Medical journal of Zambia最新文献

{"title":"Bilharzial-associated Squamous Cell Carcinoma of the Bladder in Pregnancy: A Case Report","authors":"Suwilanji Simwanza, M. Lubeya, Patricia Chipalabwe, J. Kabwe, A. Nyirenda, D. Lombe, L. Kasonka","doi":"10.55320/mjz.48.3.191","DOIUrl":"https://doi.org/10.55320/mjz.48.3.191","url":null,"abstract":"Squamous cell carcinoma (SCC) of the bladder is a rare and devastating malignancy, usually associated with Schistosoma haematobium, particularly in bilharzia-endemic regions of sub-Saharan Africa. Little is written about the condition in pregnancy. \u0000A 21-year-old Gravida 2 Para 1 at 28 weeks gestation presented with worsening symptoms of dysuria, increased frequency of micturition, backache, a painful suprapubic mass and haematuria over a period of 3 weeks. On examination, vital signs were normal, the height of fundus was 26cm, with a tender suprapubic mass. Extraperitoneal laparotomy revealed multiple signs of a bladder malignancy which were confirmed by histopathology as Schistosoma haematobium ova and invasive keratinising SCC of the bladder, grade 1. Intraoperatively, T4 carcinoma staging was confirmed. The patient was delivered prematurely by caesarean section due to worsening symptoms. Palliative care was instituted as the functional status of the patient did not allow for definitive management. \u0000Subclinical urinary schistosomiasis can progress to a SCC of the bladder, presenting with symptoms implicated in conditions such as bladder lithiasis, Urinary tract infections and pregnancy. Urine cytology and mass drug administration should be enforced as means of early detection and prevention, respectively in endemic regions.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75507752","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":"Trosier's sign: A Rare Presentation of Metastatic Prostate Cancer","authors":"N. Chamileke, B.F.K. Odimba, Félix Michelo, Bupe Chilufya, Yani Bassem","doi":"10.55320/mjz.48.3.918","DOIUrl":"https://doi.org/10.55320/mjz.48.3.918","url":null,"abstract":"Prostate cancer is the second most common cause of cancer death in men globally. The most common sites of metastasis include the bone, lymph nodes, lungs, liver, pleura, and adrenal glands. A 65-year-old Zambian man presented with neck swelling for 3 months with mild lower urinary tract symptoms. He reported that the swelling was fast growing, painless and with no history of trauma. On examination, Trosier’s sign was present. Histology report following a lymph node incision biopsy demonstrated Adenocarcinoma. Prostate specific antigen (PSA) was also positive. A follow up prostate biopsy found adenocarcinoma Gleason 8. This case highlights the need for a high index of suspicion in older, male patients presenting with unexplained neck swelling and no known history of prostatic adenocarcinoma. \u0000 ","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90689776","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":"Clinical and Gynaecological Determinants of Menopause Symptom Severity in Kwara State, Nigeria","authors":"J. Olarinoye, A. Olarinoye, B. Olagbaye","doi":"10.55320/mjz.48.3.762","DOIUrl":"https://doi.org/10.55320/mjz.48.3.762","url":null,"abstract":"Background \u0000A number of factors are known to predict how menopause symptoms are perceived by women in different cultures. The aim of this study was to explore the correlation between the gynaecological and medical histories of middle belt Nigerian women and the severity of their menopausal symptoms. \u0000Method \u0000Women with natural menopause between age 40 and 60 years were randomly evaluated for menopause symptoms using Menopause Rating Scale (MRS) questionnaire. The total MRS scores were correlated with certain medical and gynaecological parameters using Pearson’s Bivariate Correlate while logistic regression analysis was used to isolate independent factors. \u0000Result \u0000Three hundred and eighty-five women responded for the study. Their mean age was 51.3±0.3 years. The mean MRS score was 14.02±0.44 and 40% of the women studied had severe symptoms on the rating scale while others were mild. Age, menstrual cycle length, age at first delivery, diastolic BP and mean arterial pressure were significantly correlated with the total MRS score but only the age showed an independent impact on regression analysis. History of breast problem, presence of diabetes and history of contraceptive use were also positively associated with menopause severity. \u0000Conclusion \u0000The medical and gynaecological histories of women play a significant role in determining how they perceive menopausal symptoms and cannot be ignored in their evaluation. \u0000 ","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"92 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78226513","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":"Diagnosis of Hunter Syndrome (Mucopolysaccharidosis Type II) in a Resource­ Limited Setting: A Case Report from Zambia","authors":"L. Nchimba, E. Mpabalwani, M. Inambao, Nfwama Kawatu","doi":"10.55320/mjz.48.3.769","DOIUrl":"https://doi.org/10.55320/mjz.48.3.769","url":null,"abstract":"Abstract \u0000Hunter syndrome is one of the Mucopolysaccharidosis (MPS), type II. It is a rare genetic disorder due to a deficiency in the enzyme Iduronate 2-sulphatase. This deficiency leads to the accumulation of glycosaminoglycans (GAGs) dermatan sulphate and heparan sulphate. The GAGs accumulate both intracellularly and extracellularly, leading to abnormalities in different organ systems in the body. The definitive diagnosis of Hunter syndrome requires biochemical methods which can be a challenge in resource-limited settings, Zambia included.  Presented here is a case of Hunter Syndrome in a 12-year-old male child and highlight clinical acumen as the main ingredient in making the diagnosis and distinguishing different types.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76311933","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":"Non-suicidal and Suicidal Self-harm at a Psychiatric Centre: A review of cases","authors":"L. Oluwole, A. Obadeji, M. Dada","doi":"10.55320/mjz.48.3.858","DOIUrl":"https://doi.org/10.55320/mjz.48.3.858","url":null,"abstract":"Background \u0000Previous self-harm has been reported as an important risk factor for future attempts and death by suicide, therefore understanding the psychosocial characteristics of people with a history of self-harm may help in developing models for reduction of suicide. The objective of this study was to present the psychosocial characteristics of patients who presented with self-harm and recorded them in our suicidality register. \u0000Method \u0000This is a review of the suicidality register of patients who presented with deliberate self-harm and were referred and reviewed by the psychiatric unit at the Ekiti State University Teaching Hospital (EKUSTH). Data were retrieved from the register and enter in SPSS version 25. Descriptive statistics such as mean with standard deviation and frequency were done to describe the characteristics of interest. \u0000Results \u0000Of the 33 cases reviewed, the majority were females 51.6%, aged 29years and below, single (67.7%), unemployed 17 (51.5%), and had depression as the primary psychiatry diagnosis (54.5%). Although multiple reasons were given for self-harm, the desire to die was the commonest (54.5%) while ingestion of poisons was the commonest (75.8%) method adopted. \u0000Conclusion \u0000Previous self-harm is an important risk factor for future attempts and death by suicide, understanding the psychosocial characteristics of people with a history of self-harm may help in developing frameworks for a surveillance system for self-harm and attempted suicides.  ","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89465976","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":"The Obstetric outcomes associated with advanced maternal age at the University Teaching Hospitals Women and Newborn Hospital in Lusaka, Zambia","authors":"Felix Simute, L. Kasonka, B. Vwalika","doi":"10.55320/mjz.48.3.894","DOIUrl":"https://doi.org/10.55320/mjz.48.3.894","url":null,"abstract":"Introduction: Pregnant women aged 35 years and above have traditionally been termed as of advanced maternal age. These women are considered to have a higher incidence of obstetric complications than younger ones \u0000Objectives: To investigate socio-demographic characteristics and obstetric outcomes in women of advanced age who delivered at the Women and Newborn Hospital, in Lusaka, Zambia. \u0000Methods: This was a cross-sectional study in which a total of 226 postnatal women, both of advanced (35 years and above) and optimal age (20 - 34 years), that met the eligibility criteria were recruited. Systematic random sampling was used to recruit study participants and data was collected using a structured questionnaire, review of patient's hospital records, and the labour ward delivery registers. Statistical analysis was performed using a statistical package for social sciences (SPSS) version 26 software. \u0000Results: The prevalence of advanced maternal age was 14.1%. The mean ages were 38years (range 35 - 46 years) and 28 years in advanced and optimal maternal age groups respectively. Socio­ demographic characteristics that were found to be significantly associated with advanced maternal age included; education (P=0.036), occupation (P= 0.015), the cultural belief of large families (P=0.003), and contraception use (P= 0.001). There were more married women among advanced age women 105 (92.9%) than among optimal age women 99 (87.2%), however, there was no significant difference between the two groups (P=0.262). Divorce (P=0.689), income (P=0.701), and history of subfertility P=0.291) were also not found to be different between the two groups. With regards to maternal outcomes, advanced maternal age was significantly associated with severe pre­ eclampsia (AOR 2.131; 95% CI 1.190 - 3.816; P=0.011), postpartum haemorrhage (AOR 1.400; 95% CI 0.187 - 0.855; P=0.018), caesarean deliveries (AOR 1.395; 95% CI 1.115 - 4.719; P=0.028) and antepartum haemorrhage (AOR 2.425; 95% CI 1.029 - 5.714; P=0.043). On foetal outcomes, advanced maternal age was significantly associated with NICU admissions (AOR 3.075; 95% CI 1.298 - 7.287; P=0.011). However, there was no association with APGAR score at 5 minutes (P=0.174), birth weight (P=l.000), gestation age at birth (P=0.676), and PROM (P=0.557) \u0000Conclusion: Generally, women of advanced maternal age were associated with more adverse obstetric outcomes than women of optimal childbearing age. Hence, there is a need to sensitise these women and their spouses on the risk of advanced maternal age on obstetric outcomes and the need for not postponing conception until the late 3rd decade of life.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79101769","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":"Congenital pulmonary airway malformation-Two case reports and diagnosis challenges in a resource limited setting","authors":"Muleya Inambao Inambao KKazuma azuma, Susanna Mwanza, L. Nchimba, Chalilwe Chungu, Jonathan Nchengamwa, D. Kabamba, E. Mpabalwani","doi":"10.55320/mjz.48.3.810","DOIUrl":"https://doi.org/10.55320/mjz.48.3.810","url":null,"abstract":"Congenital Pulmonary Airway Malformation (CPAM) is a rare abnormality of pulmonary airway malformation and may remain undiagnosed until it is discovered as an incidental finding later in life. Reported here are two cases of CPAM, a seven-month-old infant and a two-year-old toddler. A seven-month-old ex-premature male infant presented with recurrent pneumonia and failure to thrive. He had an unresolving consolidation on chest radiograph and was eventually treated as pulmonary tuberculosis with no response. Computerised tomography scan (CT-scan) chest revealed bilateral CPAM of lungs. A 2-year-old female toddler presented to the University Teaching Hospital, Department of Paediatrics & Child Health, as a referral from a second level hospital with a long-standing history of recurrent symptoms and signs of pneumonia with failure to thrive. She was commenced on antituberculous treatment with no improvement. A CT-scan of the chest revealed bilateral CPAM of lungs. These two cases highlight clinical, diagnostic and treatment challenges in children with CPAM in a resource limited setting like Zambia.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"90 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75640167","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":"Early versus late presentation in labour by parturient women at a tertiary facility in North Central Nigeria: A cross-sectional study","authors":"G. Ezeoke, K. Adesina, Afusat Olabinjo, Olumuyiwa O. Ogunlaja, A. Fawole, A. Adeniran","doi":"10.55320/mjz.48.3.821","DOIUrl":"https://doi.org/10.55320/mjz.48.3.821","url":null,"abstract":"Background: Adequate intrapartum care is important in modulating pregnancy outcome through prevention, early recognition and appropriate treatment of intrapartum complications. \u0000Aim: To compare labour outcome following early to that of late presentation in labour. \u0000Methods: A comparative study at a tertiary hospital in North central Nigeria. Participants were pregnant women who presented early (cervical dilatation ≤ 5cm) or late (cervical dilation 9 or 10cm) at the study site with singleton, live foetus at ≥28weeks gestation. Deliveries before arrival at the delivery room were excluded from the study. Data was obtained from the hospital delivery records while data management was performed with SPSS version 21.0; p-value <0.05 was significant. \u0000Results: Out of the 8,645 deliveries, 5,809 (67.2%) presented early while 2,836 (32.8%) presented late in labour. Late presentation was higher among booked women (1716 vs. 1120; p<0.001) as well as prior treatment and presentation after onset of complications (1964 vs. 872; p<0.001). Labour interventions including augmentation of labour (2718 vs. 316; p<0.001), episiotomy (2319 vs. 949; p<0.001), assisted breech delivery, ventouse, forceps and caesarean deliveries were higher for early while obstructed labour (95 vs. 238) was higher for late presentation. The perinatal mortality was 78/1,000 and 192/1,000 live birth for early and late presentations in labour. \u0000Conclusion: Late presentation in labour is associated with higher perinatal mortality; antenatal clinic health education should emphasize early presentation in labour while admissions into health institutions should be regulated based on available manpower and facilities for patient management.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75525705","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":"Can medicine be taught online? Cavendish University's transition from contact classes to online learning during the COVID-19 pandemic","authors":"Longa Kaluba, Mordecai Malambo, Christine Mutati, Pauline Chabinga, M. Simuyemba, Welani Chilengwe, Muhumpu Kafwamfwa","doi":"10.55320/mjz.48.3.829","DOIUrl":"https://doi.org/10.55320/mjz.48.3.829","url":null,"abstract":"Introduction: The COVID-19 pandemic imposed dramatic changes on teaching and learning worldwide. Many universities transitioned from contact classes to utilizing fully electronic online modes. This study aims to evaluate Cavendish University School of Medicine students' online learning experience during the COVID-19 pandemic. \u0000Method: This was an exploratory cross-sectional study that used simple random sampling to select participants at Cavendish University Zambia. An online questionnaire was distributed to the selected students at the time of the conclusion of the semester. The survey was voluntary, and all data were collected and recorded via google forms with maintaining anonymity. \u0000Results: A total of 385 participants took part in the survey. Most of the participants were female124 (50.4%) and studying MBChB 171 (44.7%). The study found that there was a significant difference in the level ofunderstanding(p value=0.01), the ability to explain online classes (p value=0.04), and internet reliability (p value=0.04) across and within programs. Most students were affected by load­ shedding but the observed difference in median scores was not significant (p value=0.07). \u0000Conclusion: Teaching online presented an opportunity to complete the semesters' curriculum during the coronavirus pandemic. With obstacles like electricity load shedding and unstable internet reliability, students reported high rates of motivation, confidence in the materials taught, and exam preparedness.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85712780","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":"Opinions of Zambian Radiographers on Extending their Role in Interpretation and Reporting on General Radiographic Images: A Cross-Sectional Survey","authors":"O. Bwanga, E. Chanda, Stefan Kafwimbi, J. Sichone","doi":"10.55320/mjz.48.3.896","DOIUrl":"https://doi.org/10.55320/mjz.48.3.896","url":null,"abstract":"Background: There is a critical shortage of radiologists in Zambia to report on all imaging examinations. Radiologists have concentrated on specialised imaging examinations, thereby leaving the interpretation of general radiography examinations to the referring medical practitioners, whose competence in image interpretation is not at the same level as radiologists. This can lead to misdiagnosis and mismanagement of patients. \u0000 Objective: This study aimed at determining the opinions of Zambian radiographers on extending their role in the interpretation and reporting of general radiographic images. \u0000 Methodology: This study was conducted using a cross-sectional survey approach. Data were collected using an online questionnaire. Radiographers with a minimum of two years’ work experience were invited to participate in the study. Both quantitative and qualitative data were collected. Descriptive statistics were used to analyse quantitative data, while thematic analysis was used for qualitative data. \u0000 Results: A total of 81 participants responded to the survey. A major finding showed that most radiographers (N=78, 95%) had a positive attitude towards image reporting because it improves the delivery of imaging services. Most of the radiographers were also willing to be trained at a postgraduate level (93%, N=76), and indicated the need to extend the scope of practice to include image reporting (N=78, 95%). The main challenges identified were inadequate advocacy and possible resistance from medical professions. \u0000Conclusion:  Radiographers are prepared to venture into image reporting. It is anticipated that this role extension can supplement radiologists in providing diagnostic reports and ensure that all patients have access to this service. \u0000 ","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79980531","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}