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Prevalence of hypertensive retinopathy in patients with pregnancy-induced hypertension (PIH) at Parirenyatwa Group of Hospitals.

2023-05-29T01:08:10Z

Title: Prevalence of hypertensive retinopathy in patients with pregnancy-induced hypertension (PIH) at Parirenyatwa Group of Hospitals. Authors: Chimera Muchemwa, Batsirai Lizzie Abstract: Pregnancy-induced hypertension(PIH)is a spectrum of disorders associated with significant fetal and maternal morbidity and mortality. It is a multisystem disorder which does not spare the visual system. Some effects of PIH on the retina(hypertensive retinopathy)and choroid(hypertensive choroidopathy),can be potentially blinding if not recognised and managed promptly though in the majority of patients there is resolution within six weeks post-partum without sequelae. As the eye is the “window to one’s body”, the presence of hypertensive retinopathy can predict fetal outcomes, severity and likelihood of progression of pregnancy-induced hypertension. Objectives: This study sought to: Determine the prevalence of hypertensive retinopathy in patients with PIH presenting at Parirenyatwa Group of Hospitals. Establish the severity of hypertensive retinopathy in the study population. Identify associations between hypertensive retinopathy with age, parity, previous history of PIH, blood pressure (systolic and diastolic), degree of proteinuria and the presence of the Human Immunodeficiency virus (HIV)in the study population. Identify sight-threatening complications associated with hypertensive retinopathy in the study population. Study design: This was a hospital based cross-sectional study and was carried out fromthe8thofSeptember 2016to the 31stof March2017.Methods: Participants were selected by convenience sampling from patients admitted at Mbuya Nehanda Maternity Hospital. Eligible patients were pregnant women from 24 weeks gestation onwards with a diagnosis of PIH. Patients unwilling to participate in the study, those with pre-existing hypertension, media opacities and systemic illnesses which caused retinal pathology similar to hypertension were excluded from the study. Data was collected using a specially designed study tool .All subjects had a medical history taken and an ocular examination which included visual acuity, anterior segment examination and a dilated fundus examination with both the direct and indirect ophthalmoscope. Fundus photographs were taken for selected cases. The Keith-Wagener-Barker classification of hypertensive retinopathy was used for grading of retinopathy. An overall grade of the hypertensive retinopathy was assigned to each patient on the basis of the eye with the most severe changes. Results: A total of163 patients were recruited. Seventy-five patients (46%) had gestational hypertension, 74 (45.4%) had pre-eclampsia and 14 (8.6%) had eclampsia. A total of 111 subjects (68.1%) had clinically evident hypertensive retinopathy. Fifty-eight participants(52.3%) had grade 1 changes, 32(28.8%)had grade 2changes, 17(15.3%)had grade 3 and 4(3.6%)had grade 4 hypertensive retinopathy respectively. There was a statistically significant positive association(p<0.05),between hypertensive retinopathy and blood pressure(both systolic and diastolic), proteinuria, severity of PIH, duration of PIH since diagnosis and parity. There was no significant association(p>0.05),between hypertensive retinopathy and HIV status, visual acuity, gestation and maternal age. None of the patients had retinal detachment or choroidopathy. Conclusion: The prevalence of hypertensive retinopathy was significantly high in our study population in comparison to other studies. Positive risk factors for developing hypertensive retinopathy in our study population included high blood pressure, severity of PIH, proteinuria, duration with PIH and increasing parity. However, the majority of patients did not have sight threatening complications.

“Lived experiences of young women of the quality of obstetric care services provided by midwives at Mabvuku Birthing Centre and its satellites in Harare, Zimbabwe”

2023-05-27T01:08:27Z

Title: “Lived experiences of young women of the quality of obstetric care services provided by midwives at Mabvuku Birthing Centre and its satellites in Harare, Zimbabwe” Authors: Gundani, Helen Vupenyu Abstract: The quality of obstetric care services (QOCS) tends to determine young women’s choice of where to receive the intended services, yet in lower income countries like Zimbabwe little research on such services is documented. The purpose of this study was to explore the lived experiences of child-bearing age women of the QOCS regarding the QOCS provision in maternity clinics in Harare eastern district and its Satellites in order to understand the degree of their satisfaction with the obstetric care (OC) that they received. Also, to develop a model of care that can fulfil the knowledge and theory gap. Permission was approved by the relevant Research Ethics Committees for protection of the participants. A descriptive phenomenological qualitative approach was used to hear from the perspective of the care users. Data were collected until saturation. Giorgi’s technique analysed the data and a Hulton, et. al., (2000/2007) and the Southern Relational Path frameworks were used to guide the study. Semi–structured interview guides were used for the focus group discussions and individual in–depth interview platforms, and notes were written in a research diary and transcriptions were done daily after recording. Thirty-one participants were purposefully recruited from the pre-natal, labour, post-natal records and those who came for post-natal care services after consenting.Some women were satisfied with the QOCS that they received, citing warm and sensitive reception especially from the male midwives, while others were dissatisfied with the care. They mentioned poor monitoring of deliveries that led to self-deliveries, lack of empathy, rudeness and mistreatment during labour and birthing. Some environmental barriers such as crowdedness in the admissions room, labour, and post-natal rooms were reported. Confusing, inadequate and inconsistent information on family planning drugs, immunizations and breastfeeding concepts were reported. Insensitive cultural and religious values among the care providers were also noted as cause for concern. A model of care that might provide some useful insights that could improve the care and eventually improve QOCS was developed. The study concludes that women prefer quality obstetric care that constitutes the availability of resources both physical and human, namely trained and competent staff; medicines and sundries; longer clinic stays in order to rest and gain more information on infant care and breastfeeding and adequate space to allow husbands and significant others to accompany them on booking day. Staff need to be warm and empathetic, culturally and religiously sensitive for better maternity care uptake.

Investigations of the potential effects repeated doses of a hydroethanolic extract of crinum macowanii on memory learning and neuromotor behaviour in two different mouse models of alzheimer's disease.

2023-05-29T01:08:09Z

Title: Investigations of the potential effects repeated doses of a hydroethanolic extract of crinum macowanii on memory learning and neuromotor behaviour in two different mouse models of alzheimer's disease. Authors: Mohammed, Saaqib Jilani Abstract: Alzheimer’s disease, the most common form of dementia, is a significant cause of morbidity worldwide. There is no cure for Alzheimer’s disease and current management is only symptomatic. According to Alzheimer’s Disease International, 68% of all people living with dementia will be from lower middle income countries by the year 2050. Galantamine, an alkaloid obtained from Galanthus caucasicus (Amarylildaceae)is an approved treatment of Alzheimer’s disease. Crinum macowanii is a bulbous, alkaloid rich plant which belongs to the same family. Galantamine, Donepezil, Rivastigmine, Tacrine and Memantine are all FDA approved drugs for the management of Alzheimer’s disease, two of which are of herbal origin. Hence, it becomes imperative to research more effective and efficient natural medical treatment options for AD. The primary aim of this study was to investigate if a hydroethanolic extract of Crinum macowanii had any effect on learning and memory behaviour using the Morris Water Maze and the Novel Object Recognition task. Methodology: Two groups of BALB/c mice were used to assess the memory enhancing effects of Crinum macowanii using two different animal models. Namely, the aluminum chloride and scopolamine mouse model. Induction of amnesia was carried out using oral administration of scopolamine in the scopolamine model and oral administration of aluminium chloride in the aluminium chloride mouse model. Crinum macowanii(10, 20, 40 mg/kg) was tested against scopolamine and aluminum chloride induced cognitive decline. The Morris Water Maze and Novel Object Recognition tests were the behavioural models used to assess learning and memory behaviour. Escape latencies and time spent in the target quadrant were measured for the Morris Water Maze while the discrimination index was calculated for the Novel Objection Recognition test.Neuromotor function was assessed using the rotarod test. Biochemical tests to assess the acetylcholinesterase enzyme, antioxidant assays and basic phytochemical analysis were also performed. One-way analysis of variance followed by Tukey’s post hoc test were performed and P<0.05 was considered significant. Results: In the Morris Water Maze test, the Crinum macowanii40 mg/kg group was observed to have a significantly smaller escape latency than the aluminum(26.77s vs 56.43s)and scopolamine(24.1s vs 58.4s)treated groups(P<0.0001). Crinum macowanii40 mg/kg treated mice were also observed to be comparable to the donepezil 3 mg/kg group. During the short-term memory task of the Novel Object Recognition test, it was observed that Crinum macowanii40 mg/kg(59.86%)treated mice had a significantly higher discrimination index than aluminum chloride(49.11%)treated mice (P<0.0316). The same was not observed during the long-term memory phase as no significant difference was seen in the discrimination index between Crinum macowanii and aluminum chloride treated mice(P=0.0621). Against scopolamine induced cognitive decline, the Crinum macowanii group at high doses (40 mg/kg) demonstrated a significantly higher discrimination index than the scopolamine treated mice. Results for the antioxidant assay suggest that the extract of Crinum macowanii possesses antioxidant activity. Results of the rotarod test depict that the extract of the Crinum macowanii40 mg/kg group spent significantly more time on the rotating rod than the scopolamine treated group. Conclusion: The findings of this study suggest that the hydroethanolic extract obtained from the bulbs of Crinum macowanii at a dose of 40 mg/kg improved learning and memory behaviour in the aluminum and scopolamine mouse model. Hence, Crinum macowanii may be useful in the treatment of Alzheimer’s disease and related dementia. However, further studies are recommended which should study the effect of individually isolated alkaloids from Crinum macowanii against cognitive decline.

An assessment of the level knowledge on brain concussion signs and symptoms and safe return to play in high school first team soccer players in Harare, Zimbabwe during the 2017 season.

2023-05-29T01:08:07Z

Title: An assessment of the level knowledge on brain concussion signs and symptoms and safe return to play in high school first team soccer players in Harare, Zimbabwe during the 2017 season. Authors: Nyamapfene, Brighton Valentine Abstract: Concussion is a very common form of mild traumatic brain injury. It may occur with head to head or head to ball collision most common in contact sports. Soccer is the most popular contact sport in Zimbabwe with over 90% of high schools participating. Level of knowledge on concussion signs, symptoms and return to safe play has been postulated to be associated with some different demographic factors such as school’s categorization and sex. The level of knowledge on brain concussion in High school first team soccer players in Harare, Zimbabwe is unknown. Objectives: To evaluate high school first team soccer players’ concussion knowledge on signs, symptoms and safe return to play among children from different school classification categories in Harare, Zimbabwe in 2017. Methods: A descriptive, cross-sectional study was carried out on different school categories based on the per-capita grant in accordance with the Zimbabwe Ministry of Education’s Annual Statistical Report of 2013.S1 schools are the elite schools which include private schools whilst S2 are found in high density suburbs. S3 schools are found in rural areas. This follows a randomization of participants (n=881) who were divided into S1 (n=451), S2 (n=343) and S3 (n=82) categories. A self-administered modified RoCKAS-ST questionnaire was used to evaluate the concussion and safe return to play knowledge among participants under supervision. Data analysis: Data was analyzed using Statistical package for Social Scientist (SPSS) version 16. 0. Descriptive statistical analysis was carried out using Z test for proportions, for testing the differences in proportions between the groups. Student‘s t-test for independent groups was used to check relationships on continuous variables while categorical variables were expressed as percentages and frequencies , and compared using the Chi-square test to compute a p-value. Logistic regressions was used to estimate odds ratios and 95 % confidence intervals for the risk factors. Results were presented as means ± SEM, and comparisons between multiple groups will be made using ANOVA. All statistical tests were considered statistically significant if p< 0.05. Results: A minority of high school soccer players (2%) demonstrated adequate concussion knowledge on signs, symptoms and safe return to play. Females were significantly more knowledgeable than their male counterparts (p=0.01). There was no difference in knowledge scores among S1, S2 and S3 schools (p=0,812). The most popular concussion source of information were teachers (55.6 %). Conclusion: The majority of high school first team soccer players in Harare, Zimbabwe lack adequate knowledge on signs, symptoms and safe return to play post-concussion. Loss of consciousness is the most correctly recognized sign in 61% of participants. The majority of players have a misconception on the importance of mental rest. Teachers remain pivotal on concussion knowledge transfer. There is no difference in concussion knowledge level among S1, S2 and S3 schools.