Determinants of fertility in Malawi: Does women autonomy dimension matter?

Background: Power inequality within the household and sexual relationships is linked to poor reproductive health. Malawi Government through National Sexual and Reproductive Health and Rights policy is committed to women empowerment as well fertility reduction. However, there is limited evidence in Malawi regarding whether women's autonomy in the household is an independent determinant of fertility.

Do women with autonomy in the household experience less intimate partner violence in Malawi? Evidence from the 2015-16 Demographic and Health Survey.

In Malawi, the prevalence of intimate partner violence (IPV), or closely related violence, is estimated at 42% according to the 2015-16 Malawi Demography and Health Survey (MDHS). This study investigated the association between women's autonomy in household decision-making participation as well as sexual autonomy and IPV among married and cohabiting women aged 15-49 years in Malawi. Secondary data were taken from the 2015-16 MDHS.

Patterns and determinants of modern contraceptive use and intention to usecontraceptives among Malawian women of reproductive ages (15-49 years).

Background: Malawi is one of the countries in SSA with the highest TFR. This study aimed to explore factors associated with modern contraceptive use and intention to use contraceptives among women of reproductive ages (15-49 years) in Malawi.

Methods: The study used secondary data from 2015 to 16 Malawi Demographic and Health Survey (MDHS) dataset.

Patterns and correlates of ownership and utilization of insecticide-treated bed-nets for malaria control among women of reproductive age (15-49 years) in Malawi.

Malaria is a major public health concern in Malawi. This study explored the patterns and correlates of ownership and utilization of ITNs for malaria control among women of reproductive age in Malawi. Data were derived from the multi-stage cross-sectional Malaria Indicator Survey (MIS) conducted in 2017, which followed ITN distribution in 2012 and 2015.

Intrapulmonary gallstone.

An octogenarian presented to her primary care physician with hemoptysis and a disabling chronic cough that developed several months after a complicated partial cholecystectomy. During investigation, a biopsy sample showed a right lower lobe inflammatory mass containing bile pigment and abundant neutrophils. Thoracotomy performed approximately 18 months after symptom onset confirmed a right lower lobe lung abscess together with a large gallstone embedded at its center and a healed defect in the right hemidiaphragm.

The effect of a large proximal haemodialysis arterio-venous fistula on weaning off cardiopulmonary bypass: case report.

An increasing number of renal dialysis-dependent patients with Arterio-Venous fistulae are undergoing cardiac surgery.The fistula has important effects on systemic hemodynamics in dialysis patients. The flow is significantly and positively related to cardiac output and cardiac index, and inversely related to pulmonary vascular resistance.

Smoking after cardiac transplantation.

Although smoking cessation is a prerequisite prior to listing for cardiac transplantation, some patients return to smoking after recovery. We have covertly assessed the smoking habits of our cardiac transplant recipients (with ethical approval) since 1993 by measuring urinary cotinine: a level of >500 ng/mL signifying continued tobacco use. We retrospectively analyzed survival, causes of death and the development of graft coronary artery disease (GCAD) with respect to the number of positive and negative cotinine levels.

Clinical experience with assisted venous drainage cardiopulmonary bypass in elective cardiac reoperations.

Reoperative cardiac surgery is associated with substantial morbidity and mortality due to technical problems at sternal reentry, which can result in laceration of the right ventricle, innominate vein injury, or embolization from patent grafts. To minimize the risk associated with reentry, we adopted the method of assisted venous drainage in the cardiopulmonary bypass circuit with peripheral cannulation for cardiac reoperations. From March 1999 to May 2003, a series of 52 patients (38 males; mean age 48.

Pacing to restore right ventricular contraction after surgical disconnection for arrhythmia control in right ventricular cardiomyopathy.

Ventricular tachycardia in ARVC (arrhythmogenic right ventricular cardiomyopathy) is typically managed by ICD implantation, with a limited role of catheter ablation. Surgical disconnection of the right ventricular (RV) has been used to control ventricular tachycardia (VT) in ARVC, but it often led to refractory RV failure due to loss of RV contraction after surgery. We report multisite pacing to recruit the disconnected RV to prevent ventricular failure.

Right ventricular disarticulation. An 18-year single centre experience.

Objective: Right ventricular disarticulation (RVD) is an accepted procedure in the treatment of ventricular tachycardia of right ventricular origin. We set out to review the long-term outcomes with RVD at our institution for patients with arrhythmogenic right ventricular dysplasia (ARVD) or refractory tachycardia. A renewed interest in this operation has come about in patients unable to tolerate implantable cardioverter defibrillators.

Functional status and quality of life in patients surviving 10 years after lung transplantation.

Although many lung allograft recipients achieve long-term survival, there is a lack of published data regarding these patients' functional status and quality of life (QoL). We evaluated all 10-year survivors at our institution and, utilizing the SF-36 questionnaire, compared their QoL to population normative and chronic illness data. Twenty-eight (29%) of 96 patients survived > or =10 years following 11 single, 6 bilateral and 11 heart-lung procedures.

Mediastinitis in heart and lung transplantation: 15 years experience.

Background: Mediastinitis after sternotomy carries a very high mortality, especially in patients receiving immunosuppressive treatment.

Methods: A retrospective analysis of the data for patients who had undergone cardiopulmonary transplantation between May 1985 and December 2000 was undertaken. A total of 776 patients had either a median sternotomy or a transverse sternotomy through a clam-shell incision.

Perfadex for clinical lung procurement: is it an advance?

Background: Extensive laboratory experience suggested that low potassium dextran lung preservation solution (Perfadex; Medisan, Uppsala, Sweden) is superior to Euro-Collins (EC; Frusen, Hamburg, Germany), the clinical standard. The purpose of this study was to evaluate Perfadex in clinical lung transplantation.

Methods: A retrospective analysis of the outcome of 69 consecutive lung allografts retrieved and used for transplantation was made.

Effect of WBC reduction of transfused RBCs on postoperative infection rates in cardiac surgery.

Background: WBC-replete blood transfusion has been suggested as an independent cause of increased postoperative infection.

Study Design And Methods: A total of 597 patients undergoing elective coronary artery or heart valve surgery were randomly assigned to receive plasma-reduced (PR), buffy coat-depleted (BCD), or WBC-filtered (WCF) RBCs in the event of requiring blood transfusion. Details of postoperative course were recorded.

Concurrent coronary grafting of the donor heart with left internal mammary artery: 10-year experience.

We report 4 donor hearts with palpable atherosclerosis on the surface of the left anterior descending coronary artery (LAD), which was thought to be significant. The heart ordinarily would have been rejected in the absence of availability of donor coronary angiography or bench angiography. Instead, we accepted the organ and bypassed the atherosclerotic lesion with a left internal mammary artery.

Thoracoscopic mapping and cryoablation of right ventricular tachycardia.

A 14-year-old girl with right ventricular dysplasia and recurrent drug refractory ventricular tachycardia underwent thoracoscopic mapping cryoablation. Good access to the right ventricular free wall was obtained. We suggest this technique may have an important role in the management of patients with right ventricular tachycardia.

Severe left main stem stenosis in a cardiac transplant recipient: successful treatment by coronary stenting.

A 58-year-old male underwent orthotopic cardiac transplantation for ischemic cardiomyopathy. At routine coronary angiography 2 years later, he was found to have severe concentric stenosis of the left main coronary artery but was asymptomatic. Revascularization was recommended on prognostic grounds and after discussion with his cardiac transplant surgeon, percutaneous coronary intervention with elective stenting was offered.

Effect of low molecular weight heparin (fragmin) on bleeding after cardiac surgery.

Background: Fragmin (Dalteparin, Pharmacia Ltd, Milton Keynes, UK), a low molecular weight heparin, is now recommended in the treatment of unstable angina. Due to the greater bioavailability and longer half-life of Fragmin compared with conventional heparin we postulated that this may influence postoperative bleeding after cardiac surgery for unstable angina.

Methods: We investigated the influence of the agent on postoperative bleeding after cardiac surgery.

Prosthetic heart valve endocarditis caused by Bacillus circulans.

We report a case of prosthetic valve endocarditis due to Bacillus circulans in a 56-year-old woman. Pre-operative blood cultures were negative and the organism was only recovered on culture of the explanted mechanical valve. We discuss the reasons for the late clinical presentation of this case, 15 months post valve replacement, caused by an organism which is conventionally regarded as 'early' pathogen.

Early results with the Carbo-seal composite valve conduit for aortic root replacement.

Background And Aims Of The Study: Composite graft replacement of the aortic root is still a complex operation, transgraft hemorrhage being one of the most severe complications. The aim of the study was to evaluate early results with the Carbo-seal composite conduit for aortic root replacement.

Methods: A retrospective review of 21 patients operated on for ascending aortic aneurysm and/or dissection with the open technique between August 1993 and February 1998 is presented; 12 patients had Marfan syndrome and nine were non-Marfan.

Role of orthotopic heart transplantation in the management of patients with recurrent ventricular tachyarrhythmias following myocardial infarction.

Objective: To report the outcome of an intention to treat by heart transplantation strategy in two groups of patients after infarction, one with both left ventricular failure (LVF) and ventricular tachyarrhythmias (VTA) (group A) and the other with progressive LVF following antiarrhythmic surgery for VTA (group B).

Patients And Methods: Group A comprised 17 consecutive patients for whom transplantation was considered the best primary non-pharmacological treatment; group B comprised five consecutive patients assessed and planned for transplantation after antiarrhythmic surgery.

Results: In group A, eight patients underwent transplantation and all survived the first 30 day period.

Orthotopic cardiac transplantation for the failing Fontan circulation.

Objective: Modified Fontan procedures are now employed in several conditions unsuitable for bi-ventricular repair. Selection criteria have been relaxed. The procedure is palliative.