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Bulawayo, Zimbabwe

Masukume G.,Mpilo Central Hospital | Zumla A.,University College London
Clinical Medicine, Journal of the Royal College of Physicians of London | Year: 2012

Medicine is traditionally known as an 'art', and not an exact 'science'. Medical images of clinical signs and pathology were communicated through 'metaphors' in the 19th and early 20th centuries to make recognition easier in anticipation of the clinical counterpart when encountered in medical practice. They have served as teaching aids, enhancing memory retention for medical students, nurses and doctors and have withstood the test of time. Standard medical textbooks contain metaphors that have become entrenched in teaching, learning and examining in medical schools and hospitals worldwide. The continued use of metaphors has given rise to an ongoing debate, particularly in Africa, due to the usage of inappropriate or unfamiliar metaphors which are not locally or culturally relevant. Despite this, medical analogies will no doubt continue to be useful for medical education, clinical practice and 'aide memoirs' for examinations, and bring light humour, for a long time to come. © Royal College of Physicians, 2012. All rights reserved.

Mavondo G.A.,Institute of Health science | Mangena Z.,Mpilo Central Hospital | Kasvosve I.,University of Botswana | Kasvosve I.,University of Zimbabwe
Clinica Chimica Acta | Year: 2012

Background: Prostate cancer (Pca) disease burden is highest among male blacks. Oxidative stress due to hemoglobin-related oxygen reactive species is a risk factor for cancer development. The polymorphic haptoglobin (Hp) protein inhibits hemoglobin-related oxidative stress. The antioxidant capacity of Hp is genetically determined. We studied the effect of Hp polymorphism on susceptibility to Pca. Subjects and methods: In a case-control study, 201 participants (60 hospital-based controls, 62 benign prostate hypertrophy (BPH) and 79 prostate cancer (Pca) patients were studied. Serum prostate specific antigen (PSA) was measured using an immunoradiometric assay and Hp phenotype was determined using starch gel electrophoresis. Haptoglobin phenotype distribution was compared between groups according to disease state. Results: Serum PSA concentrations were markedly elevated in BPH and Pca patients compared to control subjects. Overall, Hp 1-1 was present in 50 individuals (25%), Hp 2-1 in 91 persons (46%) and 46 subjects (23%) had Hp 2-2. Thirteen individuals (6%) were anhaptoglobinaemic. The Hp1 allele frequency was not significantly different according to clinical history; 0.472 (95% CI 0.343-0.601), 0.567 (95% CI 0.395-0.619) and 0.507 (95% CI 0.441-0.693) for control group, BPH and Pca patients, respectively. Conclusion: Our results suggest that Hp polymorphism is neither associated with risk of developing Pca nor outcome of the disease. © 2011 Elsevier B.V.

Masukume G.,Mpilo Central Hospital
Malawi Medical Journal | Year: 2012

PubMed and Google Scholar were searched to obtain articles originating from Mpilo Central Hospital, Bulawayo, Zimbabwe - 1958 to August 2011 (54 years). 168 articles cited 999 times were retrieved giving about 6 citations per article. Analysis of publication trends over time as well as publication avenues is made. The full research dataset for this study is shared. This study adds to the body of knowledge on teaching hospital research performance assessment particularly in low-income settings, a topic with few studies. Africa needs data on research.

Ashmawy H.,Mpilo Central Hospital
UroToday International Journal | Year: 2011

INTRODUCTION: The erect penis is very vulnerable to blunt trauma, which is mostly sustained during sexual intercourse or through vigorous manipulations during masturbation or other violent sexual activities. These actions may lead to a fracture of the penis. The purpose of this retrospective study is to review the effect of early surgical exploration and repair of penile fractures and to report the overall healing of these injuries and the patient's ability to regain erectile function. METHODS: A total of 20 patients presented with a fractured penis between October 1999 and November 2009. Their mean age was 27 years (range, 16-48 years). All were managed with surgical repair within 24 hours of the injury by the same surgeon (HA). Postoperative follow-up occurred monthly up to 6 months. The outcome measures were: (1) patient satisfaction with the cosmetic results, and (2) patient satisfaction with erectile function, as determined by the International Index of Erectile Function (IIEF). Complications during the follow-up period were summarized. RESULTS: All 20 patients had successful wound healing, although 4 patients who were HIV-positive developed superficial wound infections that were treated by antibiotics. All patients reported normal psychogenic response, nocturnal erection, and full sexual activity at 3 months after surgery. The mean IIEF score was 23.5 out of a total 25 points (range, 22-25). CONCLUSION: A fractured penis is a urological emergency that is best treated with immediate surgical exploration and repair of the tunica albuginea and any associated injuries. Surgical repair minimizes the incidence of erectile dysfunction. © 2011 UroToday International Journal/Vol 4/Iss 1/February.

Crofts J.F.,University of Bristol | Mukuli T.,Mpilo Central Hospital | Murove B.T.,Mpilo Central Hospital | Ngwenya S.,Mpilo Central Hospital | And 14 more authors.
Bulletin of the World Health Organization | Year: 2015

Problem In Zimbabwe, many health facilities are not able to manage serious obstetric complications. Staff most commonly identified inadequate training as the greatest barrier to preventing avoidable maternal deaths. Approach We established an onsite obstetric emergencies training programme for maternity staff in the Mpilo Central Hospital. We trained 12 local staff to become trainers and provided them with the equipment and resources needed for the course. The trainers held one-day courses for 299 staff at the hospital. Local setting Maternal mortality in Zimbabwe has increased from 555 to 960 per 100 000 pregnant women from 2006 to 2011 and 47% of the deaths are believed to be avoidable. Most obstetric emergencies trainings are held off-site, away from the clinical area, for a limited number of staff. Relevant changes Following an in-hospital train-the-trainers course, 90% (138/153) of maternity staff were trained locally within the first year, with 299 hospital staff trained to date. Local system changes included: the introduction of a labour ward board, emergency boxes, colour-coded early warning observation charts and a maternity dashboard. In this hospital, these changes have been associated with a 34% reduction in hospital maternal mortality from 67 maternal deaths per 9078 births (0.74%) in 2011 compared with 48 maternal deaths per 9884 births (0.49%) in 2014. Lessons learnt Introducing obstetric emergencies training and tools was feasible onsite, improved clinical practice, was sustained by local staff and associated with improved clinical outcomes. Further work to study the implementation and effect of this intervention at scale is required. © 2015 World Health Organization. All rights reserved.

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