Background The descending aorta velocity is important predictor of aortic disease in children and can be very helpful in some clinical and surgical decision making.Aim The purpose of this study is to assess the normative values of descending aorta velocity among children from South-East Nigeria. It also aimed to assess the correlation between age, body surface area and mean velocity across the descending aorta. Methods This is a cross-sectional study where the descending aorta velocity of one hundred and eleven children were enrolled consecutively using digitized two-dimensional and Doppler echocardiography.ResultsA total of 111 children had echocardiography to study their cardiac structures and compute their mean scores of their descending aorta velocity. The mean velocity across the descending aorta was 1.3±0.2m/s with maximum and minimum velocities of 2.06 and 0.84cm respectively. The mean descending aorta velocity in males (1.37±0.24 m/s) was significantly higher than that in females (1.24±0.18); (Student T test 3.09, p = 0.03). There was no correlation between age and mean velocity across the descending aorta (Pearson correlation coefficient; -0.03, p = 0.7) nor between body surface area and descending aorta velocity (correlation coefficient 0.01, p= 0.8). Conclusions The presented normalized values of the descending aorta velocity using a digitized two-dimensional and Doppler echocardiography among healthy children will serve as a reference values for further studies and can be applied for clinical and surgical use in children with various cardiac anomalies.
{"title":"Assessment of descending aortic blood flow velocities with continuous wave Doppler echocardiography among healthy Children in South East Nigeria","authors":"J. Chinawa, A. Chinawa, B. Chukwu, Jude T Onyia","doi":"10.4314/mmj.v36i1.1","DOIUrl":"https://doi.org/10.4314/mmj.v36i1.1","url":null,"abstract":"Background The descending aorta velocity is important predictor of aortic disease in children and can be very helpful in some clinical and surgical decision making.Aim The purpose of this study is to assess the normative values of descending aorta velocity among children from South-East Nigeria. It also aimed to assess the correlation between age, body surface area and mean velocity across the descending aorta. Methods This is a cross-sectional study where the descending aorta velocity of one hundred and eleven children were enrolled consecutively using digitized two-dimensional and Doppler echocardiography.ResultsA total of 111 children had echocardiography to study their cardiac structures and compute their mean scores of their descending aorta velocity. The mean velocity across the descending aorta was 1.3±0.2m/s with maximum and minimum velocities of 2.06 and 0.84cm respectively. The mean descending aorta velocity in males (1.37±0.24 m/s) was significantly higher than that in females (1.24±0.18); (Student T test 3.09, p = 0.03). There was no correlation between age and mean velocity across the descending aorta (Pearson correlation coefficient; -0.03, p = 0.7) nor between body surface area and descending aorta velocity (correlation coefficient 0.01, p= 0.8). Conclusions The presented normalized values of the descending aorta velocity using a digitized two-dimensional and Doppler echocardiography among healthy children will serve as a reference values for further studies and can be applied for clinical and surgical use in children with various cardiac anomalies.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140244875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
IntroductionIn Malawi there is a perception that goitre is common and causes significant public health and economic burdens. The purpose of this study was to assess the demographic distribution, clinical presentation, investigations, management, outcomes and complications of goitre seen at Queen Elizabeth Central Hospital (QECH), Blantyre, Malawi.Method A single hospital-based descriptive retrospective study from January 2017 to December 2018 for all patients presenting with goitre.Results Out of 9073 patients who presented to ENT department, 105 patients presented with goitre representing 1% of all patients seen during the study period. The Male: Female ratio was 1:25. The mean symptom duration with goitre was 4 years (SD +/- 6.4). Thyroid function test results were available in 54 patients and out of these, 53(98%) patients were euthyroid. Ultrasound scan (USS) reports were available in 44 patients, of these 32(73%) were multinodular goitres. In 70 cases, pathology results were available and showed that 20% were thyroid cancers and that papillary thyroid carcinoma was the commonest cancer (64%).Two recurrent laryngeal nerve injuries were recorded in 79 surgical procedures representing 2.5% of patients (6.3% overall complication rate). Inpatient stay ranged from 2 days to 49 days (median 3 days).Conclusion Goitre at our centre is more common in women than in men. One in five patients in this cohort had thyroid cancers. This prevalence is higher than other areas in the world highlighting the need for cytology services on every patient before surgery and histology services after surgery. Recurrent laryngeal nerve injury and other complications were infrequent demonstrating local high safety of thyroid surgery, despite late presentation to the ENT department.
{"title":"Clinical features and Surgical Outcomes of Thyroid Goitre Presenting to Ear, Nose and Throat Department of Queen Elizabeth Central Hospital, Blantyre, Malawi","authors":"Michel Tohadi Ahoka, W. Mulwafu","doi":"10.4314/mmj.v36i1.6","DOIUrl":"https://doi.org/10.4314/mmj.v36i1.6","url":null,"abstract":"IntroductionIn Malawi there is a perception that goitre is common and causes significant public health and economic burdens. The purpose of this study was to assess the demographic distribution, clinical presentation, investigations, management, outcomes and complications of goitre seen at Queen Elizabeth Central Hospital (QECH), Blantyre, Malawi.Method A single hospital-based descriptive retrospective study from January 2017 to December 2018 for all patients presenting with goitre.Results Out of 9073 patients who presented to ENT department, 105 patients presented with goitre representing 1% of all patients seen during the study period. The Male: Female ratio was 1:25. The mean symptom duration with goitre was 4 years (SD +/- 6.4). Thyroid function test results were available in 54 patients and out of these, 53(98%) patients were euthyroid. Ultrasound scan (USS) reports were available in 44 patients, of these 32(73%) were multinodular goitres. In 70 cases, pathology results were available and showed that 20% were thyroid cancers and that papillary thyroid carcinoma was the commonest cancer (64%).Two recurrent laryngeal nerve injuries were recorded in 79 surgical procedures representing 2.5% of patients (6.3% overall complication rate). Inpatient stay ranged from 2 days to 49 days (median 3 days).Conclusion Goitre at our centre is more common in women than in men. One in five patients in this cohort had thyroid cancers. This prevalence is higher than other areas in the world highlighting the need for cytology services on every patient before surgery and histology services after surgery. Recurrent laryngeal nerve injury and other complications were infrequent demonstrating local high safety of thyroid surgery, despite late presentation to the ENT department.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140244872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BackgroundPregnancy and labor are independent risk factors for the development of urinary incontinence (UI). Although UI is common during pregnancy, it is a health problem mostly neglected by pregnant women. The high prevalence of UI in pregnancy and its effects on the postpartum period justifies the need to determine the knowledge and attitudes of pregnant women regarding the prevention and management of UI. It is necessary to increase the awareness of pregnant women about UI, educate, consultant, and integrate pelvic floor muscle training into prenatal care services. This study aims to determine the UI awareness of pregnant women and their knowledge and attitudes in this context.Methods This cross-sectional study was conducted with 255 pregnant women in a university hospital in Turkey between March and September 2020. Data were collected using the Incontinence Knowledge Questionnaire (PIKQ) and Urinary Incontinence Attitude Scale (UIAS). Results The UI prevalence was 51% during pregnancy. The mean score of PIKQ was 8.07±2.64, and only 6.3% of participants correctly answered all the questions regarding UI. The mean score of UIAS was 42.33±3.48. A positive correlation was found between UI knowledge and attitude score (r=0.35, p=0.00).ConclusionsThe results showed that although UI is prevalent during pregnancy, pregnant women’s knowledge of UI is poor. Nearly half of pregnant women need information. They tend to display positive attitudes towards UI, but not sufficient to improve their health-seeking behavior. Strategies should be developed to increase pregnant women’s awareness of UI and to encourage them health-seeking behaviors for the prevention/management of UI during prenatal visits.
{"title":"Awareness of urinary incontinence in pregnant women as a neglected issue: a cross-sectional study","authors":"Manolya Parlas, Dilek Bilgiç","doi":"10.4314/mmj.v36i1.9","DOIUrl":"https://doi.org/10.4314/mmj.v36i1.9","url":null,"abstract":"BackgroundPregnancy and labor are independent risk factors for the development of urinary incontinence (UI). Although UI is common during pregnancy, it is a health problem mostly neglected by pregnant women. The high prevalence of UI in pregnancy and its effects on the postpartum period justifies the need to determine the knowledge and attitudes of pregnant women regarding the prevention and management of UI. It is necessary to increase the awareness of pregnant women about UI, educate, consultant, and integrate pelvic floor muscle training into prenatal care services. This study aims to determine the UI awareness of pregnant women and their knowledge and attitudes in this context.Methods This cross-sectional study was conducted with 255 pregnant women in a university hospital in Turkey between March and September 2020. Data were collected using the Incontinence Knowledge Questionnaire (PIKQ) and Urinary Incontinence Attitude Scale (UIAS). Results The UI prevalence was 51% during pregnancy. The mean score of PIKQ was 8.07±2.64, and only 6.3% of participants correctly answered all the questions regarding UI. The mean score of UIAS was 42.33±3.48. A positive correlation was found between UI knowledge and attitude score (r=0.35, p=0.00).ConclusionsThe results showed that although UI is prevalent during pregnancy, pregnant women’s knowledge of UI is poor. Nearly half of pregnant women need information. They tend to display positive attitudes towards UI, but not sufficient to improve their health-seeking behavior. Strategies should be developed to increase pregnant women’s awareness of UI and to encourage them health-seeking behaviors for the prevention/management of UI during prenatal visits.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140247026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Among the risk factors and underlying etiology of acute portal vein thrombosis, viral hepatitis is an extremely rare cause. We report a case of a young healthy 40-year-old male who was diagnosed with acute hepatitis A virus infection and presented with acute portal vein thrombosis. This article describes the possible pathophysiological mechanisms, clinical symptoms, and treatment of acute portal vein thrombosis in this patient. Based on this patient’s history and treatment, we encourage testing for hepatitis A serological markers in the emergency department in a population with recent hepatitis A exposure risk factors and concurrent unexplained acute portal thrombosis.
{"title":"A special case of acute portal vein thrombosis","authors":"Xin Li, Zhoupeng Wu","doi":"10.4314/mmj.v36i1.10","DOIUrl":"https://doi.org/10.4314/mmj.v36i1.10","url":null,"abstract":"Among the risk factors and underlying etiology of acute portal vein thrombosis, viral hepatitis is an extremely rare cause. We report a case of a young healthy 40-year-old male who was diagnosed with acute hepatitis A virus infection and presented with acute portal vein thrombosis. This article describes the possible pathophysiological mechanisms, clinical symptoms, and treatment of acute portal vein thrombosis in this patient. Based on this patient’s history and treatment, we encourage testing for hepatitis A serological markers in the emergency department in a population with recent hepatitis A exposure risk factors and concurrent unexplained acute portal thrombosis.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140245631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Martin Kamponda, F. Bickton, Donnie Mategula, M. Nliwasa, Benno Kreuels, J. Kumwenda
BackgroundExtra-pulmonary tuberculosis (EPTB) accounts for 15% of the 1.4 million patients with TB notified in 2019. EPTB carries a high risk of mortality and so early diagnosis and treatment are important to reduce this risk. Diagnosis of EPTB in low- and middle-income countries is challenging. This study investigated the diagnostic performance of Xpert MTB Ultra for the diagnosis of EPTB (pericardial, pleural, and ascitic fluid) in adults at a referral hospital in Malawi. MethodsAdults with suspected extra-pulmonary TB were screened for evidence of extra-pulmonary fluid and tested for TB using Xpert MTB Ultra, mycobacterial culture, and a Focused Abdominal Sonography in HIV-associated TB (FASH scan). The diagnostic performance of the Xpert MTB Ultra was compared to mycobacterial culture and a composite reference standard defined as a positive FASH scan or a positive mycobacterial culture or a clinical TB diagnosis (constitutional symptoms not otherwise explained with response to empirical TB treatment).ResultsThere were 174 patients recruited: 99/174 (57%) pleural, 70/174 (40%) ascitic and 5/174 (3%) pericardial. Overall, 10/174 (6%) had bacteriologically confirmed TB and 30/174 (17%) were started on TB treatment based on a positive FASH scan or a clinical TB diagnosis. The sensitivity and specificity of Xpert ultra compared to culture was 83% (95%CI:36%-100%) and 98% (95%CI:94%-99%), respectively. Compared to the composite reference standard, the sensitivity of Xpert Ultra was 17% (95%CI:7%-34%) and specificity was 98% (95%CI:94%-100%). ConclusionXpert MTB Ultra provides good diagnostic performance on pleural, pericardial and ascitic fluid with reference to mycobacterial culture. Improved EPTB diagnostic tests are required to improve patient outcomes. We recommend larger multi-centre studies to corroborate our findings.
{"title":"The diagnostic performance of Xpert MTB/RIF Ultra on Pericardial, Pleural and Ascitic cohort study fluids for diagnosis of extra-pulmonary Tuberculosis at a referral hospital in Malawi","authors":"Martin Kamponda, F. Bickton, Donnie Mategula, M. Nliwasa, Benno Kreuels, J. Kumwenda","doi":"10.4314/mmj.v35i4.1","DOIUrl":"https://doi.org/10.4314/mmj.v35i4.1","url":null,"abstract":"BackgroundExtra-pulmonary tuberculosis (EPTB) accounts for 15% of the 1.4 million patients with TB notified in 2019. EPTB carries a high risk of mortality and so early diagnosis and treatment are important to reduce this risk. Diagnosis of EPTB in low- and middle-income countries is challenging. This study investigated the diagnostic performance of Xpert MTB Ultra for the diagnosis of EPTB (pericardial, pleural, and ascitic fluid) in adults at a referral hospital in Malawi. MethodsAdults with suspected extra-pulmonary TB were screened for evidence of extra-pulmonary fluid and tested for TB using Xpert MTB Ultra, mycobacterial culture, and a Focused Abdominal Sonography in HIV-associated TB (FASH scan). The diagnostic performance of the Xpert MTB Ultra was compared to mycobacterial culture and a composite reference standard defined as a positive FASH scan or a positive mycobacterial culture or a clinical TB diagnosis (constitutional symptoms not otherwise explained with response to empirical TB treatment).ResultsThere were 174 patients recruited: 99/174 (57%) pleural, 70/174 (40%) ascitic and 5/174 (3%) pericardial. Overall, 10/174 (6%) had bacteriologically confirmed TB and 30/174 (17%) were started on TB treatment based on a positive FASH scan or a clinical TB diagnosis. The sensitivity and specificity of Xpert ultra compared to culture was 83% (95%CI:36%-100%) and 98% (95%CI:94%-99%), respectively. Compared to the composite reference standard, the sensitivity of Xpert Ultra was 17% (95%CI:7%-34%) and specificity was 98% (95%CI:94%-100%). ConclusionXpert MTB Ultra provides good diagnostic performance on pleural, pericardial and ascitic fluid with reference to mycobacterial culture. Improved EPTB diagnostic tests are required to improve patient outcomes. We recommend larger multi-centre studies to corroborate our findings.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139618017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vimbainashe Evidence Kahoto, M. Kwarteng, Bismark Owusu- Afriyie, Ebenezer Zaabaar, Samuel Kyei
AimThe study aimed to determine the epidemiology and evaluate the trends in the uptake of refractive error services in Harare. MethodsA clinic-based retrospective study at the Greenwood Park Eye Centre and its three subsidiaries was conducted from January 1, 2015 to December 31, 2020. Results12,216 patients’ records were retrieved, out of which 1074 (8.79%) had refractive error cases. The prevalence of visual impairment at presentation was 5.80% [95% CI: 5.39 – 6.23]. Among those with refractive error, the sample prevalence of visual impairment before correction was 41.30% [CI: 38.3 – 44.3, 95%], and 2.20% [95% CI: 1.4 – 3.3] after correction. There was inconsistency in the percentage utilization of refractive error services, with the highest being 42.60% in 2015. Refractive error types were related to age, employment position, and type of visual impairment prior to refractive error treatment. ConclusionThere was a low percentage of refractive error services uptake in urban Zimbabwe.
{"title":"Epidemiology and trends in the uptake of refractive error services in Harare, Zimbabwe: a hospital-based retrospective study","authors":"Vimbainashe Evidence Kahoto, M. Kwarteng, Bismark Owusu- Afriyie, Ebenezer Zaabaar, Samuel Kyei","doi":"10.4314/mmj.v35i4.3","DOIUrl":"https://doi.org/10.4314/mmj.v35i4.3","url":null,"abstract":"AimThe study aimed to determine the epidemiology and evaluate the trends in the uptake of refractive error services in Harare. MethodsA clinic-based retrospective study at the Greenwood Park Eye Centre and its three subsidiaries was conducted from January 1, 2015 to December 31, 2020. Results12,216 patients’ records were retrieved, out of which 1074 (8.79%) had refractive error cases. The prevalence of visual impairment at presentation was 5.80% [95% CI: 5.39 – 6.23]. Among those with refractive error, the sample prevalence of visual impairment before correction was 41.30% [CI: 38.3 – 44.3, 95%], and 2.20% [95% CI: 1.4 – 3.3] after correction. There was inconsistency in the percentage utilization of refractive error services, with the highest being 42.60% in 2015. Refractive error types were related to age, employment position, and type of visual impairment prior to refractive error treatment. ConclusionThere was a low percentage of refractive error services uptake in urban Zimbabwe.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139526893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kayhan Ozdemir, Ahmet Tarık Harmantepe, U. Dulger, E. Gonullu, Enis Dikicier, Z. Bayhan, F. Altıntoprak
BackgroundIt is controversial which treatment method is superior in plastron appendicitis and the research is still going on. The aim of this study is to compare treatment methods for plastron appendicitis in the adult population with our experience. Materials and MethodsThe data of 92 patients who were diagnosed with plastron appendicitis in university hospital between 2015 and 2021 were analyzed retrospectively. Data were taken from the hospital database. The patients were divided into three groups: those treated with primary surgery, with interval appendectomy and only with conservative method.Results Interval appendectomy resulted in a lower rate of conversion to open surgery compared to primary surgery, shorter operative time, and lower complication rates. Surgical procedures were found to be superior in detecting neoplasms compared to conservative treatment. After conservative treatment, one of three patients was retreated with the diagnosisof acute appendicitis.ConclusionIn plastron appendicitis, routine interval appendectomy can be performed due to its advantages over other treatments such as the frequency of attacks after conservative treatment, the risk of the tumor being overlooked in conservative treatment, and the high rate of complications and conversion to open surgery in the primary surgery group.
{"title":"Comparison of treatment methods in plastron appendicitis: a tertiary center experience","authors":"Kayhan Ozdemir, Ahmet Tarık Harmantepe, U. Dulger, E. Gonullu, Enis Dikicier, Z. Bayhan, F. Altıntoprak","doi":"10.4314/mmj.v35i4.5","DOIUrl":"https://doi.org/10.4314/mmj.v35i4.5","url":null,"abstract":"BackgroundIt is controversial which treatment method is superior in plastron appendicitis and the research is still going on. The aim of this study is to compare treatment methods for plastron appendicitis in the adult population with our experience. Materials and MethodsThe data of 92 patients who were diagnosed with plastron appendicitis in university hospital between 2015 and 2021 were analyzed retrospectively. Data were taken from the hospital database. The patients were divided into three groups: those treated with primary surgery, with interval appendectomy and only with conservative method.Results Interval appendectomy resulted in a lower rate of conversion to open surgery compared to primary surgery, shorter operative time, and lower complication rates. Surgical procedures were found to be superior in detecting neoplasms compared to conservative treatment. After conservative treatment, one of three patients was retreated with the diagnosisof acute appendicitis.ConclusionIn plastron appendicitis, routine interval appendectomy can be performed due to its advantages over other treatments such as the frequency of attacks after conservative treatment, the risk of the tumor being overlooked in conservative treatment, and the high rate of complications and conversion to open surgery in the primary surgery group.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139616525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background People living with the Human Immunodeficiency Virus (HIV) encounter a range of complex challenges that impact their physical, psychological, and social well-being. The combined effects of these challenges significantly impact their daily functioning. Despite the relatively high prevalence of HIV in Malawi, there is limited knowledge on how the challenges experienced by people living with HIV correlate with their societal participation and performance of activities.ObjectivesThis study aimed to explore the lived experience of people living with HIV and how the challenges experienced impact societal participation and activity performance.Method: A qualitative exploratory study design was used. Fourteen participants were purposefully selected for the study, with an equal number of males and females. The data was gathered through semi-structured interviews and manually analyzed using thematic analysis.Results It was found that participants faced discrimination, stigma, depression, anxiety, and worries. The study participants associated their taking of antiretroviral therapy with physical impairments such as dizziness, leg pain, yellow eyes, and fatigue. The physical impairments hampered participants’ ability to walk, work, conduct business, perform household chores, and care for children.ConclusionThis study identified the difficulties that people living with HIV faced in their communities and how these challenges impact societal participation and performance in activities. There is a need for a holistic approach to managing these challenges and making referrals to specialized professionals.
背景 人类免疫缺陷病毒（HIV）感染者会遇到一系列复杂的挑战，影响他们的生理、心理和社会福祉。这些挑战的综合效应严重影响了他们的日常功能。尽管马拉维的 HIV 感染率相对较高，但人们对 HIV 感染者所经历的挑战与他们的社会参与和活动表现之间的关系知之甚少：采用定性探索性研究设计。研究特意挑选了 14 名参与者，男女人数相等。通过半结构式访谈收集数据，并使用主题分析法对数据进行人工分析。结果发现，参与者面临歧视、羞辱、抑郁、焦虑和担忧。研究参与者将服用抗逆转录病毒药物与头晕、腿痛、眼睛发黄和疲劳等身体缺陷联系起来。这些身体缺陷妨碍了参与者行走、工作、做生意、做家务和照顾孩子的能力。有必要采取综合方法来应对这些挑战，并将他们转介给专业人员。
{"title":"Lived experience of people living with HIV in Blantyre, Malawi: An exploratory qualitative study","authors":"Talumba Mankhokwe, E. Chisati, Mokgobadibe Ntsiea","doi":"10.4314/mmj.v35i4.2","DOIUrl":"https://doi.org/10.4314/mmj.v35i4.2","url":null,"abstract":"Background People living with the Human Immunodeficiency Virus (HIV) encounter a range of complex challenges that impact their physical, psychological, and social well-being. The combined effects of these challenges significantly impact their daily functioning. Despite the relatively high prevalence of HIV in Malawi, there is limited knowledge on how the challenges experienced by people living with HIV correlate with their societal participation and performance of activities.ObjectivesThis study aimed to explore the lived experience of people living with HIV and how the challenges experienced impact societal participation and activity performance.Method: A qualitative exploratory study design was used. Fourteen participants were purposefully selected for the study, with an equal number of males and females. The data was gathered through semi-structured interviews and manually analyzed using thematic analysis.Results It was found that participants faced discrimination, stigma, depression, anxiety, and worries. The study participants associated their taking of antiretroviral therapy with physical impairments such as dizziness, leg pain, yellow eyes, and fatigue. The physical impairments hampered participants’ ability to walk, work, conduct business, perform household chores, and care for children.ConclusionThis study identified the difficulties that people living with HIV faced in their communities and how these challenges impact societal participation and performance in activities. There is a need for a holistic approach to managing these challenges and making referrals to specialized professionals.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139527290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Tracheobronchial variations (TBVs) are more common than previously believed due to the increasing use of multi-detector computed tomography (MDCT). This study aimed to assess TBVs in cases of pneumoconiosis, one of the oldest occupational diseases that still poses a threat to public health. Methods This was a descriptive study that involved reviewing chest MDCT images of 34 cases of pneumoconiosis and 34 control cases retrospectively from January 2020 to April 2022. Variations in the trachea, right main bronchus, left main bronchus, lobar and segmental branches of the cases in the patient and control groups were evaluated according to Boyden’s nomenclature. Results The frequency of TBV was 32.4% in pneumoconiosis cases. Although the frequency of TBV was higher in the patient group than in the control group, the difference was not statistically significant (p=0.086). Furthermore, there was no significant difference in terms of TBV classification between the patient and control groups (p=0.407). Additionally, the presence of TBV did not affect the distribution of International Labour Organization categories in pneumoconiosis cases (p=0.360).ConclusionsAlthough our study provides initial insights into the occurrence of TBVs in pneumoconiosis cases, further research is needed to clarify the relationship between these variations and the disease.
{"title":"Tracheobronchial variations in Pneumoconiosis cases: multidetector computed tomography diagnosis","authors":"Defne Kalaycı, Mehmet Maruf Aydın","doi":"10.4314/mmj.v35i4.4","DOIUrl":"https://doi.org/10.4314/mmj.v35i4.4","url":null,"abstract":"Background Tracheobronchial variations (TBVs) are more common than previously believed due to the increasing use of multi-detector computed tomography (MDCT). This study aimed to assess TBVs in cases of pneumoconiosis, one of the oldest occupational diseases that still poses a threat to public health. Methods This was a descriptive study that involved reviewing chest MDCT images of 34 cases of pneumoconiosis and 34 control cases retrospectively from January 2020 to April 2022. Variations in the trachea, right main bronchus, left main bronchus, lobar and segmental branches of the cases in the patient and control groups were evaluated according to Boyden’s nomenclature. Results The frequency of TBV was 32.4% in pneumoconiosis cases. Although the frequency of TBV was higher in the patient group than in the control group, the difference was not statistically significant (p=0.086). Furthermore, there was no significant difference in terms of TBV classification between the patient and control groups (p=0.407). Additionally, the presence of TBV did not affect the distribution of International Labour Organization categories in pneumoconiosis cases (p=0.360).ConclusionsAlthough our study provides initial insights into the occurrence of TBVs in pneumoconiosis cases, further research is needed to clarify the relationship between these variations and the disease.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139617230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acute respiratory failure is an important reason for pediatric intensive care admissions. Lung parenchymal disease, airway obstruction, or neuromuscular dysfunction are the most common causes. Negative pressure pulmonary edema, characterized by pulmonary edema associated with upper airway obstruction, can rarely cause sudden onset respiratory failure. Herein, we describe an infant who suffered sudden onset respiratory failure and pulmonary hemorrhage while being held facedown for a bath, was admitted to the pediatric intensive care unit, intubated and mechanically ventilated for three days, and was diagnosed with negative pressure pulmonary edema, and discharged without any sequelae. Negative pressure pulmonary edema is a rare entity. Its true frequency is not known due to the lack of awareness. This report aimed to increase clinician familiarity with negative pressure pulmonary edema in patients with sudden onset respiratory failure and/or pulmonary hemorrhage.
{"title":"An exceptional cause of acute respiratory failure in an infant: negative pressure pulmonary edema.","authors":"Göktuğ Özdemir, Zeynelabidin Ozturk","doi":"10.4314/mmj.v35i4.8","DOIUrl":"10.4314/mmj.v35i4.8","url":null,"abstract":"<p><p>Acute respiratory failure is an important reason for pediatric intensive care admissions. Lung parenchymal disease, airway obstruction, or neuromuscular dysfunction are the most common causes. Negative pressure pulmonary edema, characterized by pulmonary edema associated with upper airway obstruction, can rarely cause sudden onset respiratory failure. Herein, we describe an infant who suffered sudden onset respiratory failure and pulmonary hemorrhage while being held facedown for a bath, was admitted to the pediatric intensive care unit, intubated and mechanically ventilated for three days, and was diagnosed with negative pressure pulmonary edema, and discharged without any sequelae. Negative pressure pulmonary edema is a rare entity. Its true frequency is not known due to the lack of awareness. This report aimed to increase clinician familiarity with negative pressure pulmonary edema in patients with sudden onset respiratory failure and/or pulmonary hemorrhage.</p>","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10865057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139741315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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