1358 research outputs found
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The use of mass miniature radiographs of the chest in anthropology
No full textThe present study was designed to discover from miniature radiographs of the chests of a population of individuals examined at an interval of a year, first, the accuracy with which the measurement of a number of selected parameters graphs; and second, the reliability of the technique in providing a constant picture for an individual after the interval of a year. Dependency on the answers to these two preliminary questions would rest the decision whether or not it would be worthwhile proceeding, within the limitations of the material to hand, to a further study designed to provide a body of information concerning (a) measurements of the normal adult thorax and its contents and (b) similarities and differences, if any, that exist in respect to the shapes of chests in several groups of peoples
An overview of spontaneous reporting of adverse drug reactions (ARDs) in Zimbabwe
No full textThe deaths of over 100 people in 1937 in the USA from the ingestion of antifreeze used as a solvent for sulfanilamide and the foetal malformations of thalidomide in Europe in the 1960s resulted in the development of drug regulatory agencies as we know them today.1 These authorities licence medicines for the market using the criteria of safety, efficacy and quality. However, clinical trials are inefficient at determining safety since they involve relatively few, selected patients in controlled prescribing environments. It is necessary to monitor marketed medicines for safety under normal prescribing. This is post marketing surveillance or pharmacovigilance. Various systems are available ranging from compulsory reporting of adverse drug reactions (ADRs) through intensive hospital monitoring to spontaneous voluntary reporting.2 The latter, is more common since it is inexpensive and easy to* * implement whilst being useful in identifying uncommon ADRs
Effectiveness and safety of high dose oxytocin for augmentation of labour in nulliparous women
No full textaugmentation of labour in nulliparous women.
Design: An open randomised controlled clinical trial.
Setting: Harare Maternity Hospital, Zimbabwe.
Subjects: 258 nulliparous women, with spontaneous onset of labour, who required augmentation.
Main Outcomes Measures: Duration of augmentation, mode of delivery, maternal and neonatal complications. Interventions: Women were randomly allocated to either low dose (starting at 4 mlU/minute) or high dose (starting at lOmIU/minute) oxytocin group.
Results: Of the 258 women enrolled, 133 were randomized to the low and 125 to the high starting oxytocin dose groups. The groups were comparable for maternal and gestational age. There was no difference in mean cervical dilatation before augmentation of labour; six cm in both groups (p=0.167). The mean augmentation to delivery interval was shorter in the high dose group, 218 versus 326 minutes (p< 0.001). There was no difference in the mode of delivery and fetal outcome in terms of birthweight, five minute Apgar score, admission to neonatal unit and perinatal death.
Conclusion: A high starting dose of oxytocin infusion is as safe but more effective for augmentation of labour in nulliparous women, compared to a low starting dose
Effects of Mother-Based Promotion of Exclusive Breastfeeding on Duration and Severity of Diarrhoea and Pneumonia: A Cluster Randomized Controlled Trial, Midlands Province, Zimbabwe, 2013
No full textExclusive breastfeeding rates remain very low in most countries in sub Sahara Africa. We assessed the effects of a mother based intervention on duration of diarrhoea and pneumonia in communities that were trained and not trained in community infant and young child feeding (cIYCF) in the two districts in Midlands Province.
Methods:
We evaluated communities trained in cIYCF and or not trained and a mother based promotion of exclusive breastfeeding intervention (Newsletter) using a two-by-two factorial cluster randomized controlled trial. Consenting mother infant pairs identified within 72 hours of delivery were followed up at 14 and 20 weeks. Primary outcomes were duration of diarrhoea and pneumonia as well as severity of diarrhoea. Clusters were facility catchment areas assigned by an independent statistician using randomization generated by a computer in Stata 10. All admitting facilities and facilities at borders were excluded as buffer zones and eight clusters were analyzed: cIYCF- Newsletter (2 clusters, 90 mother infant pairs), cIYCF (88 mother infant pairs), Newsletter (92) and Control (87).
Results:
A total of 357 mother infant pairs (excluding twins) were available for analysis in all the clusters. The interaction between community infant and young child feeding training and the newsletter was statistically significant at 14 weeks (p = 0.022). The mean duration of diarrhoea was 2.9 days (SD = 0.9) among infants of mothers who resided in communities trained and received a newsletter compared to 5.2 days (SD = 1.1) in communities that received neither. The protective efficacy of the cIYCF plus newsletter was 76% during the first 20 weeks of life. In the two way ANOVA, the newsletter was more effective on duration of pneumonia (p = 0.010) at 14 weeks and remained significantly effective at 20 weeks (p <0.0001) while the preventive efficacy of the newsletter on pneumonia at 20 weeks was 74%.
Conclusion: A combined community and mother-based promotion of exclusive breastfeeding reduces duration of diarrhoea at 14 weeks and at 20 weeks the newsletter worked better for both duration of diarrhoea and pneumonia compared to cIYCF trainin
Rights inference: Understanding the meaning of Section 46 of the Constitution of Zimbabwe beyond Gubbay CJ’s dictum.
No full textThe Constitution of Zimbabwe guarantees a wide range of
fundamental rights. These are set out in Chapter four-the Declaration
of Rights. However, the Constitution is silent on a number of
fundamental rights which include the right to access adequate
housing, the right to development and the right to the protection of
family. Thus, the Constitution does not expressly provide for these
rights, yet in the preamble it, captures and expresses a vision of a
prosperous and just society that is based on human dignity. There is
a real risk that this vision will remain a pipe dream if individuals do
not enjoy these rights. In this paper, I examine how and the extent to
which the interpretive guidelines set out in section 46 of the
Constitution, can be applied as a tool to infer or read in rights that
are not expressly provided for in the Constitution’s Declaration of
Rights. Inevitably I also examine the theoretical underpinnings of
the rules provided for in section 46 and argue that, the courts need
to engage with those theories in a critical and nuanced fashion in
order to develop a meaningful jurisprudence on how fundamental
rights should be interpreted in Zimbabwe
Susceptibility of Zimbabwean Streptococcus agalactiac (group B streptococcus',; GBS) isolates to four different antibiotics
No full textObjective: To establish the susceptibility of Zimbabwean GBS strains isolated from hospitalised patients to four antibiotics. Design: Cross sectional survey. Settings: Four regions of Zimbabwe (Bindura, Bulawayo, Harare, and Masvingo). Subjects: 113 GBS isolates from hospitalised patients in Bindura, Bulawayo, Harare and Masvingo, of whom most were suffering from infectious diseases. Main Outcome Measures: All isolates were tested for their susceptibility to clindamycin, erythromycin, penicillin and tetracycline. Results: All isolates were 100 % sensitive to clindamycin, 98 % to penicillin, 86 % to erythromycin; 2 % of the isolates showed intermediate susceptibility to penicillin and 100% showed resistance to tetracycline. Conclusion: Penicillin is still the antibiotic of choice for treatment of GBS infections and for intrapartum chemoprophylaxis in Zimbabwe. For patients who are allergic to penicillin, clindamycin will be the drug of choice for both treatment and/or chemoprophylactic use in Zimbabw
Comparison of In Vitro bioavailability of proprietary propranolol preparations
No full textDissolution rate studies were conducted to compare the release rate of propranolol from two proprietary preparations. Propranolol was released at a faster rate from Rexigen* when compared to Inderal* which suggests that plasma levels of the drug would be higher in patients taking the former preparation. Both preparations showed satisfactory dissolution but problems may be encountered if a patient stabilized on one brand were to change to the other
The prevalence of coronary heart disease in human immunodeficiency virus positive individuals in Harare, Zimbabwe
No full textCoronary heart disease is complex with several well established as well as postulated risk factors and pathogenetic mechanisms. This public health problem is a major cause of morbidity and mortality in the industrialised world. HIV is now well recognised as a risk factor for coronary and ischaemic heart disease in the industrialised world but has been hitherto not studied in the black African population. In this study a case control autopsy series of HIV-positive and negative deceased black Zimbabweans was done with the objective of estimating the coronary heart disease rates in these individuals and establishing an association, if any, between HIV-infection and CHD. CHD was present with prevalence rates of 18.1% and 9.5% in HIV-positive and negative individuals respectively, although these prevalence rates were not as high as those in industrialised countries where CHD has reached epidemic proportions. There was however no statistically significant association between HIV infection and CHD. It has therefore become necessary for clinicians treating HIV-positive black African patients to actively investigate for and manage coronary heart disease and its risk factors. There is potential to reduce previously unrecognised morbidity and mortality in HIV. In addition coronary heart disease is now prevalent in the general black Zimbabwean population and may be a source of clinically apparent disease
Clinical pharmacologist wanted - where?
No full textMany people could define with ease the job of a cardiologist, a paediatrician or an obstetrician. However, only a few would have any clear idea of how a clinical pharmacologist might fill a day. Indeed, within the medical profession, and often within the scientific community, there has been a sneaking suspicion that clinical pharmacologists are themselves unsure of their remit. This article describes the possible role for clinical pharmacologists and different areas where they can make significant contributions to medical services
The need for peri-operative supplemental oxygen
No full textMolecular oxygen is a colourless and odourless gas which is essential to life. It accounts for 21% of the atmospheric air. Apart from its central role in oxidative phosphorylation to produce biological energy in the form of adenosine triphosphate (ATP), molecular oxygen is used as substrate by two other enzyme systems for the killing of bacteria in the phagocytes and for collagen synthesis by the fibroblast during wound healing.18 In the immediate post operative period atmospheric oxygen might become inadequate for a number of reasons including hypoventilation due to central pharmacological depression, diffusion hypoxia and increased metabolic rate due to shivering (the so called halothane shakes)