M. Adeyemi, M. Ernest, Shakira Sanni-Abdullahi, Ehigie Igben, Ashiru Garba, Mirian Nnebedum
Background: According to surveys, mandibular injuries aetiology varies between countries and even between centers in the same country. Mandibular fractures are the second most frequent facial injury, accounting for 15.5% to 59% of all facial fractures globally. The study aimed to find out if there were predictable patterns of fractured in the north central part of Nigeria. Materials and Methods: Mandibular fracture patients treated during a 4-year period were identified in a retrospective analysis and examined based on factors including age, sex, mode of trauma, month and day of the week of presentation, number and anatomic location, treatment method and sequelae. Results: The study reviewed 75 participants between the ages of 2 and 70. The mean age was 30.69 ± 11.22 years, and the gender split was 70 males (93.20%) and 5 females (6.80%), with a p-value of 0.09. The main cause was motorbike accident (68%) and head on collision was the major mechanism of trauma road traffic accidents (RTAs, 68.8%) and none of motorbike riders nor did passengers wear crash helmet. A total of ninety-nine fractures out of one hundred and six fractures were observed in males. A small percentage of patients (33%) exhibited altered consciousness, however there was no statistically significant link between the aetiology and level of consciousness (p=0.818). Conclusion: The mandibular body was most severely impacted and the primary mechanism of injury was head-on collision between two motorbikes. Speed restrictions and legislative law should be placed on the use of crash helmet.
{"title":"PATTERN OF MANDIBULAR FRACTURES IN A NIGERIAN TERTIARY HEALTH INSTITUTION; A 4-YEAR RETROSPECTIVE STUDY","authors":"M. Adeyemi, M. Ernest, Shakira Sanni-Abdullahi, Ehigie Igben, Ashiru Garba, Mirian Nnebedum","doi":"10.55320/mjz.50.3.422","DOIUrl":"https://doi.org/10.55320/mjz.50.3.422","url":null,"abstract":"Background: According to surveys, mandibular injuries aetiology varies between countries and even between centers in the same country. Mandibular fractures are the second most frequent facial injury, accounting for 15.5% to 59% of all facial fractures globally. The study aimed to find out if there were predictable patterns of fractured in the north central part of Nigeria. \u0000Materials and Methods: Mandibular fracture patients treated during a 4-year period were identified in a retrospective analysis and examined based on factors including age, sex, mode of trauma, month and day of the week of presentation, number and anatomic location, treatment method and sequelae. \u0000Results: The study reviewed 75 participants between the ages of 2 and 70. The mean age was 30.69 ± 11.22 years, and the gender split was 70 males (93.20%) and 5 females (6.80%), with a p-value of 0.09. The main cause was motorbike accident (68%) and head on collision was the major mechanism of trauma road traffic accidents (RTAs, 68.8%) and none of motorbike riders nor did passengers wear crash helmet. A total of ninety-nine fractures out of one hundred and six fractures were observed in males. A small percentage of patients (33%) exhibited altered consciousness, however there was no statistically significant link between the aetiology and level of consciousness (p=0.818). \u0000Conclusion: The mandibular body was most severely impacted and the primary mechanism of injury was head-on collision between two motorbikes. Speed restrictions and legislative law should be placed on the use of crash helmet.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"156 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140477318","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}
Abstract Background There is no published case of diastolic dysfunction arising due to bedaquiline treatment for Multi-Drug Resistant Tuberculosis (MDR-TB). Diastolic dysfunction is not listed as a potential complication of treatment with bedaquiline. This case report is the first to link bedaquiline to diastolic dysfunction. Clinicians should be aware of this potential complication, and ensure that patients are monitored and investigated appropriately. Case Presentation A 47 year old female presented with fever, productive cough and drenching night sweats for more than 2 weeks prior to presentation. There was no hemoptysis, chest pains or weight loss. She however, felt breathless after a heavy bout of coughing. Fever was intermittent, and most pronounced at night. The patient denied any weight loss over the past month. The patient had no history of HIV, diabetes, hypertension or heart disease. There were no previous episodes of TB. There was history of contact with a patient with MDR-TB patient. The patients’ son, who shared a house and all living spaces with the patient, was being treated for MDR-TB at the time of presentation. The patient did not drink or smoke. There was no history of illicit drug use. She worked as a restaurant manager. Due to the history of very close contact with MDR-TB, the patient was commenced on the longer, oral only regimen for MDR-TB which includes bedaquiline. Four weeks after commencement of bedaquiline, the patient complained that both feet were swelling. There were no other symptoms or signs of cardiovascular disease. An Echocardiogram done during the fifth month showed an ejection fraction of 71% and diastolic dysfunction. The patient was commenced on diuretics and continued on MDR-TB treatment. An echocardiogram that was repeated at month 15 review showed an ejection fraction of 64%, normal left ventricle and normal systolic and diastolic function. Conclusions Diastolic Dysfunction has not previously been reported in patients on bedaquiline. This is the first case report to link bedaquiline to diastolic dysfunction. More studies need to be done to determine conclusively whether bedaquiline can cause diastolic dysfunction.
{"title":"Diastolic dysfunction due to bedaquiline: A case report","authors":"Ireen C. Bwalya","doi":"10.55320/mjz.50.3.412","DOIUrl":"https://doi.org/10.55320/mjz.50.3.412","url":null,"abstract":"Abstract \u0000Background \u0000There is no published case of diastolic dysfunction arising due to bedaquiline treatment for Multi-Drug Resistant Tuberculosis (MDR-TB). Diastolic dysfunction is not listed as a potential complication of treatment with bedaquiline. This case report is the first to link bedaquiline to diastolic dysfunction. Clinicians should be aware of this potential complication, and ensure that patients are monitored and investigated appropriately. \u0000Case Presentation \u0000A 47 year old female presented with fever, productive cough and drenching night sweats for more than 2 weeks prior to presentation. There was no hemoptysis, chest pains or weight loss. She however, felt breathless after a heavy bout of coughing. Fever was intermittent, and most pronounced at night. The patient denied any weight loss over the past month. The patient had no history of HIV, diabetes, hypertension or heart disease. There were no previous episodes of TB. There was history of contact with a patient with MDR-TB patient. The patients’ son, who shared a house and all living spaces with the patient, was being treated for MDR-TB at the time of presentation. The patient did not drink or smoke. There was no history of illicit drug use. She worked as a restaurant manager. Due to the history of very close contact with MDR-TB, the patient was commenced on the longer, oral only regimen for MDR-TB which includes bedaquiline. Four weeks after commencement of bedaquiline, the patient complained that both feet were swelling. There were no other symptoms or signs of cardiovascular disease. An Echocardiogram done during the fifth month showed an ejection fraction of 71% and diastolic dysfunction. The patient was commenced on diuretics and continued on MDR-TB treatment. An echocardiogram that was repeated at month 15 review showed an ejection fraction of 64%, normal left ventricle and normal systolic and diastolic function. \u0000Conclusions \u0000Diastolic Dysfunction has not previously been reported in patients on bedaquiline. This is the first case report to link bedaquiline to diastolic dysfunction. More studies need to be done to determine conclusively whether bedaquiline can cause diastolic dysfunction.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"43 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140475950","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}
Background: Tuberculosis (TB) remains a leading infectious cause of morbidity and mortality in Zambia. Vitamin D deficiency has been associated with increased TB incidence and severity but data for the Zambian setting is lacking, inclusive of the general population. We sought to determine the prevalence of vitamin D deficiency and its associated factors in active TB patients in comparison to matched adults from the general population without TB, and to compare clinical and radiological severity of TB based on vitamin D status. Methods: We enrolled 89 TB patients and 78 matched adults from the general population. Demographic and clinical data was collected. The key findings on physical examination were body mass index (BMI), mid upper arm circumference (MUAC), and signs of undernutrition. Clinical severity was assessed using the TB I Score and the Karnofsky Performance Index (KPI).Chest x-ray and measurement of serum vitamin D levels were done. Radiological severity was assessed using the Timika chest x-ray score. Vitamin D was measured using the Cobas® E411 analyser from Roche Diagnostics (Germany) with vitamin D deficiency defined as <30 ng/ml and chi square used to analyse vitamin D deficiency as a categorical variable. Results: The median (IQR) age was 27.5 (24-38) years in the TB patients and 32 (25-37) years in the non-TB adults (p=0.30).Sixty-nine (77.53%) of the TB patients and 57 (73.08%) of the comparison group were male (p=0.51). The prevalence of vitamin D deficiency was 33.71 % in the TB patients and 15.38% in the comparison group (p <0.01). Associations with vitamin D deficiency were active TB (AOR =2.27; 95% CI = 1.04- 4.95; p=0.04) and undernutrition (AOR 14.5; 95% CI 1.65-126.97; p=0.02). Median (IQR) KPI was 70 (60-80) in the vitamin D deficient patients compared to 80 (70-90) in non- vitamin D deficient patients (p=0.01). Median (IQR) Timika chest x-ray score was 75 (45-115) in the vitamin D deficient TB patients compared to 42.5 (20-75) in the non- vitamin D deficient patients (p<0.01). Conclusions: We found a significant difference in the prevalence of vitamin D deficiency in active TB patients compared with matched non-TB adults. Vitamin D deficiency was associated with active TB and under nutrition. TB patients with vitamin D deficiency had more clinical and radiological severe disease than those with normal vitamin D levels. These findings warrant further studies on the role of vitamin D supplementation in TB in Zambia.
背景：结核病（TB）仍然是赞比亚发病和死亡的主要传染病因。维生素 D 缺乏与结核病发病率和严重程度的增加有关，但赞比亚缺乏包括普通人群在内的相关数据。我们试图确定活动性肺结核患者中维生素 D 缺乏症的患病率及其相关因素，并与普通人群中未患肺结核的成年人进行比较，同时根据维生素 D 状态比较肺结核的临床和放射学严重程度。研究方法我们招募了 89 名肺结核患者和 78 名与之匹配的普通成年人。我们收集了人口统计学和临床数据。体格检查的主要结果是体重指数（BMI）、中上臂围（MUAC）和营养不良的迹象。采用肺结核 I 评分和卡诺夫斯基表现指数（KPI）评估临床严重程度。胸部 X 光检查和血清维生素 D 含量测量采用 Timika 胸部 X 光评分法评估放射学严重程度。使用罗氏诊断公司（德国）的 Cobas® E411 分析仪测量维生素 D，维生素 D 缺乏的定义是 <30 纳克/毫升，并将维生素 D 缺乏作为一个分类变量使用卡方进行分析。结果结核病患者的年龄中位数（IQR）为 27.5（24-38）岁，非结核病成人的年龄中位数（IQR）为 32（25-37）岁（P=0.30）。69 名（77.53%）结核病患者和 57 名（73.08%）对比组患者为男性（P=0.51）。肺结核患者中维生素 D 缺乏的比例为 33.71%，对比组为 15.38%（P <0.01）。活动性肺结核（AOR =2.27；95% CI =1.04-4.95；P=0.04）和营养不良（AOR 14.5；95% CI 1.65-126.97；P=0.02）与维生素 D 缺乏有关。维生素 D 缺乏患者的 KPI 中位数（IQR）为 70（60-80），而非维生素 D 缺乏患者的 KPI 中位数（IQR）为 80（70-90）（P=0.01）。缺乏维生素 D 的肺结核患者 Timika 胸部 X 光评分的中位数（IQR）为 75（45-115），而非缺乏维生素 D 的患者为 42.5（20-75）（P<0.01）。结论我们发现，活动性肺结核患者与匹配的非肺结核成人相比，在维生素 D 缺乏症的患病率上存在明显差异。维生素 D 缺乏与活动性肺结核和营养不良有关。与维生素 D 水平正常的结核病患者相比，维生素 D 缺乏的结核病患者的临床和放射学病情更为严重。这些发现值得进一步研究维生素 D 补充剂在赞比亚结核病中的作用。
{"title":"Vitamin D deficiency and its associated factors in active TB patients at a tertiary hospital and three primary health care level facilities in Lusaka, Zambia: A cross sectional analytical study","authors":"Chalomba Chitanika, Patrick Lungu, S. Lakhi","doi":"10.55320/mjz.50.2.347","DOIUrl":"https://doi.org/10.55320/mjz.50.2.347","url":null,"abstract":"Background: Tuberculosis (TB) remains a leading infectious cause of morbidity and mortality in Zambia. Vitamin D deficiency has been associated with increased TB incidence and severity but data for the Zambian setting is lacking, inclusive of the general population. We sought to determine the prevalence of vitamin D deficiency and its associated factors in active TB patients in comparison to matched adults from the general population without TB, and to compare clinical and radiological severity of TB based on vitamin D status. \u0000Methods: We enrolled 89 TB patients and 78 matched adults from the general population. Demographic and clinical data was collected. The key findings on physical examination were body mass index (BMI), mid upper arm circumference (MUAC), and signs of undernutrition. Clinical severity was assessed using the TB I Score and the Karnofsky Performance Index (KPI).Chest x-ray and measurement of serum vitamin D levels were done. Radiological severity was assessed using the Timika chest x-ray score. Vitamin D was measured using the Cobas® E411 analyser from Roche Diagnostics (Germany) with vitamin D deficiency defined as <30 ng/ml and chi square used to analyse vitamin D deficiency as a categorical variable. \u0000Results: The median (IQR) age was 27.5 (24-38) years in the TB patients and 32 (25-37) years in the non-TB adults (p=0.30).Sixty-nine (77.53%) of the TB patients and 57 (73.08%) of the comparison group were male (p=0.51). The prevalence of vitamin D deficiency was 33.71 % in the TB patients and 15.38% in the comparison group (p <0.01). Associations with vitamin D deficiency were active TB (AOR =2.27; 95% CI = 1.04- 4.95; p=0.04) and undernutrition (AOR 14.5; 95% CI 1.65-126.97; p=0.02). Median (IQR) KPI was 70 (60-80) in the vitamin D deficient patients compared to 80 (70-90) in non- vitamin D deficient patients (p=0.01). Median (IQR) Timika chest x-ray score was 75 (45-115) in the vitamin D deficient TB patients compared to 42.5 (20-75) in the non- vitamin D deficient patients (p<0.01). \u0000Conclusions: We found a significant difference in the prevalence of vitamin D deficiency in active TB patients compared with matched non-TB adults. Vitamin D deficiency was associated with active TB and under nutrition. TB patients with vitamin D deficiency had more clinical and radiological severe disease than those with normal vitamin D levels. These findings warrant further studies on the role of vitamin D supplementation in TB in Zambia. \u0000 ","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"96 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139387967","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}
Background: Menstrual periods do not normally end suddenly; instead, there is frequently a period of transitional changes before and following the cessation of the period. Women typically endure physiological changes as a result of hormonal fluctuations, which impact their physical, emotional, and quality of life. Therefore, this study explored menopausal associated problems occurring in women residing in Lusaka, Zambia. Methods: A cross-sectional study was conducted for a period of six months on 171 women aged 40 – 60 years old who were bedsitters for a hospital patient or visited the hospital. The univariate (unadjusted) and multivariable (adjusted) logistic regression using backwards stepwise analysis was performed to identify factors associated with the most common symptom women face after menopause reporting at 95 % confidence interval (95 % CI). Results: The study revealed that the average age of menopause onset was 47.43 ± 4.46 years, with 75% of the women experiencing menopause between the ages of 45 and 55. Women complained of back pain (66.1%), headache (45%), hot flushes (30.6%), and mood changes (24.0%). Widowed (AOR 2.94; 95 % CI: 1.24–6.63), Obese (AOR 3.19; 95 % CI: 1.16 – 8.73), overweight (AOR 3.91; 95 % CI: 1.31 – 11.73) and early menopause (AOR 0.35, 95% CI: 0.13 – 0.92) were associated with back pain. Conclusion: Women experience a variety of menopausal and postmenopausal problems like back pain, headache, hot flushes and mood changes which will require interventions to improve the health of women.
{"title":"Age of Onset of Menopause and Factors Associated with Common Symptoms Among Women in Lusaka District, Zambia","authors":"Mabvuto Mulenga","doi":"10.55320/mjz.50.2.407","DOIUrl":"https://doi.org/10.55320/mjz.50.2.407","url":null,"abstract":"Background: Menstrual periods do not normally end suddenly; instead, there is frequently a period of transitional changes before and following the cessation of the period. Women typically endure physiological changes as a result of hormonal fluctuations, which impact their physical, emotional, and quality of life. Therefore, this study explored menopausal associated problems occurring in women residing in Lusaka, Zambia. Methods: A cross-sectional study was conducted for a period of six months on 171 women aged 40 – 60 years old who were bedsitters for a hospital patient or visited the hospital. The univariate (unadjusted) and multivariable (adjusted) logistic regression using backwards stepwise analysis was performed to identify factors associated with the most common symptom women face after menopause reporting at 95 % confidence interval (95 % CI). Results: The study revealed that the average age of menopause onset was 47.43 ± 4.46 years, with 75% of the women experiencing menopause between the ages of 45 and 55. Women complained of back pain (66.1%), headache (45%), hot flushes (30.6%), and mood changes (24.0%). Widowed (AOR 2.94; 95 % CI: 1.24–6.63), Obese (AOR 3.19; 95 % CI: 1.16 – 8.73), overweight (AOR 3.91; 95 % CI: 1.31 – 11.73) and early menopause (AOR 0.35, 95% CI: 0.13 – 0.92) were associated with back pain. Conclusion: Women experience a variety of menopausal and postmenopausal problems like back pain, headache, hot flushes and mood changes which will require interventions to improve the health of women.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":" 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139138510","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}
Flavia Muyinza Nalule, Mazuba Makamo, Sali Edward Tamale, B. Vwalika
Background: The considerable emotional, physical and financial burden associated with infertility and its treatment in general, demands that factors strongly associated with the outcome should be identified and regulated prior to embryo transfer. This will improve the outcome of IVF and provide a patient centered approach to treatment. Methods: This was a cross sectional study at the Lusaka IVF and fertility clinic. The study aimed to identify factors associated with successful IVF treatment. 414 women had undergone IVF treatment and were eligible. The data was collected from patients’ files and entered in excel then exported to Stata V13.1.for analysis. The participant’s characteristics were compared using the Chi square. The success rate was calculated and associations measured using univariate and multivariate logistic regression. Results: The success rate of IVF treatment was 31% in the study period. Factors associated with successful IVF treatment include age, number of embryos transferred and the sperm factor. These were statistically significant. It was noted that post-menopausal women were 3 times more likely to have a successful IVF than those less than 35 years. Conclusion: The success rate of IVF treatment at LIVF clinic was 31%. The factors associated with successful IVF treatment were age of the woman, order of embryos transferred and use of donor sperm. There is need to engage the law makers to come up with a legal framework that will guide on the handling of gametes which will include sperm and oocyte donation and receiving, freezing, transportation and surrogacy.
{"title":"Factors associated with successful In-Vitro Fertilization Treatment at Lusaka IVF and Fertility Clinic in Zambia","authors":"Flavia Muyinza Nalule, Mazuba Makamo, Sali Edward Tamale, B. Vwalika","doi":"10.55320/mjz.50.2.372","DOIUrl":"https://doi.org/10.55320/mjz.50.2.372","url":null,"abstract":"Background: The considerable emotional, physical and financial burden associated with infertility and its treatment in general, demands that factors strongly associated with the outcome should be identified and regulated prior to embryo transfer. This will improve the outcome of IVF and provide a patient centered approach to treatment. Methods: This was a cross sectional study at the Lusaka IVF and fertility clinic. The study aimed to identify factors associated with successful IVF treatment. 414 women had undergone IVF treatment and were eligible. The data was collected from patients’ files and entered in excel then exported to Stata V13.1.for analysis. The participant’s characteristics were compared using the Chi square. The success rate was calculated and associations measured using univariate and multivariate logistic regression. Results: The success rate of IVF treatment was 31% in the study period. Factors associated with successful IVF treatment include age, number of embryos transferred and the sperm factor. These were statistically significant. It was noted that post-menopausal women were 3 times more likely to have a successful IVF than those less than 35 years. Conclusion: The success rate of IVF treatment at LIVF clinic was 31%. The factors associated with successful IVF treatment were age of the woman, order of embryos transferred and use of donor sperm. There is need to engage the law makers to come up with a legal framework that will guide on the handling of gametes which will include sperm and oocyte donation and receiving, freezing, transportation and surrogacy.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":" 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139138528","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}
Background: Mycetoma also synonymous referred to as Madura's foot is a chronic granulomatous cutaneous infection caused by some genera of fungi and bacteria, leading to progressive and proliferative destruction of soft tissue and the nearby anatomical structures if no intervention is offered on time. Case presentation: We report a case of actinomycetoma in an African adult man residing in a rural-urban setup. After histological confirmation, the client was conservatively managed with oral medication: 1) dapsone 100mg once a day and trimethoprim/sulfamethoxazole(septrin) 160mg/800mg three times daily for one year with an excellent outcome. Conclusions: The gist of this rare case is to exemplify the role of integrated management of patients without underplaying the role of good clinical practice. Also, a call and advocate for improved health care services in the sub-Saharan countries. This will prevent or reduce avoidable medical complications caused by neglected and treatable diseases like actinomycocetoma.
{"title":"Madura Foot in an African Adult Male in Zambia: A likely Case of Misdiagnosis","authors":"Malan Malumani, M. Miyoba, Kebby Kyakilika","doi":"10.55320/mjz.50.2.384","DOIUrl":"https://doi.org/10.55320/mjz.50.2.384","url":null,"abstract":"Background: Mycetoma also synonymous referred to as Madura's foot is a chronic granulomatous cutaneous infection caused by some genera of fungi and bacteria, leading to progressive and proliferative destruction of soft tissue and the nearby anatomical structures if no intervention is offered on time. Case presentation: We report a case of actinomycetoma in an African adult man residing in a rural-urban setup. After histological confirmation, the client was conservatively managed with oral medication: 1) dapsone 100mg once a day and trimethoprim/sulfamethoxazole(septrin) 160mg/800mg three times daily for one year with an excellent outcome. Conclusions: The gist of this rare case is to exemplify the role of integrated management of patients without underplaying the role of good clinical practice. Also, a call and advocate for improved health care services in the sub-Saharan countries. This will prevent or reduce avoidable medical complications caused by neglected and treatable diseases like actinomycocetoma.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":" 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139140289","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}
Fair Banji Mwiinga, Roster Chihwaka Malimba, Mutinta Mirriam Nzima, Billiat Chongo, Faith Banda Malambo, Hope Chisoya, Joan Tembo, Edward Sakala
Erb-Duchenne paralysis is a neurological condition characterized by paralysis of the arm which occurs due to injury of the upper trunk of C5-C6 of the brachial plexus and can lead to disturbances in movement and sensation. Erb-Duchenne paralysis commonly presents with a “Waiter’s Tip” deformity characterized by elbow extension, medial rotation of the arm, forearm pronation, and wrist flexion. Management of Erb-Duchenne paralysis may involve strengthening exercises, range of motion exercises, manual therapy, and neuromuscular electrical stimulation. However, in most cases, the diagnosis of Erb-Duchenne paralysis is not detected early enough for rehabilitation outcomes to be maximized. We herein report a case of a 6-months old child who had Erb-Duchenne paralysis in the left upper limb. The aim of this case report is to highlight the importance of early detection and rehabilitation of Erb-Duchenne paralysis. Furthermore, the report also discusses the physiotherapy techniques that can be used to optimize outcomes.
{"title":"Early detection and rehabilitation in Erb-Duchenne paralysis before age 1 year: A Case Report From Lusaka Zambia","authors":"Fair Banji Mwiinga, Roster Chihwaka Malimba, Mutinta Mirriam Nzima, Billiat Chongo, Faith Banda Malambo, Hope Chisoya, Joan Tembo, Edward Sakala","doi":"10.55320/mjz.50.2.353","DOIUrl":"https://doi.org/10.55320/mjz.50.2.353","url":null,"abstract":"Erb-Duchenne paralysis is a neurological condition characterized by paralysis of the arm which occurs due to injury of the upper trunk of C5-C6 of the brachial plexus and can lead to disturbances in movement and sensation. Erb-Duchenne paralysis commonly presents with a “Waiter’s Tip” deformity characterized by elbow extension, medial rotation of the arm, forearm pronation, and wrist flexion. Management of Erb-Duchenne paralysis may involve strengthening exercises, range of motion exercises, manual therapy, and neuromuscular electrical stimulation. However, in most cases, the diagnosis of Erb-Duchenne paralysis is not detected early enough for rehabilitation outcomes to be maximized. We herein report a case of a 6-months old child who had Erb-Duchenne paralysis in the left upper limb. The aim of this case report is to highlight the importance of early detection and rehabilitation of Erb-Duchenne paralysis. Furthermore, the report also discusses the physiotherapy techniques that can be used to optimize outcomes.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":" December","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139136830","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}
Background: Enhanced recovery after surgery (ERAS), with its aim of reducing operative stress and accelerating rehabilitation, became a standard perioperative care in multiple surgical specialties in developed world. However, little is known about the implementation of the fast-track pathways in a low-resource environment. The objective of the study was to describe our experience and share lessons obtained in using ERAS protocol in general surgery patients. Methods: In this descriptive study, all consecutive patients with no age restrictions undergoing elective and urgent abdominal surgery were assessed for inclusion in ERAS program. A retrospective analysis encompasses 98 patients aged two weeks to 87 years with male to female ratio of 2.3:1. Outcomes were functional recovery, postoperative complications, and length of hospital stay. Results: All elements of ERAS protocol including minimal incision length laparotomy and accelerated postoperative care were used; however, certain components were modified depending on the availability of the resources and patient’s condition. Postoperative period complicated in 17.4% of cases, seven patients (7.4%) died after urgent operations, and no mortality was recorded after elective procedures. Median length of stay was 4.0 days. Local and systemic septic complications, paralytic ileus and performing of the stoma reversal procedure during the same hospital stay were reasons for delayed discharge. Conclusion: This study indicates that employment of ERAS program for general surgery population at a second level hospital is feasible and safe. Further larger-scale studies are needed.
{"title":"Implementation of Enhanced Recovery after Surgery at a General hospital in Zambia","authors":"S. Karachentsev","doi":"10.55320/mjz.50.2.419","DOIUrl":"https://doi.org/10.55320/mjz.50.2.419","url":null,"abstract":"Background: Enhanced recovery after surgery (ERAS), with its aim of reducing operative stress and accelerating rehabilitation, became a standard perioperative care in multiple surgical specialties in developed world. However, little is known about the implementation of the fast-track pathways in a low-resource environment. The objective of the study was to describe our experience and share lessons obtained in using ERAS protocol in general surgery patients. Methods: In this descriptive study, all consecutive patients with no age restrictions undergoing elective and urgent abdominal surgery were assessed for inclusion in ERAS program. A retrospective analysis encompasses 98 patients aged two weeks to 87 years with male to female ratio of 2.3:1. Outcomes were functional recovery, postoperative complications, and length of hospital stay. Results: All elements of ERAS protocol including minimal incision length laparotomy and accelerated postoperative care were used; however, certain components were modified depending on the availability of the resources and patient’s condition. Postoperative period complicated in 17.4% of cases, seven patients (7.4%) died after urgent operations, and no mortality was recorded after elective procedures. Median length of stay was 4.0 days. Local and systemic septic complications, paralytic ileus and performing of the stoma reversal procedure during the same hospital stay were reasons for delayed discharge. Conclusion: This study indicates that employment of ERAS program for general surgery population at a second level hospital is feasible and safe. Further larger-scale studies are needed.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":" 32","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139138295","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. Bwanga, Ncheebe Sindaza, Malunga Chipulu, Patrick Mwenga Kinda, Joseph Mulenga
Orthopaedic theatre radiography plays a critical role in the treatment of bone injuries and joint diseases. Fluoroscopic imaging using a mobile image intensifier (C-arm) is required to aid in trauma orthopaedic surgery. Plain X-rays using a mobile X-ray machine are also required for non-trauma corrective orthopaedic surgery. In Zambia, there are an increase in the use of motor vehicles and associated road traffic accident (RTA) injuries. Assaults and falls are other common mechanisms of trauma injuries reported in Zambia. The growing number of trauma patients puts a strain on trauma and orthopaedic services, particularly theatre radiography. Most trauma patients require surgical treatment of their bone injuries. However, in terms of establishing a well-organised trauma and orthopaedic healthcare system in the country, less emphasis has been paid to this problem. As a result, theatre radiography is similarly underdeveloped. This review aimed to assess orthopaedic theatre radiography services and raise awareness among stakeholders on this important topic in Zambia. As the country's planned improved orthopaedic services evolve, the radiography profession must begin bolstering training and advocating for more theatre radiography equipment.
骨科手术室放射成像在治疗骨伤和关节疾病方面发挥着至关重要的作用。创伤骨科手术需要使用移动式图像增强器（C 型臂）进行透视成像。非创伤矫形外科手术也需要使用移动 X 光机进行普通 X 光检查。在赞比亚，机动车的使用和相关的道路交通事故（RTA）伤害有所增加。袭击和跌倒是赞比亚报告的其他常见创伤机制。越来越多的外伤病人给外伤和矫形服务带来了压力，尤其是放射科。大多数外伤病人的骨伤需要手术治疗。然而，在该国建立组织完善的创伤和骨科医疗保健系统方面，对这一问题的重视程度较低。因此，手术室放射摄影也同样发展不足。本次审查旨在评估骨科手术室放射成像服务，并提高赞比亚利益相关者对这一重要问题的认识。随着赞比亚计划改善骨科服务的发展，放射摄影专业必须开始加强培训，并倡导增加手术室放射摄影设备。
{"title":"A Review of Orthopaedic Theatre Radiography Services in Zambia","authors":"O. Bwanga, Ncheebe Sindaza, Malunga Chipulu, Patrick Mwenga Kinda, Joseph Mulenga","doi":"10.55320/mjz.50.2.351","DOIUrl":"https://doi.org/10.55320/mjz.50.2.351","url":null,"abstract":"Orthopaedic theatre radiography plays a critical role in the treatment of bone injuries and joint diseases. Fluoroscopic imaging using a mobile image intensifier (C-arm) is required to aid in trauma orthopaedic surgery. Plain X-rays using a mobile X-ray machine are also required for non-trauma corrective orthopaedic surgery. In Zambia, there are an increase in the use of motor vehicles and associated road traffic accident (RTA) injuries. Assaults and falls are other common mechanisms of trauma injuries reported in Zambia. The growing number of trauma patients puts a strain on trauma and orthopaedic services, particularly theatre radiography. Most trauma patients require surgical treatment of their bone injuries. However, in terms of establishing a well-organised trauma and orthopaedic healthcare system in the country, less emphasis has been paid to this problem. As a result, theatre radiography is similarly underdeveloped. This review aimed to assess orthopaedic theatre radiography services and raise awareness among stakeholders on this important topic in Zambia. As the country's planned improved orthopaedic services evolve, the radiography profession must begin bolstering training and advocating for more theatre radiography equipment.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":" 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139138609","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. Nawa, Khumbuso Elizabeth Phiri, C. Sialubanje, B. Hamainza, Japhet Chiwaula
Introduction: Prompt diagnosis and appropriate treatment of fever can prevent severe disease and mortality. Delayed diagnosis and treatment of infections contribute significantly to the high under-five mortality ratio, especially in sub-Saharan Africa. This study assessed the prevalence and associated factors to prompt diagnosis and treatment of fever among under-five children in Zambia. Methods: The study used secondary data from the Malaria Indicator Survey of 2021. Descriptive statistics using measures of frequencies, medians and interquartile ranges were done, and cross-tabulations and logistic regression were used to assess measures of association. The significance level was set at a P-value of 0.05 and a confidence level of 95%. The data was analysed in STATA 14. Results: A total of 3003 under-five children were included; 728 (19.5%) had a fever in the two weeks preceding the survey. The prevalence of prompt health-seeking behaviour was 57.3%, which raises concerns that 42.7% of the children with fever did not have prompt treatment within the same or the next day of fever onset. Male sex aOR = 1.52 (95%CI 1.10 – 2.12) and the use of IRS aOR 1.8(1.30 – 2.50) were associated with increased odds of prompt health-seeking behaviour. Conclusion: This study found that the prevalence of fever among under-five children in Zambia was comparable to other sub-Saharan African countries. Health-seeking behaviour among children with fever was sub-optimal, as a considerable proportion did not seek treatment. Factors associated with health-seeking behaviour among children with fever included sex and staying in a house with indoor residual spraying.
{"title":"Prevalence and Factors Associated with Prompt Diagnosis and Treatment of Fever among Under-five Children in Zambia; Evidence from a Country-wide Cross-Sectional Survey.","authors":"M. Nawa, Khumbuso Elizabeth Phiri, C. Sialubanje, B. Hamainza, Japhet Chiwaula","doi":"10.55320/mjz.50.2.398","DOIUrl":"https://doi.org/10.55320/mjz.50.2.398","url":null,"abstract":"Introduction: Prompt diagnosis and appropriate treatment of fever can prevent severe disease and mortality. Delayed diagnosis and treatment of infections contribute significantly to the high under-five mortality ratio, especially in sub-Saharan Africa. This study assessed the prevalence and associated factors to prompt diagnosis and treatment of fever among under-five children in Zambia. Methods: The study used secondary data from the Malaria Indicator Survey of 2021. Descriptive statistics using measures of frequencies, medians and interquartile ranges were done, and cross-tabulations and logistic regression were used to assess measures of association. The significance level was set at a P-value of 0.05 and a confidence level of 95%. The data was analysed in STATA 14. Results: A total of 3003 under-five children were included; 728 (19.5%) had a fever in the two weeks preceding the survey. The prevalence of prompt health-seeking behaviour was 57.3%, which raises concerns that 42.7% of the children with fever did not have prompt treatment within the same or the next day of fever onset. Male sex aOR = 1.52 (95%CI 1.10 – 2.12) and the use of IRS aOR 1.8(1.30 – 2.50) were associated with increased odds of prompt health-seeking behaviour. Conclusion: This study found that the prevalence of fever among under-five children in Zambia was comparable to other sub-Saharan African countries. Health-seeking behaviour among children with fever was sub-optimal, as a considerable proportion did not seek treatment. Factors associated with health-seeking behaviour among children with fever included sex and staying in a house with indoor residual spraying.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":" 32","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139139281","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：