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Biomedical subjects

H M Chinyanga

Publications and source records attributed to H M Chinyanga.

At least 19 recordsLinked to original sources

Neuropathic pain--from mice to men.

The past decade has seen great progress in understanding the syndrome of neuropathic pain, its causes and in finding new drugs that promise great benefit. For example, an early outcome of the research has been the observation that the new drugs do not blunt normal pain sensation--a pattern beginning to find explanation through the realisation that neural pain circuits rewire themselves, both anatomically and biochemically, after nerve injury. In this article, we discuss a case of a known diabetic patient with intractable pain and the course of management provided by the use of novel tools and devices coming to the fore in this rapidly expanding specialty.

Adult↗

Trends in cancer pain management.

BACKGROUND: Pain is a prevalent symptom in cancer patients, affecting up to 50% of patients undergoing active cancer treatment and up to 90% of those with advanced disease. Although adequate relief can be achieved in the majority of cancer patients, pain is often treated inadequately in traditional settings and sometimes even under the management of more specialised units. In this review the authors use their experience and that of others to review the evaluation and diagnosis of pain syndromes and the principles of management. This is in keeping with increasing recognition by bodies such as the World Health Organisation and other governmental agencies who have recognised the importance of pain management as part of routine cancer care. Conducting a comprehensive assessment, competently providing analgesic drugs, and communicating with the patient and family allow effective management of pain in the cancer patient.

Acute Disease↗

Lung function, blood gases, pH and serum electrolytes of small-scale miners exposed to chrome ore dust on the Great Dyke in Zimbabwe.

We measured and compared lung function indices and some blood parameters (gases, electrolytes, glucose, pH, red cell indices) of 54 male small-scale miners (SSM) chronically exposed to chrome ore dust to those of 50 nonmining control subjects (NMC) and 46 large-scale chrome miners (LSM) who had taken internationally recommended precautionary measures (secondary control). The respirable dust level in the SSM environment (6.0 +/- 0.5 mg/m3) was significantly higher (P < 0.001) than in the NMC and LSM environments (0.3 +/- 0.1 mg/m3 and 0.5 +/- 0.3 mg/m3, respectively). There were no significant differences in neither dust levels nor lung function status between NMC and LSM environments. The values of FVC, FEV1, PEFR and FEV1% of the SSM were 3.5 +/- 0.09 l, 2.61 +/- 0. 09 l, 6.07 +/- 0.36 l/second and 76.19 +/- 2.36%, respectively. These values were significantly lower than those of NMC (P < 0.01, respectively). However, the blood parameters of the SSM and NMC were not significantly different. The results are indicative of both restrictive and obstructive ventilatory defects in the SSM which may be attributed exposure to chrome ore dust in the environment. Associated risk factors appear to be advancing age, prolonged exposure to chrome ore dust and acid base disturbance.

Adult↗

The need for a regular comprehensive health surveillance on industrial workers.

The movement of people during some of their daily occupations and activities releases an amount of dust into the air. Even dust that has settled on floors and flat surfaces is made airborne by air currents. Of greater concern is the dusty environment caused by the operations within the workplace, such as handling of dusty materials, machining, cutting, drilling, milling, rock blastic and pounding. Fortunately, a lot of the dust is harmless except when present in high concentrations when it can cause some discomfort. At such levels it is termed 'nuisance dust'. However, some form of dusts are distinctly harmful, giving rise to impairment of lung function and pneumoconiosis (dust-induced changes in the lung).

Air Pollution, Indoor↗

The history of the Central African Journal of Medicine 1953 to 1999.

The Central African Journal of Medicine Company was founded in 1953 and registered in 1954 in accordance with the then existing company act. Its purpose was to assist medical personnel in central Africa find a place to publish the results of their research endeavours as well as an avenue to disseminate their clinical observation and updates. Since its first publication 46 years ago, to the present, the journal has attracted research papers from as far afield as Nigeria in West Africa, China, Hong Kong, the middle east and all the SADC states.

Faculty, Medical↗

Pain: friend or foe.

Pain, the most urgent of symptoms usually signals the presence of potential or on-going injury to tissue which requires attention. The warning that pain provides is, therefore, a good thing and in a way friendly. When pain continues or resumes after the healing process of injury is complete, it is no longer signalling on-going tissue damage but becomes a disease in its own right. That, in essence, is the presentation of most chronic pain syndromes referred to Pain Clinics for investigation and treatment.

Ambulatory Care↗

Neuroleptic malignant syndrome.

While on holiday in Zimbabwe, a forty-one year old woman with a long history of intermittent psychiatric illness developed what was diagnosed as neuroleptic malignant syndrome. She was admitted to the Intensive Care Unit of Harare Central Hospital and was treated successfully with bromocriptine and dantrolene.

Adult↗

Misdiagnosis of aneurysms: a case report.

Three cases in which aneurysms were misdiagnosed to less serous lesions are described. Attention is drawn to the possibility of these errors whose consequences can be fatal. Some of the problems associated with the handling of an inadvertently opened aneurysm are discussed.

Adolescent↗

Use of a modified Doppler flow detector for percutaneous cannulation of the internal jugular vein.

To lessen the risks associated with cannulation of the internal jugular vein, a method to identify the contours of the carotid artery and internal jugular vein at the site of cannulation is proposed. This method uses a doppler flow detector equipped with an adjustable electronic filter which selectively enhances the sound component due either to the arterial or venous flow. This method has been applied clinically and was found to be useful in the identification of the vessels. Since doppler flow detectors are readily available in many hospitals and the required modification is simple, we hope that other institutions will find this technique useful in their clinical practice.

Catheterization↗

Assessment of immediate post-anaesthetic recovery in young children following intravenous morphine infusions, halothane, and isoflurane.

Within 15 minutes of terminating general anaesthesia, progressive recovery of consciousness, spontaneous ventilation and cough, and limb movements were assessed in 60 young children (age range 0-5 years, mean +/- SEM; 2.83 +/- 0.34; weight 13.86 +/- 0.41 kg). All patients were ASA physical status class I-III, received a standard intravenous induction (atropine 0.02 mg X kg-1, thiopental sodium 5 mg X kg-1, diazepam 0.2 mg X kg-1), were intubated with an orotracheal tube following the administration of metocurine, 0.4 mg X kg-1, and were maintained under general anaesthesia with nitrous oxide and oxygen in a 70:30 mixture administered by a T-piece circuit. They were ventilated mechanically to maintain normal blood-oxygen tension and normocarbia. The patients were assessed in three equal groups according to the anaesthetic supplement they received. Group I received intravenous infusions of morphine sulfate (loading dose 60 micrograms X kg-1 administered over 5 minutes followed by a continuous intravenous infusion of 2 micrograms X kg-1 X min-1. Patients in Groups II and III had 0.5 per cent halothane and 1.0 per cent isoflurane respectively added to the nitrous oxide/oxygen fresh gas mixture rather than morphine sulphate infusions. By the end of the study period, there was no significant difference in the degree of recovery between the morphine and the isoflurane groups but the patients in the halothane group had recovered to a lesser degree. Generally, the patients in the morphine group were awake but not crying, while those in the other two groups were less sedated.

Anesthesia, General↗

The heart rate response to succinylcholine in children: a comparison of atropine and glycopyrrolate.

To determine whether intravenous atropine and glycopyrrolate are equally effective in preventing succinylcholine-induced heart rate changes, we studied the heart rate during the first 78 seconds of anaesthesia in 40 children anaesthetized with either thiopentone, atropine (0.02 mg X kg-1) and succinylcholine (2 mg X kg-1), or thiopentone, glycopyrrolate (0.01 mg X kg-1) and succinylcholine (2 mg X kg-1). Each treatment group was divided into four subgroups which differed only in the interval (6, 10, 15, 20 seconds) between injection of atropine or glycopyrrolate and succinylcholine. During the 54 seconds after succinylcholine, the mean heart rate of each subgroup decreased transiently and then returned to the pre-induction heart rate or higher. There was no difference in either the magnitude or the duration of the decrease in heart rate or the subsequent increase in heart rate between respective subgroups. Bradycardia occurred in only two patients, both of whom received glycopyrrolate. We conclude that atropine (0.02 mg X kg-1) and glycopyrrolate (0.01 mg X kg-1) are equally effective in attenuating succinylcholine-induced changes in heart rate in children.

Anesthesia, General↗