South Sudan Medical Journal最新文献

{"title":"Reflections on a clinical observership in London: Lessons and impact on medical training","authors":"Patrick Mayan Paul","doi":"10.4314/ssmj.v17i2.8","DOIUrl":"https://doi.org/10.4314/ssmj.v17i2.8","url":null,"abstract":"No abstract.","PeriodicalId":56200,"journal":{"name":"South Sudan Medical Journal","volume":"27 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141109242","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":"Prevalence and associated factors of family planning among students of health training institutes in Juba: A cross sectional descriptive study","authors":"Kon Alier, Ezbon WApary, Akway Cham, Rita Tulba, Lueth Garang, Abdallah Malual, Tumalu Angok, Achol Ajuet, Aldo Kuot, Donato Akuei","doi":"10.4314/ssmj.v17i2.3","DOIUrl":"https://doi.org/10.4314/ssmj.v17i2.3","url":null,"abstract":"Introduction: Family planning (FP) is less prevalent in South Sudan yet information on the subject is scarce and varied from one source to another. This study assessed the prevalence and associated factors in family planning among students at health science training institutes in Juba City. \u0000Method: This was a cross-sectional survey of students’ self-reported utilisation of FP methods. Four hundred randomly selected students from five health training institutes (HTIs) in Juba City participated. Data collection was done using a pretested structured questionnaire. IBM SPSS 23 software was used for data analysis. Chi squared tests and regression analyses were performed to determine the associated factors. \u0000Results: Among the 400 participants, the lifetime prevalence of FP methods was 77.3%, of which modern contraceptive use was 22%. FP was more prevalent among participants aged 45-50 (85.7%) and females (80.7%). Eighty-seven percent of divorced couples and 91.3% of traditional believers reported practicing FP. More nursing/midwifery cadres within the professional category reported practicing FP, as well as 90.4% of rural respondents. Eighty-three percent of respondents working in pharmacies said they practice FP, compared to 68.1% of those working in clinics. FP practice was similar among participants who were aware (78.9%) and those who denied being aware (72.5%). Marital status (p < 0.001), religion (p < 0.001), residence (p < 0.001), and place of work (p = 0.037) were significantly associated with FP. \u0000Conclusion: The prevalence of family planning among students at Health Training Institutes in Juba City is high compared to national estimates, but the contraceptive overall prevalence rate is still low. It is significantly associated with marital status, religion, residence, and place of work. There is a need to continue the effort.","PeriodicalId":56200,"journal":{"name":"South Sudan Medical Journal","volume":"56 42","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141108528","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":"Ischaemic strokes and myocardial infarctions in a young male cannabis user","authors":"Annabelle Culling, Eluzai Hakim, Oliver Pearce, Michelle Dharmasiri","doi":"10.4314/ssmj.v17i2.4","DOIUrl":"https://doi.org/10.4314/ssmj.v17i2.4","url":null,"abstract":"Ischaemic cerebral infarctions are seen in young people but, under the age of 30, multiple bilateral infarcts are uncommon; genetic pre-disposition and co-morbidities often underlie them. There is growing awareness of the potential impact of modifiable risk factors, such as cannabis, for those experiencing stroke and other cardiovascular events. A case of a 29-year-old man is de­scribed who presented with sudden onset occipital headache and right eye vision loss. Computerised axial tomographic scanning (CT) of the brain dem­onstrated multifocal bilateral areas of low attenuation. A brain magnetic reso­nance imaging (MRI), confirmed bilateral acute cerebral infarctions. In view of a significant elevation in troponin levels at a previous admission, cardiac via­bility magnetic resonance imaging (cvMRI) was carried out and demonstrated acute infarction affecting the left ventricular apex and multiple smaller infarcts elsewhere within the myocardium. On this occasion he did not complain of chest pain. The electrocardiogram (ECG) showed ischaemic changes. The patient denied a family history of ischaemic heart disease, diabetes mellitus, hypertension and hypercholesterolaemia, but admitted to daily use of can­nabis and cigarette smoking. We considered the regular use of cannabis as a possible aetiology in the development of multi-territory cerebral and myocar­dial infarcts, previous myopericarditis and left ventricular dysfunction","PeriodicalId":56200,"journal":{"name":"South Sudan Medical Journal","volume":"34 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141111242","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":"Inadequacy of a 12.5 cm MUAC as a cutoff for malnutrition for children aged three to five years","authors":"Emmanuel Gai, J. C. McIntosh","doi":"10.4314/ssmj.v17i2.2","DOIUrl":"https://doi.org/10.4314/ssmj.v17i2.2","url":null,"abstract":"Introduction: MUAC (mid-upper arm circumference) is a simple and easily taught screening tool for identifying malnutrition in children. South Sudan use a MUAC of 12.5 cm for children aged between six months and five years as a cut-off for moderate acute malnutrition. Currently, in South Sudan, children from six months to five years have the same MUAC cutoff for malnutrition. \u0000Method: This study evaluated the sensitivity of using a MUAC of 12.5 cm as a screening tool for children between 6 and 60 months applied to data obtained from children enrolled in urban and rural primary schools in Maridi County, South Sudan. We used the 12.5 cm cutoff which was 2 standard deviations from the median for boys at nine months and for girls at 20 months. We also used 14.0 cm as the cutoff and compared the number of children identified, and also the false positive rate, assuming -2 SD from the median to be the accepted norm for malnutrition. Finally, we considered two different standards, using 14.0 cm for children aged 3-5 years and 12.5 cm for children under three years. \u0000Results: Comparing the results obtained using the two different MUAC standards (12.5 cm versus 14.0 cm) against a single MUAC standard there is a dramatic difference in outcome. Using the current standard (12.5 cm), only 7.3% of the children were found to be malnourished. Using 14.0 cm, 33.8 % were found to be malnourished (Table 4). If we accept the norm of 2 SD below the median for age as an adequate definition of malnutrition, the false positive rate using 14.0 cm is 9.6 %, an acceptable figure for a screening device, but the false negative rate for 12.5 cm is 17.4 %, a clearly unacceptable rate for a screening device. If, however, instead of using one cut-off for children from six months to five years, a period characterized normally by rapid growth and changes in body composition, we used two different standards—12.5 cm for those under three years and 14 cm for those aged 3-5 years, the number of false positives drops down to 2.7% and false negatives to 0.9 % \u0000Conclusion: We suggest that the use of 12.5 cm for malnourished children is inappropriate above two years, that 14 cm would be a more appropriate screening measurement from 3-5 years of age.","PeriodicalId":56200,"journal":{"name":"South Sudan Medical Journal","volume":"59 33","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141108249","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":"A haemopneumothorax revealing thoracic endometriosis","authors":"K. Ghebouli, A. Haddam, Amar Djender, M-A Kecir, M. Belbekri, S. Merouani, Houda Amrane, Kenza Bendjoudi","doi":"10.4314/ssmj.v17i2.5","DOIUrl":"https://doi.org/10.4314/ssmj.v17i2.5","url":null,"abstract":"Thoracic endometriosis is a rare disease but its actual frequency may be underestimated. Optimal management remains controversial. A multidisciplinary management approach, including surgery and hormone therapy, seems to give the best results and reduces recurrence. We report a case of a patient presenting with recurrent haemopneumothorax caused by thoracic endometriosis and treated surgically by video thoracoscopy and hormonal treatment.","PeriodicalId":56200,"journal":{"name":"South Sudan Medical Journal","volume":"53 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141110768","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":"A giant primary ovarian fibrosarcoma in a South Sudanese patient","authors":"Isaac Rial, Lifteri George Vasilli, Kenneth Sube, Suni Anthony, Stephen Lukudu, Justin Tongun, Joseph Lako","doi":"10.4314/ssmj.v17i2.6","DOIUrl":"https://doi.org/10.4314/ssmj.v17i2.6","url":null,"abstract":"Ovarian fibrosarcomas account for less than 1% of all ovarian malignancies. Clinical diagnosis is extremely difficult. A 20-year-old, illiterate, married nulliparous woman presented to our Outpatient Department Clinic (OPD) with chronic abdominal distension. Ultrasound and CT scan revealed a very large intra-abdominal mass, 23.8x27.8x35.7cm. She underwent a laparotomy and left salpingo-oophorectomy with her uterus and right adenexum conserved. After surgery, the mass weighed 11.1kg and measured 43x38x35cm. Histological findings were in line with a giant primary ovarian fibrosarcoma. To date, as far as we are aware, this is the largest ever recorded primary ovarian fibrosarcoma.","PeriodicalId":56200,"journal":{"name":"South Sudan Medical Journal","volume":"30 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141112465","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":"Endoscopically diagnosed hookworm infestation in an adult with chronic iron deficiency anaemia","authors":"Mohamed Mukhtar Abdirahman, Emmanuel Baruhanga, Andrew Muhumuza, Robert Wagubi, Raymond Atwine, Christine Tumuhimbise, Florence Tusiime, Caleb Tuhumwire, B. Lumori","doi":"10.4314/ssmj.v17i2.7","DOIUrl":"https://doi.org/10.4314/ssmj.v17i2.7","url":null,"abstract":"Despite advances in hookworm control and prevention campaigns, the prevalence remains high in sub-Saharan Africa. Iron deficiency anaemia is a major complication in those with prolonged infection, a high hookworm burden, and undernutrition, though most infected people are asymptomatic. While infected patients are commonly diagnosed by the presence of ova or cysts in the stool, gastrointestinal (GI) endoscopy is required for those with negative stool tests and chronic iron deficiency anaemia. A 48-year-old female with symptoms of anaemia for nearly two years presented to Mbarara Regional Referral Hospital with worsening palpitations, easy fatigability, and dizziness over a period of one month. She was given blood transfusions on two occasions. She lives near the lake where she also gets water for drinking and domestic use. We advise GI endoscopy for all patients with chronic iron deficiency anaemia of unexplained aetiology on standard non-invasive testing. Hookworm’s mass empirical treatment policy in endemic areas should be further emphasised.","PeriodicalId":56200,"journal":{"name":"South Sudan Medical Journal","volume":"33 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141110813","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":"No smoke without fire: Recreational cannabis use among South Sudanese youth","authors":"Nyakomi Adwok","doi":"10.4314/ssmj.v17i2.1","DOIUrl":"https://doi.org/10.4314/ssmj.v17i2.1","url":null,"abstract":"No abstract.","PeriodicalId":56200,"journal":{"name":"South Sudan Medical Journal","volume":"61 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141113133","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":"Prevalence and perceptions of voluntary medical male circumcision among University of Juba students, South Sudan","authors":"K. Alier, Akway M. Cham, Jonathan Majok, K. Sube, Achan Nyang, Ezbon Wapary, James Malek, John Makuei, Jok Malith, Lual Mayuol, Yak Adim","doi":"10.4314/ssmj.v17i1.3","DOIUrl":"https://doi.org/10.4314/ssmj.v17i1.3","url":null,"abstract":"Introduction: Voluntary medical male circumcision (VMMC) is one of the key interventions against heterosexual spread of HIV. However,  its prevalence in South Sudan is not clearly understood. This study aimed to assess the prevalence and perceptions of VMMC among  University of Juba students.Method: A cross sectional descriptive study design was adopted. Data from randomly selected students from six schools of the University  of Juba were collected using a respondent-administered structured questionnaire. IBM SPSS Statistics version 23.0 was used  for data analysis. Chi-squared tests were performed to determine variables significantly associated with VMMC.Results: Amongst 390 students interviewed, the prevalence of VMMC was 41.8% and the overall male circumcision rate was 83.8%. Most  respondents expressed positive attitudes and perceptions towards VMMC. The respondents believe VMMC is an important health  programme. The decision to get circumcised is associated with age, marital status, religion and state of origin (p<0.001).Conclusion: Most participants were circumcised and perceive VMMC positively. A countrywide study and scale up of the current VMMC  programme are recommended.","PeriodicalId":56200,"journal":{"name":"South Sudan Medical Journal","volume":"14 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139958669","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":"Paranasal sinuses in patients with chronic rhinosinusitis,Tanzania","authors":"E. Massawe, Happy E. Somboi, Asterius Muganyizi, Petra Joseph","doi":"10.4314/ssmj.v17i1.4","DOIUrl":"https://doi.org/10.4314/ssmj.v17i1.4","url":null,"abstract":"Introduction: Chronic rhinosinusitis is inflammation of the nasal cavity and paranasal sinuses that lasts for at least twelve weeks.  Paranasal sinus variations account for various pathologies, including chronic rhinosinusitis. This study assessed the anatomical variations  of paranasal sinuses among patients with chronic rhinosinusitis attending otorhinolaryngology services in a tertiary hospital in Tanzania. \u0000Method: This was a descriptive prospective cross-sectional study of 120 patients aged 15 years and above who fulfilled the Rhinosinusitis  Task Force criteria. A structured checklist was used to collect socio-demographic characteristics and clinical presentations. Cone-beam  computed tomography scan and the Lund-Mackay scoring system were used. Data analysis was done using SPSS version 26, and p-values  <0.05 were considered statistically significant. \u0000Results: A total of 120 patients were enrolled with a median age of 37 (IQR 27-52)  years, with 40% aged 30-49 years. There were 65 (54.2%) males, and 55 (45.8%) females. Maxillary sinuses were affected in 85.8% of all  patients with chronic rhinosinusitis. The overall proportion of anatomical variation was 53.3%, with concha bullosa, deviated nasal  septum, Onodi cells, and septal spur being the most common, accounting for 40.6%, 25.0%, 23.4%, and 20.3%, respectively. Twenty-four  patients with concha bullosa had chronic maxillary rhinosinusitis, with 14 (58.3%) having ipsilateral rhinosinusitis. \u0000Conclusion: Half of the  patients had one or more paranasal sinus anatomical variations. The most common variants were concha bullosa followed by deviated  nasal septum. Onodi cells and septal spurs were rarely identified. Most patients with concha bullosa had ipsilateral maxillary sinusitis.  ","PeriodicalId":56200,"journal":{"name":"South Sudan Medical Journal","volume":"214 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140449730","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}