Spontaneous atlanto-axial dislocation and trisomy 21: causal factors and management.

Spontaneous atlanto-axial (C1-C2) dislocation is an atlanto-axial instability, found in 10 to 30% of trisomy 21 patients, the majority of whom is asymptomatic. We report a case of a 21 years-old woman, with trisomy 21, admitted in our department presenting a spinal cord compression syndrome with right hemiparesis associated with a cervicalgia evolving for 3 months of admission without trauma. Standard cervical radiography showed a C1-C2 dislocation with posterior displacement of the odontoid process.

Access to continued professional education among health workers in Blantyre, Malawi.

Objective: To describe the current status of continued professional development (CPD) of healthcare personnel within the Ministry of Health (MoH) health centres in Blantyre, Malawi.

Design: A cross-sectional descriptive study utilizing an interviewer-administered questionnaire.

Subjects: Healthcare workers in public health centers in Blantyre District, Malawi.