Medical journal of Zambia最新文献

{"title":"PATTERN OF MANDIBULAR FRACTURES IN A NIGERIAN TERTIARY HEALTH INSTITUTION; A 4-YEAR RETROSPECTIVE STUDY","authors":"M. Adeyemi, M. Ernest, Shakira Sanni-Abdullahi, Ehigie Igben, Ashiru Garba, Mirian Nnebedum","doi":"10.55320/mjz.50.3.422","DOIUrl":"https://doi.org/10.55320/mjz.50.3.422","url":null,"abstract":"Background: According to surveys, mandibular injuries aetiology varies between countries and even between centers in the same country. Mandibular fractures are the second most frequent facial injury, accounting for 15.5% to 59% of all facial fractures globally. The study aimed to find out if there were predictable patterns of fractured in the north central part of Nigeria. \u0000Materials and Methods: Mandibular fracture patients treated during a 4-year period were identified in a retrospective analysis and examined based on factors including age, sex, mode of trauma, month and day of the week of presentation, number and anatomic location, treatment method and sequelae. \u0000Results: The study reviewed 75 participants between the ages of 2 and 70. The mean age was 30.69 ± 11.22 years, and the gender split was 70 males (93.20%) and 5 females (6.80%), with a p-value of 0.09.  The main cause was motorbike accident (68%) and head on collision was the major mechanism of trauma road traffic accidents (RTAs, 68.8%) and none of motorbike riders nor did passengers wear crash helmet. A total of ninety-nine fractures out of one hundred and six fractures were observed in males.  A small percentage of patients (33%) exhibited altered consciousness, however there was no statistically significant link between the aetiology and level of consciousness (p=0.818). \u0000Conclusion: The mandibular body was most severely impacted and the primary mechanism of injury was head-on collision between two motorbikes. Speed restrictions and legislative law should be placed on the use of crash helmet.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"156 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140477318","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":"Diastolic dysfunction due to bedaquiline: A case report","authors":"Ireen C. Bwalya","doi":"10.55320/mjz.50.3.412","DOIUrl":"https://doi.org/10.55320/mjz.50.3.412","url":null,"abstract":"Abstract \u0000Background \u0000There is no published case of diastolic dysfunction arising due to bedaquiline treatment for Multi-Drug Resistant Tuberculosis (MDR-TB). Diastolic dysfunction is not listed as a potential complication of treatment with bedaquiline. This case report is the first to link bedaquiline to diastolic dysfunction. Clinicians should be aware of this potential complication, and ensure that patients are monitored and investigated appropriately. \u0000Case Presentation \u0000A 47 year old female presented with fever, productive cough and drenching night sweats for more than 2 weeks prior to presentation. There was no hemoptysis, chest pains or weight loss. She however, felt breathless after a heavy bout of coughing.  Fever was intermittent, and most pronounced at night. The patient denied any weight loss over the past month. The patient had no history of HIV, diabetes, hypertension or  heart disease. There were no previous episodes of TB. There was history of contact with a patient with MDR-TB patient. The patients’ son, who shared a house and all living spaces with the patient, was being treated for MDR-TB at the time of presentation. The patient did not drink or smoke. There was no history of illicit drug use. She worked as a restaurant manager.  Due to the history of very close contact with MDR-TB, the patient was commenced on the longer, oral only regimen for MDR-TB which includes bedaquiline. Four weeks after commencement of bedaquiline, the patient complained that both feet were swelling.  There were no other symptoms or signs of cardiovascular disease. An Echocardiogram done during the fifth month showed an ejection fraction of 71% and diastolic dysfunction. The patient was commenced on diuretics and continued on MDR-TB treatment. An echocardiogram that was repeated at month 15 review showed an ejection fraction of 64%, normal left ventricle and normal systolic and diastolic function. \u0000Conclusions \u0000Diastolic Dysfunction has not previously been reported in patients on bedaquiline. This is the first case report to link bedaquiline to diastolic dysfunction. More studies need to be done to determine conclusively whether bedaquiline can cause diastolic dysfunction.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"43 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140475950","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":"Vitamin D deficiency and its associated factors in active TB patients at a tertiary hospital and three primary health care level facilities in Lusaka, Zambia: A cross sectional analytical study","authors":"Chalomba Chitanika, Patrick Lungu, S. Lakhi","doi":"10.55320/mjz.50.2.347","DOIUrl":"https://doi.org/10.55320/mjz.50.2.347","url":null,"abstract":"Background: Tuberculosis (TB) remains a leading infectious cause of morbidity and mortality in Zambia. Vitamin D deficiency has been associated with increased TB incidence and severity but data for the Zambian setting is lacking, inclusive of the general population. We sought to determine the prevalence of vitamin D deficiency and its associated factors in active TB patients in comparison to matched adults from the general population without TB, and to compare clinical and radiological severity of TB based on vitamin D status. \u0000Methods: We enrolled 89 TB patients and 78 matched adults from the general population. Demographic and clinical data was collected. The key findings on physical examination were body mass index (BMI), mid upper arm circumference (MUAC), and signs of undernutrition. Clinical severity was assessed using the TB I Score and the Karnofsky Performance Index (KPI).Chest x-ray  and measurement of serum vitamin D levels  were done. Radiological severity was assessed using the Timika chest x-ray score. Vitamin D was measured using the Cobas® E411 analyser from Roche Diagnostics (Germany) with vitamin D deficiency defined as <30 ng/ml and chi square used to analyse vitamin D deficiency as a categorical variable. \u0000Results: The median (IQR) age was 27.5 (24-38) years in the TB patients and 32 (25-37)  years in the non-TB adults (p=0.30).Sixty-nine (77.53%) of the TB patients and 57 (73.08%) of the comparison group were male (p=0.51). The prevalence of vitamin D deficiency was 33.71 % in the TB patients and 15.38% in the comparison group (p <0.01). Associations with vitamin D deficiency were active TB (AOR =2.27; 95% CI = 1.04- 4.95; p=0.04) and undernutrition (AOR 14.5; 95% CI 1.65-126.97; p=0.02). Median (IQR) KPI was 70 (60-80) in the vitamin D deficient patients compared to 80 (70-90) in non- vitamin D deficient patients (p=0.01). Median (IQR) Timika chest x-ray score was 75 (45-115) in the vitamin D deficient TB patients compared to 42.5 (20-75) in the non- vitamin D deficient patients (p<0.01). \u0000Conclusions: We found a significant difference in the prevalence of vitamin D deficiency in active TB patients compared with matched non-TB adults. Vitamin D deficiency was associated with active TB and under nutrition. TB patients with vitamin D deficiency had more clinical and radiological severe disease than those with normal vitamin D levels. These findings warrant further studies on the role of vitamin D supplementation in TB in Zambia. \u0000 ","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"96 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139387967","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":"Age of Onset of Menopause and Factors Associated with Common Symptoms Among Women in Lusaka District, Zambia","authors":"Mabvuto Mulenga","doi":"10.55320/mjz.50.2.407","DOIUrl":"https://doi.org/10.55320/mjz.50.2.407","url":null,"abstract":"Background: Menstrual periods do not normally end suddenly; instead, there is frequently a period of transitional changes before and following the cessation of the period. Women typically endure physiological changes as a result of hormonal fluctuations, which impact their physical, emotional, and quality of life. Therefore, this study explored menopausal associated problems occurring in women residing in Lusaka, Zambia. Methods: A cross-sectional study was conducted for a period of six months on 171 women aged 40 – 60 years old who were bedsitters for a hospital patient or visited the hospital. The univariate (unadjusted) and multivariable (adjusted) logistic regression using backwards stepwise analysis was performed to identify factors associated with the most common symptom women face after menopause reporting at 95 % confidence interval (95 % CI). Results:  The study revealed that the average age of menopause onset was 47.43 ± 4.46 years, with 75% of the women experiencing menopause between the ages of 45 and 55. Women complained of back pain (66.1%), headache (45%), hot flushes (30.6%), and mood changes (24.0%). Widowed (AOR 2.94; 95 % CI: 1.24–6.63), Obese (AOR 3.19; 95 % CI: 1.16 – 8.73), overweight (AOR 3.91; 95 % CI: 1.31 – 11.73) and early menopause (AOR 0.35, 95% CI: 0.13 – 0.92) were associated with back pain. Conclusion: Women experience a variety of menopausal and postmenopausal problems like back pain, headache, hot flushes and mood changes which will require interventions to improve the health of women.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":" 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139138510","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":"Factors associated with successful In-Vitro Fertilization Treatment at Lusaka IVF and Fertility Clinic in Zambia","authors":"Flavia Muyinza Nalule, Mazuba Makamo, Sali Edward Tamale, B. Vwalika","doi":"10.55320/mjz.50.2.372","DOIUrl":"https://doi.org/10.55320/mjz.50.2.372","url":null,"abstract":"Background: The considerable emotional, physical and financial burden associated with infertility and its treatment in general, demands that factors strongly associated with the outcome should be identified and regulated prior to embryo transfer. This will improve the outcome of IVF and provide a patient centered approach to treatment. Methods: This was a cross sectional study at the Lusaka IVF and fertility clinic. The study aimed to identify factors associated with successful IVF treatment. 414 women had undergone IVF treatment and were eligible. The data was collected from patients’ files and entered in excel then exported to Stata V13.1.for analysis. The participant’s characteristics were compared using the Chi square. The success rate was calculated and associations measured using univariate and multivariate logistic regression. Results: The success rate of IVF treatment was 31% in the study period. Factors associated with successful IVF treatment include age, number of embryos transferred and the sperm factor. These were statistically significant. It was noted that post-menopausal women were 3 times more likely to have a successful IVF than those less than 35 years. Conclusion: The success rate of IVF treatment at LIVF clinic was 31%. The factors associated with successful IVF treatment were age of the woman, order of embryos transferred and use of donor sperm. There is need to engage the law makers to come up with a legal framework that will guide on the handling of gametes which will include sperm and oocyte donation and receiving, freezing, transportation and surrogacy.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":" 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139138528","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":"Madura Foot in an African Adult Male in Zambia: A likely Case of Misdiagnosis","authors":"Malan Malumani, M. Miyoba, Kebby Kyakilika","doi":"10.55320/mjz.50.2.384","DOIUrl":"https://doi.org/10.55320/mjz.50.2.384","url":null,"abstract":"Background: Mycetoma also synonymous referred to as Madura's foot is a chronic granulomatous cutaneous infection caused by some genera of fungi and bacteria, leading to progressive and proliferative destruction of soft tissue and the nearby anatomical structures if no intervention is offered on time.   Case presentation: We report a case of actinomycetoma in an African adult man residing in a rural-urban setup. After histological confirmation, the client was conservatively managed with oral medication: 1) dapsone 100mg once a day and trimethoprim/sulfamethoxazole(septrin) 160mg/800mg three times daily for one year with an excellent outcome.   Conclusions: The gist of this rare case is to exemplify the role of integrated management of patients without underplaying the role of good clinical practice. Also, a call and advocate for improved health care services in the sub-Saharan countries. This will prevent or reduce avoidable medical complications caused by neglected and treatable diseases like actinomycocetoma.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":" 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139140289","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 detection and rehabilitation in Erb-Duchenne paralysis before age 1 year: A Case Report From Lusaka Zambia","authors":"Fair Banji Mwiinga, Roster Chihwaka Malimba, Mutinta Mirriam Nzima, Billiat Chongo, Faith Banda Malambo, Hope Chisoya, Joan Tembo, Edward Sakala","doi":"10.55320/mjz.50.2.353","DOIUrl":"https://doi.org/10.55320/mjz.50.2.353","url":null,"abstract":"Erb-Duchenne paralysis is a neurological condition characterized by paralysis of the arm which occurs due to injury of the upper trunk of C5-C6 of the brachial plexus and can lead to disturbances in movement and sensation. Erb-Duchenne paralysis commonly presents with a “Waiter’s Tip” deformity characterized by elbow extension, medial rotation of the arm, forearm pronation, and wrist flexion. Management of Erb-Duchenne paralysis may involve strengthening exercises, range of motion exercises, manual therapy, and neuromuscular electrical stimulation. However, in most cases, the diagnosis of Erb-Duchenne paralysis is not detected early enough for rehabilitation outcomes to be maximized. We herein report a case of a 6-months old child who had Erb-Duchenne paralysis in the left upper limb. The aim of this case report is to highlight the importance of early detection and rehabilitation of Erb-Duchenne paralysis. Furthermore, the report also discusses the physiotherapy techniques that can be used to optimize outcomes.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":" December","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139136830","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":"Implementation of Enhanced Recovery after Surgery at a General hospital in Zambia","authors":"S. Karachentsev","doi":"10.55320/mjz.50.2.419","DOIUrl":"https://doi.org/10.55320/mjz.50.2.419","url":null,"abstract":"Background: Enhanced recovery after surgery (ERAS), with its aim of reducing operative stress and accelerating rehabilitation, became a standard perioperative care in multiple surgical specialties in developed world. However, little is known about the implementation of the fast-track pathways in a low-resource environment. The objective of the study was to describe our experience and share lessons obtained in using ERAS protocol in general surgery patients. Methods: In this descriptive study, all consecutive patients with no age restrictions undergoing elective and urgent abdominal surgery were assessed for inclusion in ERAS program. A retrospective analysis encompasses 98 patients aged two weeks to 87 years with male to female ratio of 2.3:1. Outcomes were functional recovery, postoperative complications, and length of hospital stay. Results: All elements of ERAS protocol including minimal incision length laparotomy and accelerated postoperative care were used; however, certain components were modified depending on the availability of the resources and patient’s condition. Postoperative period complicated in 17.4% of cases, seven patients (7.4%) died after urgent operations, and no mortality was recorded after elective procedures. Median length of stay was 4.0 days. Local and systemic septic complications, paralytic ileus and performing of the stoma reversal procedure during the same hospital stay were reasons for delayed discharge. Conclusion: This study indicates that employment of ERAS program for general surgery population at a second level hospital is feasible and safe. Further larger-scale studies are needed.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":" 32","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139138295","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 Review of Orthopaedic Theatre Radiography Services in Zambia","authors":"O. Bwanga, Ncheebe Sindaza, Malunga Chipulu, Patrick Mwenga Kinda, Joseph Mulenga","doi":"10.55320/mjz.50.2.351","DOIUrl":"https://doi.org/10.55320/mjz.50.2.351","url":null,"abstract":"Orthopaedic theatre radiography plays a critical role in the treatment of bone injuries and joint diseases. Fluoroscopic imaging using a mobile image intensifier (C-arm) is required to aid in trauma orthopaedic surgery. Plain X-rays using a mobile X-ray machine are also required for non-trauma corrective orthopaedic surgery. In Zambia, there are an increase in the use of motor vehicles and associated road traffic accident (RTA) injuries. Assaults and falls are other common mechanisms of trauma injuries reported in Zambia. The growing number of trauma patients puts a strain on trauma and orthopaedic services, particularly theatre radiography. Most trauma patients require surgical treatment of their bone injuries. However, in terms of establishing a well-organised trauma and orthopaedic healthcare system in the country, less emphasis has been paid to this problem. As a result, theatre radiography is similarly underdeveloped. This review aimed to assess orthopaedic theatre radiography services and raise awareness among stakeholders on this important topic in Zambia. As the country's planned improved orthopaedic services evolve, the radiography profession must begin bolstering training and advocating for more theatre radiography equipment.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":" 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139138609","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 Factors Associated with Prompt Diagnosis and Treatment of Fever among Under-five Children in Zambia; Evidence from a Country-wide Cross-Sectional Survey.","authors":"M. Nawa, Khumbuso Elizabeth Phiri, C. Sialubanje, B. Hamainza, Japhet Chiwaula","doi":"10.55320/mjz.50.2.398","DOIUrl":"https://doi.org/10.55320/mjz.50.2.398","url":null,"abstract":"Introduction: Prompt diagnosis and appropriate treatment of fever can prevent severe disease and mortality. Delayed diagnosis and treatment of infections contribute significantly to the high under-five mortality ratio, especially in sub-Saharan Africa. This study assessed the prevalence and associated factors to prompt diagnosis and treatment of fever among under-five children in Zambia. Methods: The study used secondary data from the Malaria Indicator Survey of 2021. Descriptive statistics using measures of frequencies, medians and interquartile ranges were done, and cross-tabulations and logistic regression were used to assess measures of association. The significance level was set at a P-value of 0.05 and a confidence level of 95%. The data was analysed in STATA 14.  Results: A total of 3003 under-five children were included; 728 (19.5%) had a fever in the two weeks preceding the survey. The prevalence of prompt health-seeking behaviour was 57.3%, which raises concerns that 42.7% of the children with fever did not have prompt treatment within the same or the next day of fever onset. Male sex aOR = 1.52 (95%CI 1.10 – 2.12) and the use of IRS aOR 1.8(1.30 – 2.50) were associated with increased odds of prompt health-seeking behaviour. Conclusion:  This study found that the prevalence of fever among under-five children in Zambia was comparable to other sub-Saharan African countries. Health-seeking behaviour among children with fever was sub-optimal, as a considerable proportion did not seek treatment. Factors associated with health-seeking behaviour among children with fever included sex and staying in a house with indoor residual spraying.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":" 32","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139139281","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}