1.Buruli Ulcer in the Proximal Right Thigh and Groin: A Case Report
Pacific Journal of Medical Sciences 2012;9(2):70-76
We report a case of histopathologically proven Buruli ulcer (BU) in a 25-year-old man which was found at the proximal right thigh and groin – an unusual site of occurrence. Laboratory results including Gram and ZN stains were negative while a culture on Lowenstein Jensen media at 33oC from the tissues produced a positive growth of Mycobacterium ulcerans. Histology of the edges of the ulcer showed a granulomatous lesion consistent with BU. This highlights the differentiation of Buruli ulcer from tropical ulcer and, to a lesser extent other forms of skin malignancies and benign skin lesions. The ulcer presented by the young man was Buruli ulcer.
2.Mortality prediction using POSSUM scoring system for laparotomy patients in Mulago National Referral Hospital, Uganda.
Kitara DL ; Kakande I ; Mugisa DB.
Pacific Journal of Medical Sciences 2012;9(2):38-46
Prediction of serious complications is an essential part of risk management in surgery. Knowing which patient to operate and those at high risk of dying contributes significantly to the quality of surgical care and cost reduction. The postoperative mortality of patients who underwent laparotomy in Mulago Hospital was studied using Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM). Consecutive patients who underwent laparotomy in Mulago Hospital were recruited and consent obtained. Patients operated were followed up to the 30th postoperative day. Postoperative deaths were promptly investigated and findings recorded. Follow-up of patients was conducted by phone and surgical review once a week in outpatient. Ethical approval was obtained from the Institutional Review Board (IRB) of Makerere University Medical School. Seventy-six patients participated and the observed mortality was 14.5% and the predictive value of POSSUM using Receiver Operative Characteristics (ROC) curve was 0.817 (95% Confidence Interval 0.711, 0.924) and the Hosmer and Lemeshow test predicted 18.2% of mortality and survival 100%. Postoperative mortality can be predicted in the modern management of surgery using POSSUM. It is markedly influenced by the preoperative, operative and postoperative conditions of the patients.
3.Nodding Syndrome in Uganda - A Disease Cluster: An Epidemiological Dilemma.
Pacific Journal of Medical Sciences 2013;11(1):21-33
Nodding Syndrome (NS) was recently described in children in Northern Uganda. The affected children were in the age group 5 – 15 years. They were stunted, malnourished, dehydrated, mentally retarded and get recurrent seizures. The objective of this study was to describe the cluster distribution of NS cases in Northern Uganda. We conducted a cross-sectional study using available data on the burden of NS in Northern Uganda and used GPS to map the locations of the most affected areas. The results obtained indicate that Nodding Syndrome in Northern Uganda occurs in clusters in the following locations Odek, Atiak, Angagura, Awere, Laguti, Labongo-Amida, Atanga, Pajimo, Palabek Kal and Palabek Gem sub counties and mainly along Aswa and Pager rivers and their tributaries. Nodding Syndrome in Northern Uganda occurs in clusters predominantly along two rivers; perhaps it is an indication for environmental, dietary and common epidemiological exposures for the syndrome.
4.HIV/AIDS among youths in Gulu: a post-conflict northern Uganda.
Kitara DL ; Nakitto A ; Aloyo JK ; Mwaka AD.
Pacific Journal of Medical Sciences 2013;12(1):10-23
HIV/AIDS is one of the commonest reasons for admission of youths in Gulu Hospital. There are no specific studies that have been carried out to determine the prevalence of HIV/AIDS among the youths in this post-conflict region. This study aimed to describe the characteristics of HIV positive youths attending care in Gulu Hospital. A cross-sectional study was conducted among youths aged 13 to 24 years in the specific clinics of Gulu Hospital from January to December 2010 to identify and describe those youths that were HIV positive. A total sample size of 280 HIV positive patients was calculated using the Kish & Leslie formula. Ethical approval was obtained from Gulu Hospital Committee. Majority of respondents 174 (62%) who re-tested for HIV knew their HIV status and most tested between April and June 90 (32%). HIV infection was more prevalent among females 252 (90%), particularly those who were single 118 (47%). HIV infection is more common among female youths in the post-conflict northern Uganda.