Malawi Medical Journal最新文献

{"title":"Effect of an educational programme on critical care nurses' competence at two tertiary hospitals in Malawi","authors":"Rodwell Gundo, Beatrice Gundo, E. Chirwa, A. Dickinson, Gael Mearns","doi":"10.4314/mmj.v33i4.3","DOIUrl":"https://doi.org/10.4314/mmj.v33i4.3","url":null,"abstract":"Background Critical care specialty deals with the complex needs of critically ill patients. Nurses who provide critical care are expected to possess the appropriate knowledge and skills required for the care of critically ill patients. The aim of this study was to assess the effect of an educational programme on the competence of critical care nurses at two tertiary hospitals in Lilongwe and Blantyre, Malawi. Methods A quantitative pre- and post-test design was applied. The training programme was delivered to nurses (n = 41) who worked in intensive care and adult high dependency units at two tertiary hospitals. The effect of the training was assessed through participants' self-assessment of competence on the Intensive and Critical Care Nursing Competence Scale and a list of 10 additional competencies before and after the training. Results The participants' scores on the Intensive and Critical Care Nursing Competence Scale before the training, M = 608.2, SD = 59.6 increased significantly after the training, M = 684.7, SD = 29.7, p <.0001 (two-tailed). Similarly, there was a significant increase in the participants' scores on the additional competencies after the training, p <.0001 (two-tailed). Conclusion The programme could be used for upskilling nurses in critical care settings in Malawi and other developing countries with a similar context.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"33 1","pages":"236 - 241"},"PeriodicalIF":0.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42493023","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":"D-dimer/Fibrinogen ratio and recurrent exacerbations might have a potential impact to predict 90-day mortality in patients with COPD exacerbation","authors":"C. Aydın, B. Yıldız, Didem Gorgun Hattatoglu","doi":"10.4314/mmj.v33i4.8","DOIUrl":"https://doi.org/10.4314/mmj.v33i4.8","url":null,"abstract":"Background According to the World Health Organisation reports (WHO), COPD is the third leading cause of overall in the World by 2020. Aim We aimed to determine the prognostic predictors of 90-day mortality after an initial exacerbation in patients with acute exacerbation of COPD (AECOPD). Results Increased Charlson Comorbidity Score(CCS) (HR:1.47; p<0.05), readmission after initial exacerbation (HR:1.47; p<0.05) were predictive risk factors for 30-day mortality in multivariable regression model. The 90-day mortality rate was %11.8. Hypertension, increased median age, nutrition risk score (NRS), CCS, CAT score, and mMRC 4th level were possible risk factors for 90-day mortality. There was a significant difference in the mortality of patients with D-dimer/Fibrinogen ratios>0.11 and ≤0.11 (HR:2.47; p<0.05). Recurrent exacerbations after discharge were predictive risk factors for 90-day mortality in the multivariable regression model (HR:2.25; p<0.001) with the increased mortality risk 4.73 times (HR:4.73; p=0.002). Furthermore, a 1-unit increment of acute exacerbation increased the mortality risk 3.39 times (HR:3.39; p<0.001). Conclusion Our study showed that D-dimer/Fibrinogen ratio but not D-dimer and recurrent exacerbations after discharge might have a critical impact on 90-day mortality.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"33 1","pages":"276 - 280"},"PeriodicalIF":0.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43906117","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":"Knowledge, Practices and Use of Contact Lenses Among University Students in Turkey","authors":"Hamide Zengin, S. Y. Çaka, Elif Erbay Özdede, I. Tatar, N. Çınar","doi":"10.4314/mmj.v33i4.5","DOIUrl":"https://doi.org/10.4314/mmj.v33i4.5","url":null,"abstract":"Aim This study was conducted to determine the prevalence of contact lens (CL) use among university students, their awareness on CL, and CL users' practices for the cleaning and care of CLs. Methods The data of this cross-sectional study were collected between April 2019 and July 2019. The sample consisted of university students who volunteered to participate in the study. The data obtained from the study were evaluated by Statistical Package for the Social Science (SPSS) 22.0 package program in computer environment. Results 929 students participated in the study and the average age of them was 21.99±1.85 years (Min. 18 – Max. 24), and it was determined that 36.6% (n=340) of the participants were male, 10.2% (n=95) of the total were using CL, 91.6% (n=87) of them used CL due to visual impairment. When students' levels of knowledge about the hygiene and care in CL use were examined 85.4% (n=82) washed their hands before wearing/removing CL, 85.3% (n=81) cleaned the lens container and filled it with new solution when the solution in the container was reduced, 18.5% (n=17) continued wearing CL while sleeping, 6.5% (n=6) washed CL with tap water, and 28.3% (n=26) of them stated that they swam in the sea with CL. It was determined that the prevalence of CL use was higher (p= .045) among smoking students. Conclusion Health professionals are important in the trainings to be given to increase the students' knowledge of hygiene and care regarding the use of CL. More studies are needed on the effect of smoking status on CL use.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"33 1","pages":"253 - 260"},"PeriodicalIF":0.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47443723","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":"Effectiveness of Functional Electrical Stimulation - Cycling Treatment in Children with Cerebral Palsy","authors":"Natalya Özen, E. Unlu, Ozgur Zeliha Karaahmet, E. Gurcay, I. Gundogdu, E. Umay","doi":"10.4314/mmj.v33i3.1","DOIUrl":"https://doi.org/10.4314/mmj.v33i3.1","url":null,"abstract":"Aim The purpose of this study was to evaluate the effects of functional electrical stimulation (FES) bicycle therapy system on motor function, gait pattern, spasticity, daily living activities, and aerobic capacity in children with cerebral palsy (CP) and to compare the results with sham stimulation and standard treatment. Methods Patients with cerebral palsy who received botulinum toxin type-A injections to lower extremities and those with Gross Motor Function Measure Classification System (GMFCS) levels I – III, were included in the study. Twenty-five patients were randomly assigned into three treatment groups for 4-weeks: Group 1, FES-cycling and standard treatment; Group 2, Sham stimulus FES-cycling and standard treatment; Group 3, Standard treatment. Clinical assessment tools included the Modified Ashworth Scale (MAS), Modified Tardieu Scale (MTS), Pediatric Functional Independence Measure (WeeFIM), GMFCS, Gross Motor Function Measure-88 (GMFM-88), selective motor control tests, 6-minute walk test, and Visual Gait Analysis (VGA). Results In all groups, there were significant improvements in MAS, MTS, WeeFIM, GMFM-88, 6-minute walk test, and VGA scores. No changes in GMFCS levels were observed in any group. At the end of the study, there was no significant difference among the groups in terms of any clinical assessment parameter. Conclusions All groups showed statistically significant improvements in motor function, walking pattern, spasticity, daily living activities, and aerobic capacity in patients with CP following the rehabilitation period. Although FES-cycling demonstrated no superiority over the other approaches and provided no additional benefit to the results, FES appears to be safe and well-tolerated in children with CP, at least as much as standard exercise treatment.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"33 1","pages":"144 - 152"},"PeriodicalIF":0.8,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46392963","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":"Timed Average Mean Maximum Velocity (TAMMV) of Cerebral Blood Flow of Children and Adolescents with Sickle cell Disease: correlation with clinical and hematological profiles in country","authors":"B. Chukwu, Lyra Menezes, T. Fukuda, J. Filho, Marilda S Gonçalves","doi":"10.4314/mmj.v33i3.4","DOIUrl":"https://doi.org/10.4314/mmj.v33i3.4","url":null,"abstract":"Background Detection of abnormal TAMMV with transcranial Doppler is fundamental in primary stroke prevention in children with sickle cell disease (SCD). The study aimed at evaluating TAMMV and correlating it with clinical and hematological profiles of children and adolescent with SCD. Methods Transcranial Doppler was performed on subjects aged 2–16 years, using a 2 MHz probe placed over the transtemporal windows. Pulse oximetry was used to determine the peripheral oxygen saturation while clinical and hematological profiles were retrieved from their medical records. Results One hundred and thirty five patients were recruited. The mean TAMMV was 125cm/s. Patients with HbSS had a significantly higher TAMMV (131cm/s) than those with HbSC (107cm/s). Only one (0.74%) patient had abnormal TAMMV. TAMMV correlated inversely with oxygen saturation, Hct and patient's age, and positively with white cell and platelet counts. Previous history of acute chest syndrome (ACS) and recurrent painful crises increased the risk of development of abnormal and conditional velocity. Conclusion Frequency of abnormal TAMMV in this study was low. Younger children and those with HbSS had higher TAMMV. Age, oxygen saturation and haematocrit correlated negatively while white cell and platelet counts correlated positively with TAMMV. Previous history of ACS and recurrent bone pain were associated with increased risk of having abnormal and conditional TAMMV.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"33 1","pages":"169 - 177"},"PeriodicalIF":0.8,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43167699","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":"Supporting the implementation of guidelines to prevent mother-to-child-transmission of HIV in Malawi: a multi-case study.","authors":"Chifundo Zimba, Gwen Sherwood, Barbara Mark, Jeenifer Leeman","doi":"10.4314/mmj.v33i3.5","DOIUrl":"10.4314/mmj.v33i3.5","url":null,"abstract":"<p><strong>Background: </strong>High HIV infection and fertility rates contributed to over 12,000 children acquiring HIV from their mothers in 2011 in Malawi. To prevent mother-to-child transmission of HIV, Malawi adopted the Option B+ guidelines, and for three years, the University of North Carolina (UNC) Project provided support to strengthen guideline implementation in 134 health centres. Little is known about how implementation support strategies are delivered in low resource countries or contextual factors that may influence their delivery. The limited descriptions of support strategies and salient contextual factors limits efforts to replicate, target, and further refine strategies. Guided by the Interactive Systems Framework for Dissemination and Implementation, this study describes factors influencing implementation of support strategies and how they impacted health center staff capacity to implement Option B+ in Malawi.</p><p><strong>Methods: </strong>A qualitative multi-case study design was applied. Data were collected through site visits to 4 heath centres (2 low- and 2-high performing centres). We interviewed 18 support providers and recipients between October 2014 and October 2015. Data were analysed using content, thematic, and cross-case analysis.</p><p><strong>Results: </strong>Four categories of strategies were used to support Option B+ guidelines implementation: training, technical assistance (TA), tools, and resources. All heath-centres implemented Option B+ guidelines for care provided between the antenatal and labor and delivery periods. Gaps in Option B+ implementation occurred during community activities and during post-delivery care, including gaps in testing of children to ascertain their HIV status at 6 weeks, 12 months, and 24 months. Salient contextual factors included staffing shortages, transportation challenges, limited space and infrastructure, limited stocks of HIV testing kits, and large patient populations.</p><p><strong>Conclusions: </strong>Understanding factors that influence implementation support strategies and delivery of the Option B+ guidelines, such as availability of staff and other materials/drug resources, is critical to designing effective implementation support for low resource settings.</p>","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"33 1","pages":"178-185"},"PeriodicalIF":1.2,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8843178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41652266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacists' Readiness to Receive, Recommend and Administer COVID-19 Vaccines in an African Country: An Online Multiple-Practice Settings Survey in Nigeria.","authors":"Abdulmuminu Isah, Chukwuemeka Michael Ubaka","doi":"10.4314/mmj.v33i3.9","DOIUrl":"10.4314/mmj.v33i3.9","url":null,"abstract":"<p><strong>Background: </strong>Without a cure, vaccination is the most reliable means of combating COVID-19 pandemic, since non-pharmacological measures could not prevent its spread, as evidenced in the emergence of a second wave. This study assessed the readiness of pharmacists to receive, recommend and administer COVID-19 vaccines to clients in Nigeria.</p><p><strong>Methods: </strong>This was a cross-sectional study in which responses were collected from pharmacists in Nigeria through Google Form link. A 21-item questionnaire was developed and validated for the study. The link was shared on the WhatsApp groups of eligible respondents. The response was downloaded into Microsoft Excel (2019) and cleared of errors. This was uploaded into KwikTables (Beta Version 2021) for data analysis. Descriptive statistics such as frequencies and percentages were used to describe the data. Chi-squared test was used to determine the relationship between all the responses and the practice areas of the pharmacists.</p><p><strong>Results: </strong>A total of 509 pharmacists responded to the study, but 507 indicated their areas of practice. The highest response of 247(48.7%) was obtained from hospital pharmacists, then community pharmacists; 157(31.0%). Hospital and community pharmacists accounted for 96 and 66 of the 191(37.7%) pharmacists that would probably accept the vaccine (p=0.126). The Pfizer-bioNTech vaccine was the preferred brand for 275(54.2%) respondents. Healthcare Professionals>Elderly>General Populace>Children was the order of roll-out recommended by 317(62.5%). Adverse-effect-following-immunization was the concern of 330(65.1%) pharmacists. Age was a factor in their likelihood of recommending the COVID-19 vaccine to clients (p=0.001).</p><p><strong>Conclusion: </strong>This study established that most pharmacists are willing to accept to be vaccinated against COVID-19, recommend and administer it to other citizens. They were impressed by the effectiveness and cost of some of the vaccines, but were concerned about their possible adverse effects. The pharmacists would want the authorities to consider strategies that will make the vaccines accessible to all citizens.</p>","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"33 3","pages":"210-220"},"PeriodicalIF":1.2,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ef/1c/MMJ3303-0210.PMC8843180.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9591065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Herbal Medicine, Diabetes Care at Primary Care Facilities and Prevention of Vertical HIV Transmission.","authors":"Adamson S Muula","doi":"10.4314/mmj.v33i3.12","DOIUrl":"10.4314/mmj.v33i3.12","url":null,"abstract":"","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"33 1","pages":"229-230"},"PeriodicalIF":1.2,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8843182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42623203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seroprevalence of hepatitis B and C viral infections in the premarital adult population of Al Majmaah, Saudi Arabia","authors":"S. Mir, B. Alshehri","doi":"10.4314/mmj.v33i3.10","DOIUrl":"https://doi.org/10.4314/mmj.v33i3.10","url":null,"abstract":"Background Viral hepatitis is a major global health problem affecting millions of people worldwide. The main objective of the present study was to estimate the seroprevalence of hepatitis C and hepatitis B in Saudi adults undertaking premarital screening voluntarily. Methodology This observational retrospective study was conducted at King Khaled General Hospital, Al Majmaah, Saudi Arabia, for a period of 3 years (October 1, 2016 to September 30, 2019). The prevalence of hepatitis B and hepatitis C infections was calculated using Microsoft Excel and the hematological data analysis was performed using SPSS software. A total of 3755 premarital Saudi adults who voluntarily participated in the premarital screening were included in this study. Subjects were screened for hepatitis C virus (HCV) and hepatitis B virus (HBV). The demographic and epidemiological parameters included patient age, sex, nationality, and seropositivity for HBV and/or HCV. Results Of the 3755 subjects, eight (0.242%) and 12 (0.364%) subjects were positive for HCV and HBV, respectively. Among the 12 HBV-positive subjects, nine (75%) subjects were men, and three (25%) subjects were women. However, among the eight HCV-positive subjects, five (62.5%) subjects were men, and three (37.5%) subjects were women. Conclusion This study concluded that the prevalence of HBV infection was slightly higher than that of HCV infection among the Saudi adult population of Al Mjamaah. In addition, both HBV and HCV were less prevalent in women than in men in the study population.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"33 1","pages":"221 - 225"},"PeriodicalIF":0.8,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46575037","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":"Breast metastasis from rectal carcinoma: A case report and review of the literature","authors":"Dan-dan Wang, Su-jin Yang, Wei-xian Chen","doi":"10.4314/MMJ.V33I3.11","DOIUrl":"https://doi.org/10.4314/MMJ.V33I3.11","url":null,"abstract":"Background Metastasis from extramammary primary tumor to breast is extremely rare. Case Summary A 59-year-old woman with 1-year history of rectal cancer presented with asymptomatic breast mass. At 16 months after the diagnosis of rectal mucinous adenocarcinoma, a breast mass was confirmed by ultrasonography and identified by pathology and immunohistochemistry as a metastasis from the rectal cancer. Treatments included chemotherapy (6 cycles: 300 mg irinotecan on day 1, 4.5 mg raltitrexed on day 2, 450 mg bevacizumab on day 3), radiotherapy, and surgical resection. Two years of follow-up examinations (6-months intervals) showed no evidence of recurrence or novel distant metastasis. Conclusion Breast metastasis from rectal carcinoma is a rare secondary malignancy. Final diagnosis can be established by histopathology and immunohistochemistry.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"33 1","pages":"226 - 228"},"PeriodicalIF":0.8,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49621948","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}