Background: Zambia’s healthcare workforce is reportedly inadequate for the country’s healthcare needs. This stems from healthcare professionals, particularly radiographers, exiting the public health sector for non-governmental organizations or other countries with attractive conditions of service. This study is required to explore and describe the workplace experiences of public health sector radiographers in the province of Lusaka in Zambia and to examine how these experiences influence job satisfaction and staff retention. Methods: The study used a qualitative research design. Semi-structured interviews were conducted to collect data from 20 purposively selected public service radiographers, working in the Lusaka district of Zambia. Interviews were recorded, transcribed, and analysed by themes. Results: Five themes emerged: physical work environment, remunerations and rewards, staff workloads, leadership and supervision, and professional development. This study established that participants appreciate their physical work environment which constitutes modern and various imaging equipment. However, the majority of the participants expressed dissatisfaction with their workplace experiences owing to inadequate workspaces, inadequate salaries, a lack of incentives and rewards, increased workloads and inflexible work schedules, unapproved leadership style, lack of performance recognition and support for continuing professional development. Conclusion: The study findings provided information on the deficiencies within public service radiographers’ work environment. To enhance job satisfaction and retention, the employer needs to address the challenges being experienced by the radiographers.
{"title":"Workplace experiences of diagnostic radiographers, on job satisfaction and staff retention in the public health sector in Lusaka District of Zambia","authors":"M. Bwalya, Roshnee Sunder, F. Munsanje, O. Bwanga","doi":"10.55320/mjz.50.4.454","DOIUrl":"https://doi.org/10.55320/mjz.50.4.454","url":null,"abstract":"Background: Zambia’s healthcare workforce is reportedly inadequate for the country’s healthcare needs. This stems from healthcare professionals, particularly radiographers, exiting the public health sector for non-governmental organizations or other countries with attractive conditions of service. This study is required to explore and describe the workplace experiences of public health sector radiographers in the province of Lusaka in Zambia and to examine how these experiences influence job satisfaction and staff retention. \u0000Methods: The study used a qualitative research design. Semi-structured interviews were conducted to collect data from 20 purposively selected public service radiographers, working in the Lusaka district of Zambia. Interviews were recorded, transcribed, and analysed by themes. \u0000Results: Five themes emerged: physical work environment, remunerations and rewards, staff workloads, leadership and supervision, and professional development. This study established that participants appreciate their physical work environment which constitutes modern and various imaging equipment. However, the majority of the participants expressed dissatisfaction with their workplace experiences owing to inadequate workspaces, inadequate salaries, a lack of incentives and rewards, increased workloads and inflexible work schedules, unapproved leadership style, lack of performance recognition and support for continuing professional development. \u0000Conclusion: The study findings provided information on the deficiencies within public service radiographers’ work environment. To enhance job satisfaction and retention, the employer needs to address the challenges being experienced by the radiographers. \u0000 ","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"28 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140363634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Computed Tomography (CT) technology has evolved into a vital diagnostic tool in modern medical practice, leading to the development and extension of the CT radiographer's role. While some countries have made progress in developing and extending radiographers' roles in CT, resource-constrained settings like Zimbabwe have been slower to implement these changes. The purpose of this review is to inform role changes for radiographers in Zimbabwe and similar settings by reviewing the literature on role development and extension for radiographers in CT. The review explores the concepts of role development and extension, emphasizing the necessity for changes in radiographers' roles in CT due to factors such as radiologists shortages, cost containment, quality improvement needs, and technological advancements. It also addresses the opposition to role development and extension, emphasizing the fundamental impetus for these changes should be to provide high-quality and effective patient-centered care. The paper delves into specific areas of role development and extension for radiographers in CT, including intravenous (IV) cannulation and contrast media administration, performing CT colonoscopy examinations, reporting on CT brains, and the significance of research and clinical audit in CT. It underscores the potential benefits of these expanded roles, such as improved patient care, workflow efficiency, and the workload of radiologists, as well as advancements in education, service delivery, and technological innovations. The review underscores the need for further research to ensure evidence-based implementation of role development and extension for radiographers in CT. Embracing these changes and providing the necessary support and training can lead to improved patient care, address skill shortages, and advance the radiography profession in resource-constrained settings like Zimbabwe.
{"title":"Role Development and Extension for Radiographers in Computed Tomography: Literature Review Findings and their Application to Zimbabwe","authors":"B. Chinene, O. Bwanga","doi":"10.55320/mjz.50.4.449","DOIUrl":"https://doi.org/10.55320/mjz.50.4.449","url":null,"abstract":"Computed Tomography (CT) technology has evolved into a vital diagnostic tool in modern medical practice, leading to the development and extension of the CT radiographer's role. While some countries have made progress in developing and extending radiographers' roles in CT, resource-constrained settings like Zimbabwe have been slower to implement these changes. The purpose of this review is to inform role changes for radiographers in Zimbabwe and similar settings by reviewing the literature on role development and extension for radiographers in CT. The review explores the concepts of role development and extension, emphasizing the necessity for changes in radiographers' roles in CT due to factors such as radiologists shortages, cost containment, quality improvement needs, and technological advancements. It also addresses the opposition to role development and extension, emphasizing the fundamental impetus for these changes should be to provide high-quality and effective patient-centered care. The paper delves into specific areas of role development and extension for radiographers in CT, including intravenous (IV) cannulation and contrast media administration, performing CT colonoscopy examinations, reporting on CT brains, and the significance of research and clinical audit in CT. It underscores the potential benefits of these expanded roles, such as improved patient care, workflow efficiency, and the workload of radiologists, as well as advancements in education, service delivery, and technological innovations. The review underscores the need for further research to ensure evidence-based implementation of role development and extension for radiographers in CT. Embracing these changes and providing the necessary support and training can lead to improved patient care, address skill shortages, and advance the radiography profession in resource-constrained settings like Zimbabwe.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"58 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140363759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Adeyemi, M. Ernest, Shakira Sanni-Abdullahi, Ehigie Igben, Ashiru Garba, Mirian Nnebedum
Background; Traumatic dental injury (TDI) has grown to be a significant public health issue due to its high prevalence as well as the significant negative effects it has on quality of life. This study aimed to examine the prevalence and causes of TDI in a Dental outpatient clinic for 4 years. Method: A retrospective study was conducted on 52 TDI patients who were treated at a Tertiary Institution's Dental Outpatient clinic between June 1, 2017, and June 1, 2021. Data on age, gender, etiology, types of teeth involved, types of dental trauma, the day the incidents occurred, and treatment options were retrieved. Traumatized teeth were classified using Andreasen’s classification. Statistical analysis was carried out using SPSS version 20.0. Result A total of 208 patients with maxillofacial injuries (163 males and 45 females) aged 1 to 81 years were examined. The prevalence of TDI was 25%. Male and female prevalences were 18.2% and 6.7%, respectively. There were 52 TDI patients with a mean age of 16.5 ± 12.02. The most common reason for TDI was motorcycle accidents at 30.77%. Avulsion(40.67%) and subluxation(50%) were the most frequently diagnosed injuries in the permanent dentition and primary dentition, respectively. There was no association between trauma source and dentition type (p=0.342), nor was there a difference between trauma source and gender(p=0.863). Conclusion.The study observed that a high percentage of 40.38% had an injury to three or more teeth resulting in attendant functional and esthetic complications. Hence public health issue that warrants urgent government attention.
{"title":"Traumatic dental injuries in a tertiary institution in Nigeria: a 4-year retrospective analysis","authors":"M. Adeyemi, M. Ernest, Shakira Sanni-Abdullahi, Ehigie Igben, Ashiru Garba, Mirian Nnebedum","doi":"10.55320/mjz.50.3.423","DOIUrl":"https://doi.org/10.55320/mjz.50.3.423","url":null,"abstract":" Background; \u0000 Traumatic dental injury (TDI) has grown to be a significant public health issue due to its high prevalence as well as the significant negative effects it has on quality of life. This study aimed to examine the prevalence and causes of TDI in a Dental outpatient clinic for 4 years. \u0000Method: \u0000A retrospective study was conducted on 52 TDI patients who were treated at a Tertiary Institution's Dental Outpatient clinic between June 1, 2017, and June 1, 2021. \u0000 Data on age, gender, etiology, types of teeth involved, types of dental trauma, the day the incidents occurred, and treatment options were retrieved. Traumatized teeth were classified using Andreasen’s classification. Statistical analysis was carried out using SPSS version 20.0. \u0000Result \u0000 \u0000A total of 208 patients with maxillofacial injuries (163 males and 45 females) aged 1 to 81 years were examined. The prevalence of TDI was 25%. Male and female prevalences were 18.2% and 6.7%, respectively. There were 52 TDI patients with a mean age of 16.5 ± 12.02. \u0000The most common reason for TDI was motorcycle accidents at 30.77%. Avulsion(40.67%) and subluxation(50%) were the most frequently diagnosed injuries in the permanent dentition and primary dentition, respectively. There was no association between trauma source and dentition type (p=0.342), nor was there a difference between trauma source and gender(p=0.863). \u0000Conclusion.The study observed that a high percentage of 40.38% had an injury to three or more teeth resulting in attendant functional and esthetic complications. Hence public health issue that warrants urgent government attention.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140479639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. Ogunbode, Temitope Azeez Olukunke, R. Abdus-salam
Background: Postpartum family planning is vital in the prevention of unintended pregnancy and closely spaced pregnancies in the first year post-delivery. This study was designed to examine the postpartum women’s knowledge, attitude, belief and readiness to contraceptive use. Methods: This descriptive cross-sectional study was conducted in the postnatal clinic of the University College Hospital, Ibadan, Nigeria using an interviewer-assisted structured questionnaire among one hundred and ninety-four consenting recently delivered women. Data was analysed using IBM Statistics for Windows Version 23.0. Tests of association was done using chi-square and statistical significance was set at p-value of < 0.05. Results: Many of the respondents (60.8%) were in the age group 30-39 years and the majority (90.3%) had tertiary level of education. Most of the respondents got their information from health talks at antenatal clinic (42.8%) and health workers (42.3%). The majority (82.5%) of respondents were aware of contraception and 157(80.9%) intended to use contraceptives, however, only 54(34.4%) were willing to adopt a method at the postnatal clinic visit. The most preferred contraceptive methods were implants (23.4%). Respondents with three or more children alive(p=0.001), had statistically significant associations with prior use of contraception while those with the tertiary level of education(p=0.001) and of the Christian religion (p=<0.001) had statistically significant associations with good knowledge of contraception. Conclusion: The knowledge and readiness to use contraceptives was high but only about half were willing to adopt a method at the postnatal clinic. Robust prenatal counselling may help to increase the uptake of postpartum contraception.
背景：产后计划生育对于预防产后第一年内的意外怀孕和间隔过短的怀孕至关重要。本研究旨在调查产后妇女对使用避孕药具的知识、态度、信念和意愿。研究方法这项描述性横断面研究是在尼日利亚伊巴丹大学学院医院的产后门诊进行的，在 194 名同意的新近分娩的妇女中使用了由访谈员协助的结构化问卷。数据使用 IBM 统计学视窗版 23.0 进行分析。使用卡方检验关联性，统计显著性以 p 值小于 0.05 为标准。结果许多受访者（60.8%）的年龄在 30-39 岁之间，大多数受访者（90.3%）受过高等教育。大多数受访者（42.8%）从产前诊所的健康讲座和卫生工作者（42.3%）那里获得信息。大多数受访者（82.5%）了解避孕知识，157 名受访者（80.9%）打算使用避孕药具，但只有 54 名受访者（34.4%）愿意在产后就诊时采用避孕方法。最受欢迎的避孕方法是皮下埋植避孕法（23.4%）。有三个或三个以上存活子女的受访者（p=0.001）与之前使用避孕药具有显著的统计学关联，而受过高等教育（p=0.001）和信奉基督教（p=<0.001）的受访者与避孕知识的丰富程度有显著的统计学关联。 结论 使用避孕药具的知识和意愿都很高，但只有约一半的人愿意在产后诊所采用避孕方法。强有力的产前咨询可能有助于提高产后避孕率。
{"title":"Knowledge, attitude and readiness to use contraceptives among postpartum women at a tertiary hospital in southwest Nigeria.","authors":"O. Ogunbode, Temitope Azeez Olukunke, R. Abdus-salam","doi":"10.55320/mjz.50.3.411","DOIUrl":"https://doi.org/10.55320/mjz.50.3.411","url":null,"abstract":"Background: Postpartum family planning is vital in the prevention of unintended pregnancy and closely spaced pregnancies in the first year post-delivery. This study was designed to examine the postpartum women’s knowledge, attitude, belief and readiness to contraceptive use. \u0000Methods: This descriptive cross-sectional study was conducted in the postnatal clinic of the University College Hospital, Ibadan, Nigeria using an interviewer-assisted structured questionnaire among one hundred and ninety-four consenting recently delivered women. Data was analysed using IBM Statistics for Windows Version 23.0. Tests of association was done using chi-square and statistical significance was set at p-value of < 0.05. \u0000Results: Many of the respondents (60.8%) were in the age group 30-39 years and the majority (90.3%) had tertiary level of education. Most of the respondents got their information from health talks at antenatal clinic (42.8%) and health workers (42.3%). The majority (82.5%) of respondents were aware of contraception and 157(80.9%) intended to use contraceptives, however, only 54(34.4%) were willing to adopt a method at the postnatal clinic visit. The most preferred contraceptive methods were implants (23.4%). Respondents with three or more children alive(p=0.001), had statistically significant associations with prior use of contraception while those with the tertiary level of education(p=0.001) and of the Christian religion (p=<0.001) had statistically significant associations with good knowledge of contraception. \u0000Conclusion: The knowledge and readiness to use contraceptives was high but only about half were willing to adopt a method at the postnatal clinic. Robust prenatal counselling may help to increase the uptake of postpartum contraception.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"55 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140478384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
INTRODUCTION The Interpregnancy Interval (IPI’s) is defined as the spacing between a live birth and the beginning of the following pregnancy according to the world health organization. Research has shown that short IPI’s are associated with adverse maternal and perinatal outcomes. The IPI therefore offers an opportunity for women to optimize their health status in between pregnancies for better pregnancy outcomes. AIMS AND OBJECTIVES This study was aimed at determining the prevalence of short IPI’s and further determining the demographic, sociocultural and health care related factors associated with short IPI’s among women of reproductive age in Lusaka, Zambia. METHODOLOGY This was a cross sectional study involving 218 women aged between 15 and 49 years attending antenatal clinics at selected hospitals. Eligible participants were recruited using systematic random sampling method and a structured interviewer administered questionnaire was used to collect the data which was later processed using Epi-Data and exported to STATA for analysis. RESULTS The results of this study revealed that the prevalence of short IPI’s was 33.4%. Among the factors associated with short IPI’s, it was noted that women aged 35 years or older were 61% (aOR=0.39;95% CI:0.21-0.98) less likely to have short IPI’s compared to those aged less than 25 years. Furthermore, women from Matero hospital had 4.89 (95% CI; 2.59-11.6) times higher odds of short IPI’s than women from Chawama hospital. In addition, women who reported having discussed the pregnancy with their partners were 59% (aOR=0.41; 95% CI; 0.31-0.96) less likely to have short IPI’s compared to those who did not discuss. For those women who indicated that they did not receive information about recommended IPI’s from health care workers, their odds of short IPI’s were 4.47% (95% CI; 1.57-12.6) times higher than those who received the information. CONCLUSION Based on the results of this study, raising awareness among women on the recommended birth intervals and encouraging partner participation on when to have the next child may help in efforts to avert the problem of short IPI’s and its effect on maternal and perinatal outcomes. KEY WORDS : Short interpregnancy intervals, antenatal care, maternal adverse outcomes, perinatal adverse outcomes
{"title":"Prevalence and Factors associated with Short Interpregnancy Intervals among women attending antenatal care at first level hospitals in lusaka, zambia.","authors":"Imanga Ikabongo, B. Vwalika, M. Lubeya","doi":"10.55320/mjz.50.3.352","DOIUrl":"https://doi.org/10.55320/mjz.50.3.352","url":null,"abstract":"INTRODUCTION \u0000The Interpregnancy Interval (IPI’s) is defined as the spacing between a live birth and the beginning of the following pregnancy according to the world health organization. Research has shown that short IPI’s are associated with adverse maternal and perinatal outcomes. The IPI therefore offers an opportunity for women to optimize their health status in between pregnancies for better pregnancy outcomes. \u0000AIMS AND OBJECTIVES \u0000This study was aimed at determining the prevalence of short IPI’s and further determining the demographic, sociocultural and health care related factors associated with short IPI’s among women of reproductive age in Lusaka, Zambia. \u0000METHODOLOGY \u0000This was a cross sectional study involving 218 women aged between 15 and 49 years attending antenatal clinics at selected hospitals. Eligible participants were recruited using systematic random sampling method and a structured interviewer administered questionnaire was used to collect the data which was later processed using Epi-Data and exported to STATA for analysis. \u0000RESULTS \u0000The results of this study revealed that the prevalence of short IPI’s was 33.4%. Among the factors associated with short IPI’s, it was noted that women aged 35 years or older were 61% (aOR=0.39;95% CI:0.21-0.98) less likely to have short IPI’s compared to those aged less than 25 years. Furthermore, women from Matero hospital had 4.89 (95% CI; 2.59-11.6) times higher odds of short IPI’s than women from Chawama hospital. In addition, women who reported having discussed the pregnancy with their partners were 59% (aOR=0.41; 95% CI; 0.31-0.96) less likely to have short IPI’s compared to those who did not discuss. For those women who indicated that they did not receive information about recommended IPI’s from health care workers, their odds of short IPI’s were 4.47% (95% CI; 1.57-12.6) times higher than those who received the information. \u0000CONCLUSION \u0000Based on the results of this study, raising awareness among women on the recommended birth intervals and encouraging partner participation on when to have the next child may help in efforts to avert the problem of short IPI’s and its effect on maternal and perinatal outcomes. \u0000KEY WORDS : Short interpregnancy intervals, antenatal care, maternal adverse outcomes, perinatal adverse outcomes","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"59 29","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140476248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gossypibomas are infrequent abdominal pathology associated with increased morbidity and mortality. They are foreign bodies of predominantly cotton material that are erroneously left in body cavities following surgery. They represent an extremely rare but avoidable cause of bowel obstruction and should be considered as a differential diagnosis in patients presenting with Bowel obstruction following previous abdominal surgery. We present the case of a young woman with clinical features in keeping with mechanical bowel obstruction from suspected post-operated adhesion. However, intra-operative finding revealed a complete transmural migration of a Gossypiboma into the terminal ileum. She had segmental ileal resection, extraction of the gossypiboma and primary end-to-end ileo-ileal anastomosis. Her recovery period was uneventful. Keywords; Anastomosis, Bowel obstruction, Gossypiboma, laparotomy
{"title":"BOWEL OBSTRUCTION FROM COMPLETE TRANSMURAL MIGRATION OF A GOSSYPIBOMA INTO THE ILEUM; A RARE OCCURRENCE","authors":"H. Agada, Yakubu MALGWA ISHAKU, Joel Iliya","doi":"10.55320/mjz.50.3.416","DOIUrl":"https://doi.org/10.55320/mjz.50.3.416","url":null,"abstract":"Gossypibomas are infrequent abdominal pathology associated with increased morbidity and mortality. They are foreign bodies of predominantly cotton material that are erroneously left in body cavities following surgery. They represent an extremely rare but avoidable cause of bowel obstruction and should be considered as a differential diagnosis in patients presenting with Bowel obstruction following previous abdominal surgery. \u0000We present the case of a young woman with clinical features in keeping with mechanical bowel obstruction from suspected post-operated adhesion. However, intra-operative finding revealed a complete transmural migration of a Gossypiboma into the terminal ileum. She had segmental ileal resection, extraction of the gossypiboma and primary end-to-end ileo-ileal anastomosis. Her recovery period was uneventful. \u0000Keywords; Anastomosis, Bowel obstruction, Gossypiboma, laparotomy","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"550 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140474055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pharidah Rajan Ibrahim Omar Sundi, A. Asombang, Nkengeh N. Tazinkeng, Lisa Liang Philpotts, A. Adekunle, Rodrigue Ndabashinze
Background Gastrointestinal (GI) malignancies account for greater than one-third of cancer-related deaths worldwide. In Zambia, there is a lack of data on epidemiology, diagnosis, management, and outcomes. We sought to review existing literature to determine the extent of research and identify gaps in knowledge pertaining to GI malignancies in Zambia. Methods We systematically searched databases including Ovid MEDLINE, CINAHL, Web of Science Core Collection, Cochrane Library via Ovid, Embase, Africa Wide Information via Ebsco, African Index Medicus and African Journals Online, to identify studies on GI malignancies including colorectal (CRC), pancreatic (PC), gastric (GC), esophageal (EC) and liver cancers (LC) in Zambia. Results Of 323 studies screened, 27 were included in the final analysis. The included studies assessed an individual GI cancer or more than one GI cancer as follows: GC only (n=10, 37%), EC only (n=5, 18%), LC only (n=5, 18%), CRC only (n=2, 7%), PC only (n=1, 4%), PC, CRC, EC, GC, LC combined (n=1, 4%), CRC, EC, GC, LC combined (n=1, 4%), CRC, EC, GC combined (n=1, 4%) and EC, GC combined (n=1, 4%). Gastric cancer was the most studied (n =14 articles), followed by esophageal (n=9 articles), liver cancer (n=7 articles), colorectal (n=5 articles) and pancreatic cancer (n=2 articles). Conclusion There is paucity of published data. Existing studies have focused mainly on prevalence and risk factors. Longitudinal studies examining incidence, prognosis and survival are needed. Keywords: Gastrointestinal cancer, Zambia, risk factors, management, clinical outcomes.
背景 胃肠道（GI）恶性肿瘤占全球癌症相关死亡人数的三分之一以上。在赞比亚，缺乏有关流行病学、诊断、管理和结果的数据。我们试图对现有文献进行回顾，以确定研究范围，并找出赞比亚消化道恶性肿瘤相关知识的不足之处。方法 我们系统地检索了 Ovid MEDLINE、CINAHL、Web of Science Core Collection、Cochrane Library via Ovid、Embase、Africa Wide Information via Ebsco、African Index Medicus 和 African Journals Online 等数据库，以确定有关赞比亚消化道恶性肿瘤（包括结直肠癌 (CRC)、胰腺癌 (PC)、胃癌 (GC)、食管癌 (EC) 和肝癌 (LC) 的研究。 结果 在筛选出的 323 项研究中，27 项被纳入最终分析。纳入的研究对一种或多种消化道癌症进行了评估，具体情况如下：仅 GC（n=10，37%），仅 EC（n=5，18%），仅 LC（n=5，18%），仅 CRC（n=2，7%），仅 PC（n=1，4%），PC、CRC、EC、GC、LC 合并（n=1，4%），CRC、EC、GC、LC 合并（n=1，4%），CRC、EC、GC 合并（n=1，4%）以及 EC、GC 合并（n=1，4%）。研究最多的是胃癌（n=14 篇文章），其次是食管癌（n=9 篇文章）、肝癌（n=7 篇文章）、结直肠癌（n=5 篇文章）和胰腺癌（n=2 篇文章）。 结论 已发表的数据很少。现有研究主要侧重于发病率和风险因素。需要对发病率、预后和存活率进行纵向研究。 关键词胃肠道癌症、赞比亚、风险因素、管理、临床结果。
{"title":"Gastrointestinal malignancies in Zambia: a scoping review","authors":"Pharidah Rajan Ibrahim Omar Sundi, A. Asombang, Nkengeh N. Tazinkeng, Lisa Liang Philpotts, A. Adekunle, Rodrigue Ndabashinze","doi":"10.55320/mjz.50.3.400","DOIUrl":"https://doi.org/10.55320/mjz.50.3.400","url":null,"abstract":"Background \u0000Gastrointestinal (GI) malignancies account for greater than one-third of cancer-related deaths worldwide. In Zambia, there is a lack of data on epidemiology, diagnosis, management, and outcomes. We sought to review existing literature to determine the extent of research and identify gaps in knowledge pertaining to GI malignancies in Zambia. \u0000Methods \u0000We systematically searched databases including Ovid MEDLINE, CINAHL, Web of Science Core Collection, Cochrane Library via Ovid, Embase, Africa Wide Information via Ebsco, African Index Medicus and African Journals Online, to identify studies on GI malignancies including colorectal (CRC), pancreatic (PC), gastric (GC), esophageal (EC) and liver cancers (LC) in Zambia. \u0000Results \u0000Of 323 studies screened, 27 were included in the final analysis. The included studies assessed an individual GI cancer or more than one GI cancer as follows: GC only (n=10, 37%), EC only (n=5, 18%), LC only (n=5, 18%), CRC only (n=2, 7%), PC only (n=1, 4%), PC, CRC, EC, GC, LC combined (n=1, 4%), CRC, EC, GC, LC combined (n=1, 4%), CRC, EC, GC combined (n=1, 4%) and EC, GC combined (n=1, 4%). Gastric cancer was the most studied (n =14 articles), followed by esophageal (n=9 articles), liver cancer (n=7 articles), colorectal (n=5 articles) and pancreatic cancer (n=2 articles). \u0000Conclusion \u0000There is paucity of published data. Existing studies have focused mainly on prevalence and risk factors. Longitudinal studies examining incidence, prognosis and survival are needed. \u0000 \u0000Keywords: Gastrointestinal cancer, Zambia, risk factors, management, clinical outcomes. \u0000 ","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"218 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140473901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Musenge, L. Prashar, C. Ezeala, Fastone Mathews Goma
Background: Cassia abbreviata plant extracts are used traditionally to treat various ailments including diabetes mellitus. However, very few animal studies have been conducted to investigate potential hypoglycaemic effects locally. We examined phytochemicals, median lethal dose and effects of Cassia abbreviata extracts and fractions on oral glucose tolerance in non-diabetic male Wistar rats. Methods: Qualitative and Lorke’s methods were used to screen for phytochemicals and acute toxicity testing. Rats weighing 160 - 250 g were divided into 4 groups of 3 rats (phase one) and 4 groups of 1 rat (phase two) each for acute toxicity. Main experiments comprised 8 groups (extracts) and 7 groups (fractions) of 6 rats per group. Doses of 762 mgkg-1, 381 mgkg-1, and 190 mgkg-1 for extracts, 381 mg.kg-1 for the fractions, 10 mg.kg-1 for sitagliptin and 10 mL.kg-1 of vehicle were administered. Thereafter, blood glucose levels were assessed using Accu-Chek glucometer. Results: Leaf methanolic extract and ethyl acetate fraction contained more phytochemicals. Acute toxicity test revealed no mortality in all the groups except for leaf ethanolic and methanolic crude extracts in phase two at dose 5000 mg.kg-1. Root bark ethanolic extract 381 mg.kg-1 showed significant hypoglycaemic effect at 60 min and 180 min while 381 mg.kg-1 n-hexane fraction showed significant hypoglycaemic effect only at 180 min. Sitagliptin 10 mg.kg-1 minimally reduced the blood glucose levels at 60 min. Conclusion: More phytochemicals were observed in leaf methanolic extract and ethyl acetate fraction. Both extracts and fractions were considered practically non-toxic following acute toxicity testing. Root bark ethanolic extract and n-hexane fraction revealed better hypoglycaemic effects. Hypoglycaemic bioactivity observed may be due to various mechanisms.
{"title":"Phytochemical Screening, median lethal dose and effects of Cassia abbreviata Oliv. crude extracts and fractions on oral glucose tolerance in non-diabetic male Wistar rats","authors":"E. Musenge, L. Prashar, C. Ezeala, Fastone Mathews Goma","doi":"10.55320/mjz.50.3.427","DOIUrl":"https://doi.org/10.55320/mjz.50.3.427","url":null,"abstract":"Background: Cassia abbreviata plant extracts are used traditionally to treat various ailments including diabetes mellitus. However, very few animal studies have been conducted to investigate potential hypoglycaemic effects locally. We examined phytochemicals, median lethal dose and effects of Cassia abbreviata extracts and fractions on oral glucose tolerance in non-diabetic male Wistar rats. \u0000Methods: Qualitative and Lorke’s methods were used to screen for phytochemicals and acute toxicity testing. Rats weighing 160 - 250 g were divided into 4 groups of 3 rats (phase one) and 4 groups of 1 rat (phase two) each for acute toxicity. Main experiments comprised 8 groups (extracts) and 7 groups (fractions) of 6 rats per group. Doses of 762 mgkg-1, 381 mgkg-1, and 190 mgkg-1 for extracts, 381 mg.kg-1 for the fractions, 10 mg.kg-1 for sitagliptin and 10 mL.kg-1 of vehicle were administered. Thereafter, blood glucose levels were assessed using Accu-Chek glucometer. \u0000Results: Leaf methanolic extract and ethyl acetate fraction contained more phytochemicals. Acute toxicity test revealed no mortality in all the groups except for leaf ethanolic and methanolic crude extracts in phase two at dose 5000 mg.kg-1. Root bark ethanolic extract 381 mg.kg-1 showed significant hypoglycaemic effect at 60 min and 180 min while 381 mg.kg-1 n-hexane fraction showed significant hypoglycaemic effect only at 180 min. Sitagliptin 10 mg.kg-1 minimally reduced the blood glucose levels at 60 min. \u0000Conclusion: More phytochemicals were observed in leaf methanolic extract and ethyl acetate fraction. Both extracts and fractions were considered practically non-toxic following acute toxicity testing. Root bark ethanolic extract and n-hexane fraction revealed better hypoglycaemic effects. Hypoglycaemic bioactivity observed may be due to various mechanisms.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"13 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140477121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kateta Edward, Jane Chanda Kabwe, Agness Mtaja, L. Kabwe
Background Premature coronary artery disease (PCAD) is considered when coronary artery disease (CAD) occurs in the younger population, less than 45 years old in males. Modifiable risk factors are present in about 80% of patients with PCAD such as smoking, diabetes, high blood pressure and obesity. High serum lipoprotein (a) level has recently emerged as a risk factor for PCAD. However, it is not routinely investigated in young patients presenting with acute coronary syndromes. Case Presentation A 34-year-old African man presented to our hospital with 2 hours of worsening left sided chest pain. He gave a history of long-standing chest pain in the past that was being managed as peptic ulcer disease. He also complained of a slow heart rate. He had no traditional cardiovascular risk factors. The only significant history was a recent recovery from COVID-19 infection two months prior. His physical examination was only significant for a bradycardia, ECG revealed a hyper acute inferior STEMI without right ventricular involvement. Echo showed a normal left ventricle with reduced ejection fraction (EF: 50%), wall motion abnormalities consistent of an inferior MI. He immediately received streptokinase with good clinical and ECG response. His coronary angiogram showed a severe lesion and plaque rupture in the mid-distal segment of a dominant right coronary artery. Percutaneous coronary intervention (PCI) was successfully done, and one drug eluting stent was implanted. He was placed on guideline directed medical therapy for secondary prevention. The only significant possible aetiology found was an elevated Lipoprotein (a) (137mg/dl). Subsequent serum Lipoprotein (a) remained persistently elevated despite therapy with high dose niacin. He was recommended for a PCSK9 receptor blocker, but this medication is not available in the country and the patient could not meet the costs. He remains stable to current medications with no recurrence of chest pain, two years after the index event, the Lipoprotein (a) levels are still high. Conclusions: Lipoprotein (a) appears to be an important overlooked cardiovascular risk factor for premature coronary artery disease especially in the absence of traditional risk factors. It should always be considered in the screening of premature coronary cardiovascular disease. The acute presentation in this patient was probably triggered by SARS COV-2 infection.
{"title":"Lipoprotein (a) as a cause of premature coronary artery disease; a case report of a 34-year-old male patient presenting with ST elevation myocardial infarction.","authors":"Kateta Edward, Jane Chanda Kabwe, Agness Mtaja, L. Kabwe","doi":"10.55320/mjz.50.3.403","DOIUrl":"https://doi.org/10.55320/mjz.50.3.403","url":null,"abstract":"Background \u0000Premature coronary artery disease (PCAD) is considered when coronary artery disease (CAD) occurs in the younger population, less than 45 years old in males. Modifiable risk factors are present in about 80% of patients with PCAD such as smoking, diabetes, high blood pressure and obesity. High serum lipoprotein (a) level has recently emerged as a risk factor for PCAD. However, it is not routinely investigated in young patients presenting with acute coronary syndromes. \u0000Case Presentation \u0000A 34-year-old African man presented to our hospital with 2 hours of worsening left sided chest pain. He gave a history of long-standing chest pain in the past that was being managed as peptic ulcer disease. He also complained of a slow heart rate. He had no traditional cardiovascular risk factors. The only significant history was a recent recovery from COVID-19 infection two months prior. His physical examination was only significant for a bradycardia, ECG revealed a hyper acute inferior STEMI without right ventricular involvement. Echo showed a normal left ventricle with reduced ejection fraction (EF: 50%), wall motion abnormalities consistent of an inferior MI. He immediately received streptokinase with good clinical and ECG response. His coronary angiogram showed a severe lesion and plaque rupture in the mid-distal segment of a dominant right coronary artery. Percutaneous coronary intervention (PCI) was successfully done, and one drug eluting stent was implanted. He was placed on guideline directed medical therapy for secondary prevention. The only significant possible aetiology found was an elevated Lipoprotein (a) (137mg/dl). Subsequent serum Lipoprotein (a) remained persistently elevated despite therapy with high dose niacin. He was recommended for a PCSK9 receptor blocker, but this medication is not available in the country and the patient could not meet the costs. He remains stable to current medications with no recurrence of chest pain, two years after the index event, the Lipoprotein (a) levels are still high. \u0000Conclusions: \u0000Lipoprotein (a) appears to be an important overlooked cardiovascular risk factor for premature coronary artery disease especially in the absence of traditional risk factors. It should always be considered in the screening of premature coronary cardiovascular disease. The acute presentation in this patient was probably triggered by SARS COV-2 infection.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"380 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140472371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Chinene, Lavin Mutandiro, E. Mushosho, Lyman Khumbula, Admire Zanga, Josephat Banhwa, O. Bwanga
Ultrasound imaging is an important tool in healthcare, used for screening, diagnosis, monitoring, and treating diseases. It works by using sound waves to generate images based on echoes reflected back from the object being examined. Advancements in ultrasound technology have made it more accessible to other healthcare professionals, resulting in its expanded application across all fields of medicine. In Zimbabwe, radiographers play a crucial role in providing ultrasound services, helping to address the shortage of radiologists, and improve patient access to quality imaging. However, there is a lack of available literature on ultrasound imaging human resources in Zimbabwe. This article reviews the historical development of ultrasound training for radiographers in Zimbabwe, highlighting the challenges and opportunities associated with their expanded role in ultrasound. It also emphasizes the benefits of involving radiographers in ultrasound services, such as improved patient care, cost savings, utilization of their knowledge and skills, and enhanced job satisfaction. The paper provides recommendations for the future, including the need for clear clinical leadership, specialized ultrasound programs, and continuous professional development (CPD) activities to ensure high-quality ultrasound services in the country. The insights presented aim to inform policy decisions and promote equitable access to essential ultrasound imaging in the Zimbabwean healthcare system.
{"title":"Role of Radiographers in the Provision of Diagnostic Medical Ultrasound Services in Zimbabwe: Past, Present and Way Forward","authors":"B. Chinene, Lavin Mutandiro, E. Mushosho, Lyman Khumbula, Admire Zanga, Josephat Banhwa, O. Bwanga","doi":"10.55320/mjz.50.3.424","DOIUrl":"https://doi.org/10.55320/mjz.50.3.424","url":null,"abstract":"Ultrasound imaging is an important tool in healthcare, used for screening, diagnosis, monitoring, and treating diseases. It works by using sound waves to generate images based on echoes reflected back from the object being examined. Advancements in ultrasound technology have made it more accessible to other healthcare professionals, resulting in its expanded application across all fields of medicine. In Zimbabwe, radiographers play a crucial role in providing ultrasound services, helping to address the shortage of radiologists, and improve patient access to quality imaging. However, there is a lack of available literature on ultrasound imaging human resources in Zimbabwe. This article reviews the historical development of ultrasound training for radiographers in Zimbabwe, highlighting the challenges and opportunities associated with their expanded role in ultrasound. It also emphasizes the benefits of involving radiographers in ultrasound services, such as improved patient care, cost savings, utilization of their knowledge and skills, and enhanced job satisfaction. The paper provides recommendations for the future, including the need for clear clinical leadership, specialized ultrasound programs, and continuous professional development (CPD) activities to ensure high-quality ultrasound services in the country. The insights presented aim to inform policy decisions and promote equitable access to essential ultrasound imaging in the Zimbabwean healthcare system.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"582 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140471123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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