SSMJ November 2020
According to WHO, “bites by venomous snakes can cause acute medical emergencies involving severe paralysis that may prevent breathing, cause bleeding disorders that can lead to fatal haemorrhage, cause irreversible kidney failure and severe local tissue destruction that can cause permanent disability and limb amputation.”
News, Reports and Policy
UNOCHA South Sudan Floods Maps
The SolarSPELL initiative, based out of Arizona State University (ASU), is developing an offline Digital Nursing and Midwifery Library to empower nursing and midwifery educators and students at the Juba School of Nursing and Midwifery (JSNM) in South Sudan. While visiting Juba in 2019, the co-founders of SolarSPELL and an ASU Edson College of Nursing and Health Innovation professor saw first-hand the lack of infrastructure and resources in hospitals and healthcare training facilities.
Continuous Positive Airway Pressure (CPAP) provides an air pressure that maintains the patency of the airway in patients with a variety of breathing problems. Nurses provide the hour to hour management of patients who require CPAP. The aim of this study was to assess the knowledge of nurses about CPAP machine usage at the tertiary hospital in Tanzania which serves the largest number of patients who require CPAP.
This was a cohort retrospective study conducted at St Francis Hospitals Nsambya and Naggalama. The sample size was two hundred and two patients. A consecutive sampling technique with replacement of missing charts was used. The Principal Investigator and the research assistants then made telephone calls to the patients inviting them for an interview in the two hospitals, and for those who could not attend questionnaires were administered to them on phone. This was done sequentially until the sample size for each hospital was reached. If a given telephone was not available or went unanswered, we telephoned the next patient in the sequence on the register. Inguinodynia was assessed using the Numerical Rating Pain Score (NPS). Recurrence was assessed by physical examination.
Every five minutes, somebody dies from a snakebite. According to the World Health Organization (WHO), an estimated 5.4 million people get bitten worldwide every year and around 81,000 to 138,000 people die each year because of snake bites. In Africa alone, 435,000 to 580,000 victims suffer snakebite envenoming and South Sudan could be one of the countries with the highest incidence. However, snakebite still receives less attention globally than other Neglected Tropical Diseases (NTDs) and comprehensive programmes and efforts to provide care to snakebite patients are limited.
The Pharmacy and Poisons Board (PPB) in Kenya defines an ADR as a response to a drug which is noxious and unintended, that occurs at doses used in humans for the prophylaxis, diagnosis or therapy of disease, or for the modification of physiological function. Modern ADR reporting practice began in 1961 when thalidomide caused phocomelia among new-borns. The PPB in Kenya launched the Department of Pharmacovigilance (PV) in 2004 and started the National PV Centre in 2009 to report ADRs and product quality issues.
Uterine fibroids are benign monoclonal neoplasms arising from smooth muscle cells in the uterine wall. They are common gynaecological tumours in women of reproductive age, but, a rare occurrence in adolescence.
We present a case of a Nigerian 18-year-old undergraduate with abnormal uterine bleeding and abdominal swelling with a clinical diagnosis of uterine fibroids. She had an open abdominal myomectomy. Histology confirmed uterine fibroids. There is need for medical practitioners to consider this condition as a differential diagnosis especially among this group of women albeit a rare occurrence.
Heterotopic pregnancy, although common with assisted reproductive technologies, is very rare in natural conceptions. A high index of suspicion can help in timely diagnosis and appropriate intervention especially in low resource settings like South Sudan. Delayed diagnosis puts the mother at risk of potentially life-threatening complications. We report the case of heterotopic pregnancy in a young female that was successfully treated.
Cases in which a foreign body is embedded in the maxillofacial region are uncommon and rarely reported. Our case is an unusual one of an arrow stuck in the face (in the naso-orbitoethmoid and maxillary region) during a fight resulting in severe pain and discomfort. To our knowledge, impaction with this type of foreign body has not been previously reported.
The patient was successfully treated, using a multidisciplinary approach, with the patient assessed and treated by a variety of specialists.
It is evident that there is a shortage of doctors in sub-Saharan Africa. Statistics show that 25% of the world’s disease burden occurs in Africa which has only 1.7% of the worlds doctor population and accounts for 1% of the world’s financial resources for health. All specialities in medicine are affected.
“The College aims to improve access to well-trained physicians across the region by establishing a network of dedicated training centres and implementing an internationally recognized postgraduate medical qualification. The college will ultimately improve health outcomes for the region’s >200 million inhabitants, with a focus on expanding healthcare provision in centres serving the rural population.”