Malawi medical journal : the journal of Medical Association of Malawi
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Acute compartment syndrome of the thigh is rare but has been described as a result of femur fracture and also thigh contusion in sports injury. Emergency fasciotomy has routinely been the recommended treatment. We describe a patient with a closed femur fracture, initially without any syndrome whilst on traction, and required surgical intervention. ⋯ This case is unusual in that symptoms started 12 days after injury possibly after manipulation of the leg whilst on traction. Diagnosis is mainly clinical with an earliest alarming sign being disproportional increasing pain on passive stretch of the group of muscles. A high index of suspicion and prompt intervention are required to diagnose and treat compartment syndrome and prevent irreversible damage.
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To describe perceptions of medical students, recent medical graduates, faculty of the College of Medicine, University of Malawi and private medical practitioners (PMPs) towards an attachment of undergraduate medical students in private medical doctors' offices. ⋯ Faculty, medical students and recent graduates of the Malawi College of Medicine do not perceive PMPs as a resource to be tapped for the training of medical students.
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The aim of this longitudinal study was to assess the effect of rotating shift work on perceived sleep quality and sleep duration of nurses at Queen Elizabeth Central Hospital, Blantyre, Malawi. Twenty four female nurses were recruited at random from among personnel engaged in rotating shift work. The nurses worked a three-phase schedule: five day shifts (7.00 - 17.00) followed by three night shifts (17.00 - 7.00) and five days off. ⋯ One-way analysis of variance revealed a significant effect of shift phase on total sleep duration (F = 36.8, d.f. = 8, P < 0.000) and perceived sleep quality (F = 8.81, d.f. = 3, P < 0.000). Night shift work was associated with reduction of sleep quality and duration. The after effects of night shifts persisted during days of the recovery period indicating accumulation of fatigue.