scholarly journals Outcomes of Dorsal and Ventral Buccal Graft Urethroplasty at a Tertiary Hospital in Uganda

ISRN Urology ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
S. Kaggwa ◽  
M. Galukande ◽  
H. Dabanja ◽  
H. Luweesi
Keyword(s):  
Success Rate ◽  
Buccal Mucosa ◽  
Tertiary Hospital ◽  
Sub Saharan Africa ◽  
Team Approach ◽  
Sexually Transmitted ◽  
Urethral Strictures ◽  
Sub Saharan ◽  
A Prospective Study

Purpose. Although the use of buccal mucosa in substitution urethroplasty has been practiced for some years, it has not been free of controversy over which surgical technique is the most appropriate to use. There is paucity of data in Sub-Saharan Africa about its success; this study presents the outcomes of dorsal and ventral buccal graft urethroplasty at a sub-Saharan tertiary hospital. Methods. This is a prospective study in which buccal mucosa was used for ventral and dorsal grafts; followup was up to two years. All patients provided informed written consent for the procedures. Results. Seventy-two patients with bulbar urethral strictures underwent buccal graft one-stage urethroplasty. Mean age was 55 years; etiology of the strictures was postinflammatory due to urethritis from sexually transmitted infections 97% (70/72) and trauma 3% (2/72). Buccal mucosa grafts were harvested from the cheek using a two-team approach. Grafts were placed on the ventral and dorsal urethral surfaces in 32 and 40 cases, respectively; the success rate was 84 and 80%, respectively. Repeated urethroplasty was successfully done among 10% (7/72) and patients reported resolution of symptoms in the follow-up period. Conclusion. There was no difference between dorsal and ventral onlay buccal graft outcomes for bulbar urethral strictures. The success rate was 80 to 84%.

scholarly journals Buccal One-Stage Mucosal Graft Urethroplasty for Urethral Stricture. Results of 10 Years of Experience.

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Gezim Galiqi ◽  
Artan Koni ◽  
Flamur Tartari ◽  
Albert Pesha ◽  
Shpetim Ymeri ◽  
...  
Keyword(s):  
Success Rate ◽  
Urethral Stricture ◽  
Buccal Mucosa ◽  
Dorsal Surface ◽  
Success Rates ◽  
Lower Lip ◽  
Bulbar Urethra ◽  
Urethral Strictures ◽  
Buccal Mucosa Graft

Aim: Representing our data regarding use of buccal mucosa for treatment of recurrent urethral stricture. Evaluating effectiveness of buccal graft for reconstruction of urethral segment both penile and bulbar urethra. Materials and methods: We repaired 95 urethral strictures with buccal mucosa grafts from 2004 to 2015. Mean patient age was 39 years. The etiology of stricture was unknown in 54% of cases in other cases ischemia, trauma, instrumentation was the reason. 96% had undergone previous urethrotomy or dilation. The buccal mucosa graft was harvested from lower lip mostly. Mean graft length was 3.8 cm. The graft was placed on the ventral and dorsal bulbar urethral surface in 61 and 34 cases, respectively. In pendulous urethra we routinely use the dorsal graft the Asopa inlay graft or Barbagli onlay graft. Clinical outcome was considered a success or failure at the time that any postoperative procedure was needed, including dilation. Mean follow-up was 36 months (range 16 to 62). Results: We had a success rate of 77% with dorsal inlay or onlay flap for pendulous urethra inferior than ventral graft used for bulbar urethra which was 81% success rate. Conclusions: In our experience the placement of buccal mucosa grafts into the ventral or dorsal surface of the bulbar urethra showed an acceptable success rates 81% and 77% respectively. Longer times of follow up is need to see if the results deteriorated more.

scholarly journals Outcome of buccal mucosa urethroplasty in the management of urethral strictures

2017 ◽  
Vol 89 (2) ◽  
pp. 139 ◽  
Author(s):  
Basri Cakiroglu ◽  
Orhun Sinanoglu ◽  
Ersan Arda
Keyword(s):  
Success Rate ◽  
Buccal Mucosa ◽  
High Volume ◽  
Single Stage ◽  
Fistula Formation ◽  
Internal Urethrotomy ◽  
Voiding Difficulty ◽  
Urethral Strictures ◽  
Buccal Mucosa Graft

Objective: The objective of the study is to report the outcome of buccal mucosal urethroplasty. Materials and methods: The follow up data of 15 patients undergoing single stage urethroplasty from September 2010 to September 2015 were retropectively reviewed. They received buccal mucosa graft for urethroplasty. The patients were followed for complications and outcome. Results: Mean age was 53.7 ± 13.6 The stricture length ranged from 3 to 6 cm (mean 4.4 ± 0.8). The success rate for buccal mucosa urethroplasty (BMU) was 67.7% at 12th month. Three patients presenting with voiding difficulty in the 3rd month and one in the next 12 months, had urethral restenosis. One patient had fistula formation at 6th month postoperatively. Five patients underwent retreatment procedures such as internal urethrotomy, urethroplasty and/or internal urethrotomy. Conclusions: The buccal mucosa is easy to obtain and handle, therefore BMU can be safely and effectively managed outside high volume institutions.

scholarly journals Postoperative Sepsis Among HIV-Positive Patients with Acute Abdomen at Tertiary Hospital in Sub-Saharan Africa: a Prospective Study

2019 ◽  
Vol 1 (6) ◽  
pp. 465-472
Author(s):  
Mohamed Abdullahi Awale ◽  
Timothy Makumbi ◽  
Gideon Rukundo ◽  
Gideon K. Kurigamba ◽  
Geoffrey Kisuze ◽  
...  
Keyword(s):  
Prospective Study ◽  
Acute Abdomen ◽  
Tertiary Hospital ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Postoperative Sepsis ◽  
Sub Saharan ◽  
A Prospective Study

scholarly journals The Burden of Hand Injuries at a Tertiary Hospital in Sub-Saharan Africa

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
P. Makobore ◽  
M. Galukande ◽  
E. Kalanzi ◽  
S. C. Kijjambu
Keyword(s):  
Road Traffic ◽  
Tertiary Hospital ◽  
Hand Injuries ◽  
Sub Saharan Africa ◽  
Trauma Patients ◽  
The Road ◽  
Injury Occurrence ◽  
Sub Saharan ◽  
On The Road

Background. Hand injuries are common worldwide and lead to heavy financial losses in terms of treatment, job loss, and time off duty. There is paucity of data on hand injuries in sub-Saharan Africa. The aim of this study was to determine the burden and early outcomes of hand injuries at a tertiary hospital.Method. A descriptive prospective study. Eligible patients were recruited over 5 months and followed up for four weeks. Pain, nerve function, and gross functions of the hand were assessed.Results. In total 138 patients were enrolled out of 2940 trauma patients. Of these, 122 patients returned for follow-up. The majority of the patients were males (83%). Mean age was 26.7 years (SD 12.8). The commonest places of injury occurrence were the workplace (36%), home (28%), and on the road (traffic crushes) (23%). Machines (21.3%) were the commonest agent of injuries; others were knives (10%) and broken glass (10%). Sixty-three (51%) patients still had pain at one month.Conclusions. Hand injuries accounted for 4.7% of all trauma patients. Road traffic crushes and machines were the commonest causes of hand injuries. Men in their 20s were mostly involved. Sensitization for prevention strategies at the workplace may be helpful.

scholarly journals Dorsally Placed Buccal Mucosal Graft Urethroplasty in Treatment of Long Urethral Strictures Using One-Stage Transperineal Approach

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Kamyar Tavakkoli Tabassi ◽  
Alireza Ghoreifi
Keyword(s):  
Success Rate ◽  
Operative Procedure ◽  
Transmitted Disease ◽  
Lichen Sclerosus ◽  
Sexually Transmitted ◽  
One Stage ◽  
Urethral Strictures ◽  
Buccal Mucosal Graft ◽  
The Mean

Objectives. To evaluate the results of one-stage buccal mucosal urethroplasty in treatment of long urethral strictures. Methods. This retrospective study was carried out on 117 patients with long urethral strictures who underwent one-stage transperineal urethroplasty with dorsally placed buccal mucosal grafts (BMG). Success was defined as no need for any intervention during the follow-up period. Results. Among 117 patients with mean age of 39.55±15.98 years, the strictures were located in penile urethra in 46 patients (39.32%), bulbar urethra in 33 (28.20%) and were panurethral in 38 (32.48%). The etiology of the urethral stricture was sexually transmitted disease (STD) in 17 (14.53%), lichen sclerosus in 15 (12.82%), trauma in 15 (12.82%), catheterization in 13 (11.11%), transurethral resection (TUR) in 6 (5.13%), and unknown in 51 (43.59%). The mean length of strictures was 9.31±2.46 centimeters. During the mean followup of 18.9±6.7 months success rate was 93.94% in bulbar strictures, 97.83% in penile strictures, and 84.21% in panurethral strictures (P value: 0.061). Conclusions. The success rate of transperineal urethroplasty with dorsally placed buccal mucosal grafts is equal in different sites of strictures with different etiologies. So reconstruction of long urethral strictures may be safely and effectively performed at a simple single operative procedure using this method of urethroplasty.

scholarly journals Adverse Drug Reactions in Paediatric In-Patients in a South African Tertiary Hospital

2018 ◽  
Vol 65 (4) ◽  
pp. 389-396 ◽  
Author(s):  
Memela Makiwane ◽  
Eric Decloedt ◽  
Maxwell Chirehwa ◽  
Bernd Rosenkranz ◽  
Mariana Kruger
Keyword(s):  
South African ◽  
Tertiary Hospital ◽  
Paediatric Oncology ◽  
Sub Saharan Africa ◽  
Severity Scale ◽  
Probability Scale ◽  
Period Data ◽  
Sub Saharan ◽  
A Prospective Study ◽  
Reason For Admission

Abstract Background The prevalence of adverse drug reaction (ADR) rates in children in sub-Saharan Africa is unknown. Objectives To describe the prevalence of ADRs in paediatric in-patients at a tertiary hospital in South Africa. Methods This is a prospective study during a 3-month study period. Data collected included age, sex, diagnosis, medicines received and ADRs experienced. Causality were assessed, using the 10-question Naranjo probability scale and classified according to the Hartwig severity scale. Results There were 61 ADRs in 18.4% (52 of 282) of patients. Median age of patients was 1.4 years (interquartile range: 0.5–5.3 years). ADR was the primary admission reason in 31%. The majority of the ADRs were moderate 45.9% (28 of 61), and only 11.5% severe (7 of 61). Paediatric oncology patients suffered significantly more ADRs (56.5%; 13 of 23) [odds ratio 7.3 (3.0–17.9), p < 0.01], followed by HIV-infected patients (42.9%; 9 of 21). Conclusion The prevalence of ADRs was 18.4%, while 31% was the reason for admission.

Quality of Care for Adult Inpatients with Malaria in a Tertiary Hospital in Uganda

2020 ◽  
Author(s):  
Ronald Kiguba ◽  
Charles Karamagi ◽  
Sheila M. Bird
Keyword(s):  
Quality Of Care ◽  
Severe Disease ◽  
Malaria Diagnosis ◽  
Tertiary Hospital ◽  
Sub Saharan Africa ◽  
Timely Initiation ◽  
Sub Saharan ◽  
Malaria Microscopy

Abstract Background: Prompt detection and appropriate treatment of malaria prevents severe disease and death. The quality of care for adult malaria inpatients is not well documented in sub-Saharan Africa, particularly in Uganda. We sought to describe the patterns of malaria diagnosis and treatment among adult inpatients admitted to the medical and gynaecological wards of Uganda’s 1790-bed Mulago National Referral Hospital from December 2013 to April 2014.Methods: A prospective cohort of 762 consented inpatients aged >18 years was assembled. Proportions of inpatients who received preadmission and in-hospital antimalarials, missed Day 1 dosing of hospital-initiated antimalarials and/or had malaria microscopy done were determined. Multivariable logistic regression was used to identify risk-factors for missed Day 1 dosing of antimalarials.Results: One in five (19%, 146/762) inpatients had an admitting or discharge malaria diagnosis or both; with median age of 29 years (IQR, 22 to 42 years). Microscopy was requested in 77% (108/141) of inpatients with an admitting malaria diagnosis; results were available for 46% (50/108), of whom 42% (21/50) tested positive for malaria parasitaemia. Only 13% (11/83) of inpatients who received in-hospital injectable artesunate (AS) or quinine (Q) received follow-up oral artemether-lumefantrine (AL); only 2 of 18 severe malaria cases received follow-up oral AL. Injectable AS only (47%, 47/100) was the most frequent hospital-initiated antimalarial followed by injectable Q only (23%, 23/100). A quarter (25%, 25/100; 95% CI: 17% to 35%) of inpatients missed Day 1 dosing of hospital-initiated antimalarials. Each additional admitting diagnosis was more than two-fold likely to increase the odds of missed Day 1 dosing of in-hospital antimalarials (aOR = 2.6, 95% CI: 1.52-4.56; P-value = 0.001).Conclusions: Half the malaria microscopy results were not available; yet, the rate of testing was high. The majority of inpatients initiated on injectable AS or Q did not receive the recommended follow-up treatment of oral AL. One in four inpatients delayed to initiate hospital antimalarials by at least one calendar day. The hospital should encourage prompt availability of malaria test-results to promote the timely initiation and completion of antimalarial treatment, thereby improving the quality of care for hospitalized malaria patients in Uganda.

scholarly journals Predictors of lost to follow up from antiretroviral therapy among adults in sub-Saharan Africa: a systematic review and meta-analysis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Hafte Kahsay Kebede ◽  
Lillian Mwanri ◽  
Paul Ward ◽  
Hailay Abrha Gesesew
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Care Services ◽  
Validity Assessment ◽  
Sub Saharan ◽  
Lost To Follow Up

Abstract Background It is known that ‘drop out’ from human immunodeficiency virus (HIV) treatment, the so called lost-to-follow-up (LTFU) occurs to persons enrolled in HIV care services. However, in sub-Saharan Africa (SSA), the risk factors for the LTFU are not well understood. Methods We performed a systematic review and meta-analysis of risk factors for LTFU among adults living with HIV in SSA. A systematic search of literature using identified keywords and index terms was conducted across five databases: MEDLINE, PubMed, CINAHL, Scopus, and Web of Science. We included quantitative studies published in English from 2002 to 2019. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for methodological validity assessment and data extraction. Mantel Haenszel method using Revman-5 software was used for meta-analysis. We demonstrated the meta-analytic measure of association using pooled odds ratio (OR), 95% confidence interval (CI) and heterogeneity using I2 tests. Results Thirty studies met the search criteria and were included in the meta-analysis. Predictors of LTFU were: demographic factors including being: (i) a male (OR = 1.2, 95% CI 1.1–1.3, I2 = 59%), (ii) between 15 and 35 years old (OR = 1.3, 95% CI 1.1–1.3, I2 = 0%), (iii) unmarried (OR = 1.2, 95% CI 1.2–1.3, I2 = 21%), (iv) a rural dweller (OR = 2.01, 95% CI 1.5–2.7, I2 = 40%), (v) unemployed (OR = 1.2, 95% CI 1.04–1.4, I2 = 58%); (vi) diagnosed with behavioral factors including illegal drug use(OR = 13.5, 95% CI 7.2–25.5, I2 = 60%), alcohol drinking (OR = 2.9, 95% CI 1.9–4.4, I2 = 39%), and tobacco smoking (OR = 2.6, 95% CI 1.6–4.3, I2 = 74%); and clinical diagnosis of mental illness (OR = 3.4, 95% CI 2.2–5.2, I2 = 1%), bed ridden or ambulatory functional status (OR = 2.2, 95% CI 1.5–3.1, I2 = 74%), low CD4 count in the last visit (OR = 1.4, 95% CI 1.1–1.9, I2 = 75%), tuberculosis co-infection (OR = 1.2, 95% CI 1.02–1.4, I2 = 66%) and a history of opportunistic infections (OR = 2.5, 95% CI 1.7–2.8, I2 = 75%). Conclusions The current review identifies demographic, behavioral and clinical factors to be determinants of LTFU. We recommend strengthening of HIV care services in SSA targeting the aforementioned group of patients. Trial registration Protocol: the PROSPERO Registration Number is CRD42018114418

scholarly journals Persistence of mRNA indicative of Plasmodium falciparum ring-stage parasites 42 days after artemisinin and non-artemisinin combination therapy in naturally infected Malians

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Almahamoudou Mahamar ◽  
Kjerstin Lanke ◽  
Wouter Graumans ◽  
Halimatou Diawara ◽  
Koualy Sanogo ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Artemisinin Combination Therapy ◽  
Parasite Prevalence ◽  
Sub Saharan Africa ◽  
Ring Stage ◽  
Qrt Pcr ◽  
Sub Saharan ◽  
Stage Parasite ◽  
Ring Stage Parasite

Abstract Background Malaria control in sub-Saharan Africa relies upon prompt case management with artemisinin-based combination therapy (ACT). Ring-stage parasite mRNA, measured by sbp1 quantitative reverse-transcriptase PCR (qRT-PCR), was previously reported to persist after ACT treatment and hypothesized to reflect temporary arrest of the growth of ring-stage parasites (dormancy) following exposure to artemisinins. Here, the persistence of ring-stage parasitaemia following ACT and non-ACT treatment was examined. Methods Samples were used from naturally infected Malian gametocyte carriers who received dihydroartemisinin–piperaquine (DP) or sulfadoxine–pyrimethamine (SP–AQ) with or without gametocytocidal drugs. Gametocytes and ring-stage parasites were quantified by qRT-PCR during 42 days of follow-up. Results At baseline, 89% (64/73) of participants had measurable ring-stage parasite mRNA. Following treatment, the proportion of ring-stage parasite-positive individuals and estimated densities declined for all four treatment groups. Ring-stage parasite prevalence and density was generally lower in arms that received DP compared to SP–AQ. This finding was most apparent days 1, 2, and 42 of follow-up (p < 0.01). Gametocytocidal drugs did not influence ring-stage parasite persistence. Ring-stage parasite density estimates on days 14 and 28 after initiation of treatment were higher among individuals who subsequently experienced recurrent parasitaemia compared to those who remained free of parasites until day 42 after initiation of treatment (pday 14 = 0.011 and pday 28 = 0.068). No association of ring-stage persistence with gametocyte carriage was observed. Conclusions The current findings of lower ring-stage persistence after ACT without an effect of gametocytocidal partner drugs affirms the use of sbp1 as ring-stage marker. Lower persistence of ring-stage mRNA after ACT treatment suggests the marker may not reflect dormant parasites whilst it was predictive of re-appearance of parasitaemia.

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