Malawi Medical Journal最新文献

Aim: This study was conducted to investigate the relationship between nurses' fear of COVID-19, professional commitment and medical error tendency.

Methods: This study was use correlational research design with 312 nurses in January-April 2021. Data were collected online using a demographic characteristics questionnaire, the Fear of COVID-19 Scale (FCV-19S), the Professional Commitment Scale (PCS), and the Scale of Tendency to Medical Errors (STME). The study was approved by ethics committee. Number, mean, and standard deviation were used for sociodemographic variables. Participants' FCV-19S, PCS, and STME scores were calculated. The correlations between scale scores were determined using Pearson's correlation coefficient and Spearman correlation analysis.

Results: Participants had a mean FCV-19S, PCS, and STME score of 19±8.17, 72.21±13.58, and 4.58±0.51, respectively. FCV-19S scores were weakly and positively correlated with PCS overall score (r=0.200, p<0.001), "willingness to make an effort (r=0.273, p<0.001)" and "belief in goals and values (r=0.115, p=0.043)" subscale scores. FCV-19S scores were weakly and positively correlated with STME "communication (r=0.119, p=0.036)" subscale score.

Conclusion: Nurses who feared more about COVID-19 were found to have higher professional commitment, greater willingness to make an effort, and stronger belief in goals and values. Nurses who feared more COVID-19 were less likely to make communication-related medical errors.

Background: We described the demographic/clinical characteristics and in-hospital outcome of patients with COVID-19 at the University of Nigeria Teaching Hospital (UNTH) during the first wave to inform evidence-based responses during subsequent waves in Africa.

Methodology: We conducted retrospective cohort analyses of adult patients ≥18 years with PCR or GeneXpert-confirmed SARS-CoV-2 infection. Data was extracted from patients' medical records from 1st May to 30th September 2020. Based on disease severity, patients were either hospitalized (82) or managed at home (90). Logistic regression and cox-proportional hazard models were used to determine predictors of severe COVID-19 disease and in-hospital mortality, respectively.

Results: Of 172 cases, 113 (65.7%) were males, and the mean age was 45 ± 19 years. The majority were urban dwellers (72.1%), 19.8% had a positive history of contact with a confirmed/suspected case, 15.7% were healthcare workers while 68 (39.5%) had co-morbidities. Symptomatic patients comprised 73.3% of cases. Fever (p=0.02) and breathlessness (p=0.03) were commoner in males while diarrhoea (p<0.01) was predominant in females. On multivariate analysis, severe COVID-19 was predicted by the presence of co-morbidity (AOR= 14.44, 95% C.I= 4.79- 43.58, p <0.001)and prior antibiotic/antimalarial use (AOR= 6.35, 95% C.I= 2.24- 18.05, p =0.001) while being a non-healthcare worker (AOR= 0.18, 95% C.I= 0.04-0.78, p=0.02) was protective. However, none of the variables assessed predicted in-hospital mortality.

Conclusion: Our findings underscore the contributions of demographic variables in COVID-19 transmission and gender differences in clinical presentation. Underlying comorbidity likewise prior antimicrobial use increased the likelihood of severe COVID-19. The absence of mortality predictors in our study may be related to the relatively small number of deaths. Further studies are recommended to unravel the predominance of severe disease in healthcare workers.

The aim of this study is to conduct an epidemiological examination of Turkish citizens and refugees who requested an ambulance due to Out-of-hospital cardiac arrest (OHCA) at the Kayseri 112 emergency services between 2019 and 2020. This study was carried out in the province of Kayseri, which is one of the largest cities in Turkey. The study population includes OHCA patients for whom EMS were activated for any reason in 2019-2020. Data were taken from the Emergency Healthcare Automation System used by Kayseri Emergency Medical Services. A total of 5977 OHCA cases (Turkish 5736, Refugees 241) in which Emergency Medical Servises (EMS) was activated during the research period were included. A rate of 55.6% of patients Turkish nationality and 66.0% refugees were male (p<0.001). Observing at the cause of arrest, we find that 95.7% of cases among Turkish citizens and 82.6% of cases among refugees had a medical cause; while the suicide rate among Turkish citizens was 0.9%, this rate was 5.0% in refugee patients (p<0.001). It was found that the rate of OHCA increased with age and that the average OHCA age was lower in men and refugees. In addition, there is no difference between Turkish nationals and refugees in the use of emergency services for OHCA cases.

Background: Renal disease is a recognized complication of sickle cell anaemia (SCA), especially from the third decade of life and is linked to disease severity. This study assessed the association between disease severity and renal function among SCA patients using routine and newer markers of renal function.

Methods: This cross-sectional study recruited 85 SCA patients. Disease severity was assessed using modified Adegoke criteria which include the frequency of transfusion, painful crises, packed cell volume, and history of complications such as hypertension and chronic leg ulcers. Renal function was assessed using urea, creatinine, and beta-2-microglobulin (β2-M). Association was determined between renal function and disease severity using Pearson's correlation. P-value < 0.05 was taken as significant.

Results: The mean age of participants was 27.2 ± 7.6 years with 41(48.2%) males and 44 (51.8%) females. The mean packed cell volume, serum creatinine, serum urea, and β2-M were 24.0± 4.1%,17.6±7.5 mg/dL, 0.7±0.3mg/dL, 3.4±1.2mg/l respectively. A majority (54.1%) of them had a mild disease while 35.3% and 10.6% had moderate and severe diseases, respectively. Forty of the SCA patients had urine specific gravity below 1.010. The mean values of systolic blood pressure (p=0.001) diastolic blood pressure (p=0.001), serum creatinine (p=0.028) and β2M (p=0.019) significantly increased with disease severity. There was a significant positive correlation between SCA disease severity and serum urea (r=0.229; p=0.035), and serum β2-microglobulin (r=0.270; p=0.012).

Conclusion: Sickle cell anaemia severity is associated with a decline in renal function using both traditional and novel renal markers. Serum β2-M may serve as a useful marker of renal function and disease severity in SCA.

Objective: To determine the incidence, indications, the risk factors, complications, maternal morbidity and mortality of emergency peripartum hysterectomy (EPH), and perinatal outcomes at a tertiary hospital, Turkey.

Methods: We analyzed 71 cases of EPH from 2012 to 2019 at a tertiary hospital in a retrospective study. There were 142 control patients.

Results: There were 71 EPH out of 69,504 deliveries, for an overall incidence of 1.02 per 1000 births. The main indication for peripartum hysterectomy was abnormal placentation (67.6%), followed by uterine atony (28.1%), and uterine rupture (4.2%). Cesarean section (CS) and previous CS are major risk indicators for EPH. Other risk indicators are advanced maternal age (≥ 35 years) and multiparity. All patients with abnormal placentation had a previous CS. 93% of EPH were performed during and/or after CS, and 7% after vaginal delivery. 69% of EPH were made in total and 31% were subtotal. The three most common maternal morbidity included: wound infection and febrile morbidity (26.7%), bladder injury (16.9%), and disseminated intravascular coagulopathy (11.2%). There were no maternal deaths but perinatal mortality was 4%.

Conclusion: The most common indication for EPH was abnormal placentation. Also, CS and previous CS are major risk factors of EPH. Other risk factors for EPH are advanced maternal age (≥ 35 years) and multiparity. Moreover, all unnecessary CS should be avoided.

The Novel Coronavirus (COVID-19) was detected in December 2019 in the Hubei Province of China. Also known as 2019-nCoV, the outbreak was declared a pandemic by the World Health Organization (WHO) in March 2020. The WHO thus proposed country and technical guidelines in responding to the COVID-19 pandemic. This paper reviewed the preparedness of sub-Saharan African (SSA) countries in ending the pandemic through the adoption of the WHO guidelines. The Socio-Ecological Model was adopted as a conceptual framework in conducting our analysis. We realized that while striving to implement the WHO guidelines, a plethora of microsystem, mesosystem, exosystem, macrosystem, and chronosystem factors make it difficult for SSA countries to achieve the desired results aimed at halting the spread of the virus. SSA countries may, therefore, not be able to end the COVID-19 pandemic soon. We recommend various interventions including short- and long-term loan facilities from donor agencies, decentralization of COVID-19 testing to sub-national levels, and increased community engagement to improve risk communication and adherence to public health measures to end the spread of COVID-19 in SSA.