI capabilities to population health outcomes. This study employed a qualitative policy analysis and structured narrative review of international legal instruments, policy documents, and peer-reviewed literature. Data were analyzed using thematic coding and comparative policy analysis, guided by the AI Warfare–Public Health Impact (AIW–PHI) framework. Findings indicate that current governance structures are fragmented, lack enforceable mechanisms, and remain insufficiently adapted to the complexities of AI-enabled warfare. Ethical governance mechanisms—such as human oversight, accountability, and transparency—are inconsistently implemented, while public health considerations are largely absent from existing regulatory frameworks. These gaps contribute to increased health system vulnerability and heightened risks to civilian populations. This study introduces the AIW–PHI framework as a novel, governance-centered model that conceptualizes AI-enabled warfare as a structural determinant of population health mediated by governance processes. The findings underscore the need to integrate public health into AI governance and to strengthen regulatory approaches to mitigate systemic harm. This study contributes to emerging scholarship at the intersection of AI, governance, and public health and provides a foundation for future empirical research and policy development.

Keywords: Artificial intelligence; AI-enabled warfare; ethical governance; international humanitarian law; public health; health system vulnerability; population health; autonomous weapons; military AI; governance frameworks; civilian protection; AI regulation.

Title: Artificial Intelligence Warfare and Public Health: A Governance Framework for Evaluating Population Health Implications

Author: Dr. David Bull

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 21-39

Research Publish Journals

Website: www.researchpublish.com

Published Date: 15-April-2026

Abstract: The study aimed to assess the depressive symptoms and quality of life (QOL) among patients undergoing hemodialysis in a tertiary care hospital at Kolkata. A cross-sectional descriptive study approach was used. Fifty patients with chronic kidney disease (CKD) receiving hemodialysis were chosen by non-probability purposive sampling. Data were gathered using a structured demographic questionnaire, Beck’s Depression Inventory (BDI-II), and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) scale. Data analysis was conducted using SPSS version 20, including both descriptive and inferential statistics. Out of 50 participants, 40 (80%) exhibited depressive symptoms. The overall QOL was found to be poor (p<0.05). The social relationships domain had the highest mean score (44.82±19.66). Males showed better QOL than females, while older age, associated illness, and reliance on caregivers negatively affected physical and social domains. A strong negative correlation (r = -1) was observed between depressive symptoms and QOL.  High prevalence of depressive symptoms and poor QOL were evident among hemodialysis patients. Factors such as gender, age, comorbid conditions, and mobility level significantly influenced QOL. Early psychological screening and supportive interventions are essential to enhance well-being of this population.

Keywords: Chronic Kidney Disease, Hemodialysis, Depressive symptoms, Quality of Life, Beck Depression Inventory.

Title: A Study to Assess the Depressive Symptoms and Quality of Life among Patients Undergoing Hemodialysis in a Tertiary Care Hospital at Kolkata

Author: Maj Kanchan Pal, Brig Subhashini K R, Lt Col Sreekala B, Maj Shaliya Saleem

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 8-20

Research Publish Journals

Website: www.researchpublish.com

Published Date: 03-April-2026

Abstract: Background: Lateral epicondylitis, commonly known as tennis elbow, is a frequently occurring musculoskeletal disorder characterized by elbow pain and reduced functional capacity. It is often accompanied by non-specific neck pain, likely due to the biomechanical relationship between the cervical spine and the upper limb.

Objective: To determine the effectiveness of the Tyler Twist technique, inhibition–ischemic compression, and conventional therapy in alleviating pain and enhancing functional outcomes in individuals with lateral epicondylitis associated with non-specific neck pain.

Methodology: A quasi-experimental study using a one-group pre-test–post-test design was carried out on individuals aged 30–40 years diagnosed with lateral epicondylitis and non-specific neck pain. A total of 36 participants underwent interventions including the Tyler Twist technique, inhibition–ischemic compression technique, and conventional physiotherapy. Outcome measures included the Numerical Pain Rating Scale (NPRS), Patient-Rated Tennis Elbow Evaluation (PRTEE), Neck Disability Index (NDI), grip strength, and Myofascial Diagnostic Scale (MFDS). Data were analysed using descriptive statistics.

Results: The experimental group exhibited significant improvements in pain levels, muscle strength, and functional performance following the intervention.

Conclusion: The combined use of the Tyler Twist technique, inhibition–ischemic compression, and conventional therapy is effective in the management of lateral epicondylitis associated with non-specific neck pain.

Keywords: Lateral epicondylitis, non-specific neck pain, Neck Disability Index, Numerical Pain Rating Scale, Patient-Rated Tennis Elbow Evaluation, Myofascial Diagnostic Scale.

Title:  Effectiveness of Tyler Twist Technique, Inhibition – Ischemic Compression Technique and Conventional Therapy in managing Lateral Epicondylitis with Non-Specific neck pain

Author: Amisha Kapoor, Mansi Tuli

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 1-7

Research Publish Journals

Website: www.researchpublish.com

Published Date: 03-April-2026