Malawi Medical Journal最新文献

{"title":"A survey of ORF8 sequence and immunoinformatics features during alpha, delta, and wild type peaks of the SARS-CoV-2 pandemic in Iran","authors":"Alireza Tabibzadeh, Mohammad Hadi Karbalaie Niya, Hossein Keyvani, Sajad Karampoor, Parastoo Yousefi, Mohammad Hossein Razizadeh, Leila Mousavizadeh, Maryam Esghaei","doi":"10.4314/mmj.v35i2.5","DOIUrl":"https://doi.org/10.4314/mmj.v35i2.5","url":null,"abstract":"BackgroundThe Coronavirus disease 2019 (COVID-19) pandemic influences all around the world. The SARS-CoV-2 ORF8 accessory gene represents multiple functions in virus-host interaction. The current study aimed to compare the ORF8 substitutions and epitope features of these substitutions in the various SARS-CoV-2 outbreaks including delta, alpha, and wild type variants in Iran from 2020 to 2022. In addition, we evaluate B cell, HLA I and II epitopes, by in-silico approach to ORF8 binding site prediction.MethodsThe samples were collected from patients diagnosed with SARS-CoV-2 infection via a real-time PCR assay. Then, a conventional PCR was carried out for ORF8 mutations analysis and further Sanger sequencing. Possible important alterations in epitope features of the ORF8 were evaluated by epitope mapping. B cell, HLA class I and II epitopes, evaluated by online databases ABCpred, NetMHCpan-4.1, and NetMHCIIpan-3.2, respectively.Results The current study results could not represent novel variations in seven full-length ORF8 sequences or major ORF8 deletions in 80 evaluated samples. In addition, we could not find any ORF8 Δ382 during each outbreak of variants. Epitope mapping represents differences between the Alpha and other variants, especially in B cell potential epitopes and HLA I.ConclusionThe immunoinformatic evaluation of ORF8 suggested epitopes represent major differences for the Alpha variant in comparison with other variants. In addition, having mild pathogenesis of the Omicron variant does not seem to be associated with ORF8 alteration by phylogenetic evaluation. Future in-vitro studies for a clear conclusion about the epitope features of ORF8 are required.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136369112","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":"Perceptions of Physiotherapy students about their teaching environment at Kamuzu University of Health Sciences in Malawi","authors":"Grace Mukoka- Bwezani, Nesto Tarimo, Enock Madalitso Chisati, Emma Thomson","doi":"10.4314/mmj.v35i2.8","DOIUrl":"https://doi.org/10.4314/mmj.v35i2.8","url":null,"abstract":"IntroductionThe learning environment is defined as an environment where teaching is taking place, as perceived by both students and teachers. A conducive learning environment is critical for successful curriculum implementation, which also affects students’ academic performance. There have been initiatives introduced to improve the learning environment at Kamuzu University of Health Sciences (KUHeS). The purpose of this study was to ascertain physiotherapy final year students’ perceptions of their learning environment at KUHeS in Malawi.MethodologyThis study was conducted at KUHeS among final-year physiotherapy students. A retrospective, quantitative cross-sectional design was used. The study utilised secondary data on education environment which had already been collected using Dundee Ready Education Environment Measure (DREEM) forms. There were 26 completed DREEM forms for 2019/2020 academic year. Demographic data were captured. Mean and standard deviation were used to analyse the DREEM scores. Inferential analysis was conducted with p-value set at ≤ 0.05. Results The total DREEM mean score was 120/200 which represented a positive perception of students learning environment. Students’ academic self-perception scored the highest (69.13%), followed by students’ perception of learning (61.94%), students’ social self-perception (59.46%), students’ perception of atmosphere (56.25), and students’ perception of teachers (55.50%). Married students had negative perceptions (p-value = 0.05) of their teachers and students with previous college experience had positive perceptions of their academic performance (p-value = 0.02). Many statements under items of perception of teachers (mean score = 24) and social self-perceptions (mean score = 16) were considered negatively. ConclusionStudents in their final year of physiotherapy had positive perceptions of their learning environment. However, students’ perceptions of their teachers and social life were low. The learning environment had a significant impact on married students and those who had no prior experience with college life. Faculty development initiatives should aim to improve these critical areas.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136369269","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 relationship between nurses fear of COVID-19, professional commitment and tendencies to medical errors.","authors":"Derya Şımşeklı Bakirhan, Mehtap Tan","doi":"10.4314/mmj.v35i1.9","DOIUrl":"10.4314/mmj.v35i1.9","url":null,"abstract":"<p><strong>Aim: </strong>This study was conducted to investigate the relationship between nurses' fear of COVID-19, professional commitment and medical error tendency.</p><p><strong>Methods: </strong>This study was use correlational research design with 312 nurses in January-April 2021. Data were collected online using a demographic characteristics questionnaire, the Fear of COVID-19 Scale (FCV-19S), the Professional Commitment Scale (PCS), and the Scale of Tendency to Medical Errors (STME). The study was approved by ethics committee. Number, mean, and standard deviation were used for sociodemographic variables. Participants' FCV-19S, PCS, and STME scores were calculated. The correlations between scale scores were determined using Pearson's correlation coefficient and Spearman correlation analysis.</p><p><strong>Results: </strong>Participants had a mean FCV-19S, PCS, and STME score of 19±8.17, 72.21±13.58, and 4.58±0.51, respectively. FCV-19S scores were weakly and positively correlated with PCS overall score (r=0.200, p<0.001), \"willingness to make an effort (r=0.273, p<0.001)\" and \"belief in goals and values (r=0.115, p=0.043)\" subscale scores. FCV-19S scores were weakly and positively correlated with STME \"communication (r=0.119, p=0.036)\" subscale score.</p><p><strong>Conclusion: </strong>Nurses who feared more about COVID-19 were found to have higher professional commitment, greater willingness to make an effort, and stronger belief in goals and values. Nurses who feared more COVID-19 were less likely to make communication-related medical errors.</p>","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10645898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47376075","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":"Demographic characteristics, clinical presentation and in-hospital outcome among patients with Covid-19 in a Nigerian tertiary hospital.","authors":"Juliet I Mmerem, Uche S Unigwe, Michael O Iroezindu, Kyrian S Chukwu, Ifeyinwa L Ezenwosu, Geofrey O Okorie, Nneka M Chika-Igwenyi, Chidinma B Nwatu, Obinna D Onodugo","doi":"10.4314/mmj.v35i1.8","DOIUrl":"10.4314/mmj.v35i1.8","url":null,"abstract":"<p><strong>Background: </strong>We described the demographic/clinical characteristics and in-hospital outcome of patients with COVID-19 at the University of Nigeria Teaching Hospital (UNTH) during the first wave to inform evidence-based responses during subsequent waves in Africa.</p><p><strong>Methodology: </strong>We conducted retrospective cohort analyses of adult patients ≥18 years with PCR or GeneXpert-confirmed SARS-CoV-2 infection. Data was extracted from patients' medical records from 1st May to 30th September 2020. Based on disease severity, patients were either hospitalized (82) or managed at home (90). Logistic regression and cox-proportional hazard models were used to determine predictors of severe COVID-19 disease and in-hospital mortality, respectively.</p><p><strong>Results: </strong>Of 172 cases, 113 (65.7%) were males, and the mean age was 45 ± 19 years. The majority were urban dwellers (72.1%), 19.8% had a positive history of contact with a confirmed/suspected case, 15.7% were healthcare workers while 68 (39.5%) had co-morbidities. Symptomatic patients comprised 73.3% of cases. Fever (p=0.02) and breathlessness (p=0.03) were commoner in males while diarrhoea (p<0.01) was predominant in females. On multivariate analysis, severe COVID-19 was predicted by the presence of co-morbidity (AOR= 14.44, 95% C.I= 4.79- 43.58, p <0.001)and prior antibiotic/antimalarial use (AOR= 6.35, 95% C.I= 2.24- 18.05, p =0.001) while being a non-healthcare worker (AOR= 0.18, 95% C.I= 0.04-0.78, p=0.02) was protective. However, none of the variables assessed predicted in-hospital mortality.</p><p><strong>Conclusion: </strong>Our findings underscore the contributions of demographic variables in COVID-19 transmission and gender differences in clinical presentation. Underlying comorbidity likewise prior antimicrobial use increased the likelihood of severe COVID-19. The absence of mortality predictors in our study may be related to the relatively small number of deaths. Further studies are recommended to unravel the predominance of severe disease in healthcare workers.</p>","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10645895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45759230","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":"Epidemiology of out-of-hospital cardiac arrest: comparison of Turkish nationals and refugees.","authors":"İsmet Çelebı, Ahmet Ceylan","doi":"10.4314/mmj.v35i1.5","DOIUrl":"10.4314/mmj.v35i1.5","url":null,"abstract":"<p><p>The aim of this study is to conduct an epidemiological examination of Turkish citizens and refugees who requested an ambulance due to Out-of-hospital cardiac arrest (OHCA) at the Kayseri 112 emergency services between 2019 and 2020. This study was carried out in the province of Kayseri, which is one of the largest cities in Turkey. The study population includes OHCA patients for whom EMS were activated for any reason in 2019-2020. Data were taken from the Emergency Healthcare Automation System used by Kayseri Emergency Medical Services. A total of 5977 OHCA cases (Turkish 5736, Refugees 241) in which Emergency Medical Servises (EMS) was activated during the research period were included. A rate of 55.6% of patients Turkish nationality and 66.0% refugees were male (p<0.001). Observing at the cause of arrest, we find that 95.7% of cases among Turkish citizens and 82.6% of cases among refugees had a medical cause; while the suicide rate among Turkish citizens was 0.9%, this rate was 5.0% in refugee patients (p<0.001). It was found that the rate of OHCA increased with age and that the average OHCA age was lower in men and refugees. In addition, there is no difference between Turkish nationals and refugees in the use of emergency services for OHCA cases.</p>","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10645900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46666052","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":"Disease severity and renal function among sickle cell anaemia patients in a tertiary hospital, South-south, Nigeria: a cross sectional study.","authors":"Ajeigbe K Abiodun, Adejumo Oluseyi, Owojuyigbe Temilola, Ayinbuomwan Ekiye, Okesina A Bashiru","doi":"10.4314/mmj.v35i1.3","DOIUrl":"10.4314/mmj.v35i1.3","url":null,"abstract":"<p><strong>Background: </strong>Renal disease is a recognized complication of sickle cell anaemia (SCA), especially from the third decade of life and is linked to disease severity. This study assessed the association between disease severity and renal function among SCA patients using routine and newer markers of renal function.</p><p><strong>Methods: </strong>This cross-sectional study recruited 85 SCA patients. Disease severity was assessed using modified Adegoke criteria which include the frequency of transfusion, painful crises, packed cell volume, and history of complications such as hypertension and chronic leg ulcers. Renal function was assessed using urea, creatinine, and beta-2-microglobulin (β2-M). Association was determined between renal function and disease severity using Pearson's correlation. P-value < 0.05 was taken as significant.</p><p><strong>Results: </strong>The mean age of participants was 27.2 ± 7.6 years with 41(48.2%) males and 44 (51.8%) females. The mean packed cell volume, serum creatinine, serum urea, and β2-M were 24.0± 4.1%,17.6±7.5 mg/dL, 0.7±0.3mg/dL, 3.4±1.2mg/l respectively. A majority (54.1%) of them had a mild disease while 35.3% and 10.6% had moderate and severe diseases, respectively. Forty of the SCA patients had urine specific gravity below 1.010. The mean values of systolic blood pressure (p=0.001) diastolic blood pressure (p=0.001), serum creatinine (p=0.028) and β2M (p=0.019) significantly increased with disease severity. There was a significant positive correlation between SCA disease severity and serum urea (r=0.229; p=0.035), and serum β2-microglobulin (r=0.270; p=0.012).</p><p><strong>Conclusion: </strong>Sickle cell anaemia severity is associated with a decline in renal function using both traditional and novel renal markers. Serum β2-M may serve as a useful marker of renal function and disease severity in SCA.</p>","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10645894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43220324","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":"Management of sigmoid volvulus during labor: a challenging situation.","authors":"Sabri Selcuk Atamanalp, Esra Disci, Rifat Peksoz, Refik Selim Atamanalp, Cansu Tatar Atamanalp","doi":"10.4314/mmj.v35i1.13","DOIUrl":"10.4314/mmj.v35i1.13","url":null,"abstract":"","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10645896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45466602","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":"The paradox of Malawi's health workforce shortage: pragmatic and unpopular decisions are needed.","authors":"Adamson S Muula","doi":"10.4314/mmj.v35i1.1","DOIUrl":"10.4314/mmj.v35i1.1","url":null,"abstract":"","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10645906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46501918","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":"Indications, risk factors, and outcomes of emergency peripartum hysterectomy: A 7-year retrospective study at a tertiary center in Turkey.","authors":"Tayfun Vural, Burak Bayraktar, Suna Yildirim Karaca, Ceren Golbasi, Ozan Odabas, Cuneyt Eftal Taner","doi":"10.4314/mmj.v35i1.7","DOIUrl":"10.4314/mmj.v35i1.7","url":null,"abstract":"<p><strong>Objective: </strong>To determine the incidence, indications, the risk factors, complications, maternal morbidity and mortality of emergency peripartum hysterectomy (EPH), and perinatal outcomes at a tertiary hospital, Turkey.</p><p><strong>Methods: </strong>We analyzed 71 cases of EPH from 2012 to 2019 at a tertiary hospital in a retrospective study. There were 142 control patients.</p><p><strong>Results: </strong>There were 71 EPH out of 69,504 deliveries, for an overall incidence of 1.02 per 1000 births. The main indication for peripartum hysterectomy was abnormal placentation (67.6%), followed by uterine atony (28.1%), and uterine rupture (4.2%). Cesarean section (CS) and previous CS are major risk indicators for EPH. Other risk indicators are advanced maternal age (≥ 35 years) and multiparity. All patients with abnormal placentation had a previous CS. 93% of EPH were performed during and/or after CS, and 7% after vaginal delivery. 69% of EPH were made in total and 31% were subtotal. The three most common maternal morbidity included: wound infection and febrile morbidity (26.7%), bladder injury (16.9%), and disseminated intravascular coagulopathy (11.2%). There were no maternal deaths but perinatal mortality was 4%.</p><p><strong>Conclusion: </strong>The most common indication for EPH was abnormal placentation. Also, CS and previous CS are major risk factors of EPH. Other risk factors for EPH are advanced maternal age (≥ 35 years) and multiparity. Moreover, all unnecessary CS should be avoided.</p>","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10645903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42167219","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":"Application of the socio-ecological model in the efforts to end COVID-19 in Sub-Saharan Africa: The challenges and success stories.","authors":"Elvis E Tarkang, Hubert Amu","doi":"10.4314/mmj.v35i1.12","DOIUrl":"10.4314/mmj.v35i1.12","url":null,"abstract":"<p><p>The Novel Coronavirus (COVID-19) was detected in December 2019 in the Hubei Province of China. Also known as 2019-nCoV, the outbreak was declared a pandemic by the World Health Organization (WHO) in March 2020. The WHO thus proposed country and technical guidelines in responding to the COVID-19 pandemic. This paper reviewed the preparedness of sub-Saharan African (SSA) countries in ending the pandemic through the adoption of the WHO guidelines. The Socio-Ecological Model was adopted as a conceptual framework in conducting our analysis. We realized that while striving to implement the WHO guidelines, a plethora of microsystem, mesosystem, exosystem, macrosystem, and chronosystem factors make it difficult for SSA countries to achieve the desired results aimed at halting the spread of the virus. SSA countries may, therefore, not be able to end the COVID-19 pandemic soon. We recommend various interventions including short- and long-term loan facilities from donor agencies, decentralization of COVID-19 testing to sub-national levels, and increased community engagement to improve risk communication and adherence to public health measures to end the spread of COVID-19 in SSA.</p>","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10645901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45504797","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}