1358 research outputs found
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Harare doctors support the need for training in basic business and economics principles in medical school: A pilot study
No full textThe world is becoming more and more capitalist. This change is affecting all health disciplines including general practice. Lomas reported that economic factors also contribute to a change in doctors' behaviour.' This recognition has resulted in the growth of health economics as a discipline of study. Worldwide, the achievement of an effective evidence based health care system has resulted in the incorporation of health and medical economics in medical education.2 Medical doctors' roles have diversified over the years, and they are increasingly becoming a hybrid of a health care professional and a businessman. More and more medical doctors arc starting their own private practices. Medical doctors arc borrowing from other fields such as economics and business administration in order to cope and survive in the competition; e business environment. It is increasingly becoming critical and indispensable, for medical doctors to understand their expenditure patterns, how to run efficiently and generate revenue greater than expenses (profit), how to price their products and services and how to define their niche in the communit
The relationship between the level of HIV antenatal self care knowledge and HIV self care antenatal care practices among HIV positive women age 18-40 years at Chinhoyi provincial hospital.
No full textLack of adaptation of good HIV antenatal self care practice may lead to a rise in both maternal
and infant mortality rates, through mother to child transmission of HIV. The purpose of the study
was to examine the relationship between the level of HIV antenatal self care knowledge and the
nature of HIV Antenatal Self Care Practices among HIV positive pregnant women at Chinhoyi
Provincial Hospital. Orem’s self care deficit model was utilized to provide a theoretical
framework to guide the study. A descriptive co-relational design was used to guide the study. A
sample of 80 mothers was selected using simple random sampling technique. Structured
interview schedule was administered by the investigator through face to face interaction.
Descriptive statistics were used to analyze demographic, dependant and independent variables.
Inferential statistics by Statistical Package for Social Science (SPSS) were computed to examine
the relationship between the levels of HIV antenatal self care knowledge and the nature of the
HIV antenatal self care practices. Pearson's correlation coefficient test showed a moderate
significant positive relationship between the variables (r = .252*, p< = .01. The regression
analysis gave a significant effect at R² = 064 (F = 5,300). The findings showed that the nature
of HIV antenatal self care practices account for 34% positive modification, meaning other factors
other than the acquired levels of antenatal self care knowledge account for the remaining
percentage. Varying patterns to knowing resulted in varying responses in utilization of acquired
levels of knowledge by the study subjects. It is recommended that Midwives identify knowledge
patterns held by child bearing women in their areas and come up with strategies of adequately
addressing those, to help them utilize the knowledge they acquire adequately and effectively.Ministry of Health and Child Welfar
Microbiology of puerperal sepsis and its clinical implications among HIV-infected and HIV-uninfected women in a hospital sample in Zimbabwe
No full textTitle: Microbiology of puerperal sepsis and its clinical implications in a Hospital sample in Zimbabwe
Introduction: Puerperal sepsis is infection of the female genital tract occurring at any time
between the rupture of membranes or labour, and the 42nd day postpartum. Puerperal sepsis has become the leading cause of maternal death in Harare public health institutions accounting for 19% and 30% of maternal deaths for the years 2010 and 2014 respectively, from being the fourth nationwide cause at 12.3% in the year 2007. The objectives of this study were to determine the identity and antibacterial susceptibility profiles of bacteria colonizing the genital tract and blood stream, and to assess clinical
outcomes and association with HIV infection in women with puerperal sepsis.
Methodology: A prospective cohort study was conducted at Parirenyatwa and Harare
Hospitals between 02 September 2014 and 01 July 2015. Endocervical swabs and blood were collected for culture and susceptibility testing from 151 consecutive women who met the World Health Organisation criteria for puerperal sepsis. HIV sero-status, immunological status and antiretroviral therapy (ART) use were determined. Medical records were reviewed for assessment of clinical outcomes. Proportions, categorical values and means were compared using Z-test, .² test and t- test along with 95% confidence interval (CI) and p-value of <0.05.
Results: The mean age was 25.1 ±5.8years and most women were multiparous(53.6%). The majority of women had delivered at a hospital (78.1%) and by caesarean section
(57.6%). The commonest bacterial isolates were Escherichia coli (30.6%) and Klebsiella pneumoniae (15.3%). Multidrug resistant organisms (MDRO) accounted for 10.9% of the isolates. MDRO were associated with prolonged mean hospital stay 23.0days (d) compared to 10.5d in women without MDRO (p=0.009). The frequency of genital colonization with Enterobacter species was significantly higher in HIV infected (9.1%) than uninfected women (1.7%) (p=0.04). Among HIV infected women (21.9%), severe immunosuppression (CD4 500/mm³). There was a non-significant trend towards,earlier onset of sepsis; and higher rates of pelvic abscess, septic shock, wound dehiscence, peritonitis, death and need for admission into the intensive care unit (ICU)
in women with severe immunosuppression. Antiretroviral therapy use did not independently influence outcomes. Puerperal sepsis case fatality rate was 7.3%.
Conclusion: Gram negative bacilli, particularly E. coli, are the commonest bacterial isolates in puerperal sepsis. There is emergence of MDRO gram negative bacilli resistant to carbapenems, especially K. pneumoniae. MDRO and HIV associated severe immunosuppression are risk factors for prolonged hospital stay and need for surgery. Robust infection control strategies, emphasis on rational drug use and clinical culture surveillance to identify MDRO and monitor epidemiologic trends is recommended.NECTAR Mentored Research Scholarship Progra
Supernumerary teeth: Literature review
No full textA review of the literature on supernumerary teeth in general and supernumerary molars in particular was carried out on prevalence, aetiology, complications and the treatment of supernumerary teeth. Additional teeth are relatively common and are usually of simple conical shape (supernumerary teeth) but may resemble teeth of the normal size and shape. The aim of this review is to provide reference material for dental practitioners in Zimbabwe
Forgotten diseases: relapsing fever
No full textRelapsing fever is a group of conditions that is characterized by recurrent febrile episodes interspaced with periods of no symptoms at all. They are arthropod-borne spirochetal infections of the Borrellia genus and occur in two main forms: tick-borne and louse-borne. Tick-borne relapsing fever is a zoonosis that is found worldwide. The louse-borne relapsing fever is caused by B. recurrentis, and is seen in the developing world. This form usually occurs in the setting of overcrowding. It is spread from person to person and can occur in epidemics, including large ones involving millions of people. Mortality rate may reach 40% when untreated, depending on host factors such as nutritional status and concurrent illness
