Rwanda Journal of Medicine and Health Sciences

Abstract
Background
Anatomical variations of the brachial plexus are common and may significantly influence surgical approaches, regional anaesthesia, and the interpretation of peripheral nerve injuries. Variations involving the musculocutaneous nerve and its relationship with the median nerve are particularly important given their clinical implications.
Case presentation
During a routine surgical anatomy dissection course on a formalin-fixed adult male cadaver, a rare variation was identified in the left upper limb. A 4 cm common trunk arising from both the medial and lateral cords of the brachial plexus bifurcated into the median and musculocutaneous nerves. The musculocutaneous nerve did not pierce the coracobrachialis muscle but supplied it via an accessory branch, with an additional branch arising directly from the lateral cord. A distal communicating ansa brachialis between the musculocutaneous and median nerves was also observed.
Conclusion
This case highlights a rare median–musculocutaneous trunk with associated neural communications and atypical muscular innervation. Awareness of such variations is essential for clinicians involved in upper limb surgery, peripheral nerve repair, and regional anaesthesia, as they may alter expected anatomical landmarks, influence surgical strategies, and affect clinical outcomes.

Abstract
Background
Thalassemia is one of the most common hemoglobinopathies worldwide, particularly within the Middle Eastern demographics. Despite the existence of a nationwide screening program in Iraq and a decline in disease incidence, its optimal effectiveness remains uncertain, as β-thalassemia prevalence continues to rise. This paper seeks to evaluate the weaknesses of the thalassemia screening program in Iraq. It also suggests actionable strategies for policy change to further reduce disease incidence. Additionally, the discussed concepts can be applicable to other regions facing a similar burden. Factors like widespread consanguineous marriage, inadequate public knowledge, and restricted access to prenatal diagnostic services impose further burden on prevention efforts. To attain national elimination of β-thalassemia in Iraq, the Ministry of Health, in collaboration with medical organizations, must promptly address these barriers by revising policies and substantially investing in essential services.

Abstract

Background
Nano-filled bulk-fill flowable composites have gained widespread use in restorative dentistry owing to their ease of manipulation, reduced polymerisation shrinkage, and improved physical and esthetic properties. Despite these advantages, the potential leaching of unreacted monomers or residual nanoparticles remains a concern, as such release may compromise the biological safety of these materials. Therefore, the present study aimed to assess the cytotoxic potential of a nano-filled bulk-fill flowable composite on 3T3-L1 fibroblast cells using the MTT assay. This evaluation was undertaken to elucidate the material’s biosafety profile and its suitability for clinical application.
Methods
The in vitro cytotoxicity assessment was performed in accordance with ISO 10993-5 guidelines. The nano-filled light-cured composite was finely ground, and serial extract concentrations of 25, 50, and 75 mg/mL were prepared in culture medium. 3T3-L1 fibroblasts were exposed to these extracts for 48 hours, after which cell viability was quantified using the MTT assay by measuring absorbance at 570 nm. Morphological alterations in fibroblasts following exposure were examined using phase-contrast microscopy. Statistical analysis was conducted using one-way ANOVA followed by post-hoc testing, with significance set at p < 0.05.
Results
Mean cell viability was over 90 per cent at all of the concentrations (96.1 per cent, 94.3 per cent, 91.9 per cent), and was not significantly different at any of the controls (p > 0.05). Cells were attached with normal spindle morphology.
Conclusion
The tested nano-filled bulk-fill composite was found to be highly biocompatible and exhibit low cytotoxic effects, confirming that it can be used in clinical restorative cases.

Abstract

Background
Short birth intervals have been linked with increased childhood undernutrition, yet evidence in Rwanda remains limited. Using data from the 2019/2020 Rwanda Demographic and Health Survey (RDHS), this study assessed the association between birth spacing and undernutrition among children under five years.
Methods
This cross-sectional study utilized weighted data from 3,815 children under five from the 2019/2020 RDHS. Undernutrition was defined as either stunting, underweight, or wasting. Birth spacing was categorized as short (<24 months), intermediate (24 – 35 months), and optimal (≥36 months) and multivariable model was used to examine the association.
Results
The prevalence of undernutrition was 34.1%, and most (69.1%) had a birth interval ≥ 36 months. After adjusting for confounders, optimal birth spacing was associated with lower odds of undernutrition (AOR : 0.8 ; 95% CI : 0.6–0.9, p = 0.034). In addition, undernutrition was significantly associated with children from poor households, children of mothers with no education or primary education, and male children, while children of married or cohabiting mothers had lower odds of undernutrition.
Conclusion
Optimal birth spacing is associated with lower odds of child undernutrition. Public health policies should strengthen access and utilization of family planning services, maternal education, and socioeconomic support to enhance child nutrition outcomes.

Abstract

Background
Unprotected sex among female undergraduates remains a significant reproductive health concern in Nigerian tertiary institutions, yet evidence on socio-cultural predictors remains limited. This study examined reproductive health knowledge and factors associated with contraceptive use and engagement in unprotected sex among female undergraduates at Ladoke Akintola University of Technology, Ogbomoso, Nigeria.
Methods
A cross-sectional survey was conducted among 286 female undergraduate students selected, using multistage sampling techniques. Data were collected using a structured questionnaire and analysed using IBM SPSS version 27. Descriptive statistics, Chi-square tests, and binary logistic regression were employed, with statistical significance set at p < 0.05.
Results
The study revealed that most respondents (63.6%) demonstrated good knowledge of reproductive health, and the majority (85.0%) perceived institutional reproductive health support services as inadequate. Students in higher academic levels had lower odds of using contraceptives ; on the other hand, married students and those influenced by religious values had lower odds of engaging in unprotected sex.
Conclusion
Consistent contraceptive use remains low among female undergraduates, irrespective of the relatively high reproductive health knowledge. Socio-cultural factors were significantly associated with engagement in unprotected sex. Universities should strengthen youth-friendly health services and sexuality education programmes.