1358 research outputs found
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Investigation of the effect of stalanev (Stavudine, Lamivudine and Nevirapine) treatment on plasma lactate levels in adults attending Beatrice Road and Wilkins Infectious Diseases Hospital Opportunistic Infections clinics in Harare, Zimbabwe
No full textMain Objective: To evaluate the effect of Stalanev (Stavudine, Lamivudine and Nevirapine) treatment on plasma lactate levels in adults attending Beatrice Road Infectious Diseases Hospital and Wilkins Infectious Diseases Hospital Opportunistic Infections Clinics in Harare,
Design: Prospective cohort study carried out between January and May 2011
Setting: Beatrice Road and Wilkins Infectious Diseases Hospital Opportunistic Infections Clinics in Harare, Zimbabwe.
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Type 2 Diabetes Mellitus in Black Zimbabweans - Metabolic Factors and Molecular Genetics.
No full textObjectives: The main objectives of the study were (i) to determine the prevalence of the metabolic syndrome disorders, (ii) to determine the frequency, of ApoE gene polymorphism at codons 112 and 158, of the ACE gene 287-bp insertion/deletion polymorphism, of the -308GöA mutation in the 5! region of the TNF-alpha gene, and (iii) to investigate the effects of these polymorphisms on the components of the metabolic syndrome in type 2 diabetic patients.
Methods: Dyslipidaemia, obesity, hypertension, microalbuminuria, hyperinsulinaemia and insulin resistance, all intermediate traits and metabolic components found in type 2 diabetes mellitus, were determined in diabetic patients as well as non-diabetic participants. Apolipoprotein E (ApoE) gene polymorphism of the amino acid substitutions of cysteine and arginine at codons 112 and 158, angiotensin converting enzyme (ACE) gene 287-bp insertion/deletion polymorphism and the -308GöA mutation in the 5! region of the tumour necrosis factor alpha (TNF-alpha) gene were determined by the polymerase chain reaction (PCR). Polyacrylamide and agarose gels were used to electrophoretically identify the genotypes from the PCR DNA products. The genotypes from the 3 different polymorphisms were related to lipid metabolism, anthropometric measurements, microalbuminuria, hypertension, insulin resistance or hyperinsulinaemia.
Results: The data in the current study clearly demonstrates a rather high prevalence of the metabolic syndrome (36%) in Black Zimbabweans with type 2 diabetes mellitus, characterised by hypertension (69%), microalbuminuria (62%), insulin resistance (57%), dyslipidaemia (47%) and obesity (31%). The nucleotide substitutions in codons 112 and 158 of the ApoE gene reveal that Zimbabweans have an unusually high frequency of e4 (29%) and e2 (11%) alleles, compared to general Caucasian and Asian populations. The E4/4 genotype has a statistically significant influence on blood total cholesterol (p < 0.05), and low density lipoprotein cholesterol (p < 0.05) in this Black population compared to other genotypes. The ApoE polymorphism has a marked influence on triglycerides and high density lipoprotein cholesterol even if this is not statistically significant. Although Black Zimbabweans have a high D (deletion) allele frequency (64%), the ACE 287-bp insertion/deletion (I/D) polymorphism, blood pressure and microalbumin levels were not statistically significant in hypertensive versus non-hypertensive and microalbuminuric versus non-albuminuric patients, respectively. The I allele had a relationship with hypertension, insulin and BMI, although this was not statistically significant. The AA genotype compared to the AG and GG genotypes of the Nco I-sensitive polymorphism (-308 GöA) in the promoter region of the TNF-alpha gene is significantly associated with BMI (p < 0.01), diastolic blood pressure (p < 0.05), and uric acid (p < 0.05) in this populace.
Discussion: In the last few years it has been demonstrated that metabolic disorders investigated in this study are aetiological factors for cardiovascular and cerebrovascular disease. Obesity, insulin resistance, hyperinsulinaemia and nephropathy may aggravate the atherogenic lipid profile in most of these patients. Therefore, it may be critical to modify these risk factors in this population through therapeutic and nutritional interventions where possible, so as to reduce the risk of complications of macrovascular disease. The high prevalence of the e2 and e4 alleles is likely to be a heavy genetic burden as it has been shown to enhance susceptibility to diabetic nephropathy, coronary artery disease and Alzheimer disease in several populations. The ACE 287-bp insertion/deletion (I/D) polymorphism does not seem to play a major role in influencing blood pressure or diabetic nephropathy, despite the fact that Black Zimbabweans have a high D allele frequency. However the relation of the I allele with hypertension, insulin and BMI, although not statistically significant, suggests that its conferred risk may be much higher in the Zimbabwean Black population. Data from the current study suggests that TNF-alpha gene polymorphism may have a complex relationship with T2DM and that it may be a useful tool in determining subjects at high risk of developing the metabolic syndrome.
Conclusion: The data in the current study categorically shows that genetic polymorphisms contribute to biological variation in various target tissues, and one can deduce that they are capable of influencing disease susceptibility and progression. Taken together, the findings in this study suggest that these polymorphisms could be used as potential markers in T2DM subjects at risk of developing certain metabolic complications and that they may be useful in the determination of severity of these disorders. The multiple molecular mechanism whereby these polymorphisms induce the metabolic disorders is not well understood and requires further investigation
Congenital duplex gallbladder anomaly presenting as gangrenous perforated intrahepatic cholecystitis mimicking a gas forming liver abscess: A case report and literature review
No full textBackground: Ectopic intrahepatic gallbladder is a rare phenomenon. Gallbladder duplication is an even rarer phenomenon. Pathological processes arc more common in congenital anomalies of the gall bladder than normal gallbladders due to poor drainage. Case Report: We present a case of duplex gallbladder with one component intrahepatic and the other extra- hepatic, the duo draining via a common cystic duct into the common bile duct. Both gallbladder moieties were diseased. The intrahepatic moiety was gangrenous and perforated thus mimicking an intrahepatic abscess by a gas forming organism .The extra-hepatic moiety was chronically inflamed and packed with gallstones of the same physical and biochemical characteristics as the intrahepatic moiety. The definitive diagnosis was only- made at emergency laparotomy. Stone gathering and debridement of the ruptured, gangrenous intrahepatic moiety and cholecystectomy for the extra-hepatic moiety was done. On tabic cholangiography, though desired, was not available. The patient fully recovered after post-operative intensive care. Conclusion: An extensive internet literature search did not reveal any previously described case. This could be the first such case described in the world literature. Though rare, congenital anomalies of the gallbladder must be known to surgeons as they can present unexpectedly and pose diagnostic and operative surgical challenges with serious clinical implications. The management challenges experienced and literature review is presented
A study to examine the relationship between knowledge levels on self-care practices and occurance of abortion among women of child bearing age admitted for post arbotal care at Gwanda gynaecology ward.
No full textAbortion is a major public health obstetric problem across the globe. Worldwide, twenty million unsafe abortions occur each year. Eighty thousand women die each year because of complications following unsafe abortions [WHO 2006]. In Zimbabwe it is estimated that ten to fifteen thousand abortions occur annually. It is one of the leading causes of maternal morbidity and mortality. In 2008 abortion complications resulted in 35% of maternal death and were ranked ninth out of Zimbabwe’s top ten diseases/conditions [MOHCW 2009].
The purpose of this study was to determine the relationship between knowledge levels on self-care practice and occurrence of abortion among women of childbearing age. The study utilized Orem’s self-care model. The concepts used were self-care deficit, supportive educative and self-care. A descriptive correlational design was used. A non-probability sampling which is convenience sampling was employed in the study. The sample size was seventy eight subjects. The instrument used to measure the variable was a questionnaire. Descriptive statistics were used to describe, analyze and summarize data on knowledge levels on self-care practice and occurrence of abortion. Pearson’s correlation coefficient was used to establish the relationship between knowledge levels on self-care practice and occurrence of abortion. A weak negative significant relationship was noted r = -.265*, p =< 0.05.
Midwifery practice should ensure that women should be empowered with knowledge on self-care practice to prevent occurrence of abortions. Empowering women addresses the millennium Development Goal 5 which targets to reduce maternal morbidity and mortality by ¾ by the year 2015
The impact of organisational change on employees: A study of Spar Arundel, a division of Innscor Corporate Retail, Innscor Africa Private Limited
No full textThe purpose of this research is to examine and ascertain the nature of the impact that the process of organisational change undertaken within Spar Arundel, a division of Innscor Corporate Retail- Innscor Africa limited, from January 2011 to July 2012 has had on employees. This study also examines the change management strategies used and how the change process impacted on the employees.
This study was based on a case study of Spar Arundel supermarket. The research was undertaken in the social world, and was theoretical in nature, gathering empirical data through questionnaires while using quantitative research paradigms as basis. A quantitative research approach was taken with respect to the employees and managers of Spar Arundel supermarket in order to assess the impact of change on the employees and to gauge employee satisfaction. A total of 112 respondents were secured out of 172 employees.
The critical success factors for successful implementation of a change process entail transparent employee involvement at every stage of the change process. In light of this, the outcome of the survey indicated that the change vision was not communicated while employee involvement was minimal. Analysis of the perceptions and attitudes of employees towards senior management revealed total mistrust. Furthermore, the analysis clearly indicated that the change impacted negatively on the employees.
The study does not aim at being statistically representative, the company which was selected, Spar Arundel supermarket, may not be a full representation of all Spar supermarkets under Innscor Corporate Retail.
Change management though not a new subject for Zimbabwean companies continues to be poorly implemented leading to employee unrest and lack of productivity. This study is a contribution to helping enterprises in finding the best approach as well as giving examples for academic studies on how the organisational change management process can be implemented efficiently and effectively
Relationship between self-care practices and readmissions among adults aged 40-80 years with chronic heart failure at a Central Hospital In Zimbabwe
No full textReadmissions for chronic heart failure are a major concern for medical surgical nursing and can be preventable in at least 40% of the cases (Robert & Bowling, 2001). Self-care practices could influence outcomes of chronic heart failure patients such as readmissions (Lee, 2009). The purpose of this study was to describe as well as examine the relationship between self-care practices and readmission among chronic heart failure patients. The theoretical model used to guide this study was Orem’s self-care model. A non-experimental descriptive correlational study design was used. A simple random sample of 65 adults aged 40 to 80 years with chronic heart failure was selected from the outpatients’ clinics. An instrument comprising of 3 sections namely the demographic data section, the readmissions section (RS) and the chronic heart failure self-care practices section (CHFSCP) was administered using the face-to-face interview technique. The relationship of self-care practices and readmissions was analysed using the inferential statistics. Data was analysed using the Statistical Package for Social Sciences (SPSS). There was a negative linear relationship between the independent and the dependent variables (r=-.436, p<.01). This means that as self-care practices improve, the number of readmissions decreases. The effect of the independent variable on the dependent variable as indicated by R²=.191 (F=14.828, p<.01). This meant that self-care practices explained 19% of the variance observed in the readmissions. The mean score for the chronic heart failure self-care practices section was 46.5 and 33(50.8%) subjects had total scores below this mean. Medical surgical nursing practice should adopt protocols that support good self-care practices and the protocols should take an individualized approach to maximize reduction of readmissions among chronic heart failure patients
Mortality within 24 hours of admission to the Paediatric Unit, Harare Central Hospital, Zimbabwe
No full textObjective: To determine the proportion of deaths, characteristics of children and risk factors for mortality within 24hours of admission to a Paediatric hospital in Harare.
Study Design'. Prospective cohort study.
Settings: Paediatric Unit, Harare Central Hospital.
Subjects: All patients admitted to the medical wards who consented to participate were enrolled. Preadmission factors including duration of illness and health seeking behaviour prior to presentation, delays in A&E department assessed by lag time to assessment, administration of initial medications and admission to the ward were documented. The presenting clinical signs and admission diagnoses were also recorded.
Main Outcome Measure: Death within 24hours of admission.
Results: Of the 737 pediatric admissions during the study period, 54 children died within 24 hours giving a case fatality rate of 7.3%. These constituted 34.6% of total deaths in the study population (54/155).The median age of the children in this study was 16 months (Q,= 4, Qy= 36) and 53.2% were male. Having subcostal recessions on admission was significantly associated with mortality (within 24hours of admission) with a RR 2.99 (95% Cl 1.56-5.74) while socio-demographic factors, duration of illness, fever, diagnosis on admission and delays in A&E department were not.
Conclusion: The contribution of deaths within 24hours of admission to the overall mortality in children remains unacceptably high. Sub-costal recessions on admission (a proxy for severe pneumonia) had the highest risk of mortality within 24hours of admission. There is need for early identification and aggressive management of children with pneumoni
Housing land allocation in Kadoma: Implication for low-cost housing provision
No full textThis paper reviews housing land supply and land allocation strategies and practices in Kadoma. Inadequate supply of and inequitable access to serviced land is the most important factor limiting the supply of housing to low income households in the city. This research arose from the acute shortage of low cost housing land supply which has led to overcrowding and homelessness. Research has shown that land because of its scarcity and high cost is the major obstacle to the adequate provision of affordable urban housing in developing countries. This stems from the use of poor and inappropriate frameworks for the allocation of urban housing land which work against efforts by the poor to access low cost housing. Questionnaires, structured interviews and secondary data sources were used to investigate the topic. It was found out that land allocation methods in Kadoma changed between 1990 and 2011 which marginalised low income households. Low cost housing is no longer the first priority in allocating housing land in Kadoma resulting in overcrowding and the use of informal land access methods as alternatives. The paper concludes that unless concerted efforts are made by urban planners and government to address the land issue, Kadoma may in the nearest future be facing chaotic housing development
An assessment of the self-service technology (SST) on firm performance in the financial sector in Zimbabwe: A case study of FBC Bank 2009 - 11
No full textThe fast advancing global information infrastructure such as information technology, computer networks, Internet and telecommunications have enabled the development of the electronic commerce at a global level. The nearly universal connectivity which the internet offers had made it invaluable business tool. These developments have created a new type of economy , which maybe called the “ digital economy”:This fast emerging economy is bring with it rapidly changing technologies, increasing knowledge intensity in all areas of business and creating virtual supply chains and new forms of businesses and service delivery channels such as Self Service Technology (SST).
As a direct consequence of the emergence of the “digital economy”, the balance of power seems to be shifting towards the customers. Customers are increasingly demanding more value, with goods customised to their exact needs, at less cost, and as quickly as possible. To meet these demands, business needs to develop innovative ways of creating value which often require different enterprising architecture, different IT infrastructures and different way of thinking about doing business. This transformation of business from old company to a new agile electronic corporation not easy and required a lot of innovative thinking, planning and investment.
This study is to find why the local banks have not managed to capitalise on the usage of self-service technologies yet the similar products are doing well in the developed countries such as the United States, Great Britain and Germany. The return on investment as the e-channels struggle to attain a critical mass for them to be profitable. The banks are only implementing the delivery channel as a loss leader and they continue to under pressure from the demanding public.
The results indicate that the target market and product development has not been done well for the product to thrive. Product cannibalisation has been cited as the main cause why the products are failing as they are competing for thin resources. The market is largely unbanked and similar strategies have been deployed in Kenya and South Africa This study will focus on what they should do in-order to capitalise on technology as a game changing strategy