bluuebunny/crossref_metadata_2025 huggingface dataset:
Atypical Presentation and Treatment of Large Facial Neuroma: Case Report and Review
Authors: Keith Simfukwe , Shamsuloev Sherzod , Gerald Musa , Gennadevich Chmutin Egor
Published: November 2022

Background: Facial nerve neuromas (FNN) are significantly rare brain tumors. Our objective is to report a case of an atypical presentation and treatment of a large facial nerve neuroma. We review current literature and discuss issues pertaining to postoperative outcomes of large facial neuromas.

Method: We retrospectively reviewed a case of patient who presented in our center with atypical symptoms of a large intracranial facial neuroma (schwannoma), our approach to treatment, outcome and combined it with review of current literature. A review of the current literature was performed by extrapolating data relating to clinical and management details pertaining to FNN, currently listed on the Google scholar, Clinical- Trials.gov database, and PubMed. This information was tabulated and compared with our experience.

Conclusion: Large facial nerves neuromas (FNN) are very rare brain tumors which may coexist with the patient without debilitating symptoms. When diagnosed, individualized approached to archive maximal resection while preserving surrounding cranial nerves and brain stem function must be the goal. Intraoperative patient positioning, is vital for attaining maximal view, brain relaxation and minimal bleeding.
Issues of diagnosing ROHHAD Syndrome in a 2-year-old girl : A Case Report and Review of Literature
Authors: Mumba Mwela Bupe , Pushko L.V , Gutyrchik T. A , Ovsyannikov D. Yu. , Gutyrchik N. A , Petruk N. I , Petrova N. A
Published: November 2022

We present a clinical case of ROHHAD syndrome. In this article we discuss the rare occurrence of this pathology and, as a result, the issues encountered in the diagnosis and treatment of such children. Thus, in highlighting the problem, the team of Authors set the goal of emphasizing the importance of timely diagnosis, as well as correctly selecting comprehensive treatment for children with ROHHAD syndrome.
OBITUARY: Professor James Chipeta
Authors: Bowa Kasonde
Published: November 2022

Professor James Chipeta was born on the 1 March 1962 in Lundazi, Eastern Zambia. He went to school at Chizongwe Secondary School completing in 1982. He was of the top students in his class with classmates like Professor Sekelani Banda. He studied Medicine at the University of Zambia School of Medicine from 1983 to 1990.
Violence against women: A comparative study of the pattern and experience before and during pregnancy among antenatal clinic attendees
Authors: Eno Enang , Adesina Kikelomo T , Adeniran Abiodun S , Olarinoye Adebunmi O , Fawole Adegboyega A , Aboyeji Abiodun P
Published: November 2022

Background: Violence against women is increasing globally; however, its prevention and evaluation in pregnancy has not receiving adequate attention.  

Aim: To evaluate the occurrence and pattern of violence against women before and during index pregnancy.

Methods: A prospective, comparative study comprising 200 antenatal clinic attendees categorized into two groups of 100 each was conducted. Group I consisted of women who had suffered violence previously while those in group II did not have such experience. Participants were recruited at the antenatal clinic and informed consent was obtained. Participants were screened using a modified version of Abuse Assessment Screen from Centre for Disease Control; the data was analyzed using SPSS version 20.0 and p<0.05 was significant.

Result. There was similarity in the age (p0.688), marital status (p0.605), level of education (p0.914) and gestational age at booking (p0.490) among the two groups. Alcohol consumption was significantly higher (21 vs. 10; p0.045) among partners of victims of violence (group I). Physical violence decreased from 47% before to 22% during index pregnancy, sexual violence reduced from 53% vs. 50% while all cases of psychological violence (68%) occurred during pregnancy. The partner was responsible for 78.7% of physical and 84.7% of sexual violence before pregnancy as well as 91.0% of physical, 100.0% of sexual and 78.0% of psychological violence during index pregnancy.

Conclusion: Violence against women is heightened during pregnancy especially psychological violence. Routine screening for violence during pregnancy is justified because its prevalence is higher than other conditions routinely screened for in pregnancy.
Symmetrical Peripheral Gangrene as a Rare Complication of Malaria: A Case Report from the Arthur Davison Children's Hospital in Ndola, Zambia
Authors: Inambao Muleya , Mubita Mwaka , Mwape Mwewa , Mwansa Jonathan K. , Kazuma Seke , Mpabalwani Evans
Published: November 2022

Malaria is a common parasitic disease with very high mortality in tropical countries including Zambia.Symmetrical Peripheral Gangrene(SPG) is a rare complication of Malaria associated with Plasmodium falciparum infection.Reported here is a case of SPG in a 2 year 3 month old Zambian Toddler and highlight the need for awareness and prompt diagnosis and treatment.
Aphrodisiac Effects of an Ethanolic Root Extract of Ocimum fimbriatum Briq. var. fimbriatum (Kafupa) on Male Wistar Rats
Authors: Kamwela Moses , Ezeala Christian , Prashar Lavina
Published: November 2022

Background: Ocimum fimbriatum Briq. var. fimbriatum is used traditionally in Zambia for its aphrodisiac effect, but there is no scientific evidence to support this use. Therefore, this study aimed to validate the aphrodisiac effects of the plant’s root extract in rats.

Study Design: This was an experimental study in which sixty Wister rats (30 males and 30 females) were separated into 5 groups of 12 rats and treated with different doses of the extract.

Methods: The root extracts were administered at single oral doses of 100, 200, and 400 mg/kg to 30 male rats. Distilled water and sildenafil served as controls. Female rats were treated with 0.1 mg/kg diethylstilbesterol and paired to the male rats. Mounting frequency, intromission, ejaculation, and latency periods were monitored using recording cameras. Recordings were analyzed visually and expressed as mean ± standard error.

Results: The root extract produced significant dose-dependent increases in mounting, intromission, and ejaculation frequencies and latency periods, compared to negative controls. The 400 mg/kg dose produced highest number of mounts (31.33 ± 0.49, p= 0.001), intromissions (24.17 ± 0.60, p= 0.001) and ejaculations (7.67 ± 0.33, p= 0.001) compared to negative controls. At this dose, latency periods for mounting (3.00 ± 0.37min, p= 0.001) and intromission (2.1 ± 0.32 min, p= 0.001) were shortest, while the latency periods for ejaculation (6.33 ± 0.56 min, p=0.001) were longest.

Conclusion: Root extract of Ocimum fimbriatum exerted significant aphrodisiac effects in rats and justifies traditional use of the plant. Further studies are required to elucidate the active principles and mechanisms involved in this effect.
Medical Ward In-Patient Mortality Patterns at a Tertiary Hospital in Urban Zambia: A One Year Review June 2018-June 2019
Authors: Chanda Stephen Longa , Liusha Namakando , Chansa Abidan
Published: November 2022

Very little information exists about the causes of death in Zambian Hospitals. Recording of health related vital events in Zambia is often incomplete, and thus government relies on inaccurate verbal autopsies and models to guide policy and monitor increasing amounts of donor aid given towards the eradication of specific diseases. As most developing regions of the world are undergoing gradual epidemiologic transition, in-patient hospital mortality patterns become more important in reflecting this transition.The purpose of this study was to establish the inpatient mortality patterns among patients admitted to the adult medical wards of Kitwe Teaching Hospital between June 2018 and June 2019.The files of patients who had died between June 2018 and June 2019 were reviewed and death information extracted by a combined team of clinicians. This information was then inputted and analysed using SPSS version 16.0 for windows.It was observed that most (n=145, 56.60%) deaths occurred within 72 hours of admission, 47% of these deaths were of Human Immune-deficiency Virus (HIV) positive patients (p=0.04). 55% of all HIV positive related mortalities occurred within 72 hours of admission. There was a bimodal distribution of causes of death with deaths due to communicable diseases (n=118, 46.09%) occurring in the younger age groups (median age 36, p=0.000) and HIV positive and deaths due to non-communicable diseases (n=138, 53.9%) occurring in the older age groups (median age 54, p=0.000) and HIV negative. HIV (n=124, 48.44%) and TB (n=54, 21.10%) were the leading communicable causes of death. Stroke (n=37, 14.50%) and heart failure (n=24, 9.40%) were leading non-communicable causes of death. Hypertension was the most common associated cause of death (n=38, 13.80%). Overall, more men died than women (male to female ratio 1.49:1), men died at a younger age (median age 42, p=0.180) compared to women (median age 46, p=0.180).Most patients died within 72 hours of admission, with the young dying mainly from communicable diseases associated with HIV and the elderly from non-communicable diseases associated with hypertension.
Extrapulmonary Drug Resistant Tuberculosis in Zambia: Case Reports on the First Two Recorded Cases
Authors: Chewe Webster , Chansa Abidan , Lungu Patrick , Liusha Namakando
Published: November 2022

Extrapulmonary drug resistant tuberculosis (DR-TB) is a rare manifestation of disseminated tuberculosis which carries high mortality more so if the central nervous system (CNS) is affected. This paper reviews two cases of extrapulmonary DR-TB, involving two males both aged 32 years and human immunodeficiency virus (HIV) positive. The first case presented with fever and had meningeal signs while the second case was a prisoner who presented with recurrent anterior chest wall abscesses respectively. The cerebrospinal fluid (CSF) from the first patient and aspirate of the abscess from the second patient were subjected to nucleic acid amplification assays with Xpert® MTB/RIF assay (Cepheid, CA, USA) and both results showed mycobacterium positive, with rifampicin resistance detected in low titers. Both patients were initiated on all oral long regimen containing bedaquiline (BDQ) and linezolid (LZD) as core drugs. Both patients showed tremendous improvement and were almost symptom free at month three of treatment and had returned to full functional status with no apparent adverse effects. This shows the importance of high clinical inquisition and the need for clinicians to subject various bodily fluids to culture and molecular testing including GeneXpert analysis.
Haemodynamic changes and peripheral vascular characteristics associated with pathophysiological alterations in Preeclampsia patients at the University Teaching Hospital, Lusaka, Zambia
Authors: Longa Kaluba , Goma Fastone M
Published: November 2022

Background: The circadian blood pressure changes in pregnancy are poorly documented though the severity of hypertensive disorders especially in pregnancy is said to be better detected by 24hour blood pressure monitoring. The contribution of peripheral vascular variations to these alterations is yet to be elicited. The association of these changes to the renal pathological dysfunction is also not fully understood.

Materials and method: Ambulatory blood pressure measurements and kidney function tests (i.e. creatinine, protein, sodium and uric acid) were done in patients admitted to UTH for hypertension in second and third trimesters of pregnancy. The Complior was used to determine the pulse waveform, pulse wave velocity (PWV) and augmentation index (Aix) as surrogate parameters for peripheral vascular compliance.

Results: Twenty-six (26) women, between 22-42 years old and 24-36 gestational weeks, participated in this study. The majority of our population were either non- or reverse dippers (91.6%). The type A pulse waveform was dominant in all three groups indicating endothelial dysfunction. Dippers had a higher creatinine concentration in both urine andserum and uric acid in serum than non-dippers (7.051mmol/24hrs; 108.703ìmol/L;0.507mmol/L; respectively p<0.0001).The observed association of diurnal variations in hemodynamic parameters and dipping status indicates significant vascular pathology that may herald these individuals' increased risk of cardiovascular complications. The dominance of the type A pulse waveform in this population is indicative of significant endothelial dysfunction.

Conclusion: The association seen between elevated blood pressure readings and proteinuria indicates a possible common pathophysiological process that leads to increased porosity at the glomeruli.
Prevalence of Hearing Loss in Primary School Children in Lusaka, Zambia
Authors: Chibanga Racheal Kasamba Hapunda- , Aswani J , Kipingor M , Munthali J
Published: November 2022

Background: Disabling hearing loss has serious implications in a child's development as it reduces the intelligibility of speech thereby interfering with the learning process. This will negatively impact on their vocational choices.

Study objective: To determine the prevalence of hearing loss in primary school children in the central zone of Lusaka district, Zambia.

Methodology: 1277 children, aged 6 to 13 years, from public primary schools in the central zone of Lusaka district were randomly selected and examined. Clinical otologic assessment, tympanometry and audiometry screening wereconducted on all participants. Children who failed the audiometry-screening test underwent a pure tone audiometry to determine the extent and nature of their hearing impairment.

Results: The prevalence of hearing impairment was 11.5% consisting of conductive hearing loss (87.8%), sensorineural hearing loss (6.8%) and mixed hearing loss (5.4%). Hearing impairment was more common in male children (13.8%) compared to female children (9.3%) (P value= < 0.05). Thirty six point eight percent children had ear disease. Thecommonest ear disease was wax impaction (66%) found in children followed by otitis media with effusion (20%), foreign body ear (4%) and chronic suppurative otitis media (2%). The odds of developing hearing impairment in children withchronic suppurative otitis media was nine times greater than that of children without chronic suppurative otitis media OR = 9.9(95% CI, 2.33-47.43).

Conclusions: The prevalence of hearing impairment in school children in central zone of Lusaka district is high. This study shows that chronic suppurative otitis media has a statistical significant association with hearing loss and that the male children are at a higher risk of developing hearing impairment. There is urgent need for ear and hearing care awareness, and screening programs at the community level in the central zone of Lusaka district.
Relationship between Bullying Experiences, Self- Esteem and Depression among secondary school pupils
Authors: Mungala B , Nabuzoka D
Published: November 2022

Main Objective: We examined whether exposure to bullying would predict low self esteem and depression among  econdary school adolescents.

Design: We used an adolescent study sample of 250 day secondary school learners in Livingstone, Zambia, who were recruited randomly from conveniently selected day secondary schools. The sample comprised an equal number of boys(N=125) and girls (N=125) of age range 13 to 17.

Out comes: The study showed gender differences on bullying and depression among the grade nine learners with highest levels of bullying experiences, low self-esteem and depression among girls. An association (p < .05)was established between bullying and depression. Also, we were able to establish an inverse (p= -16) correlation between bullying and self-esteem. Bullying experiences (physical, social and verbal) accounted for 14.6% of variance on low self-esteem and 33.7% of variance on depression. Social bullying was the strongest predictor of low self-esteem (beta= -.491, sig = .000) and depression (beta =.332, sig =.000).

Measures: The participants self-reported their experiences of bullying on Adolescent Peer relations victim scale B (Parada 2000). Selfesteem levels were measured using the Rosenberg Self-esteem scale (Rosenberg,: 1985).The Beck depression inventory (BD1-11) from the Zambia Neurobehavioral Battery was used to measure adolescents levels ofdepression. This was a quantitative correlational study.

Results: The more bullied students were, the less self-esteem thy exhibited and the more depressed they became. Girls were more vulnerable to bullying with low self-esteem and high depression levels as compared to boys.

Conclusions: Adolescents who frequently experience bullying manifest low self-esteem and higher levels of depression. Increased frequency of exposure to bullying is a consistent predictor of adolescent depression and low selfesteem.
The Pattern and Outcome of Management of Acquired Anorectal fistulas in Children at a semi-urban Teaching Hospital
Authors: Olori Samson , Osagie Olabisi O.
Published: November 2022

Background: Acquired anorectal fistulas are a severe cause for parental concerns, and they pose considerable challenges in their management.

Aim: The aim of this study is to document the pattern of presentation and the management outcome for the cases of acquired anorectal fistula in children seen in our centre.

Method: A retrospective review of the thirteen (13) case notes of the patients with acquired anorectal fistulas managed from 2008-2011 was done. The information retrieved included; the age at presentation, sex, aetiology of the fistula, site of the fistula, the duration of the fistula to the presentation, weight loss, and other associated medical conditions, history of a developmental milestone, type of intervention, the outcome of management, HIV status of patients and parents.

Results: There were two males and eleven females; eight of whom were HIV positive. Five fistulas were due to each to faecal impaction, birth trauma, trauma from rectal enema procedure, iatrogenic following posterior sagittal ano-rectoplasty (PSARP) and sexual abuse respectively.

Conclusion: The fistula healing outcome for acquired anorectal fistula in HIV positive cases was weak compared to the trauma-related groups.
Prevalence of Tuberculosis among bedside contacts of Smear Positive Tuberculosis Patients at The University Teaching Hospital, Lusaka, Zambia
Authors: Lungu Patrick Saili , Chanda Duncan , Chongwe Gershom , Lakhi Shabir
Published: November 2022

background

Screening of contacts of TB patients is not routinely done in resource-limited countries like Zambia despite WHO recommendations, leading to missed opportunities for prevention, early diagnosis and high mortality.

OBJECTIVES

Main objective was to establish the prevalence of latent and active tuberculosis in bedside contacts of smear-positive index patients and associated risk factors.

METHODS

We recruited bedside contacts of smear-positive TB patients in medical wards and contacts of surgical patients as a comparison group using a questionnaire to collect data on various variables. Active TB was diagnosed microbiologically and radiologically, while LTBI by TST.

RESULTS

We had 64 TB-unexposed and 70 TB-exposed, with a mean age of 41.2 [±13.5] years and 40.2 [±14.7] years respectively. Prevalence of active TB in the two groups was 10.0% and 0% respectively while that of LTBI was 83.1% and 38.3% respectively. TB exposure was significantly associated with active TB (p=0.014), LTBI (p<0.001) and type of contact (p<0.001)] but not duration of exposure (p=0.057).    

CONCLUSION

Bedside contacts were at increased risk of contracting both latent and active TB. Given the significant burden of LTBI in the general population without documented TB exposure, there is an urgent to institute preventive measures to protect/treat contacts of TB patients.
Mental Health and Healthcare Provision in Zambian Correctional Facilities
Authors: Chinyama Jonathan , Menon Anitha J
Published: November 2022

Objective: The aim was to determine the prevalence of Axis- I disorders, mental health problems and mental health care service provisions in Zambian correctional facilities

Study sample: 240 inmates were interviewed using the Mini International Neuro-psychiatric interview (MINI), the Warwick-Edinburgh Mental Well-being scale (WEMWBS) and demographic questionnaire

Research Design: This was a cross-section point prevalence

Control or comparison condition: Inmates were statistically compared to each other based on the correctional facility security levels.

Results: The prevalence for current Axis- I disorders was 46.2%. Combined (current and past) prevalence was 63.3%. Major depressive episode current was the most prevalent 47 (19.6%), Psychotic disorder current 38 (15.8%), Psychotic disorder lifetime 18 (7.5%), Major depressive episode past 17 (7%), substance dependency current and Posttraumatic disorder at 14 (5.8%), Manic episode current 5 (2.1%) and the rest below 2% respectively. Total number of inmates with suicide risks was 49 out of 240 (20.4%). Out of 49, 20 (40.8%) had high- risk suicidality levels, 8(16.3%) had moderate suicidality risk- levels and 21(42.9%) had low suicidality risk- levels. Medium had the highest prevalence rate of inmates at risk of suicide 31(63.3%). Out of 31, 17(54.8%) had low risk, 6(19.4%) moderate and 8(25.8%) high-risk levels respectively.  The second highest was maximum 18(20%): out of 18, 4 (22.2%) had low risk, 2(11.1%) had moderate and 12(66.7%) high- risk levels. Maximum had the highest number of inmates who were found with high-risk 12(66.7%) of suicidal ideations and attempts followed by medium 8 (25.8%) and minimum did not register any inmates with suicide risks. There was a positive and significant relationship between suicidality risk levels and the type of correctional facility. Inmates in maximum correctional facility were more likely to have suicidal ideations and attempts than their counterparts in both.

 There was high current substance dependency in medium correctional facility with 11% distribution compared to maximum correctional facility 3%. Current substance abuse was 2% for both maximum and medium respectively. Only 1% in medium had current alcohol abuse and dependency. The prevalence of substance abuse represents the count of substance abuse and not the number of inmates because some inmates abused one or more substances.

Mental Well-being

 Minimum (50.7) ,Medium (63.2) and Maximum (37.4) respectively

Conclusion: Socio-epidemiological assessment found a high prevalence of Axis- I disorders and mental health problems compared to the general population. The low prevalence of substance abuse was largely due to the inmates’ limited access to substance in the correctional facilities. There was total absence of mental health care services in all the three correctional facilities.
Psychosocial Impact of Dental Aesthetics among Secondary School Students in Birnin Kebbi, Northern Nigeria:
Authors: Kanmodi Kehinde Kazeem , Nwafor Njideka Jacob , Iyadi Linda Ekele , Amoo Babatunde Abiodun , Eddah Kelechi Israel , Omoleke Semeeh Akinwale
Published: November 2022

Introduction: Dental aesthetics is a major determinant of good psychosocial well-being. Individuals with good dental aesthetic appearance tend to enjoy better social interactions and quality of life than those with poor dental aesthetic appearance. This study aims to assess the psychosocial impact of dental aesthetics among secondary school students in Birnin Kebbi metropolis, Kebbi State, Northern Nigeria.

Material and Methods: This study was a questionnaire-based cross-sectional survey of 692 students attending Army Day Boys Secondary School (ADBSS) and Army Day Girls Secondary School (ADGSS), Birnin Kebbi. Data collected was analysed using SPSS version 20 software.

Results: The majority (75.4%) of the 692 respondents were within the age range of 15 – 19 years of age, 50.7% were in SS 1 class, and 53.7% were females. The majority (>82%) of the respondents were confident about the appearance of their dentition, roughly half of the respondents were negatively impacted, socially, by the appearance of their dentition. There exists a statistically significant relationship between respondents’ gender and: psychosocial self-perception of their dental aesthetics (p-values<0.05); and concerns about their dental aesthetics (p-values<0.05).

Conclusion: This study concluded that many of the surveyed northern Nigeria secondary school students were not convenient with their current dental aesthetic appearances. Appropriate counselling, public health, and clinical intervention programmes may go a very long way in minimizing the negative impact of dental aesthetics-associated psychosocial problems among this population group.
Incorporating “ICT” Training into Undergraduate Medical Curriculum:
Authors: Kanmodi Kehinde Kazeem , Evbuomwan Oghosa , Nwafor Njideka Jacob , Omoruyi Emma , Buowari Dabota Yvonne
Published: November 2022

Background: The huge relevance of Information and Communications Technology (ICT) in healthcare cannot be overemphasized. Despite the huge benefits associated with the use of ICT in healthcare, many medical schools (especially in the developing countries) are yet to incorporate ICT education as an academic course in their school curricula. This study aims to assess the opinions of medical students on the incorporation of ICT as an academic course into undergraduate medical curriculum.

 

Material and Methods: This study was a cross-sectional online survey of 135 medical students. Study data was collected using an e-questionnaire which explored the participants’: level of academic exposure to ICT education, usage of digital health products, perception of the relevance of digital technologies in healthcare, and opinions on the incorporation of ICT into undergraduate medical curriculum. Collected data was analyzed using SPSS version 23 software.

 

Results: Majority of the respondents were from developing countries (95.6%), 71.1% were 21 – 25 years old, 63.7% were females, and 47.4% were final year students. Not up to one-third (28.1%) of them had ever taken a course (or obtained a degree) that is related to ICT, 5.9% did not consider digital health technologies to be of relevance to healthcare, 91.1% were of the opinion that the future of healthcare is digital, 87.4% were enthusiastic about using and/or promoting digital health strategies, and 94.8% were of the opinion that medical schools should have ICT courses in their curriculum. However, there exists no statistically significant difference between the opinions of the respondents on the incorporation of ICT into medical curriculum and their: gender, age, country of residence, location of school, and academic level (p-values>0.05).

 

 

Conclusion: This study showed that the surveyed medical students’ opinions favored the incorporation of ICT as an academic course into the medical school curriculum.
Interventional Treatment of Symptomatic Uterine Fibroid by Uterine Artery Embolisation at the University Teaching Hospital in Lusaka, Zambia
Authors: Yiqiang Liu , Sunkutu-Sichizya Veronica Kangwa , Huimin Fu , Nteeni Mutinta Siachami
Published: November 2022

Abstract

Purpose: To investigate the clinical effect of interventional therapy for symptomatic uterine fibroid by transcatheter uterine artery embolization.

Methods: 16 patients of symptomatic uterine fibroids were treated with selective uterine artery embolization, and the relief of symptoms and reduction of fibroids were observed.

Results: Bilateral uterine artery embolization was done in 16 patients. Follow-up for 5 ~ 7 months showed that the clinical symptoms of 14 patients were obviously improved, and the reexamination of 1 patient of a super large myoma showed no obvious change after 6 months. B-Ultrasound showed that the size of the tumor was reduced by 43% ~ 92%. The major complication was being is postoperative lower abdominal pain.

Conclusion: Uterine artery embolization is a safe and effective method to treat uterine fibroid.
Feasibility and Safety of Prosthetic Implants for Inguinal Hernia Repair in a Nigerian Tertiary Hospital
Authors: Ogbuanya Aloysius Ugwu-Olisa , Olisa Dr Fabian Ugonna , Oguonu Dr Amobi , Ugwu Nonyelum Benedett
Published: November 2022

Background: Worldwide, inguinal hernia repair is the commonest surgical procedure in general surgery, but the optimal repair technique for inguinal hernia has not been defined and accepted in most parts of Africa and other developing nations. The aim of this study was to determine the epidemiology of inguinal hernias and feasibility of mesh implants in our centre.

Methodology: This was a descriptive cross-sectional study of consecutive adult patients with uncomplicated inguinal hernias who received polypropylene mesh for repair of their inguinal hernias. Selection criteria included inguinoscrotal/inguinolabial hernia, recurrent or bilateral hernia or bubunoceles with wide defects. Descriptive statistics and tests of significance were done.

Results: Inguinal hernia represented 77.3% of all abdominal wall hernias encountered during the study. However, only 27.8% (100 patients) of the 360 patients that satisfied the inclusion criteria received mesh implants. Of the 100 patients studied, 31% had recurrent hernias, 48% harbored complete inguinoscrotal/inguinolabial hernia while 13% had incomplete inguinoscrotal hernia. Majority (86%) had unilateral hernia.The annual repair rates using mesh implants increased progressively from 4% in 2013 to 40% in 2017. A quarter (25%) had comorbidities. Majority (60%) of repairs were under general anesthesia. The overall postoperative complication rate was 14%. Wound infection rate was 3.5%. There was statistically significant difference in the rates of wound-related events between recurrent and primary inguinal hernias (p=0.000).  There was no mortality or recurrence recorded in this study.

Conclusion: The uptake of mesh implants for inguinal hernia repair in our environment is low, though the trend is changing with higher proportions of patients accepting mesh implants in recent time. Elective inguinal hernia surgery with polypropylene mesh is feasible, safe, effective and reproducible in our setting.
Medical School Admissions: A Review of Global Practices, Predictive Validity, and Practice Points for Africa.
Authors: Ezeala Christian Chinyere , Ezeala Mercy Okwudili , Shaikh Vaseem , Akapelwa Tumelo M , Phiri Sam Beza , Kamvuma Kingsley , Mulemena John A , Mushabati Festus , Chanda Warren , Sijumbila Gibson
Published: November 2022

Background: Processes for selection of candidates into medical schools vary globally. Knowledge of the predictive validity of a selection method is important for policy revision.

Aim: To survey the practices used by medical schools to select students and their predictive validity.

Methods: Search terms developed from the research problem were used to search Google Scholar, PubMed, and Educational Resources Information Centre (ERIC). These were “medical school,” “predictive validity,” “success,” “academic achievement” “admission criteria,” and “student selection.” Retrieved articles were screened for relevance and sorted according to countries of publication. Authors narratively reviewed the articles from each country and collated the findings. Best practices were recommended for African-based medical schools.

Results: Articles retrieved from 14 countries were included in the review. USA, Canada, UK, Australia, and New Zealand operate centralized medical school admission programs and administer nation-wide admission tests. These tests cover cognitive and non-cognitive domains. The validity of these tests in predicting medical school success were extensively studied and reported. Other countries do not operate centralized medical school admission programs. Most of these rely on cognitive excellence to select students. Few reports are available on the validity of selection practices in Africa. Most rely on cognitive excellence which highly predicted academic success during preclinical studies. Predictivity decreased during clinical phases and non-cognitive variables became better predictors of success.

Conclusion: Medical school admission processes should consider cognitive and non-cognitive factors. With non-cognitive factors, candidates with right attitudes are selected. African countries should align their practices to that of Western countries.
The practice of clinical social work in Namibia
Authors: Chipare Mwakanyadzeni Abigail , Mupazvihwo Tracy , Tapera Roy , January James
Published: November 2022

Clinical social workers are essential in the provision of mental health services for the prevention, diagnosis, and treatment of mental disorders in the community. They have a crucial role in improving and maintaining the mental health functioning of individuals. The extent to which clinical social work services are used in Namibia is poorly understood. This paper examines the evolution and practice of clinical social work in Namibia based on review of documentary evidence. Results  indicated that there is a great need for clinical social work services in Namibia as the field is relatively unknown with most social workers doing general social work duties. Challenges and solutions are discussed.
Tobacco smoking prevalent in Zambian males: Observations from the Zambia Demographic Health Survey 2013-2014.
Authors: Nalule Flavia Muyinza , Michelo Charles Cheembo , Olowski Pawel
Published: November 2022

Introduction:  Tobacco smoking is one of the biggest public health threats causing poverty, several illnesses and death. Previous studies found that the lower the education, the higher the risk of smoking. This study assessed the association between education attainment and smoking among participants of the Zambia Demographic Health Survey 2013-2014. Methodology: This was a population-based cross-sectional study. Secondary data was extracted from existing Zambia Demographic Health Survey 2013- 2014 data sets, from ten provinces in comparison with different variables to constitute a resultant data set which this study used. All successfully interviewed male and female participants who answered the question, “Do you currently smoke cigarettes?” or “Do you currently smoke or use any other type of tobacco?” were included. The data extraction form was used to extract values of dependent and independent variables and imported into statistical analysis tool Stata version 13. Descriptive statistics of individual characteristics, testing for associations using the Pearson’s Chi Square test and logistic regression were performed. Results: Overall there were 14773 men and 16411women with mean age of 15-19. Smoking prevalence was 9.9% overall and 20.4% in men, but 0.5% in women. The incidence of tobacco smoking is steadily increasing with increase in age among both men and women. There was a significant increase in the incidence of smoking between 20-24 and 25-29 particularly in male smokers. Higher socioeconomic status seems to have a protective effect, consequently smoking remains highest among poor individuals and lowest among the rich. Higher education groups had a decreased likelihood to smoke with an odds ratio of 0.5 overall, 0.2 in men and 0.1 in women. Conclusions: We report high and unchanging prevalence of smoking predominantly concentrated in rural adult populations with lower education attainment. This suggests past health promotion efforts that targeted whole population may not have been relevant to the most affected groups. This therefore calls for reshaping health promotion messages to target specific populations and settings with highest burden. Furthermore, this calls for additional explorative studies in order to examine reasons for smoking in lower educated groups including exploring how what has worked in reducing smoking in higher educated groups could be extrapolated to most affected low educated and rural populations.
Intussusception in Children treated on the basis of clinical features: A prospective observational study from Enugu State, Nigeria
Authors: Chukwubuike Kevin Emeka
Published: November 2022

Objective: Intussusception causes intestinal obstruction more commonly in infants and the symptomatology of intussusception plays a significant role in the management of the patients. The objective of this study was to evaluate of the reliability of the patients’ clinical features for surgical decision making when ultrasound is not available. Materials and Methods: This was a prospective observational study of children aged 15 years and below who had laparotomy for intussusception without preoperative ultrasound confirmation of intussusception (group A) from June 2017 to May 2018. The second group of children (group B) was children who had laparotomy for intussusception with ultrasound confirmation in the preceding year. Group A and group B were compared to determine the reliability of the clinical features in surgical decision making. Consecutive children who presented during the study period were recruited after getting consent from the parents and the study was carried out at a pediatric surgery unit of tertiary hospital in Enugu, Nigeria. Results: There were 32 patients in group A and 30 patients in group B. There were no significant difference in the patients’ demographic profiles, presenting symptoms, operative procedures, post-operative complications and mortality of the 2 groups of patients.  However, when compared with group A patients, there were more negative laparotomies in group B patients (3.1% versus 16.7%) which was statistically significant (p=.0.023), at 95% confidence interval. Conclusion: Clinical features of intussusception in children can be relied on for surgical decision making.
COVID-19 in Africa: The nuances of social distancing and handwashing
Authors: Asombang Akwi W , Akintola-Ogunremi Olaronke , Mateyo Kondwelani John , Mwabe Julie , Kpodo Joel , Ani-Amponsah Mary , Monteiro Filipe J G , Kasono Nancy , Wilson Margaret-Mary
Published: November 2022

The implementation of interventions to minimize the Corona Virus 2019 (COVID-19) pandemic in Africa has been flurry and increasingly complicated in nature. This milieu engenders and heightens vulnerabilities of critical masses living in socially- compromised situations and economically constrained communities in the current pandemic. The increasing spread of COVID-19 has necessitated enforcement of frequent hand washing, social distancing and lockdown measures as a recommended global strategy to curb community-based spread of the disease. However, pre-existing conditions in Africa impede capacity to observe hand hygiene, social distancing and lockdown. Although past epidemics in Africa created foundations for planning for future occurrences, the enormity of the current COVID-19 pandemic has overwhelmed capacity to observe globally recommended interventions. The rising trends in morbidity and mortality has gained attention from community members, stakeholders, regulatory bodies and governments, however, implementation of hand hygiene practices and mobility restrictions has not been in tandem with sustainable approaches that assure compliance and resource availability to limit cross-transmission. The aim of our article is to unveil current challenges with handwashing and social distancing in Africa and propose innovative solutions to prevent community-based COVID-19 transmission. The issues pertaining to Africa are not only related to the magnitude of the problem, but the unique nature of African contexts and the paucity of documented evidence that impede a re-envisioning of interventions that promote community health. Therefore, gaining an understanding of the inherent nuances is important to implementing globally recommended interventions.
Evolution of spontaneous dissecting mycotic superior mesenteric aneurysm in a 12 year old child
Authors: Mulenga Mulewa , Bvulani Bruce , Maleya Adrian
Published: November 2022

Visceral artery aneurysms are uncommon especially in children. One of the main complications before surgery is rupture.

This 12 year old child presented with a large, fast growing, mycotic superior mesenteric aneurysm that had all the favourable conditions for rupture. There was spontaneous dissection of the weakened media with partial erosion of the aneurysm into the wall of the third part of the duodenum. However, this aneurysm formed a thrombus that gradually occluded the lumen. This led to formation of collateral vessels for the continued vascular supply of the midgut.

The uniqueness of this case report has been highlighted from several points (the rarity of the condition in children, the favorability of the conditions to rupture, the gradual but complete luminal occlusion with the eventual formation of collaterals to supply the midgut, and the spontaneous medial dissection with partial duodenal wall erosion without causing rupture).

Although there is no standard surgical approach, early elective surgery is recommended. Non-operative approach is an option that should aim at reducing the risk for rupture. Control of blood pressure is key.

This child underwent surgery. Under total vascular exclusion, the aneurysm was opened. After total luminal occlusion and collateral blood supply to midgut was noted, infected thrombus was evacuated and the aneurysm walls debrided.

Keywords: Superior mesenteric artery, visceral artery aneurysm, aneurysm, midgut.
“Human Papilloma Virus”
Authors: Kanmodi Kehinde Kazeem , Obute ThankGod Emmanuel
Published: November 2022

Not applicable
A Critical Analysis of Sartre’s Freedom Philosophy --A Study of “Why Write?”
Authors: Min HUANG
Published: November 2022

Jean-Paul Sartre is regarded as a leading figure in the 20th-century philosophy due to his great contributions to the theories on existentialism and freedom. One of Sartre’s notable works—“Why Write?” sheds light on his philosophical contemplations on freedom and free will. On Sartre’s upcoming 117 birthday, we make an in-depth analysis into “Why Write?” in an attempt to critically and better learn about Sartre’s Freedom Philosophy. Sartre embraces absolute freedom, a consequence of which, according to Sartre, is full responsibility. However, his notion of freedom is still interspersed with contradictions if we take what he has said about absolute freedom and full responsibility into careful consideration.
Effect of Transformational Leadership on Job Satisfaction, Innovative Behavior, and Work Performance: A Conceptual Review
Authors: Nguon Vannarith
Published: November 2022

This study reviews how transformational leadership is applied around the world. It seeks to establish the style and behavior of leaders under the age of 30 years so that private and public sectors can prepare such leaders in their organizations. Transformational leadership encourages employees to achieve goals that improve their work performance. It focuses on changing employees’ attitude toward work, enabling them to cope the pressure in the workplace, and encouraging them to deliver. This study reviews and discusses the effects of transformational leadership on job satisfaction, innovative behavior, and work performance. To achieve the objectives, this study conducts an extensive review of the relevant literature. The results show that transformational leadership, as the primary variable, affects job satisfaction, innovative behavior, and work performance, the dependent variable. By influencing job satisfaction and innovative behavior, transformational leaders can influence work performance. The results also reveal that transformational leadership, job satisfaction, and innovative behavior independently impact work performance.
The Effect of Structural Reforms: Do They Differ between GDP and Adjusted Household Disposable Income?
Authors: Botev Jarmila , Égert Balázs , Turner David
Published: November 2022

The paper considers whether structural reforms have a different impact on adjusted household disposable income (AHDI) compared to GDP, particularly given that while the latter is currently used as the basis for the OECD Economics Department’s framework for evaluating the effect of structural policy reforms, the former is arguably a better measure of welfare. The main findings are that there are indeed a number of structural policies where the long-run effects on GDP and AHDI are proportionately different, so that percentage changes in the two aggregates are significantly different following a policy reform. One group of structural policies, typically those where the transmission mechanism depends mainly on productivity and capital intensity (including cuts in corporate income tax and policies to simulate business R&D) or which can weaken the bargaining power of labour (for example a loosening of EPL), have weaker long-run positive effects on AHDI than GDP. Other structural reform policies (including in-kind family benefits, family cash benefits and cuts in the income tax wedge) have a magnified effect on AHDI, so that following a policy reform, long-run percentage changes in AHDI are larger than for GDP. Cross-referencing the analysis in the paper with structural reform priorities previously identified in the OECD’s regular Going for Growth surveillance exercise, suggests that increased spending on childcare and early childhood education might usefully be part of any policy package to address the ‘cost of living crisis’ currently being faced by many OECD households.
Actitudes de profesionales del ámbito de la intervención familiar hacia las prácticas basadas en la evidencia
Authors: Pizarro Carmona Ana , Herrera Collado Ester , Hernandez Belío Merry , Pérez-Padilla Javier
Published: November 2022

A la hora de poner en marcha procesos de innovación en los servicios de intervención familiar que supongan la incorporación de programas basadas en la evidencia (PBE), es fundamental considerar el papel que desempeñan los/as profesionales, ya que de ellos depende en gran parte la fidelidad y calidad de la implementación de los programas. Este estudio se centra en analizar las actitudes de profesionales hacia las prácticas basadas en la evidencia, así como su percepción y valoración del Programa de Intervención Familiar (PIF), desarrollado en el Ayuntamiento de Pamplona (España) dentro de la cartera de servicios de preservación familiar. Los participantes fueron los/as 27 profesionales que aplican el PIF, que cumplimentaron la escala Evidence-Based Practice Attitude Scale (EBPAS) y la de Expectativas y Valoración Inicial del PIF (EVI-PIF). Los resultados obtenidos mostraron la relación existente entre las actitudes hacia las prácticas basadas en la evidencia y algunas características de los/as profesionales. Asimismo, también se encontró relación significativa entre una alta valoración del PIF y unas actitudes positivas hacia los PBE. Estos resultados avalan la importancia de las actitudes profesionales como elementos que pueden facilitar o dificultar los procesos de innovación y mejora en los servicios de atención e intervención familiar.