Malawi Medical Journal最新文献

{"title":"Efficacy of HPV E6/E7 mRNA assay, HPV DNA test and cytology in detection of high grade cervical lesions and invasive cancer at a tertiary care center in India","authors":"Sangeeta Pankaj, Jyotsna Rani, Pratibha Kumari, Kavya Abhilashi, V. Choudhary, S. Kumari, S. Shahi, Anima Xess, Rajesh Kumar Singh, Shishir Kumar, Abhay Kumar, Nihar Ranjan Biswas, Babban Jee","doi":"10.4314/mmj.v36i2.9","DOIUrl":"https://doi.org/10.4314/mmj.v36i2.9","url":null,"abstract":"BackgroundCervical cancer is caused by human papillomavirus (HPV) and remains a major public health issue. There are several methods for its diagnosis. Knowing their comparative usefulness may help in devising an appropriate strategy for early detection of this gynecological cancer in resource-constrained setting. AimThis study aims to evaluate the efficacy of human papillomavirus (HPV) E6/E7 mRNA assay, HPV DNA test and cytology in detection of high grade cervical lesions and invasive cervical carcinoma at a tertiary care center in India.MethodsA total of 106 women were recruited in this hospital based study and underwent molecular tests (HPV DNA test and mRNA assay), cytological test and colposcopic-guided biopsy. Histopathological diagnosis was considered as the gold standard. ResultsWe observed that 56 out of 106 participants had abnormal results in the terms of positive HPV DNA or E6/E7 mRNA with or without abnormal cytology or had histopathologically confirmed pre-malignant/malignant lesion. 47.2% (50/106) and 32% (34/106) women were positive for HPV DNA and E6/E7 mRNA respectively. 33% (35/106) women had abnormal cytology and 29.2% (31/106) had histologically confirmed CIN II and higher lesions. Sensitivity and specificity of cytology and HPV DNA for CIN III+ lesions were calculated as 92%, 90.4% versus 88% & 68% respectively. mRNA assay was found to be more sensitive (96%) and specific (93.3%) than other tests in detecting CIN II + lesions. ConclusionE6/E7 mRNA assay seems superior to HPV DNA test and cytology in detection of high grade cervical lesions and invasive carcinoma. It may be used as an alternative or adjunct to HPV DNA test or cytology for the purpose of cervical cancer screening and also be helpful in reducing the load for colposcopy.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141833637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoughts about the 2023/4 Malawi National Health Budget","authors":"A. Muula","doi":"10.4314/mmj.v36i2.1","DOIUrl":"https://doi.org/10.4314/mmj.v36i2.1","url":null,"abstract":"At 12% of the total national budget, the proposed 2024/24 health budget is most likely the highest ever in Malawi. I say “most likely” or probably, because I have not been careful enough to review what was the country’s health budget in the 1960’s, 80’s, or the 90’s. In addition, in the Malawi context, the budget as approved by the National Assembly and assented to by the State President, doesn’t always mean that it will be followed to the letter through treasury disbursements to Ministries, Departments and Agencies (MDAs). But 12% isn’t lower when one looks at the other sectors (defence, homeland security, foreign affairs, education and agriculture) which the same national fiscus seeks their attention.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141833666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between inferior vena cava collability index and malnutrition in critical patients: a prospective observational study","authors":"V. G. Soylu, Ayşe Yılmaz, Ö. Taşkın, U. Demir, F. Inan, Z. Doğanay","doi":"10.4314/mmj.v36i2.5","DOIUrl":"https://doi.org/10.4314/mmj.v36i2.5","url":null,"abstract":"Background We aimed to investigate the correlation between the inferior vena cava collability index(IVC-CI) used in the evaluation of fluid volume and the Nutrition Risk Index(NRI), Prognostic Nutrition Index(PNI), Geriatric Nutrition Risk Index(GNRI) and Controlling Nutritional Status Scoring(CONUT) used in the evaluation of malnutrition. MethodsThis study is a prospective observational study. Demographic data, laboratory data, Body Max Indexes(BMI), NRI, PNI, GNRI and CONUT in the first 24 hours of admission to the intensive care unit of 96 critically ill patients admitted to the tertiary intensive care unit with assisted invasive mechanical ventilator support and IVC-CI values were recorded. Patients with an IVC-CI >45% were evaluated as hypovolemia. Of the patients, 61 (63.5%) patients with an IVC-CI value of 45%≥ were group 1, and 35 (36.5%) patients with an IVC-CI value of >45% were determined as group 2. Correlation between the IVC-CI and malnutrition scores was investigated between the groups. Results As a result of the statistical analysis; there was a statistically significant difference between the two groups in terms of BMI, NRI, PNI, GNRI and CONUT (p<0.001). According to the correlation analysis results, NRI (rs=-0.716, p<0.001), PNI (rs=-0.743, p<0.001), GNRI (rs=-0.723, p<0.001), CONUT (rs=0.741, p<0.001) were significantly correlated with the IVC-CI.ConclusionsThis study shows that there is a correlation between the IVC-CI used in the evaluation of fluid volume and malnutrition.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141833851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pneumatized inferior turbinate (concha bullosa of inferior turbinate)","authors":"Anas Elamaireh, B. Alkousheh, Abdullah Al-Tarawneh, Mohammed Al-kofahi","doi":"10.4314/mmj.v36i2.13","DOIUrl":"https://doi.org/10.4314/mmj.v36i2.13","url":null,"abstract":"The nasal cavity structures are prone to different anatomical variations; one of these is concha bullosa, which best known as pneumatization of the nasal turbinate. This pneumatization is a rare phenomenon to in the inferior turbinate. We report the case of an incidental finding of inferior turbinate concha bullosa in a 30- year-old female who presented with nasal obstruction and headache. While evaluating the patient’s computed tomography image, a pneumatized right inferior turbinate accidentally found. Our patient treated medically without surgical intervention and showed good improvement in her symptoms. Physicians should be aware of the presence of such a rare variation that may lead to serious nasal symptoms if it is large enough, they should keep it in the differential diagnosis and with deal with it accordingly.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141833678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-related quality of life and its predictors among hypertensive adults 45 years and older in rural Malawi: a population-based study","authors":"Susan Banda, I. Kohler, Hans-Peter Kohler, S. C. Chichlowska","doi":"10.4314/mmj.v36i2.6","DOIUrl":"https://doi.org/10.4314/mmj.v36i2.6","url":null,"abstract":"Background Hypertension is associated with impaired Health-Related Quality of Life (HRQOL), but its assessment is rarely done in the management of hypertension in Malawi. This study aimed to evaluate the HRQOL of hypertensive adults compared to normotensive individuals and suggest possible predictors of HRQOL in hypertensive adults in rural Malawi. MethodsThis was a cross-sectional study utilizing data from the 2017 Mature Adults Cohort of the Malawi Longitudinal Study for Families and Health (MLSFH-MAC). The study included 1489 adults aged 45 and above from Rumphi, Mchinji, and Balaka districts. HRQOL was measured using the Short Form 12-item (SF-12) questionnaire. Univariable logistic regression, followed by multivariable logistic regression, was used to identify independent predictors of HRQOL in hypertensive adults. A p-value of <0.05 was considered statistically significant. ResultsThe prevalence of hypertension was 44.1%. Hypertensive participants had significantly lower physical and mental HRQOL than their normotensive counterparts (p<0.05). Multiple regression analysis showed that female sex, age, presence of comorbidities, and use of antihypertensive medications were significant predictors of poor physical HRQOL. Being female was a significant predictor of poor mental HRQOL (all p-values <0.05).ConclusionIn rural Malawi, hypertensive adults presented with lower physical and mental HRQOL. Interventions aimed at improving HRQOL should focus on hypertensive adults who are female, older, on antihypertensive medications, and with comorbidities.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141833811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying ribonucleotide reductase subunit genes as potential lung adenocarcinomas biomarkers using integrated bioinformatics analysis","authors":"Jin Shang, Blessed Kondowe, Hui Zhang, Xinming Xie","doi":"10.4314/mmj.v36i2.11","DOIUrl":"https://doi.org/10.4314/mmj.v36i2.11","url":null,"abstract":"Introduction Dysregulation of ribonucleotide reductase (RR) subunit genes (RRM1, RRM2 and RRM2B) expression is reported to be involved in the occurrence of various human malignancies. However, the prognostic value of RR subunit genes expression in lung adenocarcinoma (LUAD) patients remains controversial. Objective This study aims to analyze the expression profiles, prognostic values, and immune infiltrating associations of RR subunit genes in LUAD to explore whether RR subunit gene expression has value in the prognosis of patients with lung adenocarcinoma (LUAD).Methodology We used multiple search engines to access multiple online bioinformatics databases, including Oncomine, TIMER, GEPIA, Kaplan–Meier Plotter, PrognoScan, the Human Protein Atlas, MD Anderson Cancer Center, UCSC Xena, cBioProtal, TCGA, GEO, DAVID, and STRING databases.Results The study found that RRM1 and RRM2 might be an attractive target for treating LUAD, while RRM2B were down-expressed in LUAD (P < 0.05). The study also found that high RRM1 or RRM2 expression, or low RRM2B expression suggested poor prognosis of LUAD patients in both TCGA and GEO databases (P < 0.05). Additionally, our results indicated that RR subunit genes expressions have different characteristics with immune infiltrating, RRM2B had a slight but significant positive correlation with almost every infiltrating immune cells except CD4+ T cells (all P < 0.05). Furthermore, by co-expression gene network analysis of RR subunit genes, we found that five new hub genes (PLK1, AURKA, CDCA8, TTK and CDC45) were significantly positively correlated with RRM1 and RRM2 expression whereas were negatively correlated with RRM2B expression, and these five hub genes were identified to be related with a poor prognosis in LUAD patients (P < 0.05). Conclusion The study findings demonstrate that RR subunit genes may be a prognostic marker and therapeutic target for LUAD patients.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141833818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building a complementary approach to HIV service delivery for key populations using health facilities in collaboration with community-based organizations in Liberia","authors":"G. Kamanga, Nana Fosua Clement, Thomas Hallie, Rachel Lyimo, Danielle de Mora, Cytirus Kerbay, Michael Odo, Lisa Harris, Samretta Caldwell, J. T. Garbo, Natasha Mack, Pradeep K. Thakur, Titus Koikoi, Rose Wilcher, Helene Sherman, Christopher Akolo","doi":"10.4314/mmj.v36i2.14","DOIUrl":"https://doi.org/10.4314/mmj.v36i2.14","url":null,"abstract":"Key populations (KPs), including female sex workers (FSWs), men who have sex with men (MSM), transgender (trans) people, prisoners, and people who use drugs, have specific risk behaviours and other vulnerabilities that place them at increased risk of HIV1. In addition, they play an important role in the dynamics of HIV prevention and transmission both within and outside of KP communities, as KPs and the general population are frequently interconnected through their sexual networks.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141834085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of COVID-19 phobia on employee performance and job satisfaction: a cross-sectional study","authors":"H. Koçak, Ecem Çiçek Gümüş, D. Taşdemir","doi":"10.4314/mmj.v36i2.7","DOIUrl":"https://doi.org/10.4314/mmj.v36i2.7","url":null,"abstract":"BackgroundThe mass fear of COVID-19, which is called “coronaphobia”, causes many negative effects such as increasing unemployment rates, decreased performance in working life and organisational problems in the business world. The study is conducted to examine how COVID-19 is reflected in job performance and job satisfaction in terms of the sustainability of occupational health and safety of workers especially white-collar workers, in enterprises due to the pandemic.MethodsThe study was conducted as a descriptive, cross-sectional type. Data were collected from the employees in the designated factories by creating an online form using the “COVID-19 Phobia Scale”, “Employee Performance Scale”, and “Job Satisfaction Scale”.Results The findings obtained in the study showed a significant positive relationship between employee performance and job satisfaction.It was determined that job satisfaction and employee performance had a significant but weak relationship with COVID-19 phobia.ConclusionsThe findings expand previous studies by filling the lack of knowledge on how job performance and job satisfaction have effected at workplace during a pandemic. The study data show that job performance and job satisfaction in workplace employees affect each other and that both are affected by unexpected or extraordinary situations such as pandemics.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141833919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in severe acute malnutrition admissions, characteristics, and treatment outcomes in Malawi from 2011 through 2019","authors":"Allison I. Daniel, S. Kathumba, C. Mitambo, D. Chasweka, W. Voskuijl, Esther Kamanga, E. Mbale, R. Bandsma, I. Potani","doi":"10.4314/mmj.v36i2.3","DOIUrl":"https://doi.org/10.4314/mmj.v36i2.3","url":null,"abstract":"Background Community-based Management of Acute Malnutrition (CMAM) has been successfully implemented across Malawi, yet trends in admissions, characteristics, and treatment outcomes in children with severe acute malnutrition (SAM) have not been examined. The objective was therefore to investigate trends in admissions, characteristics including percentage of children with SAM with HIV and oedema, and treatment outcomes across the decade following implementation of CMAM.Methods This research involved a retrospective analysis of existing data routinely collected across Malawi by the Ministry of Health between 2011 and 2019.ResultsThese data showed an increase in outpatient therapeutic feeding (OTP) admissions from 30323 children in 2011 to 37655 in 2019 (p=0.045). However, a significant decrease in nutritional rehabilitation unit (NRU) admissions was observed, from 11389 annual admissions in 2011 to 6271 in 2019 (p=0.006). In children identified with SAM, the percentage with oedema decreased in OTPs with an average annual rate of reduction (AARR) of 5.6% (p=0.001) and by 26.2% in NRUs in this timeframe with an AARR of 8.5% (p<0.001). The percentage of children with SAM who had HIV decreased over time in OTPs with an AARR of 16.1% (p=0.001). HIV rates also decreased in NRUs with an AARR of 7.2% (p=0.4), but this difference was not significant. Death rates decreased in OTPs with an AARR of 6.0% (p=0.01). Mortality rates did not change in NRUs over time with an AARR of 0.9% (p=0.5) with the NRU mortality rate in 2019 being 11.0%.Conclusions These trends indicate that there has been an increase in OTP admissions and a corresponding decrease in NRU admissions. There have been decreases in the percentage of children with oedematous SAM in OTPs and in NRUs and with HIV in OTPs. Children remain at high risk of mortality in NRUs.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141834074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analyzing 10-year time trends for Hysterectomy and Oophorectomy: Focus on Endometrial sampling and risk factors for Endometrial Cancer","authors":"A. Yurtkal, Mujde Canday","doi":"10.4314/mmj.v36i2.12","DOIUrl":"https://doi.org/10.4314/mmj.v36i2.12","url":null,"abstract":"Background Hysterectomy is a versatile and commonly employed treatment option for various benign and malignant gynecological conditions. Our study aims to take a comprehensive perspective on hysterectomy over the years using accumulated data and provide clinicians with an accurate insight into the hysterectomy operation.Material-Method This retrospective observational study was conducted on women who underwent hysterectomy at our clinic between 2012 and 2021. Comprehensive medical histories of all patients were thoroughly reviewed as the primary data. Surgical procedures were categorized and compared by year. Operation indications, preoperative endometrial sampling, and the pathology results of the final hysterectomy specimens were also examined. Risk factors were evaluated in confirmed cases of endometrial cancer and atypic endometrial hyperplasia based on pathology results. The analyses were performed using IBM SPSS 20 statistical analysis software. Results In our study,752 patients(mean age: 52±8.2) underwent various hysterectomy procedures, with total abdominal hysterectomy being the most frequent(73.3%). The primary indication was uterine leiomyomas-adenomyomas(33.5%). Endometrial sampling was performed in 57.2% of patients, showing no significant difference in reliability(p=0.143) and endometrial cancer diagnosis(p=0.334). Among 38 patients diagnosed with endometrial cancer, approximately 28.9%(11 patients) did not undergo preoperative endometrial sampling. Further examination revealed that these patients were obese, 63.6% presented with spotting-like bleeding, and most were in the postmenopausal period. Risk factors for these patients and those with atypical hyperplasia indicated statistically significant positive family history(p=0.037) and estrogen therapy history(p=0.028). Out of 536 oophorectomies, 236 were performed in women under 50.ConclusionThe study highlights the need to implement the current literature and promote minimally invasive approaches. Widespread adoption of non-hysterectomy options is essential for rate reduction. Physicians must integrate current literature, refine skills in minimally invasive methods, and advance surgical techniques to achieve an idealized approach for premalignant lesions and endometrial cancer. Presenting clinic data to personalize algorithms and treatments will strengthen the literature, enhancing the field and increasing the applicability of knowledge for personalized implementation of ideal algorithms and treatments.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141834078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}