INTERNATIONAL JOURNAL OF EVIDENCE-BASED MEDICINE

Volume 1, Issue 2, 2026

Review Article
Impact of Aging on Brain Redox Balance: Mechanistic Links to Synaptic Dysfunction and Neurodegenerative Disease
International Journal of Evidence-Based Medicine, 1(2), 2026, jebm008, https://doi.org/10.63946/jebm/18873
ABSTRACT: Aging remains the most significant risk factor driving the development and progression of neurodegenerative diseases, as it reflects the gradual accumulation of molecular and cellular changes over time. Disturbance of redox balance has been recognized among these changes as a primary mechanism that links aging to synaptic decline. The imbalance favoring the production of reactive oxygen species over the capability of the antioxidant systems to neutralize them results in oxidative stress, which selectively disrupts synaptic morphology and function. In this scenario mitochondrial dysfunction is a significant factor since it not only raises oxidative stress but also reduces the energy supply necessary for standard cellular activity. At the same time, the decline of the endogenous antioxidant system due to aging further weakens neuronal defense. Oxidative modification of synaptic proteins changes their composition and roles, thereby reducing neurotransmission and plasticity. These interconnected processes underlie the pathological basis of major neurodegenerative diseases, such as Parkinson's and Alzheimer's. The complexity of the involved systems restricts the success of redox-balance-restoring therapeutic strategies, although they have a high potential. Hence, further work is necessary to enhance redox-based therapies and facilitate their translation for neurodegeneration in aging.
Review Article
Systematic Review of Antimicrobial Biomaterials for Medical Implants: Clinical Strategies for Reducing Device-Associated Infections
International Journal of Evidence-Based Medicine, 1(2), 2026, jebm006, https://doi.org/10.63946/jebm/18874
ABSTRACT: Background: Device-associated infections remain major complications of medical implants, contributing to prolonged hospitalisation, revision surgery, morbidity, and increased healthcare burden. Biofilm formation provides the biological rationale for antimicrobial implant strategies, although clinical studies often assess downstream infection outcomes rather than direct biofilm measures.
Objectives: This systematic review evaluated the clinical effectiveness, safety, and certainty of evidence for antimicrobial biomaterials and implant surface modification strategies in reducing device-associated infections, reinfection, microbial colonisation, and related complications among human implant recipients.
Methodology: A systematic search of PubMed, ScienceDirect, and Dimensions was conducted for original human studies published between 2015 and 2025. Eligible studies included randomised trials and observational cohorts evaluating antimicrobial biomaterials against conventional, uncoated, or standard-care comparators. Data extraction covered implant type, antimicrobial coating, comparator, infection-related outcomes, adverse events, and follow-up duration. Quality appraisal was performed using RoB 2 and ROBINS-I, while certainty of evidence was assessed narratively. A structured narrative synthesis was conducted because of heterogeneity in implant types, interventions, indications, comparators, and outcome definitions.
Findings: Twenty studies were included. DAC hydrogel coatings showed the most consistent association with reduced surgical site infection, periprosthetic joint infection, reinfection, and complications in selected orthopaedic settings. Silver- and iodine-coated implants showed promise in high-risk oncological reconstruction, while gentamicin-coated nails and calcium sulphate-based strategies appeared useful in trauma fixation and second-stage reimplantation. However, most studies were retrospective or non-randomised, several had serious risk of bias, and none directly quantified biofilm formation.
Conclusion: Antimicrobial biomaterials may reduce infection risk in selected implant settings, especially orthopaedic applications, but broader conclusions require cautious interpretation and stronger prospective evidence.
Original Article
Antimicrobial Susceptibility Patterns of Bacterial Isolates from Post-Caesarean Surgical Site Infections at a Nigerian Tertiary Hospital
International Journal of Evidence-Based Medicine, 1(2), 2026, jebm007, https://doi.org/10.63946/jebm/18875
ABSTRACT: Post-caesarean surgical site infections (SSIs) remain a major cause of maternal morbidity, particularly in low-resource settings, and are increasingly complicated by antimicrobial resistance. This study aimed to determine the antimicrobial susceptibility patterns and prevalence of multidrug resistance among bacterial isolates from post-caesarean SSIs at University College Hospital, Ibadan. A retrospective analysis of 66 laboratory records was conducted, out of which 52 records met the inclusion criteria. Bacterial isolates were identified using appropriate culture plates, and their antimicrobial susceptibility profiles were analysed using standard disk diffusion (Kirby–Bauer) method. A total of 75 isolates were identified, with Gram-negative organisms (68%) predominating over Gram-positive organisms (32%). The most common isolate was Pseudomonas aeruginosa, followed by Escherichia coli, Klebsiella spp, and Staphylococcus aureus. Antimicrobial susceptibility testing revealed high resistance rates to commonly used antibiotics such as amoxicillin, erythromycin, and azithromycin, while better susceptibility was observed with gentamicin, levofloxacin, and vancomycin among Gram-positive isolates. Notably, vancomycin showed 100% susceptibility. Multidrug resistance was highly prevalent, with 74.7% of isolates classified as MDR, indicating resistance to at least one agent in three different antibiotic classes. This high burden of MDR highlights a significant therapeutic challenge and underscores the role of antibiotic misuse and hospital-acquired infections in driving resistance. The findings of this study emphasize the need for routine antimicrobial susceptibility testing, strengthened infection prevention and control measures, and implementation of antimicrobial stewardship programs. Continuous surveillance and policy interventions are essential to mitigate the growing threat of antimicrobial resistance and improve clinical outcomes in post-caesarean SSIs.
Original Article
Endoscopic Correction of Vesicoureteral Reflux in Children: A Comparative Analysis of Efficacy and Safety of Minimally Invasive and Open Surgical Methods
International Journal of Evidence-Based Medicine, 1(2), 2026, jebm009, https://doi.org/10.63946/jebm/18910
ABSTRACT: Introduction: Vesicoureteral reflux (VUR) is one of the most prevalent conditions in pediatric urology, occurring in approximately 1–2% of children; among those presenting with urinary tract infections, VUR is detected in 25–40% of cases. The incidence shows no declining trend and increases annually in line with global population growth.
Methods: This retrospective-prospective, single-center, comparative cohort study enrolled 110 children aged 8 months to 18 years with VUR grades II–IV treated at the Specialized Pediatric Surgical Clinic of Samarkand State Medical University (1989–2022). Patients were allocated to two non-concurrent treatment groups based on the era of admission: the control group (CG, n=32; 1989–2011) underwent open antireflux surgery, and the study group (SG, n=78; 2012–2022) underwent endoscopic correction of VUR (ECVUR). Patients with grades I and V VUR were excluded.
Results: In the SG, the proportion of good outcomes was 78.2%, exceeding that of the CG (65.6%). Unsatisfactory results were 2.9-fold lower (6.4% vs. 18.8%). Hospitalization was significantly reduced from 16.7±3.3 to 5.2±1.2 bed-days (p<0.001). The economic efficiency coefficient improved 3.2-fold. Overall ECVUR efficacy was 93.6% versus 81.2% for open surgery.
Conclusion: Minimally invasive endourological methods demonstrate superior efficacy and safety compared with open antireflux surgery for the treatment of VUR in children.