Lumamba Mubbunu, Edwell Mwaanga, Bernard Hang'ombe, S. Siziya, Humphrey Simukoko
Background: Respiratory mucosal surface is continuously exposed to inhaled pathogens, and a protective layer of secreted mucus acts as the first line of defense against infection through a mechanism called mucociliary clearance. Mucus hypersecretion can negatively affect mucociliary clearance. Although ARBs and ACEIs are associated with induction of cough and angioedema as their side effects, no studies were found that show the effects of these drugs on Mucin-5ac, Mucin-5b, and Forkhead box protein A2. Mucin-5ac and mucin-5b are the main mucins in respiratory mucus and the viscoelasticity properties of respiratory mucus depends on them. Methods: This study used a hamster as an animal model to investigate the effects of ARB and ACEI on respiratory mucin-5ac, mucin-5b, and Forkhead box protein A2. Enalapril and Losartan were used as representative drugs for ACEIs and ARBs, respectively. The concentrations of mucin-5ac, mucin-5b, and Forkhead box protein a2 were measured using ELISA. Dunnet’s t-test was used to analyze the results. Results: Enalapril and Losartan increased mucin-5ac and mucin-5b, but the increase was not significant compared to the control (p > 0.05). However, enalapril and Losartan decreased the concentration of Forkhead box protein a2, but the decrease was not significant compared to the control (p > 0.05). Conclusions: The study found that, administration of enalapril or losartan did not have a significant effect on the concentration of Mucin-5ac, Mucin-5b, and Forkhead box protein A2. Therefore, the administration of these drugs will not reduce mucociliary clearance of the respiratory tract through the impairment of mucus production.
{"title":"Effects of angiotensin receptor blockers and angiotensin-converting enzyme inhibitors on respiratory Mucin-5ac, Mucin-C5b and Forkhead box protein-A2 of a hamster tracheal mucosa.","authors":"Lumamba Mubbunu, Edwell Mwaanga, Bernard Hang'ombe, S. Siziya, Humphrey Simukoko","doi":"10.55320/mjz.50.1.386","DOIUrl":"https://doi.org/10.55320/mjz.50.1.386","url":null,"abstract":"Background: Respiratory mucosal surface is continuously exposed to inhaled pathogens, and a protective layer of secreted mucus acts as the first line of defense against infection through a mechanism called mucociliary clearance. Mucus hypersecretion can negatively affect mucociliary clearance. Although ARBs and ACEIs are associated with induction of cough and angioedema as their side effects, no studies were found that show the effects of these drugs on Mucin-5ac, Mucin-5b, and Forkhead box protein A2. Mucin-5ac and mucin-5b are the main mucins in respiratory mucus and the viscoelasticity properties of respiratory mucus depends on them.\u0000Methods: This study used a hamster as an animal model to investigate the effects of ARB and ACEI on respiratory mucin-5ac, mucin-5b, and Forkhead box protein A2. Enalapril and Losartan were used as representative drugs for ACEIs and ARBs, respectively. The concentrations of mucin-5ac, mucin-5b, and Forkhead box protein a2 were measured using ELISA. Dunnet’s t-test was used to analyze the results.\u0000Results: Enalapril and Losartan increased mucin-5ac and mucin-5b, but the increase was not significant compared to the control (p > 0.05). However, enalapril and Losartan decreased the concentration of Forkhead box protein a2, but the decrease was not significant compared to the control (p > 0.05). \u0000Conclusions: The study found that, administration of enalapril or losartan did not have a significant effect on the concentration of Mucin-5ac, Mucin-5b, and Forkhead box protein A2. Therefore, the administration of these drugs will not reduce mucociliary clearance of the respiratory tract through the impairment of mucus production.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"74 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138606393","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}
Tumelo Muyenga, Dominion Samuel K Bamitale, Dan Kibuule, C. Hikaambo, Mutenta N Nyambe, Christian Ezeala
Background: Traditional medicine is gaining traction in Africa. 92.1% of diabetes patients at the University Teaching Hospital in Zambia use herbal medicine. Kigelia africana is a botanical species used in traditional medicine for diabetes due to its phytochemical composition. This study aimed to determine the phytoconstituents, radical scavenging activities, total flavonoid concentration, and total phenolic content of the antidiabetic bioactive Kigelia africana fruit fractions. Methods: Using UV spectrophotometer we determined the total phenolic content (TPC), total flavonoid content (TFC) and free radical scavenging activity. Alloxan-induced diabetes rat models were used to determine the antidiabetic effect in vivo. Phytoconstituent analysis was via gas-chromatography Mass spectrophotometry (GC-MS) Results: The ethyl acetate fraction demonstrated superior antidiabetic activity, reducing blood glucose levels from 28.42±2.7 mmol/l to 8.16±4.4 mmol/l. Statistical analysis showed no significant difference between the ethyl acetate fraction and Glibenclamide,(p=0.152). Although the ethyl acetate fraction had a higher reading, there was no statistically significant difference found in Total Phenolic content (TPC) (p=0.3) and Total Flavonoid content (TFC) (p=0.06). IC50 values for DPPH were 0.05330 (chloroform), 0.05352 (ethyl acetate), and 0.4013 (butanol). GC-MS analysis revealed the presence of important fatty acids, methyl furfural, furan carboxylic acid and 4-pyran-4-one derivatives. Conclusion: The GC-MS fingerprint of the antidiabetic fractions revealed important fatty acids and phenolic compounds that could be attributed to the observed antidiabetic activity.
{"title":"Antidiabetic, and radical scavenging activity of Kigelia africana fruit fractions.","authors":"Tumelo Muyenga, Dominion Samuel K Bamitale, Dan Kibuule, C. Hikaambo, Mutenta N Nyambe, Christian Ezeala","doi":"10.55320/mjz.50.1.376","DOIUrl":"https://doi.org/10.55320/mjz.50.1.376","url":null,"abstract":"Background: Traditional medicine is gaining traction in Africa. 92.1% of diabetes patients at the University Teaching Hospital in Zambia use herbal medicine. Kigelia africana is a botanical species used in traditional medicine for diabetes due to its phytochemical composition. This study aimed to determine the phytoconstituents, radical scavenging activities, total flavonoid concentration, and total phenolic content of the antidiabetic bioactive Kigelia africana fruit fractions. \u0000Methods: Using UV spectrophotometer we determined the total phenolic content (TPC), total flavonoid content (TFC) and free radical scavenging activity. Alloxan-induced diabetes rat models were used to determine the antidiabetic effect in vivo. Phytoconstituent analysis was via gas-chromatography Mass spectrophotometry (GC-MS) \u0000Results: The ethyl acetate fraction demonstrated superior antidiabetic activity, reducing blood glucose levels from 28.42±2.7 mmol/l to 8.16±4.4 mmol/l. Statistical analysis showed no significant difference between the ethyl acetate fraction and Glibenclamide,(p=0.152). Although the ethyl acetate fraction had a higher reading, there was no statistically significant difference found in Total Phenolic content (TPC) (p=0.3) and Total Flavonoid content (TFC) (p=0.06). IC50 values for DPPH were 0.05330 (chloroform), 0.05352 (ethyl acetate), and 0.4013 (butanol). GC-MS analysis revealed the presence of important fatty acids, methyl furfural, furan carboxylic acid and 4-pyran-4-one derivatives. \u0000Conclusion: The GC-MS fingerprint of the antidiabetic fractions revealed important fatty acids and phenolic compounds that could be attributed to the observed antidiabetic activity.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"49 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138606424","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}
Andrew Chisanga, Evans Mpabalwani, Aaron Nyirenda, D. Banda, C. Chabala
Background: Tuberculous Lymphadenitis (TBL) is the commonest form of Extra Pulmonary TB and poses diagnostic challenges in setting with no access to Histopathology. Our goal was to evaluate the diagnostic yield of Xpert MTB Ultra performed on lymph node aspirate obtained using Fine Needle Aspiration (FNA) in children with suspected TBL. Methods: This was a cross-sectional study conducted at a tertiary and main referral hospital in Zambia. Children aged 6 months to 15 years with lymphadenopathy and presumed TBL were enrolled. FNA was performed and lymph node aspirate samples were analysed using XPERT MTB/RIF ULTRA. Data was collected and analysed as frequencies and percentages. Logistic regression was used to measure the odds of testing positive for MTB. Results: Sixty one children were enrolled in the study, 34(55.7%) were males and a median age of 6 years (IQR: 3-11 years). Sixteen (26%) were diagnosed with TB, 7 on clinical basis while, one was positive on gastric lavage, five (31%) were positive for TB on lymph node FNA using Xpert MTB/RIF Ultra. Then, 3 were positive Histopathology, with one also positive on XPERT MTB/RIF Ultra. Alternative diagnosis included malignancies like lymphomas and acute Leukemias. While non malignant lymphadenopathy included, benign reactive lymphadenopathy and HIV associated lymphadenopathy. The prevalence of HIV among the children diagnosed with TB was 37.5% (6/16). Thirty one percent (5/16) of children with TB had a close contact with TB, OR=9.0 (95% CI: 1.3-77, p-value (<0.05). Conclusion: TBL is not uncommon in children presenting with Lymphadenopathy. FNA is a less invasive, inexpensive technique and coupled with use of Xpert MTB/RIF Ultra has potential for early diagnosis of TBL, in a low resource setting with limited Histopathology services.
{"title":"Evaluation of Fine Needle Aspiration for diagnosis of Tuberculous Lymphadenitis in Children using the Xpert MTB/RIF Ultra at the University Teaching Hospitals Children’s Hospital, Lusaka, Zambia","authors":"Andrew Chisanga, Evans Mpabalwani, Aaron Nyirenda, D. Banda, C. Chabala","doi":"10.55320/mjz.49.4.387","DOIUrl":"https://doi.org/10.55320/mjz.49.4.387","url":null,"abstract":"Background: Tuberculous Lymphadenitis (TBL) is the commonest form of Extra Pulmonary TB and poses diagnostic challenges in setting with no access to Histopathology. Our goal was to evaluate the diagnostic yield of Xpert MTB Ultra performed on lymph node aspirate obtained using Fine Needle Aspiration (FNA) in children with suspected TBL. Methods: This was a cross-sectional study conducted at a tertiary and main referral hospital in Zambia. Children aged 6 months to 15 years with lymphadenopathy and presumed TBL were enrolled. FNA was performed and lymph node aspirate samples were analysed using XPERT MTB/RIF ULTRA. Data was collected and analysed as frequencies and percentages. Logistic regression was used to measure the odds of testing positive for MTB. Results: Sixty one children were enrolled in the study, 34(55.7%) were males and a median age of 6 years (IQR: 3-11 years). Sixteen (26%) were diagnosed with TB, 7 on clinical basis while, one was positive on gastric lavage, five (31%) were positive for TB on lymph node FNA using Xpert MTB/RIF Ultra. Then, 3 were positive Histopathology, with one also positive on XPERT MTB/RIF Ultra. Alternative diagnosis included malignancies like lymphomas and acute Leukemias. While non malignant lymphadenopathy included, benign reactive lymphadenopathy and HIV associated lymphadenopathy. The prevalence of HIV among the children diagnosed with TB was 37.5% (6/16). Thirty one percent (5/16) of children with TB had a close contact with TB, OR=9.0 (95% CI: 1.3-77, p-value (<0.05). Conclusion: TBL is not uncommon in children presenting with Lymphadenopathy. FNA is a less invasive, inexpensive technique and coupled with use of Xpert MTB/RIF Ultra has potential for early diagnosis of TBL, in a low resource setting with limited Histopathology services.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139273724","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: Breast ironing, also known as breast flattening, is a practice that involves the use of an object to massage, press, or pound the breast. This practice is usually performed on girls, between the ages of 9 and 15 years The known effects of breast ironing are self-reported symptoms or signs of breast ironing by the victims. This study aims to investigate the prevalence, awareness, and adverse outcomes of Cameroonian women towards breast ironing. Methods: A mixed method design involving qualitative and cross-sectional study among women aged 18years and above. The primary outcome variable was previous experience of breast ironing. Log-binomial model was used to determine effects of breast-ironing on selected reproductive health outcomes. Results: Of 160 women interviewed, 22 (14%) had experienced breast ironing. The mean age was 26±4.62 years. All participants were aware of breast ironing. There were significant associations between being a victim of breast ironing and parity, breast symmetry, nipple anatomy, breast pain, milk quantity during lactation, breast sagging. The risk of reporting breast ironing was higher among women who experienced breast sagging earlier than expected, women who reported breast pain and women whose breasts had marked asymmetry. Conclusion: Breast ironing is prevalent in the Buea health district of Cameroon, and victims are more likely to experience adverse breast outcomes. Health education and introduction of legislation against breast ironing will go a long way to eliminate this harmful traditional practice. More studies will help to further understand drivers of breast ironing in other regions of Cameroon.
{"title":"Prevalence, Awareness And Adverse Outcomes Of Breast Ironing Among Cameroonian Women In Buea Health District","authors":"Mela Fotabong, Gbolahan Obajimi, Temitayo Lawal, Imran Morhason-Bello","doi":"10.55320/mjz.49.4.391","DOIUrl":"https://doi.org/10.55320/mjz.49.4.391","url":null,"abstract":"Background: Breast ironing, also known as breast flattening, is a practice that involves the use of an object to massage, press, or pound the breast. This practice is usually performed on girls, between the ages of 9 and 15 years The known effects of breast ironing are self-reported symptoms or signs of breast ironing by the victims. This study aims to investigate the prevalence, awareness, and adverse outcomes of Cameroonian women towards breast ironing. Methods: A mixed method design involving qualitative and cross-sectional study among women aged 18years and above. The primary outcome variable was previous experience of breast ironing. Log-binomial model was used to determine effects of breast-ironing on selected reproductive health outcomes. Results: Of 160 women interviewed, 22 (14%) had experienced breast ironing. The mean age was 26±4.62 years. All participants were aware of breast ironing. There were significant associations between being a victim of breast ironing and parity, breast symmetry, nipple anatomy, breast pain, milk quantity during lactation, breast sagging. The risk of reporting breast ironing was higher among women who experienced breast sagging earlier than expected, women who reported breast pain and women whose breasts had marked asymmetry. Conclusion: Breast ironing is prevalent in the Buea health district of Cameroon, and victims are more likely to experience adverse breast outcomes. Health education and introduction of legislation against breast ironing will go a long way to eliminate this harmful traditional practice. More studies will help to further understand drivers of breast ironing in other regions of Cameroon.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139274511","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}
A case of fatal hyperthermia in a military personnel is reported. It highlights the health hazards of over exposure to hot temperatures. A clinico-pathological aspect of the topic is discussed.
{"title":"Mad Dogs and Englishmen - A case of fatal hyperthermia in military personnel","authors":"Dr K Saasa, K. Saasa¹, Mss Patel²","doi":"10.55320/mjz.49.4.394","DOIUrl":"https://doi.org/10.55320/mjz.49.4.394","url":null,"abstract":"A case of fatal hyperthermia in a military personnel is reported. It highlights the health hazards of over exposure to hot temperatures. A clinico-pathological aspect of the topic is discussed.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139275136","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}
A. Danladi, Y. Aremu-Kasumu, Kabiru B. Sada, Olaniyi T. Fasanu, Sikiru A. Yusuf
Introduction: Women with gestational diabetes mellitus (GDM) are at an increased risk of adverse perinatal and maternal morbidities and mortalities. Hence, early detection and management of this condition is vital to ensure a good outcome for both mother and baby. Aim: The aim of the study is to determine the prevalence and associated risk factors for GDM among antenatal attendees in Federal Medical Centre Gusau (FMCG), Zamfara state, Nigeria. Methods: A descriptive cross-sectional study was carried out. Screening was done between 24 and 28-weeks gestational age with a 75g oral glucose tolerance test (OGTT). Plasma glucose measurements was performed using the glucose oxidase method. GDM was diagnosed according to the 2013 WHO diagnostic criteria. Data were collected using a proforma and analyzed using the Statistical Package for Social Sciences (SPSS) Version 26. Descriptive data were presented in frequency tables. Statistical testing using Chi-square, and multivariate analysis (Odd ratio and CI) were carried out with a level of significance set as P< 0.05. Results: One hundred and thirty-six women between the gestational ages of 24-28 weeks were recruited. The mean age of the participants was 25.9±5.4 years. The prevalence of GDM was found to be 16.9%. Fasting blood glucose alone correctly diagnosed 87% of the patients. Previous history of macrosomic babies (≥4kg) and history of GDM in previous pregnancies were significantly associated with GDM. Conclusion: The prevalence of GDM is high among antenatal attendees in Federal Medical center, Gusau.
{"title":"Gestational Diabetes Mellitus among women attending antenatal clinic in a Tertiary Hospital in Northern Nigeria","authors":"A. Danladi, Y. Aremu-Kasumu, Kabiru B. Sada, Olaniyi T. Fasanu, Sikiru A. Yusuf","doi":"10.55320/mjz.49.4.389","DOIUrl":"https://doi.org/10.55320/mjz.49.4.389","url":null,"abstract":"Introduction: Women with gestational diabetes mellitus (GDM) are at an increased risk of adverse perinatal and maternal morbidities and mortalities. Hence, early detection and management of this condition is vital to ensure a good outcome for both mother and baby. Aim: The aim of the study is to determine the prevalence and associated risk factors for GDM among antenatal attendees in Federal Medical Centre Gusau (FMCG), Zamfara state, Nigeria. Methods: A descriptive cross-sectional study was carried out. Screening was done between 24 and 28-weeks gestational age with a 75g oral glucose tolerance test (OGTT). Plasma glucose measurements was performed using the glucose oxidase method. GDM was diagnosed according to the 2013 WHO diagnostic criteria. Data were collected using a proforma and analyzed using the Statistical Package for Social Sciences (SPSS) Version 26. Descriptive data were presented in frequency tables. Statistical testing using Chi-square, and multivariate analysis (Odd ratio and CI) were carried out with a level of significance set as P< 0.05. Results: One hundred and thirty-six women between the gestational ages of 24-28 weeks were recruited. The mean age of the participants was 25.9±5.4 years. The prevalence of GDM was found to be 16.9%. Fasting blood glucose alone correctly diagnosed 87% of the patients. Previous history of macrosomic babies (≥4kg) and history of GDM in previous pregnancies were significantly associated with GDM. Conclusion: The prevalence of GDM is high among antenatal attendees in Federal Medical center, Gusau.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"47 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139271530","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}
Olakunle Olawole Oloko, O. Ogunbode, Gbolahan Obajimi, Ayodele Arowojolu
Objectives: To compare the efficacy of 24hour versus 48hour prophylaxis of amoxicillin/clavulanic acid in the prevention of postoperative infections. Study Design: This study was a randomized controlled clinical trial conducted in a tertiary hospital in Ibadan, Nigeria. Two hundred and fifty -two pregnant women scheduled for elective caesarean section were randomly assigned into two groups. After the initial pre-incision antibiotic administration, group A received the Amoxicillin/Clavulanic Acid for 24 hours while group B received the same drug for 48hours. Main Outcomes: Participants were examined on the 3rd, 10th and 17th post-operative days for evidence of infections. All entry and analysis of data was by computer using the Statistical Package for Social Sciences version 22 (IBM, New York). Statistically significant differences were determined at p value of < 0.05. Results: The incidence of postoperative wound infection, postoperative fever and endometritis in this study was 5.2%, 9.1% and 5.6% respectively. There was no significant differences in the incidence of postoperative wound infection, postoperative fever and endometritis between the two regimens of antibiotics. Conclusion: A 24-hour prophylactic regimen of amoxicillin/clavulanic acid is adequate following caesarean section and prolonged use of antibiotics is generally unnecessary, costly and inadvertently increases antibiotics resistance
{"title":"A Comparative Review of the Efficacy of 24-HourVersus 48-Hour Dose Regimen of Amoxicillin/Clavulanic Acid Prophylaxis forpostoperative infections following elective Caesarean Section at the University College Hospital, Ibadan, Nigeria: A Randomized Clinical Trial","authors":"Olakunle Olawole Oloko, O. Ogunbode, Gbolahan Obajimi, Ayodele Arowojolu","doi":"10.55320/mjz.49.4.388","DOIUrl":"https://doi.org/10.55320/mjz.49.4.388","url":null,"abstract":"Objectives: To compare the efficacy of 24hour versus 48hour prophylaxis of amoxicillin/clavulanic acid in the prevention of postoperative infections. Study Design: This study was a randomized controlled clinical trial conducted in a tertiary hospital in Ibadan, Nigeria. Two hundred and fifty -two pregnant women scheduled for elective caesarean section were randomly assigned into two groups. After the initial pre-incision antibiotic administration, group A received the Amoxicillin/Clavulanic Acid for 24 hours while group B received the same drug for 48hours. Main Outcomes: Participants were examined on the 3rd, 10th and 17th post-operative days for evidence of infections. All entry and analysis of data was by computer using the Statistical Package for Social Sciences version 22 (IBM, New York). Statistically significant differences were determined at p value of < 0.05. Results: The incidence of postoperative wound infection, postoperative fever and endometritis in this study was 5.2%, 9.1% and 5.6% respectively. There was no significant differences in the incidence of postoperative wound infection, postoperative fever and endometritis between the two regimens of antibiotics. Conclusion: A 24-hour prophylactic regimen of amoxicillin/clavulanic acid is adequate following caesarean section and prolonged use of antibiotics is generally unnecessary, costly and inadvertently increases antibiotics resistance","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139274569","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, Ernest Chanda, Edward Mwansa, Billy Nkoloma
Fluoroscopic imaging services in Zambia have been available since 1972 when the first equipment was installed at the University Teaching Hospital (UTH). However, there is limited fluoroscopy equipment use due to a critical shortage of radiologists who are traditionally trained to carry out this role. Radiologists work alongside radiographers who provide technical support and patient care. To address the shortage of radiologists, radiographers in the United Kingdom (UK) have explicitly expanded their scope of practice and started performing and reporting on fluoroscopic examinations such as barium swallow, barium meal, small bowel follow-through, barium enema, and videofluoroscopy after undergoing appropriate training. Literature from the UK shows that gastrointestinal (GI) radiographers’ performance is of a high-quality standard. The initiative has been very effective and made a significant contribution to the delivery of fluoroscopic services in that country. Therefore, the aim of this article was to review the literature on role extension for GI radiographers to guide the development and practice of fluoroscopic studies in Zambia. It is anticipated that this article will bring awareness to stakeholders such as the Ministry of Health (MOH), Schools of Radiography, the Radiological Society of Zambia (RSZ), and the Zambia Medical Association (ZMA) on this important subject.
{"title":"Changing Roles of a Radiographer in Fluoroscopy:","authors":"O. Bwanga, Ernest Chanda, Edward Mwansa, Billy Nkoloma","doi":"10.55320/mjz.49.4.393","DOIUrl":"https://doi.org/10.55320/mjz.49.4.393","url":null,"abstract":"Fluoroscopic imaging services in Zambia have been available since 1972 when the first equipment was installed at the University Teaching Hospital (UTH). However, there is limited fluoroscopy equipment use due to a critical shortage of radiologists who are traditionally trained to carry out this role. Radiologists work alongside radiographers who provide technical support and patient care. To address the shortage of radiologists, radiographers in the United Kingdom (UK) have explicitly expanded their scope of practice and started performing and reporting on fluoroscopic examinations such as barium swallow, barium meal, small bowel follow-through, barium enema, and videofluoroscopy after undergoing appropriate training. Literature from the UK shows that gastrointestinal (GI) radiographers’ performance is of a high-quality standard. The initiative has been very effective and made a significant contribution to the delivery of fluoroscopic services in that country. Therefore, the aim of this article was to review the literature on role extension for GI radiographers to guide the development and practice of fluoroscopic studies in Zambia. It is anticipated that this article will bring awareness to stakeholders such as the Ministry of Health (MOH), Schools of Radiography, the Radiological Society of Zambia (RSZ), and the Zambia Medical Association (ZMA) on this important subject.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"32 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139274223","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: Patient Satisfaction is defined as the individual’s positive evaluation of a distinct dimension of care. Satisfaction is positive when the perception of the care given meets pateints’ level of expectation. The ideal anaesthesia for ambulatory procedures should provide a rapid and smooth onset of action, good intraoperative analgesia, good operating condition, short recovery time free from side effect and high level of patient satisfaction. Patient satisfaction is a vital part of assessing quality of care, and different instruments have been developed to measure it without a consensus on an ideal one. Achieving high satisfaction among patients that undergo day case gynaecological procedures under spinal would promote the acceptance of this anaesthetic technique in our locality. Method: This was an observational prospective study in which ninety (90) patients aged 18 – 45 years with ASA class I or II scheduled for day case gynaecological procedures were recruited. Spinal anaesthesia was given in sitting position using a range of 7.5mg to 10mg of 0.5% hyperbaric bupivacaine. The procedures lasted less than one (1) hour, during which the haemodynamic parameters (SBP, DBP MAP Pulse rate, and Spo2) were monitored continually. Patients were discharged home on the same day of procedure. Two days following the procedure, a structured questionnaire on patient’s satisfaction level was administered via phone call and data collected included satisfaction with explanation of the anaesthesia for the procedure, postoperative complications and overall level of satisfaction, and acceptance of spinal anaesthesia in the future. Results: Outcome showed that 88 patients (97.8%) were overall satisfied with the use of spinal anaesthesia for Day case gynaecological procedures and 2 patients (2.2%) were not satisfied with the anaesthetic technique used for the procedure. All the patients accepted to use spinal anaesthesia for similar procedure in the future.
背景：病人满意度的定义是个人对护理的某一不同方面的积极评价。当患者对所提供的护理服务的感知达到其期望水平时，其满意度就是正面的。理想的非卧床手术麻醉应该是起效迅速、平稳，术中镇痛效果好，手术条件好，恢复时间短，无副作用，病人满意度高。患者满意度是评估医疗质量的重要组成部分，目前已开发出不同的测量工具，但尚未就理想的测量工具达成共识。如果在脊柱麻醉下进行日间妇科手术的患者满意度较高，将促进该麻醉技术在本地的接受度。研究方法这是一项前瞻性观察研究，共招募了 90 名年龄在 18-45 岁之间、ASA 分级为 I 级或 II 级、计划接受日间妇科手术的患者。患者采取坐位，使用7.5毫克至10毫克的0.5%高压布比卡因进行脊柱麻醉。手术持续时间不到一（1）小时，在此期间持续监测血流动力学参数（SBP、DBP、MAP 脉搏率和 Spo2）。患者在手术当天出院回家。术后两天，通过电话对患者的满意度进行了结构化问卷调查，收集的数据包括对手术麻醉解释的满意度、术后并发症和总体满意度，以及今后对脊髓麻醉的接受程度。结果显示结果显示，88 名患者（97.8%）对在日间妇科手术中使用脊髓麻醉总体满意，2 名患者（2.2%）对手术中使用的麻醉技术不满意。所有患者都同意今后在类似手术中使用脊髓麻醉。
{"title":"Patient’s Satisfaction with Use of Spinal Anaesthesia for Day-Case gynaecological procedures","authors":"Nweze Onochie Uchenna, Ebirim Longinus Ndubuisi, Alagbe-Briggs OlubusolaTemitope","doi":"10.55320/mjz.49.4.392","DOIUrl":"https://doi.org/10.55320/mjz.49.4.392","url":null,"abstract":"Background: Patient Satisfaction is defined as the individual’s positive evaluation of a distinct dimension of care. Satisfaction is positive when the perception of the care given meets pateints’ level of expectation. The ideal anaesthesia for ambulatory procedures should provide a rapid and smooth onset of action, good intraoperative analgesia, good operating condition, short recovery time free from side effect and high level of patient satisfaction. Patient satisfaction is a vital part of assessing quality of care, and different instruments have been developed to measure it without a consensus on an ideal one. Achieving high satisfaction among patients that undergo day case gynaecological procedures under spinal would promote the acceptance of this anaesthetic technique in our locality. Method: This was an observational prospective study in which ninety (90) patients aged 18 – 45 years with ASA class I or II scheduled for day case gynaecological procedures were recruited. Spinal anaesthesia was given in sitting position using a range of 7.5mg to 10mg of 0.5% hyperbaric bupivacaine. The procedures lasted less than one (1) hour, during which the haemodynamic parameters (SBP, DBP MAP Pulse rate, and Spo2) were monitored continually. Patients were discharged home on the same day of procedure. Two days following the procedure, a structured questionnaire on patient’s satisfaction level was administered via phone call and data collected included satisfaction with explanation of the anaesthesia for the procedure, postoperative complications and overall level of satisfaction, and acceptance of spinal anaesthesia in the future. Results: Outcome showed that 88 patients (97.8%) were overall satisfied with the use of spinal anaesthesia for Day case gynaecological procedures and 2 patients (2.2%) were not satisfied with the anaesthetic technique used for the procedure. All the patients accepted to use spinal anaesthesia for similar procedure in the future.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"185 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139272463","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}
Complications due to aspiration of barium contrast occur rarely during studies of the digestive tract. While lung tissue can tolerate small amounts of Barium large quantities can exceed the lung’s capacity and consequently lead to death especially, in geriatric patients. Barium contrast can affect pulmonary ventilation and perfusion function, causing dyspnoea, hypoxemia and respiratory failure. We herein report a barium swallow case in which an 82-year-old woman aspirated barium on the first swallow and was diagnosed with Gastroparesis. The history, procedure and patient management are discussed. The purpose of the case report is to add to the existing literature on aspiration cases during barium swallow studies and the outcomes after the aspiration. Furthermore, this case report also highlights a need for extra care when attending to senior patients with dysphagia during barium studies.
{"title":"Aspiration of Barium Contrast by a Geriatric Patient with Gastroparesis","authors":"Shamiso Sharon Chitemamwise, B. Chinene","doi":"10.55320/mjz.49.3.358","DOIUrl":"https://doi.org/10.55320/mjz.49.3.358","url":null,"abstract":"Complications due to aspiration of barium contrast occur rarely during studies of the digestive tract. While lung tissue can tolerate small amounts of Barium large quantities can exceed the lung’s capacity and consequently lead to death especially, in geriatric patients. Barium contrast can affect pulmonary ventilation and perfusion function, causing dyspnoea, hypoxemia and respiratory failure. We herein report a barium swallow case in which an 82-year-old woman aspirated barium on the first swallow and was diagnosed with Gastroparesis. The history, procedure and patient management are discussed. The purpose of the case report is to add to the existing literature on aspiration cases during barium swallow studies and the outcomes after the aspiration. Furthermore, this case report also highlights a need for extra care when attending to senior patients with dysphagia during barium studies.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80005190","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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