Tuberculosis is the leading cause of death globally from a single infectious agent. Early diagnosis is critical to reducing morbimortality. In cases of negative smear microscopy or limited sputum production, bronchoalveolar lavage (BAL) samples offer an alternative for diagnosis. Culture, the gold standard, requires a high bacterial load, extensive infrastructure and is time-consuming. Xpert MTB/RIF provides faster results with a higher cost. Previous systematic reviews present substantial limitations, including significant heterogeneity. Therefore, the diagnostic utility of Xpert MTB/RIF using BAL samples in adults with negative or scant sputum for pulmonary tuberculosis (PTB) needs to be reassessed.

A systematic search of MEDLINE, Embase, LILACS and Web of Science will be conducted without language or publication date restriction. Cross-sectional diagnostic studies of negative or sputum-scarce adults with presumptive PTB who underwent bronchoscopy to obtain samples for Xpert MTB/RIF and culture will be included. Screening and data extraction will be performed independently. Methodological quality will be assessed using the QUADAS-2 tool. A bivariate hierarchical random-effects model will synthesise sensitivity and specificity. Meta-analysis will be performed using Meta-DiSc 2.0. Heterogeneity will be assessed using I² and Cochrane thresholds. Subgroup analyses will be performed based on study design, population differences, country, culture method and risk of bias. Publication bias will be investigated using a funnel plot. The certainty of evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation approach. There was no patient or public involvement in the development of the systematic review protocol.

Ethical approval is not required as this study will use publicly available data. Findings will be disseminated through peer-reviewed publication.

CRD42025639440.

Intravenous fluids are essential components of perioperative care, supporting intravascular volume, acid–base balance and electrolyte homeostasis. Despite extensive research in adult surgical populations, paediatric-specific evidence remains limited, and clinical practice frequently relies on extrapolated adult-based recommendations. This gap is particularly relevant in paediatric non-cardiac surgery, where fluid choice may influence key physiological outcomes such as acid–base status, electrolyte balance, renal function and haemodynamic stability. Given the heterogeneity of study designs, perioperative phases, age groups and reported outcomes in the paediatric literature, a comprehensive synthesis of the existing evidence is needed before a systematic review can be undertaken.

We will conduct this scoping review following the methodological guidance of the Joanna Briggs Institute Manual for Evidence Synthesis, and the reporting will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guideline.

This scoping review will map existing evidence on perioperative intravenous fluid management in paediatric patients (

Eligibility is framed using participants, concept and context: paediatric patients (

This scoping review involves no primary data collection and relies exclusively on published literature; therefore, formal ethical approval is not required. The protocol received administrative approval from the Comité de Ética para la Investigación Científica of Universidad del Cauca (approval no. 6553, 11 June 2025). Findings will be disseminated through peer-reviewed publications, conference presentations and targeted communication with paediatric anaesthesia and surgical communities.

Adults with chronic kidney disease (CKD) experience a wide range of symptoms that significantly lower their health-related quality of life (HRQoL). Using mobile-based applications for symptom assessment and management has the potential to alleviate the symptom burden of CKD and improve patient outcomes.

This is a randomised feasibility trial to assess the feasibility, acceptability, usability and potential effects of a remote symptom assessment and management (SAM-CKD) 6 week programme delivered via a mobile application. Adults aged 18 years or older with CKD grade 4 or 5 (including those on dialysis) will be randomly assigned to the SAM-CKD programme or usual care. Primary outcomes assess the intervention’s feasibility, acceptability and usability. Secondary outcomes are changes in CKD symptoms and HRQoL between baseline, 3 weeks and 6 weeks later. Data analysis involves descriptive and intention-to-treat analyses. The study will be undertaken between December 2025 and March 2026. The findings will inform whether an effective trial is feasible and whether the study design and/or its methods need modification.

Ethical approval was granted by the Vin University and Griffith University Human Research Ethics Committee. Results will be disseminated at the participating hospital and CKD patient groups and shared via peer-reviewed publications and conference presentations.

NCT07186361.

We aimed to refine and culturally adapt an evidence-based communication intervention (EBCI), which consists of the 3R message framing model (Reframe, Reprioritise, Reform) and human papillomavirus self-sampling (HPVSS) for use in a teaching hospital in Ghana, and evaluated its acceptability, feasibility, appropriateness and adoption potential among stakeholders.

Convergent mixed-methods design.

The study was conducted at a teaching hospital and its surrounding communities in the Central Region of Ghana.

A 36-member stakeholder advisory board comprising women living with HIV (WLHIV) (n=14), healthcare providers (HCPs) (n=11) and community members (n=11) participated in Nominal Group Technique sessions to adapt the intervention. The adapted EBCI was subsequently evaluated by 45 participants (WLHIV=30 and HCPs=15).

Outcome measures included key characteristics of the EBCI, acceptability, feasibility, appropriateness and its potential for adoption, which were assessed using validated Likert-type scales and structured interview guides.

Core components of the intervention (HPVSS+3R) were retained. Hospitals and community pharmacies were the preferred self-sampling venues (97%). WhatsApp audio in English and Fante/Akan was the most favoured delivery mode for 3R messages (81%). Evaluation results revealed high acceptability (mean=22.84), feasibility (mean=22.40) and adoption (mean=21.73) on a 5–25 point scale, as well as appropriateness (mean=13.3) on a 3–15 point scale. Qualitative findings highlighted convenience, privacy, empowerment and cultural relevance, which reduced fear and increased participant engagement.

The adapted EBCI demonstrated high acceptability, feasibility, appropriateness and adoption potential among key stakeholders, supporting its integration into the Ghanaian health systems to advance cervical cancer elimination goals.

NCT06739772.

Although menstrual cups have a long history and numerous benefits, many women of reproductive age remain unaware. This study assessed the knowledge, attitude and use regarding menstrual cups and its associated factors among females of reproductive age in Siddharthanagar Municipality, Lumbini Province, Nepal.

Cross-sectional study

Siddharthanagar municipality, Rupandehi was taken as the study setting.

A total of 250 women of reproductive age group (15–49 years) residing in Siddharthanagar Municipality.

Knowledge, attitude and use of menstrual cups were assessed by a pretested structured tool. The knowledge scores for each question were given as one mark for a correct response, and the overall scores were categorised using a modified Bloom’s cut-off as follows: good knowledge≥60% and poor knowledge80%), neutral (60%–80%) and unfavourable (2 test and multivariable logistic regression analysis were performed to determine factors associated with knowledge, attitude and use at the 5% level of significance.

This study found that the majority (88.04%) had poor knowledge about the menstrual cup, with 31.2% of participants expressing a favourable attitude. Only 10.6% of participants had used a menstrual cup. The odds of adequate knowledge among the participants with bachelor and higher level of education was 3.470 times (adjusted OR (aOR)=3.470, 95% CI 1.08 to 11.10) as compared with participants with secondary or lower level of education, adjusting for other explanatory variables. The odds of having adequate knowledge among participants who were employed was 1.66 times (aOR=1.66, 95% CI 1.24 to 5.83) compared with those who were unemployed, which was 2.487 times (aOR=2.487, 95% CI 1.24 to 7.95) in case of favourable attitude. Similarly, the odds of using a menstrual cup among the participants with an adequate level of knowledge was 7.960 times (aOR=7.960, 95% CI 2.70 to 23.40) as compared with participants who had an inadequate level of knowledge, adjusting for other explanatory variables.

Our study revealed that, despite their advantages, participants have limited knowledge and usage of menstrual cups. This highlights the need for advocacy and education about menstrual cups to enable informed choices, enhance women’s quality of life and protect the environment by reducing waste from disposable menstrual products.