BackgroundCardiovascular disease (CVD) is a strongly emerging problem in developing countries. The documentation and prediction of CVD patterns are important for policy makers if actions are to be taken to curb this problem. We aimed to document the current CVD patterns in Malawi, and associate these patterns to the theory of epidemiologic transition as a means of predicting future CVD patterns.MethodsWe retrospectively analyzed the data recorded in the register of the cardiac clinic in Mzuzu Central Hospital-the only cardiac clinic run by a cardiologist in Malawi-from 2001 through 2005. The findings were interpreted in the context of the epidemiologic transition theory.ResultsOut of the 3908 new Malawian patients included in the 5-y period register, 34% had valvular heart disease (mainly rheumatic heart disease (RHD)); 24%, hypertensive heart disease; 19%, cardiomyopathies; and 14%, pericardial diseases. The other CVD patterns included congenital heart disease and arrhythmias, each representing 4% of the registered patients. Among the 1% comprising other CVD patterns, 3 cases were documented to have coronary heart disease, all of which happened in 2005.ConclusionMalawi is in the stage of receding pandemics, which is characterized by CVD patterns predominated by RHD, cardiomyopathies, and hypertensive heart disease. However, continuous observation is required to detect signs of emerging “degenerative-related” CVD patterns, which is another stage in the epidemiologic transition.

Background: Body dysmorphic disorder (BDD) is characterised by an obsessive preoccupation with a slight defect in appearance, and recognition is essential. Objective: To screen by a previously developed questionnaire the prevalence of BDD in an aesthetics clinic in Singapore. This questionnaire has a positive predictive value of 70% and a negative predictive value of 100%; patients answering that they were preoccupied with their appearance and having answered ‘yes’ in part A, answered 8 further questions (part B) grading the degree of distress (B4) and impairment (B5) of social functioning. Methods: The questionnaire was given to 396 patients: 198 attending Mandalay Aesthetics Clinic and 198 controls at a general outpatient clinic. The screen was considered suggestive of BDD if the patients: were preoccupied by their defect (question A) and qualified the degree of stress (question B4) or impairment of functioning (question B5) as moderate to severe. Results: 58.1% of patients undergoing cosmetic procedures answered ‘yes’ to question A (odds ratio = 18.21, 95% confidence interval = 9.87–33.59). 41.74 and 26.96% of those qualified the distress (question B4) and impairment (question B5) as moderate to severe. Conclusion: A calculated prevalence of 29.4% in an aesthetics centre warrants systematic screening for BDD.

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