Background: Osteoporosis is a global problem with a high prevalence in developed countries and an increasing trend in developing countries. Studies on the incidence of osteoporosis in Zambia are not documented. However, some recent data in other countries have shown an increase in this disease but awareness of this condition is sorely lacking among the population as well as health authorities, making it difficult to determine the extent of the concern in Zambia. Since the prevalence of this disease has not yet been established at the study site, this study aimed to determine the prevalence of osteoporosis among adult patients aged 40 years and above at the University Teaching Hospital (UTH). Methods: This retrospective study involved the retrieving of document data from 76 patients, aged 40 years and above, who had bone mineral density reports. Results: The study results showed that 32.9% of the patients had osteoporosis, 43.4% had osteopenia, while 23.7% had normal bone mass. Among the male patients, 47.6% had osteoporosis while 27.3% had osteoporosis among the females. However, the chi-square results at 5% level of significance showed that both men and women have an equal chance of acquiring osteoporosis (p=0.091). This study also showed a direct association between osteoporosis and age. The study established that the likelihood of being diagnosed with osteoporosis increased with age (p=0.015). Conclusion: These findings show that the prevalence of osteoporosis and its associated factors is quite high among adults above the age of 45 years.
{"title":"Prevalence of Osteoporosis in adults aged 40 years and above at the University Teaching Hospital in Lusaka, Zambia","authors":"Nchimunya Gwaba, Robson Kanongo, Shawn Haluzani, Eugene Nchimunya","doi":"10.55320/mjz.49.3.362","DOIUrl":"https://doi.org/10.55320/mjz.49.3.362","url":null,"abstract":"Background: Osteoporosis is a global problem with a high prevalence in developed countries and an increasing trend in developing countries. Studies on the incidence of osteoporosis in Zambia are not documented. However, some recent data in other countries have shown an increase in this disease but awareness of this condition is sorely lacking among the population as well as health authorities, making it difficult to determine the extent of the concern in Zambia. Since the prevalence of this disease has not yet been established at the study site, this study aimed to determine the prevalence of osteoporosis among adult patients aged 40 years and above at the University Teaching Hospital (UTH). \u0000Methods: This retrospective study involved the retrieving of document data from 76 patients, aged 40 years and above, who had bone mineral density reports. \u0000Results: The study results showed that 32.9% of the patients had osteoporosis, 43.4% had osteopenia, while 23.7% had normal bone mass. Among the male patients, 47.6% had osteoporosis while 27.3% had osteoporosis among the females. However, the chi-square results at 5% level of significance showed that both men and women have an equal chance of acquiring osteoporosis (p=0.091). This study also showed a direct association between osteoporosis and age. The study established that the likelihood of being diagnosed with osteoporosis increased with age (p=0.015). \u0000Conclusion: These findings show that the prevalence of osteoporosis and its associated factors is quite high among adults above the age of 45 years.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84087999","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: Learners’ perception of learning environment reflects educational program’s effectiveness. For new medical schools, determining effectiveness of teaching and learning is desirable quality assurance process. Aim: To determine pioneer medical students’ perception of learning environment of a new school using Dundee Ready Educational Environment Measurement (DREEM). Methods: Quantitative cross-sectional study design was adopted. Consenting medical students in second and third years of Bachelor of Medicine and Surgery degree program were surveyed with a questionnaire comprising a demographic competent and 50 DREEM items. Non-probability sampling was adopted. Completed questionnaires were sorted and rated. The resulting quantitative data were analysed for mean scores with SPSS 21 software. Mean total scores and mean scores in five subscales were determined. Scores on individual items were also analysed. Cronbach’s alpha was used to assess dataset reliability. Results: The study recorded 137 participants, 54.2 % females and 45.8 % males. Mean age was 22 (± 4.03) years. Mean total DREEM score was 117.5 (58.8 %) and interpreted as “more positive than negative.” Scores in subscales of perception of learning, perception of teachers, academic self-perception, and perception of atmosphere, were positive with mean scores of 62.9 %, 60.2 %, 63.4 %, and 55.6, respectively. Subscale of social self-perception rated poorly with mean score of 48.9 % and interpreted as “not a nice place.” Single items revealed five major problem areas: lack of adequate support, authoritarian leadership, over-emphasis on factual learning, poor memorizing, and excessive stress. Conclusion: This analysis revealed major problems and weaknesses in the new school and addressing them could improve educational quality.
{"title":"Assessing a New Medical School in Zambia Using Dundee Ready Educational Environment Measurement: A cross-sectional study","authors":"C. Ezeala, M. Ezeala, W. Zimba","doi":"10.55320/mjz.49.3.359","DOIUrl":"https://doi.org/10.55320/mjz.49.3.359","url":null,"abstract":"Background: Learners’ perception of learning environment reflects educational program’s effectiveness. For new medical schools, determining effectiveness of teaching and learning is desirable quality assurance process. \u0000Aim: To determine pioneer medical students’ perception of learning environment of a new school using Dundee Ready Educational Environment Measurement (DREEM). \u0000Methods: Quantitative cross-sectional study design was adopted. Consenting medical students in second and third years of Bachelor of Medicine and Surgery degree program were surveyed with a questionnaire comprising a demographic competent and 50 DREEM items. Non-probability sampling was adopted. Completed questionnaires were sorted and rated. The resulting quantitative data were analysed for mean scores with SPSS 21 software. Mean total scores and mean scores in five subscales were determined. Scores on individual items were also analysed. Cronbach’s alpha was used to assess dataset reliability. \u0000Results: The study recorded 137 participants, 54.2 % females and 45.8 % males. Mean age was 22 (± 4.03) years. Mean total DREEM score was 117.5 (58.8 %) and interpreted as “more positive than negative.” Scores in subscales of perception of learning, perception of teachers, academic self-perception, and perception of atmosphere, were positive with mean scores of 62.9 %, 60.2 %, 63.4 %, and 55.6, respectively. Subscale of social self-perception rated poorly with mean score of 48.9 % and interpreted as “not a nice place.” Single items revealed five major problem areas: lack of adequate support, authoritarian leadership, over-emphasis on factual learning, poor memorizing, and excessive stress. \u0000Conclusion: This analysis revealed major problems and weaknesses in the new school and addressing them could improve educational quality.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74165131","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. Bloodstream infections (BSI) are of public health concern because they are usually associated with high fatality rate if therapy is delayed. A combination of these infections with antibiotic resistance increases healthcare costs. In this study, microorganisms identified from blood cultures at Livingstone University Teaching Hospital (LUTH) between 2019 and 2021 were evaluated for their antibiotic resistance patterns. Methods: This was a single-centre laboratory based retrospective study. Data on isolated organisms from electronic laboratory system generated reports at LUTH microbiology laboratory for a period of 3 years, was analysed with SPSS version 20. Results: A total of 765 specimens were processed and only 331 (43.3%) met the inclusion criteria. Of the 331 specimens, 61.3% and 38.7% were collected from female and male patients, respectively whereas 65.9% came from out-patient departments and 34.1% from in-patient departments. The commonest bacteria isolate was Escherichia coli (27.2%) followed by Enterobacter agglomerans (22.7%), Klebsiella pneumoniae (13%), Klebsiella oxytoca (6.3%), Enterobacter aerogenes (5.4%), Enterobacter cloacae (5.4%), Citrobacter freundii (4.8%), Serratia marcescens (3.6%), Proteus mirabilis (3.3%), and Staphylococcus aureus (2.7%). Of the common utilized antibiotics, ampicillin (92.9%) was the least effective drug followed by co-trimoxazole (82.7%), nalidixic acid (68.3%), penicillin (66.7%), tetracycline (63.5%), and chloramphenicol (50.3%), while imipenem (15.4%), norfloxacin (35.3%), and nitrofurantoin (38.8%) were the most effective. The patient's gender and hospital location may have an impact on antibiotic resistance. Conclusion: The most common bacterial pathogens were Gram-negative Enterobacteriaceae that showed increased resistance to various classes of commonly used antibiotics at LUTH but with low resistance to imipenem. Due to the observed multidrug resistant pathogens for BSI, it is cardinal for healthcare facilities to monitor bacteria resistance patterns regularly and encourage the prudent use of antibiotics. However, antibiotic selection for susceptibility testing should be based on the Clinical and Laboratory Standards Institute (CLSI) and Zambia National Formulary (ZNF) recommendations to only test antibiotics1r for BSI instead of those recommended for other infections like urinary tract infections (e.g., tetracyclines).
{"title":"Assessment of Antibiotic Resistance Patterns of Bacterial Pathogens Isolated from Blood Culture Specimens at Livingstone University Teaching Hospital in Zambia","authors":"Thresa N. Mwansa, J. A. Mulemena, W. Chanda","doi":"10.55320/mjz.49.3.360","DOIUrl":"https://doi.org/10.55320/mjz.49.3.360","url":null,"abstract":"Background. Bloodstream infections (BSI) are of public health concern because they are usually associated with high fatality rate if therapy is delayed. A combination of these infections with antibiotic resistance increases healthcare costs. In this study, microorganisms identified from blood cultures at Livingstone University Teaching Hospital (LUTH) between 2019 and 2021 were evaluated for their antibiotic resistance patterns. \u0000Methods: This was a single-centre laboratory based retrospective study. Data on isolated organisms from electronic laboratory system generated reports at LUTH microbiology laboratory for a period of 3 years, was analysed with SPSS version 20. \u0000Results: A total of 765 specimens were processed and only 331 (43.3%) met the inclusion criteria. Of the 331 specimens, 61.3% and 38.7% were collected from female and male patients, respectively whereas 65.9% came from out-patient departments and 34.1% from in-patient departments. The commonest bacteria isolate was Escherichia coli (27.2%) followed by Enterobacter agglomerans (22.7%), Klebsiella pneumoniae (13%), Klebsiella oxytoca (6.3%), Enterobacter aerogenes (5.4%), Enterobacter cloacae (5.4%), Citrobacter freundii (4.8%), Serratia marcescens (3.6%), Proteus mirabilis (3.3%), and Staphylococcus aureus (2.7%). Of the common utilized antibiotics, ampicillin (92.9%) was the least effective drug followed by co-trimoxazole (82.7%), nalidixic acid (68.3%), penicillin (66.7%), tetracycline (63.5%), and chloramphenicol (50.3%), while imipenem (15.4%), norfloxacin (35.3%), and nitrofurantoin (38.8%) were the most effective. The patient's gender and hospital location may have an impact on antibiotic resistance.\u0000Conclusion: The most common bacterial pathogens were Gram-negative Enterobacteriaceae that showed increased resistance to various classes of commonly used antibiotics at LUTH but with low resistance to imipenem. Due to the observed multidrug resistant pathogens for BSI, it is cardinal for healthcare facilities to monitor bacteria resistance patterns regularly and encourage the prudent use of antibiotics. However, antibiotic selection for susceptibility testing should be based on the Clinical and Laboratory Standards Institute (CLSI) and Zambia National Formulary (ZNF) recommendations to only test antibiotics1r for BSI instead of those recommended for other infections like urinary tract infections (e.g., tetracyclines).","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87711241","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}
K. I. Muma, R. Bailey, Jessie I. M. Nyalazi, George Zulu, T. S. M. Malisawa, Lillian Musonda, Kachikonyo Sibande – Muma, E. Simulundu, P. Kaonga
Objective: Primary open-angle glaucoma in Zambia has an earlier age of onset and appears to be more clinically severe. Myocilin mutations are associated with primary open angle glaucoma in multiple populations. Therefore, we investigated the role of myocilin gene mutations in Primary Open Angle Glaucoma in a Zambian population. Methods: The unrelated primary open-angle glaucoma patients and unaffected controls recruited were from the University Teaching Hospitals Eye Hospital, Kitwe Teaching Eye Hospital and Lusaka Adventist Eye Hospital. A complete eye examination, including visual field assessment, was performed in all cases and controls.Genomic DNA was extracted from whole peripheral blood, then subjected to polymerase chain reaction to amplify exons, flanking introns and promoter regions of the myocilingene. The amplified products were screened for base mutations by auto sequence based on the Sanger method. The analyses of findings included odds ratios, chi-square, bivariate, multivariate and conditional logistic regression with 95% confidence interval and at a 5% level of significance.There was also a comparison between the identified mutations and the previously reported myocilinmutations. Results: Unrelated 165 Primary Open-Angle Glaucoma patients and unaffected 173 controls enrolled for the study. The analysis revealed 4 variants of MYOC mutations in 49 participants of the 338. The mutations included one synonymous (silent) mutation (Thr474Thr; 45/338) and three missense mutations (Ala446Thr; 16/338), (Leu158Arg; 4/338) and (Arg342Lys; 1/338). The study observed two previously reported mutations, Ala446Thr and Arg342Lys, as glaucoma causing mutations. The missense mutation, Ala446Thr, was found in 16 participants who also had silent mutations broken down as eight cases and eight controls. One control had two variants, Ala446Thr and Arg342Lys. Twenty (20) controls and 25 cases had the synonymous or silent (neutral) mutation, (Thr474Thr). The occurrence of Thr474Thr and Ala446Thr in the same cases and controls was compelling evidence to think that the synonymous mutations were not as silent as previously reported. The Thr474Thr and Ala446Thr mutations exhibited identical primary open-angle glaucomaphenotypic features in both cases and controls. In the remaining 17 cases and 12 controls the phenotype were still the same. The clinical profile in Thr474Thr mutation was statistically significant for female gender, younger age group (<40 years), older age group (≥ 65 years), positive family history, poor visual acuity, severe visual field changes, diffuse retinal nerve fibre layer defects, peripapillary atrophy surrounding the optic nerve head and high cup disc ratio between 0.8 and 1.0 Conclusions: The silent myocilin mutations, Thr474Thr, break their silence in a Zambian population. The silent mutation Thr474Thr found was associated with primary open-angle glaucoma phenotype and appeared to be a glaucoma-causing.
{"title":"Synonymous Myocilin mutations break their silence in a Zambian population attending selected referral eye health facilities","authors":"K. I. Muma, R. Bailey, Jessie I. M. Nyalazi, George Zulu, T. S. M. Malisawa, Lillian Musonda, Kachikonyo Sibande – Muma, E. Simulundu, P. Kaonga","doi":"10.55320/mjz.49.3.370","DOIUrl":"https://doi.org/10.55320/mjz.49.3.370","url":null,"abstract":"Objective: Primary open-angle glaucoma in Zambia has an earlier age of onset and appears to be more clinically severe. Myocilin mutations are associated with primary open angle glaucoma in multiple populations. Therefore, we investigated the role of myocilin gene mutations in Primary Open Angle Glaucoma in a Zambian population.\u0000Methods: The unrelated primary open-angle glaucoma patients and unaffected controls recruited were from the University Teaching Hospitals Eye Hospital, Kitwe Teaching Eye Hospital and Lusaka Adventist Eye Hospital. A complete eye examination, including visual field assessment, was performed in all cases and controls.Genomic DNA was extracted from whole peripheral blood, then subjected to polymerase chain reaction to amplify exons, flanking introns and promoter regions of the myocilingene. The amplified products were screened for base mutations by auto sequence based on the Sanger method. The analyses of findings included odds ratios, chi-square, bivariate, multivariate and conditional logistic regression with 95% confidence interval and at a 5% level of significance.There was also a comparison between the identified mutations and the previously reported myocilinmutations.\u0000Results: Unrelated 165 Primary Open-Angle Glaucoma patients and unaffected 173 controls enrolled for the study. The analysis revealed 4 variants of MYOC mutations in 49 participants of the 338. The mutations included one synonymous (silent) mutation (Thr474Thr; 45/338) and three missense mutations (Ala446Thr; 16/338), (Leu158Arg; 4/338) and (Arg342Lys; 1/338). The study observed two previously reported mutations, Ala446Thr and Arg342Lys, as glaucoma causing mutations. The missense mutation, Ala446Thr, was found in 16 participants who also had silent mutations broken down as eight cases and eight controls. One control had two variants, Ala446Thr and Arg342Lys. Twenty (20) controls and 25 cases had the synonymous or silent (neutral) mutation, (Thr474Thr). The occurrence of Thr474Thr and Ala446Thr in the same cases and controls was compelling evidence to think that the synonymous mutations were not as silent as previously reported. The Thr474Thr and Ala446Thr mutations exhibited identical primary open-angle glaucomaphenotypic features in both cases and controls. In the remaining 17 cases and 12 controls the phenotype were still the same. The clinical profile in Thr474Thr mutation was statistically significant for female gender, younger age group (<40 years), older age group (≥ 65 years), positive family history, poor visual acuity, severe visual field changes, diffuse retinal nerve fibre layer defects, peripapillary atrophy surrounding the optic nerve head and high cup disc ratio between 0.8 and 1.0 \u0000Conclusions: The silent myocilin mutations, Thr474Thr, break their silence in a Zambian population. The silent mutation Thr474Thr found was associated with primary open-angle glaucoma phenotype and appeared to be a glaucoma-causing.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"2016 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73327839","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}
The recent recommendation by the World Health organization for the use of the dapivirine vaginal ring as a promising safe, efficacious and alternate choice for HIV prevention among women at significant risk of infection presents a welcome development for countries hard hit by HIV especially those in Sub-Saharan Africa. In Namibia, there is paucity of evidence on whether this novel HIV prevention strategy would be acceptable among those women at elevated risk of acquiring the virus. This paper provides a discourse on the opportunities and potential challenges in introducing the dapivirine vaginal ring on a large scale in the country.
{"title":"Exploring the potential of dapivirine vaginal ring for HIV prevention in Namibia: a call to action ","authors":"M. A. Chipare","doi":"10.55320/mjz.49.3.361","DOIUrl":"https://doi.org/10.55320/mjz.49.3.361","url":null,"abstract":"The recent recommendation by the World Health organization for the use of the dapivirine vaginal ring as a promising safe, efficacious and alternate choice for HIV prevention among women at significant risk of infection presents a welcome development for countries hard hit by HIV especially those in Sub-Saharan Africa. In Namibia, there is paucity of evidence on whether this novel HIV prevention strategy would be acceptable among those women at elevated risk of acquiring the virus. This paper provides a discourse on the opportunities and potential challenges in introducing the dapivirine vaginal ring on a large scale in the country.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72741638","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 advent of artificially intelligent systems in the field of medical imaging has attracted a lot of attention and sparked a lot of discussion regarding the future roles of radiographers. It is widely believed that Artificial Intelligence (AI) will revolutionize the entire medical imaging field in the near future and alter the current practice of radiographers. Aim: The aim of the study was to explore Zimbabwean radiographers’ perspectives on the impact of AI use on their future roles. Methods: A qualitative explorative design employing in-depth interviews to explore the perceptions of radiographers towards AI use in medical imaging. The study recruited 10 participants and the study was conducted at 5 hospitals in Harare, 2 government and 3 privatehospitals. The interview data was then analyzed using thematic analysis according to Braun and Clarke. Results: Four themes emerged from the interview data. The themes include; Reduce roles of radiographers, Elimination of human errors, Expansion of knowledge and AI will promote radiography. Conclusion: Radiographers must be trained and have underpinning knowledge of AI.This study recommends that AI use should be included in the curriculum of radiography students.
{"title":"Radiographers’ Perspectives on the Impact of Artificial Intelligence use on their future roles: A Qualitative Study","authors":"Glenda Chivandire, L. Mudadi, B. Chinene","doi":"10.55320/mjz.49.3.363","DOIUrl":"https://doi.org/10.55320/mjz.49.3.363","url":null,"abstract":"Introduction: The advent of artificially intelligent systems in the field of medical imaging has attracted a lot of attention and sparked a lot of discussion regarding the future roles of radiographers. It is widely believed that Artificial Intelligence (AI) will revolutionize the entire medical imaging field in the near future and alter the current practice of radiographers. \u0000Aim: The aim of the study was to explore Zimbabwean radiographers’ perspectives on the impact of AI use on their future roles.\u0000Methods: A qualitative explorative design employing in-depth interviews to explore the perceptions of radiographers towards AI use in medical imaging. The study recruited 10 participants and the study was conducted at 5 hospitals in Harare, 2 government and 3 privatehospitals. The interview data was then analyzed using thematic analysis according to Braun and Clarke.\u0000Results: Four themes emerged from the interview data. The themes include; Reduce roles of radiographers, Elimination of human errors, Expansion of knowledge and AI will promote radiography.\u0000Conclusion: Radiographers must be trained and have underpinning knowledge of AI.This study recommends that AI use should be included in the curriculum of radiography students.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85782791","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: Minimal change disease (MCD) has been shown to be a common histological presentation in children presenting with nephrotic syndrome (NS) in developed countries. In Africa, information on clinical and histological characteristics of paediatric NS is scarce. This study assessed the characteristics and histological subtypes of NS. Methods: This was a prospective study that consecutively indexed children aged 2-16 years with the diagnosis of NS who were referred to the largest tertiary teaching hospital, Lusaka, Zambia. Thirteen children presenting with NS were biopsied under ultrasound guidance after ethical approval. The primary outcome of the study was to describe the histological characteristics of paediatric NS. Results: Thirteen children of African descent with a median age of onset of NS of 9.25 years (2.0-15.0) were enrolled in the study. The histopathologic lesions were as follows; four had MCD, four had focal segmental glomerulosclerosis (FSGS), one had immune complex mediated glomerulonephritis (ICMN) and four were inconclusive. Haematuria was present in eight out of 13 patients (61.5%) and hypertension was present in five of 13 patients (38.0%). Three children did not have either haematuria or hypertension. Ten of the 13 participants had primary steroid resistance. Conclusion: This study has demonstrated the need to perform a pre-treatment renal biopsy in paediatric patients presenting with NS in view of the atypical presentation, variable histopathologic findings, and unpredictable response to steroid therapy.
{"title":"Histopathological Subtypes of Primary Nephrotic Syndrome in Paediatric Patients at the University Teaching Hospital in Lusaka, Zambia","authors":"A. Mweemba, Paul Mashanga, Justor Banda","doi":"10.55320/mjz.49.3.364","DOIUrl":"https://doi.org/10.55320/mjz.49.3.364","url":null,"abstract":"Background: Minimal change disease (MCD) has been shown to be a common histological presentation in children presenting with nephrotic syndrome (NS) in developed countries. In Africa, information on clinical and histological characteristics of paediatric NS is scarce. This study assessed the characteristics and histological subtypes of NS. \u0000Methods: This was a prospective study that consecutively indexed children aged 2-16 years with the diagnosis of NS who were referred to the largest tertiary teaching hospital, Lusaka, Zambia. Thirteen children presenting with NS were biopsied under ultrasound guidance after ethical approval. The primary outcome of the study was to describe the histological characteristics of paediatric NS. \u0000Results: Thirteen children of African descent with a median age of onset of NS of 9.25 years (2.0-15.0) were enrolled in the study. The histopathologic lesions were as follows; four had MCD, four had focal segmental glomerulosclerosis (FSGS), one had immune complex mediated glomerulonephritis (ICMN) and four were inconclusive. Haematuria was present in eight out of 13 patients (61.5%) and hypertension was present in five of 13 patients (38.0%). Three children did not have either haematuria or hypertension. Ten of the 13 participants had primary steroid resistance. \u0000Conclusion: This study has demonstrated the need to perform a pre-treatment renal biopsy in paediatric patients presenting with NS in view of the atypical presentation, variable histopathologic findings, and unpredictable response to steroid therapy.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91265376","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. Mushosho, Gracious Motsi, Fadzai Musiwarwo, B. Chinene
Prostate cancer is the most common malignancy diagnosed in men and the second most common cause of cancer deaths in men. Incidence increases drastically after the age of 50, however, it is more common in males above the age of 65. Prostatic cancer is asymptomatic in its early stages, i.e., when it is still localized, hence most patients present with late-stage cancers. Patients with late-stage prostate cancer usually present with urethral obstruction, nocturia, narrow stream, and they rarely present with pain or stiffness caused by bony metastases. The common treatment for late-stage prostate cancer is hormonal therapy. We herein present a case of an 86-year-old male who presented with metastasized prostate cancer. The cancer had metastasized to the head of the femur and there was bone fracture in the neck of the femur as well. The patient received external beam radiotherapy as palliative treatment due to the limited resources in Zimbabwe. The patient did not come for follow up review and hence it was not possible to conclude whether the external beam treatment was an effective palliative treatment. The learning points in this case are as follows: stage at presentation of man with cancer of the prostate in comparison with what literature say, management done in comparison to the recommended management guidelines, follow up strategies to minimize patients absconding follow up reviews and how loss of follow up to patients treated affect future evidence-based management of patients.
{"title":"An 86-Year-Old Male with Metastasized Cancer Treated with External Beam Radiation Therapy: A Case Report from Zimbabwe","authors":"E. Mushosho, Gracious Motsi, Fadzai Musiwarwo, B. Chinene","doi":"10.55320/mjz.49.3.367","DOIUrl":"https://doi.org/10.55320/mjz.49.3.367","url":null,"abstract":"Prostate cancer is the most common malignancy diagnosed in men and the second most common cause of cancer deaths in men. Incidence increases drastically after the age of 50, however, it is more common in males above the age of 65. Prostatic cancer is asymptomatic in its early stages, i.e., when it is still localized, hence most patients present with late-stage cancers. Patients with late-stage prostate cancer usually present with urethral obstruction, nocturia, narrow stream, and they rarely present with pain or stiffness caused by bony metastases. The common treatment for late-stage prostate cancer is hormonal therapy. We herein present a case of an 86-year-old male who presented with metastasized prostate cancer. The cancer had metastasized to the head of the femur and there was bone fracture in the neck of the femur as well. The patient received external beam radiotherapy as palliative treatment due to the limited resources in Zimbabwe. The patient did not come for follow up review and hence it was not possible to conclude whether the external beam treatment was an effective palliative treatment. The learning points in this case are as follows: stage at presentation of man with cancer of the prostate in comparison with what literature say, management done in comparison to the recommended management guidelines, follow up strategies to minimize patients absconding follow up reviews and how loss of follow up to patients treated affect future evidence-based management of patients.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"114 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76750284","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}
Medical ultrasound is a particularly useful imaging method used in the diagnosis of urinary foetal anomalies. One such foetal anomaly is the posterior urethral valve (PUV), which is a congenital malformation of the male urethra occurring early in gestation life. PUV is a common cause of obstructive uropathy in males and foetal death during pregnancy. We report from a medical imaging perspective on a rare and high-risk case of a PUV detected during routine antenatal ultrasound imaging in Botswana. The first scan performed at 16 weeks of gestation age was unremarkable. However, subsequent antenatal ultrasound scans at and after 20 weeks demonstrated bilateral hydronephrosis, distended ureters, and a urinary bladder which gradually increased with the gestation age. There was also a corresponding reduction in amniotic fluid and foetal movements. As a result of these complications, the pregnancy was classified as a “high-risk.” At 30 weeks, spontaneous labour occurred and a fresh still birth was delivered.
{"title":"Incidental finding of Posterior Urethral Valve during routine antenatal ultrasound: Diagnostic imaging case report in Botswana","authors":"Cuthbert Mulenga, Osward Bwanga, Thabo A. Moloi","doi":"10.55320/mjz.49.3.369","DOIUrl":"https://doi.org/10.55320/mjz.49.3.369","url":null,"abstract":"Medical ultrasound is a particularly useful imaging method used in the diagnosis of urinary foetal anomalies. One such foetal anomaly is the posterior urethral valve (PUV), which is a congenital malformation of the male urethra occurring early in gestation life. PUV is a common cause of obstructive uropathy in males and foetal death during pregnancy. We report from a medical imaging perspective on a rare and high-risk case of a PUV detected during routine antenatal ultrasound imaging in Botswana. The first scan performed at 16 weeks of gestation age was unremarkable. However, subsequent antenatal ultrasound scans at and after 20 weeks demonstrated bilateral hydronephrosis, distended ureters, and a urinary bladder which gradually increased with the gestation age. There was also a corresponding reduction in amniotic fluid and foetal movements. As a result of these complications, the pregnancy was classified as a “high-risk.” At 30 weeks, spontaneous labour occurred and a fresh still birth was delivered.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"96 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135265505","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}
{"title":"Table of Content: Strengthening Health Education Professionals Workforce In Zambia","authors":"MJZ Special Issue SHEPIZ","doi":"10.55320/mjz...253","DOIUrl":"https://doi.org/10.55320/mjz...253","url":null,"abstract":"MJZ Special Issue - SHEPIZ","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135755934","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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