Subjects -> MEDICAL SCIENCES (Total: 8642 journals)
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MEDICAL SCIENCES (2392 journals)            First | 4 5 6 7 8 9 10 11 | Last

Showing 1401 - 1600 of 3562 Journals sorted alphabetically
Journal of the Grodno State Medical University     Open Access   (Followers: 1)
Journal of the History of Medicine and Allied Sciences     Hybrid Journal   (Followers: 17)
Journal of the International Society for Telemedicine and eHealth     Open Access   (Followers: 3)
Journal of the Learning Sciences     Hybrid Journal   (Followers: 17)
Journal of the Medical Library Association     Open Access   (Followers: 288)
Journal of the Medical Sciences (Berkala ilmu Kedokteran)     Open Access   (Followers: 1)
Journal of the National Medical Association     Full-text available via subscription  
Journal of the Peripheral Nervous System     Hybrid Journal   (Followers: 3)
Journal of the Postgraduate Institute of Medicine     Open Access  
Journal of the Renin-Angiotensin-Aldosterone System     Open Access   (Followers: 1)
Journal of the Royal Society of Medicine     Hybrid Journal   (Followers: 2)
Journal of the Ruhunu Clinical Society     Open Access  
Journal of the Scientific Society     Open Access   (Followers: 1)
Journal of the Siena Academy of Sciences     Open Access   (Followers: 1)
Journal of Therapeutic Ultrasound     Open Access  
Journal of Thyroid Research     Open Access   (Followers: 1)
Journal of Tissue Engineering     Open Access   (Followers: 6)
Journal of Tissue Viability     Full-text available via subscription   (Followers: 3)
Journal of Topology     Hybrid Journal   (Followers: 1)
Journal of Toxicology     Open Access   (Followers: 11)
Journal of Traditional Chinese Medical Sciences     Open Access   (Followers: 1)
Journal of Traditional Chinese Medicine     Open Access   (Followers: 4)
Journal of Transition Medicine     Open Access  
Journal of Translational Medicine     Open Access   (Followers: 4)
Journal of Transplantation & Stem Cell Biology     Open Access   (Followers: 1)
Journal of Ultrasonography     Open Access   (Followers: 1)
Journal of Ultrasound     Hybrid Journal   (Followers: 4)
Journal of Ultrasound in Medicine     Full-text available via subscription   (Followers: 12)
Journal of Universal College of Medical Sciences     Open Access   (Followers: 1)
Journal of University Medical & Dental College     Open Access   (Followers: 1)
Journal of University of Babylon for Pure and Applied Sciences     Open Access  
Journal of Vascular Research     Full-text available via subscription   (Followers: 2)
Journal of Vector Borne Diseases     Open Access   (Followers: 1)
Journal of Visualized Experiments     Full-text available via subscription   (Followers: 5)
Journal of Wound Care     Full-text available via subscription   (Followers: 33)
JPSCR : Journal of Pharmaceutical Science and Clinical Research     Open Access   (Followers: 1)
JRSM Open     Open Access  
Jundishapur Journal of Health Sciences     Open Access  
Jurnal Berkala Epidemiologi     Open Access   (Followers: 1)
Jurnal Berkala Kesehatan     Open Access  
Jurnal Ergonomi Indonesia (The Indonesian Journal of Ergonomic)     Open Access   (Followers: 2)
Jurnal Farmasi Galenika (Galenika Journal of Pharmacy)     Open Access   (Followers: 1)
Jurnal Ilmiah Kesehatan     Open Access  
Jurnal Kedokteran dan Kesehatan Indonesia     Open Access  
Jurnal Kesehatan     Open Access   (Followers: 1)
Jurnal Kesehatan Andalas     Open Access   (Followers: 5)
Jurnal Penyakit Dalam Indonesia     Open Access   (Followers: 1)
Jurnal PROMKES : Jurnal Promosi Kesehatan dan Pendidikan Kesehatan Indonesia (The Indonesian Journal of Health Promotion and Health Education)     Open Access  
Jurnal Sains Kesihatan Malaysia (Malaysian Journal of Health Sciences)     Open Access  
Jurnal Teknologi Laboratorium     Open Access  
Jurnal Vektor Penyakit     Open Access  
Juxta : Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga     Open Access  
Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi     Open Access  
Kaleidoscope     Open Access  
Kansas Journal of Medicine     Open Access   (Followers: 2)
Kaohsiung Journal of Medical Sciences     Open Access  
Karaelmas Science and Engineering Journal     Open Access   (Followers: 1)
Kasmera     Open Access   (Followers: 2)
Kasr Al Ainy Medical Journal     Open Access   (Followers: 1)
Keio Journal of Medicine     Partially Free  
Kerbala Journal of Medicine     Open Access   (Followers: 1)
Kind & Adolescent     Hybrid Journal   (Followers: 4)
Kind & Adolescent Praktijk     Hybrid Journal   (Followers: 2)
Kinésithérapie, la Revue     Full-text available via subscription   (Followers: 1)
Kırıkkale Üniversitesi Tıp Fakültesi Dergisi     Open Access  
Klinische Monatsblätter für Augenheilkunde     Hybrid Journal   (Followers: 1)
Klinische Pädiatrie     Hybrid Journal   (Followers: 1)
KMA - Das Gesundheitswirtschaftsmagazin     Hybrid Journal   (Followers: 2)
KnE Medicine     Open Access   (Followers: 1)
Knie Journal     Hybrid Journal   (Followers: 2)
Kocaeli Ãœniversitesi SaÄŸlık Bilimleri Dergisi     Open Access   (Followers: 3)
Kocatepe Tıp Dergisi     Open Access  
Komplementäre und Integrative Medizin     Full-text available via subscription  
Konuralp Medical Journal / Konuralp Tıp Dergisi     Open Access  
Korean Journal of Family Medicine     Open Access  
Korean Journal of Medical History     Open Access  
Krankenhaushygiene up2date     Hybrid Journal   (Followers: 1)
KYAMC Journal     Open Access  
L'Encéphale     Full-text available via subscription   (Followers: 1)
La Ciencia al Servicio de la Salud y Nutrición     Open Access  
La Lettre de Médecine Physique et de Réadaptation     Hybrid Journal   (Followers: 1)
La Medicina del Lavoro     Partially Free   (Followers: 1)
La Presse Médicale     Full-text available via subscription   (Followers: 3)
La Revue de Médecine Légale     Full-text available via subscription  
La Rivista Italiana della Medicina di Laboratorio - Italian Journal of Laboratory Medicine     Hybrid Journal  
Laboratory Animals     Hybrid Journal   (Followers: 17)
Laboratory Medicine     Full-text available via subscription   (Followers: 7)
Läkartidningen     Partially Free   (Followers: 21)
Laparoscopic, Endoscopic and Robotic Surgery     Open Access  
Laryngo-Rhino-Otologie     Hybrid Journal   (Followers: 3)
Legal Medicine     Hybrid Journal   (Followers: 356)
Leprosy Review     Full-text available via subscription   (Followers: 1)
Leviathan     Hybrid Journal   (Followers: 2)
Libyan International Medical University Journal     Open Access   (Followers: 2)
Libyan Journal of Medical Sciences     Open Access  
Libyan Journal of Medicine     Open Access  
Life Science Alliance     Open Access   (Followers: 1)
Life Sciences     Hybrid Journal   (Followers: 6)
Life Writing     Hybrid Journal   (Followers: 2)
Lifestyle Journal     Open Access   (Followers: 1)
Linacre Quarterly     Hybrid Journal   (Followers: 1)
Lippincott’s Bone and Joint Newsletter     Full-text available via subscription  
Literature and Medicine     Full-text available via subscription   (Followers: 9)
Living Ethics : Newsletter of the St. James Ethics Centre     Full-text available via subscription  
Logopedics Phoniatrics Vocology     Hybrid Journal   (Followers: 17)
London Journal of Primary Care     Open Access   (Followers: 1)
Lupus     Hybrid Journal   (Followers: 4)
Lupus Science & Medicine     Open Access   (Followers: 2)
Luts     Hybrid Journal   (Followers: 2)
Lymphatic Research and Biology     Hybrid Journal   (Followers: 2)
Maatwerk     Hybrid Journal   (Followers: 1)
mAbs     Full-text available via subscription   (Followers: 18)
Macedonian Medical Electronic Journal     Open Access  
Macedonian Medical Review     Open Access  
Magnetic Resonance Insights     Open Access   (Followers: 2)
Majalah Kedokteran Andalas     Open Access  
Majalah Kedokteran Bandung     Open Access  
Majalah Sainstekes / Sainstekes Magazine     Open Access  
Malaria Research and Treatment     Open Access   (Followers: 4)
Malawi Medical Journal     Open Access   (Followers: 6)
MAMC Journal of Medical Sciences     Open Access  
Managed Care     Free   (Followers: 3)
Manuelle Medizin     Hybrid Journal   (Followers: 1)
manuelletherapie     Hybrid Journal  
Marshall Journal of Medicine     Open Access  
Mathematical Medicine and Biology: A Journal of the IMA     Hybrid Journal   (Followers: 1)
Matrix Science Medica     Open Access  
Mayo Clinic Proceedings     Full-text available via subscription   (Followers: 17)
Mayo Clinic Proceedings : Innovations, Quality & Outcomes     Open Access   (Followers: 1)
McMaster University Medical Journal     Open Access   (Followers: 2)
Med Phoenix     Open Access  
Médecine & Droit     Full-text available via subscription  
Médecine & Longévité     Full-text available via subscription   (Followers: 1)
Médecine & Nutrition     Full-text available via subscription  
Médecine des Maladies Métaboliques     Full-text available via subscription   (Followers: 1)
Médecine du Sommeil     Full-text available via subscription  
Médecine Nucléaire     Full-text available via subscription   (Followers: 1)
Médecine Palliative : Soins de Support - Accompagnement - Éthique     Full-text available via subscription   (Followers: 2)
médecine/sciences     Full-text available via subscription   (Followers: 2)
Medical and Biological Engineering and Computing     Hybrid Journal   (Followers: 4)
Medical and Biological Sciences     Open Access   (Followers: 1)
Medical Cannabis and Cannabinoids     Open Access   (Followers: 2)
Medical Care     Hybrid Journal   (Followers: 12)
Medical Care Research and Review     Hybrid Journal   (Followers: 2)
Medical Case Reports Journal     Open Access  
Medical Case Studies     Open Access   (Followers: 2)
Medical Clinics of North America     Full-text available via subscription   (Followers: 4)
Medical Devices & Sensors     Hybrid Journal   (Followers: 1)
Medical Devices: Evidence and Research     Open Access   (Followers: 3)
Medical Dosimetry     Hybrid Journal   (Followers: 5)
Medical Education Development     Open Access   (Followers: 15)
Medical Education Online     Open Access   (Followers: 34)
Medical Education Scholarship Forum Proceedings     Open Access   (Followers: 2)
Medical Engineering & Physics     Hybrid Journal   (Followers: 8)
Medical Equipment Insights     Open Access  
Medical Ethics     Open Access   (Followers: 4)
Medical History     Hybrid Journal   (Followers: 8)
Medical Humanities     Hybrid Journal   (Followers: 21)
Medical Hypotheses     Hybrid Journal   (Followers: 5)
Medical Informatics and Engineering     Open Access   (Followers: 2)
Medical Innovation & Business     Full-text available via subscription   (Followers: 2)
Medical Instrumentation     Open Access  
Medical Journal Armed Forces India     Full-text available via subscription  
Medical Journal of Babylon     Open Access  
Medical Journal of Basrah University     Open Access   (Followers: 1)
Medical Journal of Chinese People's Liberation Army     Open Access  
Medical Journal of Dr. D.Y. Patil University     Open Access  
Medical Journal of Dr. D.Y. Patil Vidyapeeth     Open Access  
Medical Journal of Indonesia     Open Access   (Followers: 2)
Medical Journal of Pokhara Academy of Health Sciences     Open Access  
Medical Journal of Shree Birendra Hospital     Open Access   (Followers: 1)
Medical Journal of the Islamic Republic of Iran     Open Access   (Followers: 2)
Medical Journal of Zambia     Open Access  
Medical Law Cases for Doctors     Open Access   (Followers: 5)
Medical Law International     Hybrid Journal   (Followers: 8)
Medical Molecular Morphology     Hybrid Journal  
Medical Mycology Case Reports     Open Access  
Medical Perspectives     Full-text available via subscription   (Followers: 1)
Medical Photonics     Hybrid Journal   (Followers: 1)
Medical Physics     Hybrid Journal   (Followers: 18)
Medical Practice and Reviews     Open Access   (Followers: 3)
Medical Principles and Practice     Open Access  
Medical Research Journal     Partially Free   (Followers: 1)
Medical Research Journal     Open Access  
Medical Science and Discovery     Open Access  
Medical Science Educator     Hybrid Journal   (Followers: 3)
Medical Sciences     Open Access  
Medical Sciences     Open Access   (Followers: 2)
Medical Technology SA     Full-text available via subscription  
Medical University     Open Access  
Medical Writing     Hybrid Journal   (Followers: 4)
MEDICC Review     Open Access  
Medicentro Electrónica     Open Access  
Medicina     Open Access   (Followers: 1)
Medicina & Storia     Full-text available via subscription   (Followers: 1)
Medicina (Buenos Aires)     Open Access   (Followers: 4)
Medicina Clínica     Full-text available via subscription   (Followers: 7)
Medicina Clínica (English Edition)     Hybrid Journal   (Followers: 1)
Medicina Clínica Práctica     Open Access  
Medicina General y de Familia     Open Access  

  First | 4 5 6 7 8 9 10 11 | Last

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Medical Journal of Zambia
Number of Followers: 0  

  This is an Open Access Journal Open Access journal
ISSN (Print) 0047-651X
Published by African Journals Online Homepage  [263 journals]
  • Challenges sssociated with Learning Oral Diagnostic Sciences: A
           multicenter study in Nigeria

    • Authors: T.J. Lasisi, A.O. Adisa, O.A. Effiom, A.B. Olawuyi, O.G. Omitola, O.O. Soyele, O.M. Ogundana, M. Okoh
      Abstract: Introduction: Oral diagnostic sciences (ODS) comprise the subjects, oral pathology, oral medicine, oral radiology and the functional integration of these into the oral  diagnostic services. Oral diagnostic science has peculiar challenges with learning  and training in sub-Saharan Africa. Several barriers that may impede effective clinical teaching include inadequate institutional financial support and lack of access to appropriate educational space and resources. The aim of this study was to categorize challenges of learning ODS in Nigeria.
      Methods: This was a cross sectional survey of undergraduate dental students (UDS) and resident doctors (RDS) in dentistry in five institutions in Nigeria. The study included 286 participants comprised of 199 UDS and 87 RDS. Information about challenges of trainer, trainee and facilities was obtained by using pretested  structured questionnaires. Data was analyzed using SPSS version 23 and tests of associations between variables were determined using Chi-square. The level of significance was set at p < 5%. Results: The mean age of the study participants was 27.2 (± 4.6) years and 60.6% were males. The majority, 72.4% of RDS and 64.3% of UDS, indicated that getting a good ODS education was important to them. Few, 19.5% of RDS and 8.5% of UDS indicated that they would consider ODS as a career. While 37.9% of RDS decided that their examinations are fair and  objective, 50.8 % of UDS agreed that their examinations were fair and objective (p < 0.05). The percentage of RDS and UDS which felt that ODS consultants sometimes give contrary information to textbook material were 26.4% and 29.1% respectively, however 28.7% of RDS and 34.2% of UDS were undecided about this issue. Thirty-eight (43.7%) specified that lack of a structured postgraduate curriculum in ODS caused their challenge with learning
      Conclusions: Trainee level affected the participants' perceived challenges of learning ODS. Despite the differences, the results showed that most of the challenges were common to both undergraduate and postgraduate training.
      PubDate: 2018-03-15
      Issue No: Vol. 44, No. 4 (2018)
       
  • An overview of the aetiologic agents of diarrhoea diseases in children:
           How far have we gone in management and control'

    • Authors: A.A. Joseph, M.S. Odimayo, I.O. Oluwayemi, A. Fadeyi, S.A. Dada
      Abstract: Diarrhoea disease is the second leading cause of death amongst Nigerian children  (after malaria) with a prevalence rate in Nigeria of 18.8% which is one of the worst in sub-Sahara Africa. A major contributor to childhood morbidity and mortality, causes  4 million deaths each year in under-fives with each child experiencing about 5 episodes of diarrhoea yearly. We review diarrhoea diseases in children with focus on infectious diarrhoea with the aim of looking at the progress made so far in its management and control. Diarrhoea can be classified into acute and chronic;  secretory, osmotic, inflammatory or due to impaired motility;  infectious and non-infectious. In developing countries, infections are the most common causes of acute watery diarrhoea in  children, whereas chronic diarrhoea results from  non-infectious causes like inherited metabolic disorders, sensitivity to gluten or
      neoplasm. Diagnosis includes a careful history from the patient, examination of stool sample and examination of faecal swab  samples where stool is not available. Diarrhoea in this age group is mostly of infectious origin and can be viral, bacterial, parasitic or fungi. Treatment in this environment is primarily supportive with oral or intravenous fluid and preventive measures include  domestic hygiene promotion, breast-feeding promotion, improved weaning practices, probiotic use, oral  rehydration therapy with additional L-glutamine, zinc supplementation and  vaccination against childhood infectious diseases like rotavirus, measles and cholera. An aluminmagnesium silicate, Smectite® has been found to be of potential benefit in the management of diarrhoea. Use of Rotavirus vaccines, probiotics and Smectite® is being advocated.
      PubDate: 2018-03-15
      Issue No: Vol. 44, No. 4 (2018)
       
  • Knowledge and Pperception of laparoscopic surgery among surgical
           outpatients in a Nigerian Teaching Hospital

    • Authors: O.O. Afuwape, O.O. Ayandipo
      Abstract: Background: Laparoscopic surgery is the gold standard in developed countries.  Challenges indeveloping countries apart from the cost of instrumentation include a low acceptance level among patients. The consequent low volume of surgical cases debars cost reduction for surgery.Objective: The aim of this study is to determine the knowledge level and perception of laparoscopic surgery in patients attending the surgical outpatient for the first time in a teaching hospital in Nigeria. We also determined probable factors which affect this.
      Design of the study: This was a prospective study carried out on consenting new patients at the surgical out-patient clinic of the surgical out-patient clinic of a Nigerian Teaching Hospital. The questionnaire was administered to consenting patients through a face-to-face interview by nonmedical personnel who had been instructed by the investigators. Data collection was on clinic days within the period.
      Results: A total of 370 persons were recruited in this study with a male: female ratio of 1:1.79. The age distribution was between 14years and 81 years with a mean age  of 44.19. 62.6% had no knowledge of laparoscopic surgery. 108(29.3%) and  260(70.7%) had positive and negative perception respectively. Only 44% of the patients with positive perception acquired information from appropriate hospital personnel. The longer the duration of perceived knowledge by the patients the higher the tendency to have the wrong perception. The level of education was a significant contributory factor to appropriate perception of laparoscopic surgery.
      Conclusion: There is a need for public health education in the region to drive this relatively new frontier of surgery to improve our practice and encourage indigenous innovations.
      PubDate: 2018-03-15
      Issue No: Vol. 44, No. 4 (2018)
       
  • Pancreatic cancer: Patterns in a low- to middle- income Ppopulation,
           Zambia

    • Authors: A.W. Asombang, R. Madsen, M. Simuyandi, G. Phiri, M. Bechtold, J.A. Ibdah, K. Lishimpi, L. Banda
      Abstract: Introduction: In 2007, the Cancer Disease Hospital (CDH) was opened as the national referral center for patients diagnosed with cancer in Zambia. Since inception of the CDH, there has been no systematic analysis of the disease burden and implication on healthcare delivery with regards to pancreatic cancer. There are limited studies describing patterns of pancreatic cancer in a native African population. Data suggest African-Americans have a higher incidence and poorer prognosis of pancreatic cancer than non-African Americans.
      Objective: Our aim is to describe the demographic features (age, gender) of pancreatic cancer using the Cancer Disease Hospital (CDH) data base in a native African population and compare with the African-American cohort using the  Surveillance, Epidemiology End Results (SEER) Program database.
      Methods: This was a retrospective study of patients diagnosed with pancreatic  cancer at the CDH in Zambia, Southern Africa between 2007 and 2014. We entered the term “pancreatic cancer” into the CDH database, extracted patient medical records numbers, and manually located the records for review. From each chart we extracted: age, gender, geographic origin, ethnicity, clinical features at presentations, location of tumor, stage at diagnosis and treatment. Data collection tool and master code sheet created a priori were used. Data was analyzed using statistical analysis software (SAS). Descriptive statistics including means, medians as well as frequency distributions and crosstabulations were used. SEER database was used to compare subjects  between Zambia and USA. Groups were compared using Chi-square tests and Wilcoxon Signed Rank test. Ap-value less than 0.05 was used as the level of significance.
      Results: Thirty-eight charts were identified in the CDH dataset, of which 27 were included in final analysis and 11 excluded (5 non-pancreatic cancer diagnosis, 6 not manually located). The mean age of diagnosis was 55.7 years in the native African population, compared to 66.7 years for the African-Americans in the SEER  database, p < 0.0001. There were 63.0% males (CDH) compared to 48.1% (SEER), p=0.121. Further review of the CDH database revealed that the most common presenting symptom was abdominal pain (52.6%), mode of diagnosis surgical (83%, missing 3), histopathology adenocarcinoma (86%, missing 6), location head of pancreas (83%, missing 9) and stage 4 at diagnosis (100%, missing 3).
      Conclusion: Pancreatic cancer occurs at a younger age in Zambians when compared to the African American, USApopulation. There is no statistically significant difference in sex presentation between Zambian and USAblack population.
      PubDate: 2018-03-14
      Issue No: Vol. 44, No. 4 (2018)
       
  • Serum Selenium levels in Essential hypertension among adults at the
           University Teaching Hospital, Lusaka, Zambia

    • Authors: A.C. Chisulo, N Lambwe, G. Sijumbila, M. Mukosha
      Abstract: In Zambia, essential hypertension is one of the commonest and prevalent  non-communicable diseases. In the current medical literature it is not  clear on the serum selenium levels among essential hypertensive patients in Zambia despite evidence in literature of its role in development of hypertension. The present study investigated serum selenium levels in essential hypertensive adults. We hypothesized that serum selenium levels were significantly lower in this population and was a risk factor for developing hypertension. An analytical cross-sectional design was applied to a total of 245 participants. Blood was collected for serum levels of Selenium, glucose, urea, creatinine and electrolytes. Student t-test was used to compare the serum selenium levels between  hypertensive and normotensive participants. Significant (p<0.0001) lower levels of serum Selenium were observed in essential hypertensive adults (0.093mg/L ± 0.048)than in healthy normotensive adults (0.109mg/L ± 0.047). Regressionresults showed no significant relationship off Selenium levels with age (p=0.255), BMI (p-0.232), systolic blood pressure  (p=0.175) and diastolic blood pressure (p=0.195).From these findings  serum selenium levels may not be a risk factor for essential hypertension in this population. Nevertheless, more studies in the same geographical area are needed to confirm this.
      PubDate: 2018-03-14
      Issue No: Vol. 44, No. 4 (2018)
       
  • Multiple antibiotic resistance iIndex of EscherichiaColi isolates in a
           tertiary hospital in south-west Nigeria

    • Authors: A.A Joseph, M.S. Odimayo, L.B. Olokoba, A.B. Olokoba, G.O. Popoola
      Abstract: Background: The effectiveness of available antibiotics is reducing as  microorganisms device means of evading its effects, resulting in the development of superbugs. Pathogens previously susceptible are becoming resistant, and spreading beyond the hospital environment. This change is a major concern for infection control and prevention and a huge economic burden for health care. This study aims to determine the drug sensitivity pattern of E. coli isolated in a tertiary hospital lab
      Methodology: Gram negative bacilli, lactose fermenter, motile, indole positive,  glucose fermenter, gas producing isolate were identified as E.coli. Antimicrobial susceptibility testing to commonly prescribed antibiotics was carried out using the modified Kirby Bauer method and reported with the Clinical and Laboratory Standard Institute Interpretative chart. Mulitiple Antibiotic Resistance index was calculated as number of antibiotics to which isolate is resistant divided by the total number of antibiotics against which isolate was tested.
      Result: Five hundred and twenty–seven isolates were identified, among which a high rate of resistance to cefuroxime (407), high rate of intermediate susceptibility to nalidixic acid (264) and high rate of sensitivity to ceftriaxone (388) was noted. Sixty percent of the isolates had an index 0.2. Of the 40% with Multiple Antibiotic Resistance index > 0.2, 61 % were from inpatient samples.
      Conclusion: The high Multiple Antibiotic Resistance index of the E. coli isolates indicates previous exposure to antibiotics and development of resistance to commonly prescribed antibiotics, hence, antimicrobial susceptibility testing is imperative in selecting therapeutic options. Attention also needs be paid to effective infection control and prevention to curb its spread among individuals.
      PubDate: 2018-03-14
      Issue No: Vol. 44, No. 4 (2018)
       
  • The lunar effect on delivery and other birth outcomes in rural Zambia

    • Authors: J.M. Stringer, N. Sindano, B. Vwalika
      Abstract: Objective: It is a widely held belief that the period of a full moon is associated with higher birth rates compared to periods when the moon is not full. We investigated whether more births occurred during a full moon in a rural African population.
      Design: Data collected from 42 clinical sites in rural Zambia associated with the Better Health Outcomes through Mentoring and Assessment (BHOMA) Study were evaluated. We compared the proportion of pregnancies born during a full moon to the
      proportion that would be expected if there were no association.
      Main outcomes: Proportion of births during the full moon.
      Measures: Demographics and birth outcomes.
      Results: A total of 10,127 women delivered at a participating site between 8  December 2010 and 19 August 2015. Mean maternal age was 25.1 years (standard deviation [SD] 6.4 years), mean maternal weight 62.7 kg (SD 13.9 kg), 14.4% were HIV seropositive, and 3.7% were syphilis positive. The mean birth weight was 3032 g (SD 0.5 g); 49.6% newborns were female, and 1.48% were stillborn. There was a full moon during 70 of the 1715 days under observation. In the absence of an association, we would expect 70 / 1715 (4.08%) of births to occur on these days. We observed a total of 434deliveries (4.29%; 95% Confidence Interval [CI]: 3.89%, 4.68%) during these 24-hour periods. Thus, an association between the full moon and higher delivery rates was not observed (p=0.87). An additional analysis, where the entire lunar cycle was divided into 8 equal bins, also yielded no association. Finally, we did not identify any other birth outcomes that were  associated with lunar cycle (birthweight, stillbirth, gender, or congenital malformation).
      Conclusions: In this large, rural population, we found no evidence of a lunar effect on delivery or adverse birth outcomes. These results refute a common belief and should provide assurance to managers who opt to ignore lunar cycle when scheduling midwife staffing of rural clinics.
      PubDate: 2018-03-14
      Issue No: Vol. 44, No. 4 (2018)
       
  • A comparison of early neonatal deaths among preterm infants with term
           neonatal deaths at the University Teaching Hospital, Lusaka, Zambia

    • Authors: P. Kamfwa, Y. Ahmed, B. Vwalika
      Abstract: Background: Prematurity is a common complication that contributes  significantly to high neonatal mortality. In spite of many efforts by the government and other partners, non-significant decline has been achieved in the recent past. Globally, 15 million babies are born preterm (<37 weeks gestation) each year, and more than 1 million of those do not survive their first month of life. Preterm birth accounts for 75% of all perinatal mortality in some series thus identifying the determinants of preterm deaths is very crucial for policy improvement. This study was aimed at establishing factors associated with preterm deaths at UTH compared to those of term neonatal deaths.Methods: A case-control study was conducted among 208 neonates that were early neonatal deaths i.e. within 7 days in neonatal intensive care unit (NICU) at UTH in 2015. Antenatal and intrapartum details (parity, multiple pregnancy, birth weight, antenatal steroid exposure, antibiotic exposure, and the indication of admission to NICU) were obtained from 104 neonates that were preterm (between 24- 36 completed weeks  gestation) and had died and of a further 104 term neonates (>37 weeks gestation) that died around the same time. The data was collected by int e rvi ewe r- administered structured questionnaire and analyzed by SPSS v21. Bivariate analysis was used to identify variables for multivariate logistic regression model to identify obstetric determinants amongst deaths in neonates that were preterm compared to those born at term.
      Results: There were few differences between the two groups. The sex of the neonate significantly influenced the odds of dying. We confirmed that male neonates had a 57.1% higher risk than females (42.9%) of dying during the early neonatal period. More term neonates that died were male (P=0.0031) and had a very poor Apgar score (1-3) (P=0.0048). Both the indications for admission to NICU and cause of death were different in the two groups with preterms (P<0.0001) and terms P=0.0309. On
      multivariate regression analysis, poor Apgar score was associated with six-fold odds of RDS. More preterm neonates had died despite receiving steroids. None of the other factors reached statistical significance (adjOR 6.0, 95% CI 3.03-11.92, p<0.0001). Poor Apgar score was also the only factor associated with sepsis, though it was a neonate with a good Apgar score that had higher odds of dying due to sepsis. Primiparity was associated with a 2.6-fold odds (95% CI 1.03 to 6.68, p=0.04) of hypoxic ischaemic encephalopathy. On logistic regression, a preterm neonate dying only had a higher odds of being a LBW (<2500g) than any other factor [adjusted OR 132.72 (95% CI 39.49 to 387.66) P<00001]. Considering the main causes of death, hypoxic ischemic encephalopathy in preterm neonates was only associated with poor Apgar score (i.e. <7) [adjusted OR 2.03 (95% CI 1.12 to 3.67) P =0.02]. Sepsis in term neonates OR 0.2 (95% CI 0.15 to 0.54) P<00001]. Respiratory distress syndrome in preterm neonates dying was only associated with poor Apgar score [adjusted OR 6.01 (3.03 to 11.92) P<00001].
      Conclusions: Hypoxic ischemic encephalopathy as a cause of early neonatal death is commoner in term neonates but also common in preterm. Sepsis is commoner in preterm neonates as a cause of early neonatal death. Comparing different causes of death, poor Apgar score featured in all cases calling for improved resuscitation.
      PubDate: 2018-03-14
      Issue No: Vol. 44, No. 4 (2018)
       
  • Binge drinking and psychomotor performance in female social drinkers of
           Kalingalinga in Lusaka, Zambia

    • Authors: D.V. Likashi, R. Paul, L. Jason
      Abstract: Introduction: Consuming large amounts of alcohol on an irregular basis is a common form of alcohol misuse among female adolescents and  young women. This form of alcohol misuse is called binge drinking (BD) and is associated with harm to the central nervous system mainly due to repeated alternations between intense intoxication and withdrawal  episodes. Adverse effects of BD on cognitive functions such as  psychomotor skills negatively impact on women's daily living.
      Methodology: Using a matched-pairs design and snowball sampling method, the present study investigated the relationship between binge drinking and psychomotor performance in a population of female social drinkers of Kalingalinga in Lusaka, Zambia. Two specific objectives based on continuity hypothesis guided the study; to identify  characteristics of binge drinking among female social drinkers; to compare motor skills performance between female binge drinkers and their non-drinking female  counterparts. Sixty female participants (30 drinkers and 30 nondrinkers) were enrolled. Data was collected through a two-phase approach; AUDIT questionnaires in the first place and neuropsychological testing of motor skills using Grooved Pegboard and Finger Tapping tests, over a two-weeks period. Pearson's Chi-square revealed no significant differences in demographic  characteristics. Data was normally distributed as shown by Shapiro Wilk's test and skewness and kurtosis results. Hence the use of the independent samples t-test whose results showed slower psychomotor performance among binge drinkers (M=84.07, SD=10.581; M=1.2167, SD=7.260 and M=42.17, SD=.88749) on both the Grooved Pegboard and Finger tapping tests than the non-drinking control group (M=66.77, SD=8.295; M=.5167,  SD=5.050 and M=50.45, SD=.62261).
      Conclusion: In conclusion, these results seem to suggest that there is a statistically significant relationship between BD and psychomotor  performance among female social drinkers. The implication is that these women may be at risk of home and/or road accidents and that BD may impinge on their multitask-taking skills which may in turn affect their families and society. It is hoped that the results of the study will; open research prospects on female alcohol BD in Zambia and help therapists to consider focusing their efforts on the intensity and frequency of alcohol consumption as predicted by the study's regression analyses.
      PubDate: 2018-03-14
      Issue No: Vol. 44, No. 4 (2018)
       
  • Anaemia in pregnancy among pregnant women in Lusaka District, Zambia

    • Authors: M.K. Lubeya, B Vwalika
      Abstract: Objectives: This study investigated the problem of anaemia in pregnancy and its associated factors.
      Methods: The study involved 216 women booking for antenatal care between September 2015 and January 2016. A structured questionnaire was administered to all eligible women to determine their socio demographic and economic status, reproductive factors, health seeking behaviour and clinical state. Blood for a full blood count was collected. Women found with anaemia were immediately referred to their clinicians for further management. Data was analysed using SPSS software.  Inferential analyses were conducted using Chi square and Ttest. For the historical independent variables with a known significant association with anaemia, a stepwise backward logistic regression was done.
      Results: Out of 216 women enrolled in the study, Seventy nine (36.2%) were found to be anaemic. The mean haemoglobin was 11.2g/dl. Thirty six women (45.6%) had mild anaemia, forty one (51.9%) had moderate anaemia while two (2.5%) had severe anaemia. In analysis lower family income and lower intake of vegetables were statistically significant with p values of 0.020 and 0.023 respectively. After adjusting for confounders, HIV infection remained significant with HIV positive women being 2.7 times more likely to have anaemia (OR 2.7, CI 1.06-6.70) univariate
      Conclusion: Anaemia remains a public health problem among pregnant women in Zambia. Risk factors include HIV infection, Low intake of vegetables and low family income. Recommendations: Women need continued education on importance of vegetable intake during pregnancy and involvement in legal income generating activities to boost family income. Women of reproductive age under HIV care need continuous education on anaemia prevention in pregnancy.
      PubDate: 2018-03-05
      Issue No: Vol. 44, No. 4 (2018)
       
  • Outcomes and factors associated with adolescent pregnancies at the
           University Teaching Hospital, Lusaka, Zambia

    • Authors: A. Kumwenda, B. Vwalika
      Abstract: Objectives: These were to determine obstetric outcomes associated with adolescent pregnancies and those of older women at the UTH, identify factors associated with and compare the obstetric outcomes between the two age groups with determining the scale of adolescent pregnancy.
      Materials and methods: This was a comparative prospective cross sectional study with a purposeful sample of 200 pregnant adolescents and women aged between 20 and 30 years in a ratio of 1:1.
      Results: 3,456 women delivered between September and October, 2015 out of which 480 (13.9%) were adolescents. Of the 100 adolescents studied, 62(62%) had dropped out of school due to pregnancy and 81(81%) of the pregnancies were unplanned. Factors associated with adolescent pregnancies noted included mean age at coitarche (p<0.001), early marriages (p<0.001; AOR 14.6, 95% CI: 4.642 - 45.99), primary education (p 0.002; AOR 4.522, 95% CI: 1.758 – 11.634), having a boyfriend (p<0.001; AOR 12.70, 95% CI: 4.04 – 39.91) and contraceptive use. There were 95(95%) adolescents who had never used a contraceptive before compared to 40(40%) older women (p<0.001). Adolescents were also significantly associated with first degree perineal tears (p<0.001; AOR 3.46, 95% CI: 1.83 - 6.56) and preterm deliveries (p 0.026, AOR 2.60, 95% CI: 1.16 - 5.78). Furthermore, although not statistically significant, more adolescents 22(22%) had low birth weight babies compared to 14(14% older women and 11(11%) had pregnancy induced hypertension versus 7(7%) older mothers. In addition, out of the 10 documented caesarean sections among the study participants, 8(80%) were done among adolescents (p 0.052).Conclusion: Several factors and adverse obstetric outcomes are associated with adolescent pregnancies seen at the UTH. Although adolescent pregnancy is reducing, it remains high and contributing significantly to discontinuation of school. Key stakeholders need to continue targeting adolescents with appropriate health messages including an emphasis on increased access to and utilization of effective contraceptives.
      Issue No: Vol. 44, No. 4
       
 
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