Central African Journal of Medicine https://www.ajol.info/index.php/cajm <p>The <em>Central African Journal of Medicine</em> is a quarterly refereed general medical journal which seeks to promote the practice and science of medicine in Africa. Emphasis is placed on general medical topics, reflecting common and important conditions in the region. The journal also covers related medical fields. Submissions are encouraged in the form of research articles, reviews, case reports and letters.</p> en-US Copyright for articles published in this journal is retained by the journal. gangaidz@gmail.com (Prof IT Gangaidzo) cajm@medsch.uz.ac.zw (Crathilwe Nyathi [Office Manager]) Mon, 09 Nov 2020 07:49:34 +0000 OJS http://blogs.law.harvard.edu/tech/rss 60 Pulmonary hypertension in children aged two to twenty four months hospitalised with severe pneumonia at two tertiary hospitals in Harare, Zimbabwe https://www.ajol.info/index.php/cajm/article/view/201399 <p><strong><em>Objectives</em></strong>: The aim of the study was to describe the echocardiographic findings in children hospitalized with severe pneumonia, in particular the presence of pulmonary hypertension.</p> <p><strong><em>Design:&nbsp; </em></strong>A descriptive cross-sectional study was undertaken.</p> <p><strong><em>Setting:&nbsp; </em></strong>Paediatric medical wards in two tertiary, teaching hospitals in Harare, Zimbabwe.</p> <p><strong><em>Subjects</em></strong>:&nbsp; Consecutive sampling of 206 children aged 2 to 24 months meeting the WHO case definition of severe pneumonia whose caregivers gave informed consent.</p> <p><strong><em>Main Outcome Measures: </em></strong>Echocardiography findings of left ventricular contractility and estimated pulmonary hypertension defined as elevated Right Ventricular Systolic Pressure (RVSP) &gt;25mmHg, both assessed by 2D echocardiography.</p> <p><strong><em>Results:&nbsp;&nbsp; </em></strong>Elevated RVSP was found in 11.3% (n=22/195) of the participants with a mean of 35(4.2). This was not significantly associated with mortality (p=0.291). The following factors were significantly associated with elevated RVSP (p=&lt;0.05): central cyanosis, SPO2 &lt; 90% and at least two previous hospitalizations with pneumonia. Most, 98% (n=191) of patients had normal left ventricular contractility based on ejection fraction and fractional shortening. Ten of the participants died (10/195), giving a case fatality rate of 5.1%.</p> <p><strong><em>Conclusion: </em></strong>Pulmonary hypertension was found to be a complication in 11.3% of children hospitalized with severe pneumonia. Further studies are needed to evaluate its persistence.</p> C.V Shava, M Bwakura, G Kandawasvika , W Tinago , K.J Nathoo, C Bannerman Copyright (c) https://www.ajol.info/index.php/cajm/article/view/201399 Mon, 09 Nov 2020 00:00:00 +0000 Urinary tract infection: prevalence, isolated organisms and antimicrobial susceptibility pattern, South-south Nigeria https://www.ajol.info/index.php/cajm/article/view/201401 <p><strong><em>Objective:</em></strong>&nbsp; The emergence of antibiotic resistance in Urinary Tract Infection (UTI) treatment is of serious public health concern. This study, therefore, aimed at investigating the incidence rates (i.e. prevalence rates) and choice of antibiotic prescription in UTI cases in South-south, Nigeria.</p> <p><strong><em>Design:</em></strong>&nbsp; Data of three hundred (300) patients, who had been admitted for urinary tract infections, treated and discharged over the period of six years (from January, 2010 to December 2015) were studied for UTI prevalence, treatment and antimicrobial resistance pattern.</p> <p><strong><em>Results:</em></strong>&nbsp; Of the 300 cases of UTIs studied, 126 were males and 174 were females. The prevalence of UTIs was highest within the age of 21-30 years (23%). the highest prevalence of UTI (50%) was observed among students, followed by traders (28%). It was also observed that UTI was higher in patients who were married than in singles. <em>E. coli</em> was the most frequently isolated organism being from 120 (40%) patients, followed by <em>Klebsiella spp</em>. isolated from 84 (28%) patients. The antibiotic susceptibility results showed that Meropenem had the highest antibacterial effect against UTIs pathogens as all the isolates were susceptible (100%) to it, followed by Amoxicillin/Clavulanate (95.7%), Amikacin (89.3%) and Tetracycline (82.7%). <em>E. coli</em> and <em>Klebsiella</em> <em>spp</em>. were resistant to Metronidazole (0%). <em>E. coli</em> showed very low susceptibility to Amoxicillin and Chloramphenicol (19.2% and 22.5% respectively) while Klebsiella spp. showed low susceptibility to Chloramphenicol (13.4%) and Amoxicillin (29.7%).</p> <p><strong><em>Conclusions:</em></strong>&nbsp; A wide range of antimicrobials is in use with some observed low susceptibility and drug resistance by some isolated organisms hence need for emphasis on treatment compliance by patients and good antimicrobial stewardship by physicians</p> M.O Ojezele Copyright (c) https://www.ajol.info/index.php/cajm/article/view/201401 Mon, 09 Nov 2020 00:00:00 +0000 Metastatic choriocarcinoma presenting as a haemorrhagic stroke in a young woman in a low resource setting https://www.ajol.info/index.php/cajm/article/view/201402 <p>A 24-year-old right-handed nulliparous female, with no known stroke risk factors was admitted in the stroke unit with a day's history of right sided dense hemiplegia and unresponsiveness. She had a preceding background history of intermittent cough with haemoptysis for 2 months and amenorrhea for 5-months. Her workup was significantfor a low Thyroid Stimulating Hormone (TSH), elevated T4, effusion on the left side on chest X ray and intracerebral haemorrhage on non-contrast Computed Tomography (CT) brain.&nbsp; Subsequent imaging with a Magnetic Resonance Imaging (MRI) scan of the brain on day 3 post-admission revealed multiple intracerebral bleeds. A diagnosis of metastatic choriocarcinoma was made which was confirmed by a markedly elevated serum B-human chorionic gonadotrophin level. Quantitative serum B-chorionic gonadotrophin is recommended as an important investigation in young women of child bearing age presenting with hemorrhagic stroke.</p> N.S Dzvanga, N.D Jonker, G.C Jakanani, D.M Mukona, G.W Ngwende, A Mataruse Copyright (c) https://www.ajol.info/index.php/cajm/article/view/201402 Mon, 09 Nov 2020 00:00:00 +0000 Acute kidney injury due to an interaction between simvastatin and cyproterone https://www.ajol.info/index.php/cajm/article/view/201403 <p>Statins are commonly prescribed medications in patients who have cardiovascular disease. In this case report an important aspect of drug interactions involving one of the statins routinely prescribed is described. The patient in the case below developed rhabdomyolysis and subsequent Acute Kidney Injury (AKI) due to an interaction between simvastatin and cyproterone which had been prescribed for management of prostatic cancer. The AKI was severe and required Renal Replacement Therapy (RRT) in the form of haemodialysis. Renal function fortunately improved with the patient able to stop dialysis. He however remained with residual renal impairment and now has Chronic Kidney Disease (CKD). It is important always when prescribing to review the current medications a patient is taking and to assess for potential drug-drug interactions</p> R Dahwa Copyright (c) https://www.ajol.info/index.php/cajm/article/view/201403 Mon, 09 Nov 2020 00:00:00 +0000