Papua and New Guinea medical journal最新文献

This article documents the life and achievements of Judy Yaiyon Aupae from the perspectives of her three daughters. Judy was born in Enga Province and raised by her mother, who was the second wife of a chief. The article explores the origins of Judy's interest in health care as a child. It further explores her commitment to helping others through training as a nurse and, later, through working in physiotherapy. The article also documents Judy's recent gaining of further qualifications in physiotherapy through her completion of a degree at Divine Word University in Madang.

Celestine Aho, Patricia Rarau and Pamela Toliman are amongst the next generation of health researchers at the Papua New Guinea Institute of Medical Research (PNGIMR). Face-to-face interviews were conducted with all three women for the purpose of profiling women who are leaders in health and medicine in Papua New Guinea (PNG). They were asked questions about their early life and childhood, education, work life and training, and mentors who have supported their career path and leadership role. All three see opportunities before them to tackle the health challenges facing PNG, find solutions and contribute to human development in their country. At PNGIMR, Pamela is a senior scientific officer in the HIV and STI laboratory; Celestine is a senior scientific officer in the bacteriology laboratory working on pneumococcal vaccines; and Patricia is the study clinician for the Partnership in Health Project, monitoring the impact of the PNG liquefied natural gas (LNG) project.

Tessie Soi is well known in Papua New Guinea and beyond for her work with HIV/AIDS (human immunodeficiency virus/acquired immune deficiency syndrome) patients, including through the Friends Foundation, an organization that focuses on helping families affected by HIV and AIDS. This article explores Tessie's early life and childhood, providing insight into some of the values she learned from her parents. Providing details about the Friends Foundation and the Orphan Buddy Systems program, a program Tessie established to support AIDS orphans, the article offers insight into Tessie's beliefs and compassion, simultaneously highlighting the value she places on her family.

Human immunodeficiency virus (HIV) is a significant public health issue in Papua New Guinea (PNG). After heterosexual transmission (90%), the second most common route of transmission is vertically from mother to child (3.5%). Before the introduction of molecular methods of HIV testing in PNG, diagnosing exposed infants was problematic because there were no reliable assays available for accurate early infant HIV detection. This study aimed to validate and assess a global gold standard for virological early infant HIV diagnosis in PNG: the AMPLICOR HIV DNA v1.5 assay (Roche) using dried blood spot (DBS) specimens. The assay was validated in three ways: by testing well-characterized DBS and kit controls and by blinded retesting of 42 patient specimens. The assay was further investigated by comparison with a serological assay. The results indicated that the assay was robust and highly reproducible using DBS and kit controls, with 100% sensitivity and specificity. Of the 42 infant DBS specimens that were retested blindly, 100% of the test results were concordant with diagnostic results. Among the 42 infant specimens tested with the Amplicor HIV DNA v1.5 assay we found that 33% of infants (n = 14) were HIV PCR positive and 67% (n = 28) negative. The earliest point of HIV detection established for this study was three months of age. This pilot study indicates that HIV-infected infants in PNG can be effectively diagnosed using virological testing and can thus be started earlier on treatment than was previously possible with serological testing.

Background: In the recent decade in Papua New Guinea and other Pacific countries there has been an increasing trend of lifestyle diseases, including obesity associated with diabetes mellitus. Foot ulceration and infection leading to amputation are common and feared complications of diabetes. Yet these are potentially the most preventable of all complications in diabetic patients. Several studies have shown that half of all diabetic foot ulcers can be prevented by education and simple foot care. The primary goal of this study was to depict the scale of the diabetic foot as a community health problem. The secondary goal was to review the current literature on diabetic foot in order to develop a more effective preventive strategy.

Methodology: A retrospective study on the patients with diabetic foot admitted to the surgical unit at Port Moresby General Hospital (PMGH) in 2003 and 2008 was conducted. We also carried out an extensive online search on the prevention and management of diabetic foot ulcers.

Results: Our study showed an increasing trend of diabetic foot ulcers and infections from 1.4 to 2.2% of all surgical patients at PMGH over a 5-year period. Interestingly, over that period the representation of females increased from one-third to almost half of all patients with diabetic foot. Furthermore, the patients with diabetic foot complications showed a lower average hospital stay of 35 days in 2008 compared to 54 days in 2003. The literature review showed that the introduction of a diabetic podiatric team service providing simple education to diabetic patients in the form of one teaching session and/or preventive written materials, with a short explanation of diabetic foot pathology and simple preventive measures, reduced the number of amputations by half.

Recommendation: The introduction of a comprehensive foot care education program and organizing a specialist foot clinic for diabetic patients can reduce bed occupancy and health expenditure on diabetic patients as well as the number of amputations and subsequent disability.

An unusual case of severe facial and scalp actinomycosis is described. A Papuan man presented with an ulcerative tumour that was progressively spreading on the left face and scalp. Biopsy reported pseudotumour on two occasions and just granulation tissue once. Non-operative treatment was frustrating until a discharge of sulphur granules led to the diagnosis of actinomycosis. The final diagnosis was made histologically after a careful search. This report highlights the usual and unusual points in the diagnosis and management of a case of actinomycosis.

Acute appendicitis is a common cause of acute abdomen requiring an emergency appendicectomy. Complications such as perforation and peritoneal contamination leading to peritonitis can result from delay in presentation and an emergency operation. This study prospectively recruited 101 patients diagnosed with acute appendicitis to correlate the bacterial flora with the severity of appendicitis. The results show that 90 patients had acutely inflamed or gangrenous appendicitis and 11 had perforated appendicitis. The ages ranged from 6 to 49 years with a median of 20 years. There were 59 females and 42 males. The commonest isolates were aerobic bacteria such as Escherichia coli, Group D streptococci and Klebsiella pneumoniae. Mixed infection with anaerobes such as Bacteroides fragilis was seen only in perforated appendicitis. The best choices of antibiotic were a fluoroquinolone, cephalosporin and aminoglycoside for aerobic organisms and metronidazole for anaerobes.

The repair of severe bilateral cleft lip is usually done electively at three months after orthodontic appliances have pushed back the protuberant premaxilla to its expected position in the dental arch shelves. Historically the premise that the repair will break down or that the premaxilla will not recede has been challenged. This paper describes a technique that the author has used as a one-stage 'putting it all together' repair without presurgical orthodontics or lip adhesion. The results have been favourable and may bring about a rethink on the tissues' inherent plasticity, the need for early orthodontics and the effect of a muscular strut as an effective substitute for artificial appliances.