Jornal de Pesquisa Clínica

Introduction: Fifth metacarpal neck fracture is the most common fracture of the hand. It is often related to aggressive, intentional punching Due to intrinsic muscle pull, the metacarpal head angulates volarly. Some of the most common causes of hand injuries are crush/compression injuries, blunt trauma, fall, road traffic accidents, machinery injury, sports related activity, explosions and firearm injuries. A variety of methods and algorithms are available to treat the metacarpal fractures. In our study we have aimed to compare the different modalities of treatment of boxer’s fracture in the form of conservative treatment, k-wire and JESS fixator.

Materials and methods: This was a prospective study conducted from January 2021 to June 2021. 45 subjects were included in one study and divided into three groups randomly for the different treatment modalities in the form of K wire, JESS fixator and closed reduction with POP slab for boxer’s fracture. Follow up was assessed using DASH score.

Results: Only 26.6% of the patients in group A as compared to 60% in group B had excellent results. 46.6% of the patients in group C had excellent results. The study revealed a poor outcome in 26.6% of group A, 13.3% of group B and 20% of group C patients.

Conclusion: From the results, we could conclude that JESS fixator was more effective than other two modalities in the treatment of boxer’s fracture with the emphasis to be provided on regular pin tract dressing.

Introduction: Sites where clinical trial will be conducted is the main place in centralized trials in generation data by the patients. Sites without patients lead to absence of clinical trial data and failed of clinical trial. Feasibility stage in selection of sites for conducting of particular clinical trial is emphasis to presence of needed pool of patients. Recruitment of patients in centralized trials is announcing by PI of clinical sites during the feasibility stage. This is subjective decision of investigator based on integral approach like experience, incidence of disease and many other parameters. The objective approach like calculation is apparently needed for calculation of proposed recruitment on the stage of feasibility.

Materials and methods: Retrospective analysis data of four clinical trials II-III phases, conducted since 2007 to 2017 years.

Aim: To find out the approach for selecting the trial sites on predictive basis using objective methods on the on the stage of feasibility.

Statistical analysis: Data had been collected from feasibility questionnaires, open statistical sources.

Results: It was proposed the formula for evaluation of clinical trial site in perspective of recruitment.

Discussion: Selection of sites might be calculated which will decrease the number of failed clinical trials. We called the calculation “Calculated Proposed Patient’s Recruitment”-CPPR».

Management of patients with Deep Vein Thrombosis (DVT) in the Emergency Department (ED) has dramatically changed over the last 10 years in the absence of a shared management, leading to the need of a shared consensus strategy to standardize the diagnostic and therapeutic approach in acute phase of DVT in a setting where standardization is particularly difficult due to the volume of activity and the number of operators who alternate in the care of the individual patient. We perform a review and comment of a NGT work performed by a panel of 5 Italian experts who developed 21 consensus statements based on available evidence and their clinical experience. Considering the best available evidence and the longstanding clinical experience of 5 Italian EDs’ experts, the management of patients with suspected DVT to ED should be characterized by a standardized diagnostic process, guided by the estimation of pre-test clinical probability with formal and validated Clinical Prediction Rule (CPR), an increase in the number of patients discharged directly from the ED, reserving hospitalization only for high-risk patients and faster and more appropriate use of the wide range of anticoagulant drugs currently available. In conclusion such a guide will standardize the diagnostic and therapeutic approach in acute phase of DVT, limit the number of diagnostic tests performed to exclude or confirm DVT and shorten the stay time of these patients in ED without reducing safety. Indeed, the identification of simple criteria for the definition of high-risk DVT together with availability of DOACs will allow physicians to safely discharge all DVT patients who do not meet these risk criteria, directly from the emergency room.

This study explores the effect of the financial crisis on the consumer and its impact on psychological well-being and life satisfaction with the core question investigating what effect the financial crisis has on the psychological well-being and life satisfaction of house hold heads in the United Kingdom. The reversed model approach used in the study analysed from two perspectives before and after the financial crisis. One is to investigate the psychological well-being using the general health questionnaire and its effect on health, life satisfaction and financial incapability. The second is to investigate financial incapability and its effect on health, life satisfaction and psychological well-being based on the British Household Panel (1991-2009) and Understanding Society (2010) Surveys.

They are two integrated large nationwide panel surveys commissioned by the United Kingdom government as an instrument to measure social and economic indicators at the individual and household level. The result of the analysis indicates that overall life satisfaction and financial incapability are important determinants of psychological well-being. The paper further explores the impact of the financial crisis on a household head before and after the crash. The results suggest that satisfaction with life, health implications, psychological well-being, and financial capability were significantly lower after the financial crisis. In conclusion, the results explain why overall life satisfaction generally affects individuals’ psychological wellbeing and financial capability, and why those with high financial incapability have poor psychological well-being.

The kidney is an organ whose role in the human body is to eliminate toxic substances among other functions. These toxins if accumulated can cause harm to human health by disturbing metabolic processes as one of the harmful effects. Kidney or renal failure refers to the loss of kidney tissue function. The cause of such a condition is varied and the prevalence differs from place to place. This research particularly centers on the associated causative factors and comorbidities in renal failure at NTH for 2016 and 2020. It seeks to establish the magnitude of renal failure as a health challenge, its causes, comorbidities and whether and they influence patient outcome. The data will be collected from the hospital records at NTH. There is likely to be a rise in number of patients with increase in age. In addition, a similar rise is likely to be observed among the hypertensive and the HIV infected patients. The causes are expected to range from congenital abnormality to neurotoxicity. The information to be obtained will be analyzed and the conclusion drawn from the analysis will be used in the formulation of measures on how best kidney failure can be prevented or will be used as basic information in future research as efforts being made to combat renal failure.

Oral diseases are considered a major public health problem as a consequence of the high prevalence and incidence observed in all regions of the world, and dental caries is reported to be the most common childhood disease and NCD worldwide. Awareness and knowledge are one of the major tools for improving health and must therefore be assessed. The objectives of this study were to determine awareness and knowledge of oral health and the dental caries experience among school children aged 12 to 18 in Ndola. Simple random sampling from four schools chosen by convenient sampling was used to select the study participants. A total of 384 participants were issued consent forms. The study was conducted at Kansenshi High School, Dominican Convent Secondary School, Masala Secondary School and Kaniki Basic School in Ndola, Zambia. It was a school-based, descriptive, cross-sectional study conducted in September 2021. Data was collected using a self-administered questionnaire, and an oral examination using the DMFT index was carried out. Data was entered and analyzed using the IBM SPSS statistics software. Majority of the participants exhibited good awareness and knowledge towards oral health, and had healthy teeth. However, there was no significant association between level of knowledge and awareness and dental caries experience.

Obstructive Sleep Apnoea Syndrome (OSAS) and obesity are linked by bidirectional causality, where the effects of one affect the other. The factors most involved in the association between OSAS and obesity are oxidative stress, systemic inflammation, and gut microbiota. Moreover, there is a potential link between reduced lung function due to sharing common or similar inflammatory processes and the risk of Non-Alcoholic Fatty Liver Disease (NAFLD). Therefore, we hypothesize that decreased lung function could be a contributory factor to the development of NAFLD. Electronegative LDL (L5), a promising clinical biomarker for cardiovascular disease, has an important role in (cardiovascular disease) CVD risk assessment.

‘Takotsubo syndrome’ is a cardiomyopathy characterized by a temporary wall motion abnormality of the left ventricle which shares common features with acute coronary syndrome. During the COVID-19 pandemic acute coronary syndrome can be one of the initial presentations of COVID-19 infection, ranging from a ST elevation myocardial infarction to Takotsubo cardiomyopathy. We elaborate a review of the existing literature until the April 27, 2021, in order to analyze and explore the connections between Takotsubo Cardiomyopathy and the COVID-19 pandemic. We selected twenty-seven case reports/case series and three studies. The analyzed cases include 53 patients, 19 male (36%). Shared clinical features are hypertension, diabetes mellitus and dyslipidemia. The majority were COVID-19 positive, 23 requiring mechanical ventilation. A recovered cardiac function has been described in 20 patients. In COVID-19 patients, therapy involves the use of hydroxychloroquine in 15 subjects and chloroquine in one of them. Coronary angiography was not ever performed, according to clinical instability and less-probably different diagnosis. The most type of Takotsubo syndrome was the typical one, even if inverted, biventricular and atypical were reported. The overall analysis shows a higher prevalence of male patients compared to the known literature and higher rates of clinical features such as hypertension, diabetes mellitus and dyslipidemia. An increased psychological distress, the cytokine storm, augmented adrenergic responses and microvascular dysfunction heave been hypothesized playing a role. Our study explores what the existing literature offers and clarify the importance of an accurate and immediate recognition of Takotsubo syndrome during a stressful period like the COVID pandemic.

Introduction: Diabetes mellitus is a syndrome of chronic hyperglycaemia due to relative insulin deficiency, resistance or both. It is a challenging disease to manage successfully, its treatment aims on achieving adequate control of glucose levels in the blood and to properly manage it, there is need for patients to adhere to the recommended diet. Failure in the management of the disease results in many complications which are the cause of mortality worldwide. The main objective of this study was to determine the prevalence of adhering to recommended diet among diabetic patients at Matero level one hospital Lusaka, Zambia. Methodology: Analytical cross sectional study was conducted at Matero level one Hospital, Lusaka Province which included all type two diabetic patients who visited the hospital and those who were admitted to the ward who met the inclusion criteria. The total number of patients who were enrolled in the study was 59. Data was collected with the use of a questionnaire and was analyzed using SPSS 23. Results: The prevalence of adherence to recommended diet among diabetic patients at Matero level one hospital was found to be 49.2%. findings of this study shows that among the factors associated with non-adherence to recommended diet among DM 2 patients, financial constraints was the most common factor affecting 52 (88.1%) patients with the lowest being inappropriate dietary habits which had 4(6.8%). Other factors include granting self-permission 34 (57.6%) patients, lack of partner, family and friends support 32(54.2%), visiting other people’s homes and trips with 31 (52.5%) patients, eating out affected 21 (35.6%) patients and poor self-control 9 (15.3%). Conclusion: The prevalence of adherence to recommended diet was found to be low (49.2%) and so this calls for appropriate measures to be put in place such as detailed written instructions on proper diet and involvement of partners, family members and friends of the diabetic patient in the management of type 2 diabetes.

Introduction: Hepatitis B viral infection is a viral infection that attacks the liver and can cause acute and chronic disease with systemic manifestation. The infection is one of the major causes of morbidity and premature death and contributes substantially to the escalating costs of health care globally and locally. The main objective of this study is to assess the knowledge, attitude, and practice regarding viral hepatitis B infection prevention among medical students at Ndola Teaching Hospital in Ndola, Zambia. Methodology: An analytical cross sectional study was conducted among medical students studying bachelor of medicine and surgery and bachelor of dental surgery at the Copperbelt University School of medicine and Ndola Teaching Hospital. The total number of patients that met the inclusion criteria and thus enrolled in the study was 162. Ethical approval was obtained from Tropical Disease Research Centre (TDRC) and permission to conduct the study among the clinical students was granted by the copperbelt university school of medicine. Data was collected from clinical students with a use of a questionnaire and it was entered and analyzed with the use of SPSS 23. Results: The assessment, the majority of students demonstrated that they had good knowledge (91.4%), attitude (75.9%) and practice (90.7%) towards HBV prevention. Furthermore, the findings showed that there was correlation between the level of practice and knowledge, year of study and attitude toward HBV infection prevention with the P-values of 0.018, 0.028 and 0.003 respectively. Conclusion: The levels of knowledge attitude and practice among participants were high. With this outcome, we recommend that the current system of training among clinical students with regard to HBV infection prevention should continue with more emphasis on developing the right attitude.

In developing countries such as Zambia, Contraceptives methods are a priority form of solution to the family planning problems such as unintended pregnancies. However, the hormonal contraceptives are associated with a variety of risks; among them are cardiovascular conditions such as myocardial infarction, hypertension, pulmonary embolism and strokes. Hence, there is need to raise awareness and knowledge on the risks or side effects accompanying the use of contraceptives. To assess knowledge and awareness on hormonal contraceptives side effects among female students at the Copper belt University.

Background: Malaria infection in pregnancy is associated with severe maternal anemia, placental parasitaemia, low birth weight, and increased perinatal mortality to mention a few. The World Health Organization (WHO) recommends Intermittent Preventive Treatment in pregnancy (IPTp) with Sulphadoxine-Pyrimethamine (SP) at every scheduled Antenatal Care (ANC) visit in the second and third trimester alongside Long Lasting Insecticide-treated Nets (LLIN) and case management for reducing the risks associated with malaria in pregnancy. However, the purpose of this study was to assess the acceptability and use of fansidar among pregnant women at Masala and Peter Singongo clinics in Ndola. Methodology: The study was a cross sectional and the study population were the pregnant women attending ANC at Masala and Peter Singongo clinics. The data was collected via the use of self-administered questionnaires to pregnant women attending ANC in order to assess whether pregnant women accepted fansidar and used it as a malaria prophylaxis during their pregnancy. An informed consent was sought before obtaining data from the participants. The targeted sample size was 300 but due to limited numbers of pregnant women attending ANC, only 148 participants were captured during the study. Data entry and analysis was done using SPSS V26. Tabulations for statistical analysis were done and percentages were calculated. Results: A total number of 148 participants were recruited in the study of which the majority were aged 21 to 30 (49.9%), Christianity by religion (94.6%), married (64.9%), independent yet not working (57.4%), gravida 1 para 0 (27.7%) and up to secondary level of education (45.9%). However, 89.9% were aware of Intermittent Presumptive Treatment in pregnancy with sulfadoxine pyrimethamine (IPTp-SP) and 83.1% used it. 83.1% as well accepted IPTp-SP yet 83.8% received health education during ANC. 83.8% and 40.5% confirmed having been helped by health education during ANC and their education qualification respectively regarding the acceptability and use of IPTp-SP. 93.9% applauded the attitude of healthcare providers and confirmed that their attitude did not hinder but rather encouraged them to accept and use IPTp-SP. Conclusion: The study findings revealed that the majority of the participants were aware of Intermittent Presumptive Treatment in pregnancy with sulfadoxine pyrimethamine (IPTp-SP). It also revealed that majority of them accepted and used IPTp-SP though the results were still below the ministry of health standard whose target was to have 90% of pregnant mothers receive all the three doses of fansidar in pregnancy. There is need to emphasize and intensify health education at every scheduled antenatal care. There is need to put up other platforms such the radio, TV and social media by Ministry of Health in order to sensitize women on the importance of IPTp-SP. Education of pregnant women as well as an escort of pregnant mothers to the antenatal care by their spouses/fiancés/relative need to be emphasized.

Male circumcision is one of the oldest and most common surgical procedures worldwide, and is undertaken for many reasons: religious, cultural, social and medical. It is practiced culturally in Zambia by a few societies; particularly those from Northwestern Province and parts of Western province the Luvale, Lunda, Mbunda, Luchazi etc. The practice is also conducted by Muslim societies throughout the country. In these societies, the practice has been seen as a traditional rite of passage of boys to manhood for centuries. Scientists have indicated that Male Circumcision has the ability to reduce the risk of getting the HIV virus through the exposed hardened glands during the act of sex by 60%. Other benefits of Male Circumcision include the sexual female partner being safe from the risk of getting cervical cancer throughout hygienically glands that can‘t hold the HPV that leads to cancer. To evaluate the current status of perceptions, attitudes and beliefs among male grade 12 pupils at chifubu secondary school in Ndola towards male circumcision and bring forth recommendations based on the findings of the study.

With 1.1 million known cases, prostate cancer is the second most common type of cancer among men. It is second only to lung cancer which affects over 1.2 million men worldwide. African men suffer disproportionately from Prostate cancer compared to many parts of the world. Evidence shows that mortality rates from Prostate cancer are generally higher in predominantly Black African populations compared to other races. A cross sectional study design was conducted on 77 records for patients who were subjected to prostate tissue biopsy which was collected routinely at Ndola Teaching Hospital from 2017-2019. Analysis of data was done using SPSS V 26.0. The study revealed the decrease in the incidence rate and prevalence rate of prostate cancer, no association between age of patient and prostate cancer diagnosis and majority of patients are from within, Ndola with a minute number coming from outside Ndola. Gleason score is the grading system used at NTH and the majority of malignancies were graded. The practice of prostate cancer screening was associated with age and family history of cancer.

Thousands of tons of waste are generated daily in Africa. Most of it ends up in open dumps and wetlands, containing surface and ground water posing major health and environmental hazards. Generation rates for waste ranges approximately from 0.5 kilograms per day per person to 0.8 kilograms per day per person. Kitwe being the second largest city in Zambia generates large amounts of waste, this poses challenges in the management of the generated waste. The greatest challenge is with the management of solid waste. The methods of management of these refuse is usually not improved thereby exposing the environment to negative impacts that may in turn affect health.

A medical error is a preventable adverse effect of care, whether or not it is evident or harmful to the patient or failure of a planned action to be completed as intended or an unintended act, either omission or commission. Medical errors are a global issue that demands much attention, especially medication errors in all the health sectors. According to the report by National academy of Science, more people die from medical errors than road motor vehicle accidents worldwide. Medical errors are among the main causal of death and other complications in hospital setting. Additionally, Medical errors happen almost on daily basis in Zambian hospitals and clinics, yet the subject has been given a snub by medical personnel and policymakers. Therefore, this study focused on the prevalence of medical errors and common medical errors in our setting (KTH) and the reporting system of these errors. The study confirmed that medical errors still happen in our various local health facilities and at Kitwe Teaching Hospital it was found had a prevalence of 25%. The most common medical errors are: delay in treatment (20%), cross contamination (40%), poor medication (10%) and misdiagnosis (10%). These medical errors some are fatal that their result into serious outcomes and/or complications such as colostomies, amputation, death and instant death.

Cerebral Palsy (CP) is a neurological disorder caused by a non-progressive injury to the immature brain. It is one of the most common causes of physical disability in children with a prevalence of 2 to 2.5 per live births worldwide and 2 to 10 per 1000 live births in developing areas. The physical functionality of the affected children depends on the type and severity of the CP. There are different types of CP which includes spastic, dyskinesia, hypotonia and mixed type which affect developmental millstones differently. Children who are severely affected face more challenges than those who are moderately or mildly affected. The objectives of this study include; to identify challenges faced by cerebral palsy children, the mostly affected age group, the mostly affected gender, the most common delayed developmental milestone, the common types of cerebral palsy and the social economic status of CP children. A descriptive cross section study was used and data was collected from 7th September 2020 to 26th October 2020 at Kitwe District at Kitwe Teaching Hospital, physiotherapy where participants were consecutively selected. In addition, an interview questionnaire was used to collect data on the challenges faced by the cerebral palsy children. The study had 21 participants, out of which 14(66.7%) children were males and 11(52.4%) were in the age range of 4-6 years. The difference between the employed and unemployed in the ability to buy assistive devices was not significant. Only 3(14.3%) of the children were able to stand and walk out of which only 1 (4.8%) was able to run. In addition, 11(52.4%) had spastic cerebral palsy and 11(52.4%) of CP children had dental problems. The study showed that currently, male CP children at Kitwe teaching Hospital in the department of therapy are the majority. Low social economic status of parents guardians had a negative impact on the rehabilitation of CP children. The most common type of CP was spastic and most delayed millstone was running. The majority of the children had dental problems. There is need for more studies on CP in Zambia especially on the prevalence, and types of CP. In addition, more input of finances is needed for rehabilitation and social services such as education

Pallister-Killian Syndrome is a rare genetic disease caused by mosaicism for tetrasomy of chromosome 12. It is characterized by dysmorphic phenotype and multiple organs malformation. This syndrome also includes developmental disabilities such as intellectual and motor disability, muscle hypotonia and it is often related with seizures. Here below we present the case of a patient diagnosed in early neonatal period, highlighting the importance of clinical findings which define this syndromet.