Student's Journal of Health Research Africa

THE FACTORS AFFECTING UPTAKE OF VOLUNTARY MEDICAL MALE CIRCUMCISION SERVICES AMONG ADULT MALES AGED 15–50 YEARS ATTENDING NAKIVALE HEALTH CENTER III ISINGIRO

NATWIJUKA ANDREW — 2024-09-01

Medical male circumcision is the surgical removal of the foreskin which covers the penis of a male human being. Circumcision is believed to be one of the oldest and common procedures which has been done for various reasons ranging from cultural rituals, religious, and medical purposes (Sgaier et al., 2014). Traditional male circumcision has been in existence even during the times of the Old Testament. In Uganda, the Bugisu region (eastern Uganda) is regarded the birthplace of Traditional Male Circumcision (TMC) in Uganda. Common belief holds that the first male circumcision was performed in the region centuries ago. (Sabet Sarvestani et al., 2012). One hundred twenty-four (124) adult males were selected to participate in the study, and only one hundred twenty (120) adult males fully completed the study, yielding a response rate of 98.8%. On age majority of subjects were aged between 18 to 39 years 106(76.8%) and least were aged 40-49 years 14(10.1%). This study results revealed that most of the participants had received VMMC (65.2%) and received it from the health facility (68.8%). The prevalence of male circumcision in Nakivale HC III, Isingiro district was 62.5%. Education level, religion and occupation were independent significant demographic factor associated with VMMC uptake. The results of this study revealed gaps in knowledge and factors affecting VMMC, we therefore recommend that independent stake holders need no improve on sensitizing the society about VMMC through linking with nursing institutions to help in making up camps and outreaches and community education to these remote areas.

UPTAKE AND UTILISATION OF NATIONAL GUIDELINES FOR TUBERCULOSIS INFECTION, PREVENTION AND CONTROL AMONG NURSES WORKING IN RESOURCE-LIMITED SETTINGS; A CROSS-SECTIONAL STUDY IN UGANDA.

Ivan Byanga — 2024-09-01

Background

This study assessed the uptake and utilization of the “Uganda National Guidelines for TB IPC” among nurses working within health facilities in Bundibugyo District, Western Uganda. With a focus on knowledge, practices, and perceived barriers, based on a customized health belief model.

Methods

Focused on nurses, the research employed a cross-sectional design using qualitative and quantitative methods with a census technique involving 135 participants across 11 healthcare institutions, that manage TB cases within Bundibugyo district. Quantitative data was captured utilizing self-administered questionnaires and qualitative data by 11 KI and observational checklists, analyzed, and then presented in tables and narrations.

Key findings

The majority were enrolled nurses (42.9%), and gaps in nurses' recognition of the TB guidelines were attributed to limited training sessions. While nurses exhibited high knowledge of basic TB aspects, their awareness of the policy of handling TB clients in their facilities was low at 47.4% and only 35.5% of them had participated in a TB-related training or workshop during the past 2 years, weaknesses were further noted in the screening of patient beds, patient isolation units, and nose-covering practices. Perceived barriers included TB stigma, false beliefs, infrastructure inadequacies, and resources like PPE shortages.

Conclusion

There was insufficient uptake and utilization of the Guidelines within medical facilities in Bundibugyo. This is linked to a few trainings and acquaintance of the guidelines among nurses which have created knowledge gaps and other barriers: resources, stigma, and false beliefs within the surrounding communities.

Recommendations

Enhancing training programs, promoting awareness within health facilities, improving infrastructure, implementing monitoring and evaluation systems, allocating more resources, and addressing weaknesses in implementation. MoH Uganda; Policy review, centralize training programs, and continue research and development. Further research recommendations encompass in-depth studies on TB stigma, evaluating training impacts, and conducting longitudinal studies.

HEALTH INEQUALITIES AND NON-COMMUNICABLE DISEASES IN UGANDA: A SYSTEMATIC REVIEW.

Richard Kajubi — 2024-09-06

Background

Non-communicable diseases (NCDs), including cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes, are leading causes of death worldwide, particularly affecting low— and middle—income countries (LMICs). This study systematically reviews the extent of health inequalities in NCDs across various demographic groups in Uganda.

Methodology

This systematic review employed the PICO framework and followed standardized international protocols for data extraction and quality assessment. Comprehensive searches were conducted across PubMed and Web of Science databases, yielding 296 and 106 initial records from the databases respectively. After screening and applying inclusion criteria, 53 studies were included for qualitative synthesis. Data extraction focused on study characteristics, population demographics, interventions, outcomes, and key findings. Methodological quality was appraised to ensure validity, accuracy, and generalizability.

Results

The review highlights significant disparities in NCD prevalence across different demographic groups in Uganda. Notably, the elderly population in rural areas shows a high prevalence of NCDs, influenced by factors such as poor housing conditions, limited physical activity, and inadequate kitchen ventilation. Individuals living with HIV (PLHIV) exhibit compounded health burdens, with hypertension being a common comorbidity. Urban-rural disparities in NCD prevalence are evident, with lifestyle factors associated with urbanization contributing to increased risks. Alarmingly, mortality rates attributable to NCDs, particularly cardiovascular diseases and diabetes, have risen over the past decade. Barriers to healthcare access, including geographic, financial, and policy—related challenges, exacerbate these disparities.

Conclusion

Among the elderly population residing in rural areas, a strikingly high prevalence of NCDs is observed, influenced by factors such as substandard housing conditions, limited physical activity, and inadequate kitchen ventilation. This underscores the urgent need for targeted interventions aimed at improving living conditions and promoting healthy behaviors among this vulnerable demographic group.

Recommendation

Further research is warranted to explore the underlying determinants of these disparities in greater depth.

PREVALENCE OF COMORBIDITIES AMONG DIABETIC PATIENTS OF JINJA REGIONAL REFERRAL HOSPITAL. A CROSS-SECTIONAL STUDY.

VIOLET ALIMWENDA — 2024-09-01

Background

Diabetes is a complex and multifaceted condition that is often accompanied by comorbidities, which are additional health conditions that co-occur with diabetes. Study aims to assess the Prevalence of comorbidities among diabetic patients of Jinja regional referral hospital.

Methodology

A descriptive cross-sectional study that employed quantitative data techniques was used. Simple random sampling was used to select participants in the study. Descriptive statistics was used to assess the frequency distribution of the three risk categories. A Chi-square test assessed the categorical variables and trends in the prevalence of diabetic comorbidities.

Results

185(65.1%) of the respondents were females while 99(34.9%) were males. The number of patients with high cholesterol levels was 94(33.1%). The number of patients who were HIV positive was 67(23.6%). Patients who had eye problems were 64(22.5%). Patients with kidney problems were 51(18%) and heart or brain problems were 78(27.5%). Patients with footing problems were 36(12.7%). The number of patients with DPN was 75(26.4%). Patients with comorbidities were 104(36.6%) and the number of patients without comorbidities was 180(63.4%). The prevalence of diabetic comorbidities was 36.6%. The number of patients with eye problems (retinopathy) was 64, kidney problems were 51, heart problems was 78, footing problems (diabetic foot) was 36, and peripheral neuropathy was 75.

Conclusion

The prevalence of comorbidities was high given the scarcity of resources and delayed diagnostic management of diabetic complications.

Recommendations

The Ministry of Health should put more strategies to improve early diagnosis and management of Diabetes and its comorbidities.

ANTIMICROBIAL DRUG MISUSE IN THE EASTERN DEMOCRATIC REPUBLIC OF THE CONGO A CROSS-SECTIONAL STUDY: FACTORS INFLUENCING THE EMERGENCE OF ANTIMICROBIAL RESISTANCE

LAMBERT MORISHO — 2024-09-01

Background

Antimicrobial resistance is a major global public health challenge. In sub-Saharan Africa, Plasmodium resistance to new molecules on the market continues unabated. This increase in resistance is mostly due to unhealthy community practices, and also to microbial control methods that are ineffective because of our health policies. This study aimed to analyze factors involved in the emergence of antimicrobial resistance in ancient Kivu, in the eastern part of the Democratic Republic of Congo (DRC).

Materials and methods

A cross-sectional study was carried out from November 2023 to February 2024 in two cities east of the Democratic Republic of the Congo, surveying pharmacies using a standardized questionnaire. We focused on four elements within the pharmacies: the nature of the provider, the way medicines are sold (consumption), the location of the pharmacies, and the nature of drugs.

Results

Our study included 98 (56.9%) pharmacies, 66.3% (65/98) of which were located in peripheral areas with most of the untrained providers (91.7%; 11/12; p = 0.006) and in all pharmacies, 81% (47/58; p < 0.001) of their sales were based on patients' wishes. Nursing sales are 76.9% (20/26; PR: 1.9; 95% CI: 0.5-7.4; p = 0.009) undocumented among qualified staff involved in pharmacy sales.

Conclusions

The risk factors for developing antimicrobial resistance in these two cities in eastern DRC are related to undocumented drug sales and qualified providers in pharmacies. This requires a high level of awareness among those involved in the sale of medicines and those who receive them.

Recommendation

Our proposal is for strict protection of antimicrobial resources through regulation of their sale in the region.

IMPROVING HEALTH CARE-SEEKING BEHAVIORS OF CARETAKERS OF CHILDREN AGED 0-59 MONTHS IN BUGIRI DISTRICT OF EASTERN UGANDA THROUGH THE IMPLEMENTATION OF THE INTEGRATED COMMUNITY CASE MANAGEMENT PROJECT: PRE AND POST IMPLEMENTATION EVALUATION.

ALEX MUKEMBO — 2024-09-01

Introduction

Malaria, diarrhea, and pneumonia are the leading causes of death among children under five in Uganda and similar countries. The Integrated Community Case Management (iCCM) strategy aims to improve access to and use of services for these conditions at the community level. World Vision Uganda and Bugiri District, with funding from the Pfizer Foundation, implemented an 18-month iCCM project in Bugiri district. This article assesses the project's impact on health-seeking behaviors among caregivers of children aged 0-59 months for these conditions.

Methodology

453 Village Health Teams (VHTs) received a 7-day training on basic VHT skills and Integrated Community Case Management (ICCM). They were equipped with ICCM drugs, sick child job aids, and thermometers. VHTs conducted home visits to educate caretakers, and test, and treat sick children for three conditions. Severe cases were referred to health facilities. They received quarterly mentorships and used HMIS 097B to report data quarterly. Anonymized patient data were analyzed monthly using interrupted time series Poisson regression to assess intervention impact on under-five cases and mortalities.

Results

The number of under-five malaria cases tested and treated by VHTs significantly increased from 2209 to 12549 cases. at the same time, the number of cases managed at the health facilities increased from18040 to 35257 cases (P 0.000 CI 1.48-2.57). Under-five mortality due to malaria significantly reduced from 26 to 6 cases per 100000 (P 0.058 CI 0.95-12.8). Seeking treatment within 24 hours of the onset of signs (P=0.00), caregiver’s ability to recognize severe condition (P =0.00), and referral of severe cases to health facilities (P=0.001) improved.

Conclusion

Implementing iCCM significantly enhances health-seeking behaviors among caregivers of children aged 0-59 months.

Recommendations

Authors recommend extending iCCM programs to more districts and communities across Uganda and similar regions to ensure broader access to essential healthcare services for children under five.

SURVEY OF THE STATUS OF THE MEDICINAL PLANT TRADE IN DURBAN, SOUTH AFRICA.

Kuben Naidoo — 2024-09-01

Background

This study aimed to identify important plants and parts of medicinally harvested species traded in the Durban medicinal (muthi) market. A better understanding of the extent of the medicinal plant trade is necessary to enable conservationists and municipal managers to better manage threatened species and to take preventative action to protect this valuable resource.

Methods

Thirty traditional healers from the Durban muthi market in KwaZulu-Natal were interviewed and information was gathered on important plants and parts that were traded. Information was compared to previous data to ascertain whether muthi plants were being exploited.

Results

Approximately 13 species were widely harvested and sold at the Durban muthi market which includes: Siphonochilus aethiopicus, Hypoxis gerrardii, Aloe aristate, Scilla natalensis, Eucomis autumalis, Senecio serratuloides, Warburgia salutaris, Chrysanthemoides monilifera., Artemisia afra, Bidens Pilosa, Aloe ferox, Haworthia limifolia, Ocotea bullata.

These species are sold to cure a wide variety of ailments. The most common plant parts that are traded are the leaves and the stems although other parts are also collected. Single species are preferred rather than a mixture of parts from different plants. Approximately 22% of individuals interviewed indicated that they practiced unsustainable harvesting mainly due to poor harvesting practices and a lack of knowledge of the threatened status of many important species.

Conclusion

Domestication and mass cultivation may be key strategies to redress exploitation and unsustainable harvesting practices.

Recommendation

To address these issues, a multifaceted approach is required, including community engagement, improved regulatory enforcement, and initiatives to promote sustainable harvesting and cultivation practices.

HISTOPATHOLOGICAL AND IMMUNOHISTOCHEMICAL ANALYSIS OF PERIPHERAL NERVE SHEATH TUMORS: A PROSPECTIVE COHORT STUDY.

Anushree C N — 2024-09-01

Background

Peripheral nerve sheath tumors (PNSTs) are rare, heterogeneous soft tissue neoplasms arising from Schwann cells, fibroblasts, and histiocytic or macrophage-like cells. They include benign tumors like schwannomas and neurofibromas and the highly aggressive malignant peripheral nerve sheath tumors (MPNSTs).

Objective

To evaluate the histopathological features and immunohistochemical (IHC) profiles of different PNSTs using S-100, SOX10, and CD56 markers.

Methods

This prospective observational study was conducted from June 2022 to July 2023 at a tertiary care teaching hospital in India. Thirty patients under 65 years with benign or malignant PNSTs were included. Histological features were assessed using light microscopy, and IHC staining was performed with S100, SOX10, and CD56. Data were analyzed using SPSS software, with a significance level set at p<0.05.

Results

Out of 30 cases, 17 (56.7%) were neurofibromas, 12 (40%) were schwannomas, and 1 (3.3%) was an MPNST. The mean age was 38.7 years, with a male-to-female ratio of 16:14. Tumor size varied significantly between types, with MPNST and schwannomas being larger than neurofibromas (P=0.07). Schwannomas frequently exhibited Antoni A and B patterns, Verocay bodies, and hyalinized blood vessels, while neurofibromas showed spindle cells and shredded carrot-type collagen. Immunohistochemistry revealed S100 positivity in 70% of tumors, SOX10 in 86.7%, and CD56 in 43.3%. Schwannomas showed higher S100 and CD56 expression compared to neurofibromas (p<0.05).

Conclusions

The study highlights distinct histological and immunohistochemical features of PNST subtypes, with significant differences in marker expression aiding in differential diagnosis. Larger-scale studies are needed to further validate these findings in diverse populations.

Recommendations
The study recommends using histopathological and immunohistochemical analysis with markers (S100, SOX10, CD56) for accurate PNST diagnosis and emphasizes the need for larger-scale, follow-up studies. It also highlights the importance of routine analysis, multidisciplinary collaboration, comprehensive patient care, and enhanced training for pathologists.

THE EVALUATION OF THE QUALITY OF SANITATION AND STORED WATER FOR DOMESTIC USE IN THE UMLAZI P SECTION INFORMAL SETTLEMENT IN SOUTH AFRICA.

Simangaliso Shangase — 2024-09-01

Background

South Africa is faced with a struggle to manage the supply of water due to growing informal settlements where infrastructure is limited resulting in the contamination of water during collection and storage. The researcher aims to determine the level of knowledge and awareness of water contamination and the safety of water in terms of microbial and chemical content.

Aim: This study aimed to investigate the quality of stored water and the handling of storage vessels for domestic use at the informal settlement of the Umlazi P Section, in the south-west of Durban.

The study objectives:

The objectives of the study were to determine the knowledge and awareness of water contamination using a questionnaire and investigate the exposure of water to microbial agents due to poor hygiene and storage. To test stored water samples for pathogenic organisms as well as compliance with the South African Water Quality Guidelines for domestic use.

Methodology

Data collection entailed the administration of a questionnaire to 269 participants, including the laboratory analysis of water samples collected from water storage containers used in each household.

Results

A positive total coliform count was found among 13 (5%) households in the study of 269 households rendering their drinking water a high risk for domestic use despite only accounting for 5% of the population. The remaining 256 showed to have a negligible exposure to waterborne contamination. The Escherichia coli was not detected making drinking water acceptable in terms of fecal coliform bacteria.

Conclusion

The data collected from the study showed that poor hygienic practices and infrastructure were at the center of water contamination.

Recommendations

The study recommended infrastructure development, hygiene monitoring tools, and cost-effective water treatment products.

THE ROLE OF GEO-ENVIRONMENTAL VARIABLES IN UNDERSTANDING CAUSAL CO-FACTORS OF DISEASES OF UNKNOWN AETIOLOGY AND OTHER ENIGMATIC DISEASES IN AFRICA: A NARRATIVE REVIEW.

Mcmaster Vambe — 2024-09-01

Idiopathic diseases (ID) or diseases of unknown aetiology (DUA) are poorly understood diseases. These diseases are widespread in Africa and other regions of the world. In Africa, we also experience occasional outbreaks in a population, or a cluster of diseases appears for which the causes are unclear. Until now, there has been a lack of literature linking geo-environmental variables with DUA, perhaps due to under- and misdiagnosis of these diseases. However, some of the few existing reports have implicated geo-environmental variables as inducers of a wide spectrum of pathophysiological responses including apoptosis, fibrosis, inflammation, molecular damage, and oxidative tissue injuries. The present review therefore seeks to explore the critical role that these variables may play as co-factors or risk factors in the incidence and progression of a range of DUA in Africa.

A comprehensive online search of journal databases (Google Scholar, ScienceDirect, PubMed, Scopus, and SpringerLink) was mounted to obtain requisite data that would enable tangible deductions to be drawn on the extent to which geo-environmental variables act as co-factors or risk factors in unraveling the mysteries of unknown aetiology; and to demonstrate the importance of including the geo-environmental component in a multi-factor explanation of the disease causative web. The databases were used to obtain reports related to DUA, disease clusters, and geo-environmental variables as disease risk factors in Africa.

Findings from the present study help us understand and interpret unexpected DUA aetiological data, which are prerequisites for developing accurate and effective diagnosis, prevention, and improved management strategies for these diseases.

It became clear from the present study that for us to fully understand the pathogenesis and progression of DUA, healthcare professionals investigating disease clusters should, perhaps team up with Medical Geologists, a research collaboration that rarely exists in most developing countries today.

COMPARISON BETWEEN ROBOTIC ASSISTED LAPAROSCOPIC PYELOPLASTY AND LAPAROSCOPIC PYELOPLASTY AS STANDARD OF CARE FOR PELVI-URETERIC JUNCTION OBSTRUCTION: HOSPITAL-BASED COHORT STUDY.

Kumar Pankaj — 2024-09-01

Introduction

Pelvi-Ureteric Junction Obstruction (PUJO) is a significant clinical difficulty that frequently necessitates surgical treatment. This study examines and contrasts the efficacy of Robotic-Assisted Laparoscopic Pyeloplasty (RALP) and Laparoscopic Pyeloplasty (LP) in treating this problem. The objective is to assess perioperative parameters and patient outcomes to identify the most effective technique for controlling PUJO.

Methods

The study comprised individuals diagnosed with PUJO who were scheduled to undergo surgical intervention. The study included a total of 48 patients, with 32 of them undergoing LP and the remaining 16 getting RALP.

Results

48 patients (32 LP, 16 RALP) aged 10-70 years were studied, with mean ages of 34.28 (LP) and 39.38 (RALP), a male-to-female ratio of 2.2:1, and success rates of 90.63% (LP) and 93.75% (RALP) in transitioning from an obstructed (TYPE 2) to a normal (TYPE 1) O' The RALP group had a longer mean operative time (226.87 ± 32.39 minutes) than the LP group (186.53 ± 33.58 minutes). The RALP group had better patient outcomes, including faster drain removal time (1.69 ± 1.40 days vs. 3.75 ± 1.50 days), shorter hospital stay (2.88 ± 0.88 days vs. 4.06 ± 1.39 days), and somewhat higher success rate (93.75% vs. 90.63%). The success criteria were an obstructed (TYPE 2) to normal (TYPE 1) O'Reilly Curve within 3 months of surgery.

Conclusion

Although RALP has a longer operational time, it has been shown to achieve better results than LP in terms of success rate, duration of drain usage, and total length of hospital stay.

Recommendations

It is recommended that future studies include larger sample sizes and longer follow-up periods to further evaluate the long-term effectiveness of RALP and LP in the management of PUJO.

CADAVERIC STUDY OF ANATOMICAL VARIATION OF SCIATIC NERVE IN POPULATION OF BIHAR AND ITS CLINICAL APPLICATION: A CROSS-SECTIONAL STUDY.

Arti Sinha — 2024-09-01

Background

The sciatic nerve is the largest in the body. It has peroneal and tibial components. The sciatic nerve (SN) leaves the pelvis through the larger sciatic foramen under the Piriformis muscle (PM) to become the tibial nerve. After that, the sciatic nerve crosses between the pelvic ischial tuberosity and the bigger femur trochanter, ending at the popliteal fossa. Aim- Cadaveric research was undertaken to ascertain the differences in the anatomy of the sciatic nerve.

Methods

A cross-sectional investigation was done in 50 equally divided anatomical cadavers of both genders to determine the occurrence of anatomical variations in the SN exit associated with the PM. One of the methods used to acquire the data from the bodies of equal males and females involved dissecting 100 SN. The gluteal regions of the cadavers had to be in ideal condition and have been kept adequately to enable data collection and dissection, which was one criterion for inclusion.

Results

The study included 52% males and 48% females. The sciatic nerve exited inferior to the PM in 90% of limbs, inferiorly and between the PM's fascicles in 6%, and superiorly and between the fascicles in 4%. Unilateral abnormalities were 12% more common on the left side and 12.5% more frequent in females than males. The SN most often branched in the popliteal fossa (54%), followed by the gluteal region (38%) and the middle third of the thigh (8%).

Conclusion

This study highlights the anatomical variations between the SN and PM, which are crucial for clinical and surgical procedures. Awareness of these variations can enhance diagnostic accuracy and surgical outcomes, particularly in the context of SN-related conditions and interventions.

Recommendation

Further large-scale, multicenter studies are recommended to confirm these findings and provide more comprehensive insights into SN anatomical variations' prevalence and clinical implications.

ASSOCIATION OF SERUM VITAMIN D LEVELS WITH SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS- A CASE CONTROL STUDY FROM TERTIARY CARE HOSPITAL.

MEERA ANN JOHN — 2024-09-02

Background-

The Vitamin D deficiency prevalence is increasing and has been linked to numerous chronic and autoimmune conditions. This research aims to establish the relationship among Vitamin D and SLE (Systemic Lupus Erythematosus).

Methodology- A case-control research has been conducted on 42 confirmed SLE patients at the Department of Dermatology and the Department of Medicine at Silchar Medical College and Hospital, along with 50 healthy controls matched for age and gender. All samples underwent immunofluorescence testing for dsDNA, ANCA, ANA, and radioimmunoassay for levels of Vitamin-D.

Results- The average Vitamin-D levels in the SLE cases group have been calculated to be 17.57 with a SD (Standard Deviation) of 4.51. The control group had a mean of 52.23 and an SD of 2.01. A paired test comparing Vitamin-D levels in the cases of SLE as well as control groups showed a p-value of <0.001, indicating statistical significance. Following supplementation of Vitamin-D, the average in the SLE cases group had been 46.82, with an SD of 14.65. A paired sample t-test has been conducted on the data collected before as well as after Vitamin D supplementation in the SLE cases group, giving a p-value of <0.001, indicating statistical significance. There has been no statistically major relation between the various ANA types, with p-values of 0.09 following supplementation and 0.21 prior to it. As a result, statistical insignificance was concluded.

Conclusion- SLE patients have lower levels of Vitamin-D than the healthy individuals. Vitamin-D did not display a major correlation with the different patterns of ANA in patients of SLE.

Keywords: Vitamin D, SLE, Immune responses.

THE QUEST FOR ROBUST ENFORCEMENT OF THE LAW ON TRADEMARKS IN UGANDA TO MAXIMIZE ITS ECONOMIC BENEFITS. A SYSTEMATIC REVIEW.

Mary Nyamwija — 2024-09-01

Introduction

With ever-increasing cases of trademark counterfeiting and infringement globally due to sophisticated technological advancements, it has become imperative for companies to register their trademarks to enjoy the benefits that accrue from their registration. Not only has registration of trademarks benefited trademark owners, but it is also a means of technological transfer between states and a source of government revenue. In this study, the law on trademark enforcement was examined in a quest for robust enforcement mechanisms to maximize the economic benefits.

Purpose:

This study analyzed the law on trademark enforcement in Uganda in a quest for robust enforcement mechanisms to maximize the economic benefits. It involved a probe into the adequacy of the existing legal and institutional framework on trademark enforcement mechanisms since it is a necessity to any given country irrespective of its level of economic development. It not only enhances the protection of the existing trademark rights but also encourages creators and investors to settle in an environment that is conducive to creativity and investment.

Methodology

The study utilized doctrinal research methodology, analyzing data from authoritative sources like statutes, conventions, and judicial decisions, and utilizing content analysis techniques for clear and concise answers.

Results

The study revealed that Uganda has a robust legal and institutional framework for trademark enforcement though with weak penalties. The institutional framework is weak, lacking sufficient funds and trained personnel to effectively deter counterfeiting and infringement.

Conclusion

The empirical literature indicates that Uganda has a robust legal framework for trademark enforcement but the penalties are insufficient to deter counterfeiting and infringement.

Recommendations

The authors recommended the amendment of the Trademarks Act to provide sentences that are deterrent in nature, promotion of public awareness, and training of the required personnel.

RETINOPATHY IN A CASE OF FAMILIAL HYPERCHOLESTEROLEMIA WITH DIABETES- A RARE CASE REPORT.

Pallavi priyadarsani sahu — 2024-09-01

Background

Familial hyperlipidemia is a genetic disorder characterized by high levels of LDL cholesterol and is associated with an increased risk of sudden cardiac death. However, the majority of cases of familial hypercholesterolemia remain undiagnosed or diagnosed at a later stage. Hyperlipidemia per se plays a major role in the pathophysiology of diabetes and its complications. Lipid-lowering agents have a protective effect on the progression of diabetic retinopathy and reduce the risk of diabetic macular oedema. Hence in cases of familial hypercholesterolemia with diabetic retinopathy a combined and aggressive approach is vital for better visual outcome.

Case presentation

In this report, an unusual case of 54 years old male presented to the ophthalmology OPD of Kalinga Institute of Medical Sciences, Bhubaneswar with diabetic retinopathy which was unresponsive to conventional treatment. Upon thorough evaluation, he was diagnosed with a case of familial hypercholesterolemia, and lipid-lowering therapy was initiated along with intravitreal anti-VEGF injections to which he responded better and there was a significant improvement in visual acuity.

Conclusion

This case report emphasizes that all cases of diabetic retinopathy unresponsive to treatment should be thoroughly evaluated. Familial hypercholesterolemia is a grave disease with serious implications. Early diagnosis and timely intervention play a crucial role in improving visual prognosis and life expectancy in such patients.

INFLUENCE OF GUIDANCE AND COUNSELING ORIENTATION SERVICES ON LIFE SKILLS DEVELOPMENT AMONG SELECTED SECONDARY SCHOOLS IN MUDUUMA SUB-COUNTY, MPIGI DISTRICT. A CROSS-SECTIONAL STUDY.

Josephine Zawedde — 2024-09-01

Background

Guidance and counseling services are a set of comprehensive programs and interventions designed to support individuals in their personal, social, educational, and career development. The study aims to assess the Influence of guidance and counseling orientation services on life skills development in secondary schools in Muduuma Sub-county, Mpigi District.

Methodology

A cross-sectional study utilizing both qualitative and quantitative research methods. Qualitative component involved obtaining graphs, and charts. Simple Random Sampling and Purposive Sampling were used.

Results

(56.1%) of the respondents were male while (43.9%) were female. The mean score for participants' belief in the importance of the guidance and counseling Orientation services for personal development was M = 3.98 (SD = 0.981). Participants' satisfaction with the information provided during the guidance and counseling Orientation services yielded a mean score of M = 3.44 (SD = 1.218). Participants indicated a mean score of M = 3.34 (SD = 1.146) for the effectiveness of the guidance and counseling Orientation services in addressing their specific needs and concerns. The guidance and counseling Orientation services were perceived as effective in preparing participants for academic challenges, with a mean score of M = 3.66 (SD = 1.249). The perceived effectiveness of the guidance and counseling Orientation services in enhancing well-being and overall development had a mean score of M = 3.49 (SD = 1.136).

Conclusions

Individuals who held a more favorable view of the Orientation services were also more likely to report higher levels of life skills.

Recommendations

The study recommended that the Ministry of Gender, Labour and Social Development and Ministries of Education should, through District Education Officers (DEOs) and inspectors, encourage head teachers to enhance Orientation services quality and consistency.

FACTORS ASSOCIATED WITH SCHOOL ATTENDANCE AMONG PUPIL REFUGEES IN RWAMWANJA REFUGEE SETTLEMENT IN KAMWENGE DISTRICT; A CROSS-SECTIONAL STUDY.

Nafutari Tuhaisomwe — 2024-09-01

Introduction

The study aimed to investigate the correlation between psychological factors and school attendance among primary school-going refugee pupils in the Rwamwanja refugee settlement, Kamwenge District.

Methodology

A cross-sectional study involving 205 respondents assessed the impact of psychological factors like depression, anxiety, and stress on school attendance using the Depression, Anxiety, and Stress method.

Results

The response rate for the survey was 95.1%, with 195 out of 205 surveys completed, surpassing the recommended 70% threshold for data collection (Amin, 2006). A majority of the survey respondents were female (56%), and most of them (67%) fell within the 13-15 age group. Participants hailed from four different countries, with the Democratic Republic of Congo being the most represented (45%), followed by Rwanda (41%), Burundi (8%), and South Sudan (7%). The analysis of psychological factors indicated average scores of 6.7 for depression, 5.9 for anxiety, and 6.2 for stress, with slight variations between those who attended low and high school.

The data analysis indicated a strong connection between depression and school attendance, as higher depression scores were correlated with increased attendance (cOR = 1.57, 95% CI = 1.31–1.88, p<0.001). Conversely, anxiety and stress did not exhibit a notable correlation with attendance. Through multivariate regression analysis, accounting for sociodemographic variables such as age, sex, and country of origin, it was confirmed that depression remained significantly linked to school attendance (aOR = 1.59, 95% CI = 1.33–1.91, p<0.001), while anxiety and stress still demonstrated no significant impact.

Conclusion

The study concluded that psychological factors are crucial in influencing school attendance among refugee pupils, while socio-demographic factors were insignificant.

Recommendations

The study suggests that interventions focusing on psychological support and addressing socio-economic barriers can improve school attendance among refugee pupils, emphasizing the need for a holistic approach to address their educational needs.

DOES MICRORNA-140 PLAY A ROLE IN THE DEVELOPMENT AND PROGRESSION OF OESOPHAGEAL SQUAMOUS CELL CARCINOMA? - A SYSTEMATIC REVIEW.

Johannes April — 2024-09-01

Background

Oesophageal squamous cell carcinoma (OSCC) is one of the most common and lethal cancers worldwide. Despite advances in treatment, the five-year survival rate for OSCC remains suboptimal. Recent studies reveal that microRNAs (miRNAs) are involved in developing and progressing various types of cancer. Therefore, the modulation of miRNAs could have implications for new OSCC treatments. The purpose of this research was to summarise the published evidence on the impact of miRNA-140 on OSCC development and progression.

Methods

PubMed and Scopus were searched for the relevant literature. Study inclusion criteria were: basic science studies published during 1 June 2014–1 June 2023. Study exclusion criteria were: research without an appropriate analysis, non-English language publications, and grey literature. No study quality assessment tool currently exists for basic science studies, and all studies that met the eligibility criteria were incorporated in the review. The literature search results were analyzed with descriptive statistics (frequencies, percentages) and presented as a narrative synthesis.

Results

Eight papers were included in this review. All included studies were from China, and ECA109 was the most common OSCC cell line used (8 studies, 100%). Findings from studies involving transfection of OSCC cell lines with miRNA-140 mimics suggest that increased levels of miRNA-140 impair OSCC development and progression. Several genes appear to be regulated by miRNA-140 in OSCC development and progression (NFYA, ZEB1 & 2, ErbB4, and NRIP1). Hypoxia reduces miRNA-140 levels, thereby promoting OSCC development and progression. High levels of miRNA-140 were found to confer resistance to platinum-based chemotherapy drugs.

Conclusion

miRNA-140 plays multiple roles in the development and progression of OSCC, including influencing tumorigenesis, apoptosis of tumor cells, genome instability, invasion, metastasis, and chemotherapy resistance.

Recommendation

More research is needed to extend and validate these results, and to develop OSCC therapies aimed at modulating miRNA-140.

THE PREVALENCE OF CARBAPENEM-RESISTANT ENTEROBACTERIACEAE INFECTIONS IN HOSPITALIZED PATIENTS AT INKOSI ALBERT LUTHULI CENTRAL HOSPITAL: A RETROSPECTIVE COHORT STUDY IN DURBAN, SOUTH AFRICA.

Denzel Fuyane — 2024-09-01

Introduction

Carbapenems are antibiotics that fall within the beta-lactam antibiotic family utilized against multidrug-resistant Gram-negative microorganisms due to their broad range of antimicrobial action. However, there has been a rise of carbapenemase-producing organisms that are resistant to carbapenems making the treatment of infections difficult.

Aims and Objectives

The primary aim of this research is to investigate the occurrence of carbapenem-resistant Enterobacteriaceae (CRE) infections among patients receiving hospital care in Durban, South Africa, and also ascertain the predominant organisms causing these infections and evaluate the efficacy of available treatment options.

Methodology

This was a quantitative, retrospective cohort study that investigated carbapenem-resistant Enterobacteriaceae among 534 patients of all genders and age groups. The procedure involved detecting microorganisms in a patient's blood and their susceptibility patterns. Data, spanning from January 1, 2021, to December 31, 2021, was retrospectively collected through medical laboratory reports.

Results

Results showed a total of 21.8% of cases were resistant to at least one of the three carbapenems (ertapenem, imipenem, or meropenem), with Klebsiella spp. This is the most prevalent (62.7%), followed by Enterobacter spp.(18.9%) and Escherichia coli (10.8%). Furthermore, the results showed that there was no significant difference between ertapenem and imipenem in terms of their efficacy against CRE. However, meropenem demonstrated the maximum effectiveness against CRE.

Conclusion

Klebsiella spp. Emerged as the predominant microorganisms, followed by Enterobacter spp. and Escherichia coli. Evaluating the effectiveness of antimicrobial drugs revealed that meropenem consistently demonstrated superior efficacy, particularly against Klebsiella spp. andEnterobacter spp., with imipenem also showing notable effectiveness, especially against Escherichia coli.

Recommendations

These include optimizing antimicrobial use through careful prescribing, providing education and training for healthcare personnel, expanding resistance surveillance, and fostering collaboration and data sharing among healthcare facilities to address the local and global challenges of CRE infections.

AN ANALYTICAL STUDY ON PARENTERAL AND ORAL IRON THERAPY IN THE TREATMENT OF MODERATE DEGREE OF IRON DEFICIENCY ANEMIA IN PREGNANCY.

Almeta Mary P N — 2024-09-01

Background

Anemia, especially caused by insufficient iron and acute blood loss, is prevalent in pregnancy and the postpartum period. Iron requirements rise significantly during pregnancy to support both maternal and fetal needs.

Aim: To evaluate the efficacy of Intravenous Iron and oral iron therapy in moderate degree of iron deficiency anemia in the second and third trimesters of pregnant women attending Antenatal OPD or labor room in Silchar Medical College and Hospital.

Methods

An Observational Cross-Sectional Study was done on 250 pregnant women attending Antenatal OPD and patients admitted to “The Department of Obstetrics and Gynecology of Silchar Medical College and Hospital” with hemoglobin 7-9.9 g/dl. 250 Population selected randomly, separated into 2 groups with 125 each. The first group of patients who were given IVIS. The second group of people received oral ferrous sulfate tablets twice daily. The patients were asked to report after 4 weeks for estimation of Hb.

Results

Baseline Hb of a group receiving oral iron therapy and parenteral iron therapy was 8.07 ±0.70 and 8.05±0.74 respectively. After 4 weeks of therapy, a mean difference of 0.61±0.53 was found in the oral therapy group and 1.44±0.62 in parenteral therapy where the P value is <0.001. The final rise in hemoglobin in the parenteral iron therapy group was found to be 9.47±0.97 and 8.69±0.86 in the oral receiving group.

Conclusion

Parenteral iron therapy was found to be an effective, safe, and alternative therapy to oral iron therapy in the treatment management of moderate degree of iron deficiency anemia in second and third-trimester pregnant women.

Recommendation

Further studies with newer IV iron formulations to overcome the issue of affordability and the risks of infusion-related complications and increase the sample size.

HYSTEROSCOPY AS DIAGNOSTIC PROCEDURE IN ABNORMAL UTERINE BLEEDING AND ITS CORRELATION WITH HISTOPATHOLOGY: A PROSPECTIVE COHORT STUDY.

Jaya Kumari — 2024-09-01

Background

The study aimed to correlate hysteroscopic findings with histopathological findings in women presenting with abnormal uterine bleeding and to study the accuracy of hysteroscopy in the evaluation of abnormal uterine bleeding

Methods

A prospective study was conducted in the Department of Gynecology at IGIMS, Patna from November 2021 to October 2023. A total of 58 patients who came with a history of abnormal uterine bleeding during this period were selected for the study. The hysteroscopic examination was done in all these patients post-menstrually, whenever possible, except in those cases where menstrual cycles were grossly irregular or patients came with continuous bleeding per vaginum. Endometrial biopsies were taken in the same sitting and sent for histopathological examination. Then correlation between findings on hysteroscopy and histopathological examination was done.

Results

Hysteroscopy revealed that 48.27% of patients had normal findings, while 51.73% had abnormalities. The most common abnormal hysteroscopic finding was hyperplasia (20.69%), followed by endometrial polyp (10.35%), myoma/myomatous polyp (6.86%), and endometrial carcinoma (5.18%). The histopathological examination showed 53.57% of patients had normal findings, with proliferative endometrium being the most common normal finding. Among abnormal histopathological findings, hyperplasia (16.07%) and endometrial polyp (8.93%) were prevalent. The accuracy of hysteroscopy in diagnosing normal endometrium, atrophic endometrium, and endometrial carcinoma was high, with a sensitivity of 100%.

Conclusions

Hysteroscopy allows direct visualization and biopsy of abnormal uterine bleeding. It can accurately diagnose normal and abnormal situations, although it may not detect hyperplasia as well as histology. The study emphasizes combining diagnostic methods to improve accuracy.

Recommendations

Whenever possible, hysteroscopy should be used to diagnose abnormal uterine bleeding. It permits direct visualization of the uterine interior. Diagnostic accuracy is improved with hysteroscopic biopsies. Hysteroscopic-histopathological correlations need further study to improve diagnostic methods.

BREASTFEEDING MOTHER’S KNOWLEDGE OF NEONATAL HYGIENE AT MUKONO GENERAL HOSPITAL IN MUKONO MUNICIPALITY: A CROSS-SECTIONAL STUDY.

Abdul wahabu Kakooza — 2024-09-01

Background

Knowledge refers to the information, breastfeeding mothers have on how and when to clean breast-feeding bottles, the breast during the breast-feeding process, the neonates and their clothing, and how to keep the neonate’s surroundings. The study aims to describe the knowledge of breastfeeding mothers on the hygiene of their neonates.

Methodology

A quantitative descriptive cross-sectional study involving only breast-feeding mothers with babies less than 28 days of life, both those who have gone through normal delivery and caesarian section irrespective of their age, tribe, and education level. Data was analyzed using SPSS version 24.0. A simple random method was used to select 296 respondents.

Results

93.3% (28/30) of the respondents managed to at least attend one or more than one level of education. 70.0 % (21/30) of the mothers were assisted by midwives, 10.0% (3/30) were assisted by doctors, 6.7% (2/30) were assisted by traditional birth attendants, and 13.3% (4/30) were assisted by other people in the community while delivering their current babies. About 53.3 % (16/30) of the mothers knew that the baby’s cord should be cleaned with saline water, 40.0% reported bathing their neonates with soapy water and dry, majority 56.7% (12/30) knew that the mother’s breast should first be wiped before breastfeeding. Concerning the prevention of diseases in babies, 53.3% of mothers reported that it is important to dry the baby after bathing.

Conclusion

The majority of the respondents had the right knowledge about Neonatal hygiene but the proportion of those who did not have relevant adequate knowledge is a threat to the general health of the children

Recommendations

Health workers need to bridge the gap between the community and health workers to encourage mothers to seek healthcare freely without fear.

COMPARING THE EFFECTIVENESS OF ORAL ISOTRETINOIN AND CYPROTERONE COMPOUND IN ACNE TREATMENT AMONG ADULT FEMALES WITH CUTANEOUS HYPERANDROGENISM: A PROSPECTIVE STUDY.

Smita Rani Samal — 2024-09-01

Background:

Acne is a complex illness caused by androgenic stimulation of the sebaceous glands. As a result, combined oral contraceptives (COCs) including anti-androgenic progestogens are good candidates for acne treatment. The purpose of this study is to compare the effectiveness of oral isotretinoin and cyproterone compound in the treatment of nodulocystic acne, in adult females with signs of cutaneous hyperandrogenism.

Materials and Methods:

Thirty female patients with SAHA syndrome were randomly assigned into two groups of fifteen each. Group A got cyproterone compound (35 μg ethinyl estradiol and 2mg cyproterone acetate) starting day 5 of the menstrual cycle. Group B got isotretinoin at a dose of 0.5mg/kg daily. All recruited patients got topical benzoyl peroxide 3.5% gel regularly. SPSS was used to do statistical analysis. P-values < 0.05 were considered significant.

Results:

Despite a consistent reduction in ASI score in both groups, according to both physician (P = 0.63) and patient (P = 0.25) assessment, the cyproterone compound was not statistically more successful than traditional treatment of nodulocystic acne at the end of the trial. Patients in both groups reported minor and acceptable side effects, except in two cases.

Conclusion:

This study found that cyproterone compound is not more effective than isotretinoin in the treatment of nodulocystic acne in patients with SAHA syndrome or cutaneous hyperandrogenism. Indeed, additional research is needed to assess the efficacy of cyproterone molecules (independent of testosterone level) and isotretinoin in people with just nodulocystic acne.

Recommendation:

Oral isotretinoin is recommended for treating nodulocystic acne in patients with cutaneous hyperandrogenism due to its comparable efficacy to cyproterone compound and established effectiveness in reducing acne lesions. Further research should compare these treatments regardless of androgen levels in nodulocystic acne patients.

FACTORS ASSOCIATED WITH VOLUNTARY BLOOD DONATION AMONG LIRA UNIVERSITY STUDENTS. CROSS-SECTIONAL STUDY.

Julius Kayizzi — 2024-09-04

Abstract

According to UBTS, the total units of blood collected increased from 131,226 in 2007/2008 to 274,308 in 2018/19 but still less than the WHO recommendation of 1% of Uganda's population. To save the lives of patients due to accidents, obstetric and gynecological bleedings, cancers, and severe anemia with low blood volumes. This study will assess the factors associated with voluntary blood donation among Lira University students.

Methodology

A cross-sectional study using mixed methods of data collection was carried out among Lira University students. A sample size of 311 was calculated using the Yamane formula and recruited using a stratified random sampling technique and 5 key informants for qualitative data. SPSS version 20 was used for data entry and analysis. Univariate analysis was used to determine frequencies, proportions, and ranges. At bivariate analysis, a bivariate logistic regression was performed between the independent variables and dependent variable at a 95% confidence interval, Crude odds ratios (COR) were used as measures of association. Variables with P ≤0.05 were considered significant associations with the dependent variable.

Results

Their mean age was 23.7 years. The study population comprised approximately 40.5% blood donors of which 23.8% were blood donors. The majority of the participants (79.8%) had positive attitudes towards blood donation and the non-donors (61.7%) had never got a chance to donate. The majority of the respondents (59.5%) were male.

Conclusion

High awareness, influencing positive attitude, and regular blood donation drives should be prioritized if we are to achieve 1% donors of the population as recommended by WHO.

Recommendation

The Uganda Blood Transfusion Service should do more talk shows via announcements in public gatherings, and mouth-to-mouth engagements with the students, and handle first-time donors well to recruit and retain donors.

PHARMACISTS’ PERCEPTIONS ON FACTORS CONTRIBUTING TO STOCK-OUTS OF ESSENTIAL MEDICINES AT A TERTIARY HOSPITAL IN SOUTH AFRICA: A QUALITATIVE CROSS-SECTIONAL STUDY.

Tiisetso Chuene — 2024-09-01

Background

Essential medicines are one of the vital components in the provision of health services and their availability plays a crucial role in the reduction of mortality and morbidity associated with disease burden. Despite the committed action plans and several initiatives by the South African National Department of Health, there are ongoing medicine stock-outs at public health facilities across the country and this affects thousands of people. To explore this problem, this study explored pharmacists’ perceptions about factors contributing to stock-outs of essential medicines at a tertiary hospital in South Africa.

Methods

A qualitative cross-sectional study was conducted among pharmacists at a tertiary hospital in South Africa. Participants were purposively sampled and due to data saturation, 8 pharmacists participated in the study. Semi-structured, face-to-face interviews were used to collect data. Interviews were recorded and transcribed verbatim and analyzed using Tesch’s open coding process. Trustworthiness of data was measured through transferability, confirmability, credibility, and dependability.

Results

The participants included five procurement pharmacists, one stock controller pharmacist, one receiving pharmacist, and one contract pharmacist. All participants held a Bachelor of Pharmacy degree. Shortage of resources coupled with poor procurement processes affected the availability of medicines and hampered service delivery. Inconsistent deliveries from the Provincial Pharmaceutical Depot to hospitals and clinics as well as poor communication between stakeholders were also perceived as factors contributing to stock-outs of medicines.

Conclusions

Medicines supply chain management within the hospital has several gaps and shortcomings. The hospital should invest in strengthening the procurement and supply chain processes to ensure the availability of medicines.

Recommendations

To improve the availability of essential medicines, pharmacists and supply chain officers should receive continuous training on procurement processes. Formal communication forums to address challenges encountered in the provision of essential medicines should be established and sustained.

INFLUENCE OF CONFLICT MANAGEMENT COUNSELING ON MARRIAGE STABILITY OF COUPLES IN PENTECOSTAL CHURCHES IN KAMPALA, UGANDA. A CROSS-SECTIONAL STUDY.

Grace Nyamahunge Kyokuhaire — 2024-09-01

Background

African Traditional Societies systematically initiated boys and girls which prepared them for adulthood experiences like marriage. The study aims to assess the Influence of conflict management counseling on marriage stability of couples in Pentecostal Churches in Kampala, Uganda.

Methodology

A cross-sectional research design using quantitative approaches to collect data from different categories of respondents at a single point in time. The study employed a descriptive correlation study to determine the relationship between pre-marital counseling and the marriage stability of couples.

Results

Based on the aggregate mean, conflict management scored a very high aggregate mean of 4.65 and a standard deviation of 0.67. This means that pre-marital counseling in terms of conflict resolution counseling is provided to couples in Pentecostal churches at a very high level. Conflict management counseling has a weak, positive, and significant influence on the marital stability of couples in a Pentecostal church in Kampala City, r = 0.440** which means that conflict management counseling had a positive, weak, and significant influence on marital stability. When the provision of conflict management counseling increases by one unit, the marital stability of couples in Pentecostal churches also changes positively or increases by one unit.However, at a weak level. The fact that the P-value was lower than the significance level (0.000 < 0.05) when r2 was calculated, 0.193 (100), means that conflict management counseling influences positively the marital stability of couples in Pentecostal church in Kampala, Uganda at 19.3%.

Conclusion

Conflict management counseling had a weak, positive, and significant influence on the marital stability of couples in the Pentecostal church in Kampala

Recommendations

Churches should continue sensitizing the public on the benefits of pre-marital counseling as the church remains the biggest institution that provides these services to couples.

ULTRASOUND FINDINGS OF BREAST MASSES WITH HISTOPATHOLOGICAL CORRELATION: A PROSPECTIVE STUDY.

Pushpa Ranjan — 2024-09-01

Background

Breast carcinoma is the most frequent cancer and cause of death in women worldwide and in India. Early breast cancer diagnosis and therapy reduce mortality. Breast lesions are first imaged using ultrasound due of its availability, radiation-free nature, and good cost-benefit ratio. Ultrasound is preferred over mammography for diagnosing breast lesions in thick breasts and during pregnancy and lactation.

Aim

To differentiate breast lesions into benign and malignant lesions. Correlate benign and malignant lesions with histopathological findings.

Methodology

This was a prospective study. 100 patients were evaluated by ultrasound and lesions were categorized according to the Breast Imaging Reporting and Data System, Sonographic findings were correlated with histopathological findings, and statistical analysis was done.

Results

The age distribution of the patients ranged from 15 to 75 years, with a mean age of approximately 45 years. The study found that 68% of the patients had benign lesions and 32% had malignant lesions according to ultrasound. Histopathological examination confirmed that 63 patients had benign lesions, while 37 had malignant lesions. There were 2 false-positive cases (radial scars) and 5 false-negative cases (malignant phyllodes, metastatic lesions, and papillary carcinoma). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of ultrasound in diagnosing breast lesions were found to be 85.7%, 96.9%, 93.7%, 92.6%, and 93%, respectively. The most common benign lesions were fibroadenomas, followed by fibrocystic disease. Among malignant lesions, infiltrative ductal carcinoma was the most common.

Conclusions

Results demonstrated a positive correlation between the sonographic findings and histopathological diagnoses of the breast masses.

Recommendation

Ultrasound should be utilized as a primary imaging modality for evaluating breast lesions, particularly in resource-limited settings and for patients with dense breast tissue, to facilitate early and accurate differentiation between benign and malignant lesions, thereby improving patient management and outcomes.

FUNCTIONAL OUTCOME OF LATERAL APPROACH FOR TOTAL HIP REPLACEMENT: A COHORT STUDY.

Manish Kumar — 2024-09-01

Background

The majority of the cases undergoing total hip replacements have favorable outcomes in a significant number of cases the outcomes are not as per the requirement. The outcome of the surgery depends on the approach taken to perform Total hip replacement (THR). This study aims to determine the effect of the lateral approach in performing total hip replacement on the outcome of the surgery.

Method

This study considered the retrospective data as well as the prospective data of the patients undergoing total hip replacement surgery. The patients underwent THR by lateral modified approach. Harris hip score was used for functional evaluation of the hip bone and the Trendelenburg test was performed for abductor muscle strength.

Results

Among the 100 patients included in the study, the mean age was 55.55 years (SD ± 7.2), with 45% being male and 55% female. THR was performed on the left side in 63% of patients and on the right side in 37%. The most common indication for surgery was a fracture of the neck of the femur (66%). Postoperatively, 39% of patients had excellent outcomes, 55% had good outcomes, and 6% had fair outcomes based on the Harris hip score. No patients were reported to have poor outcomes. Complications included heterotrophic ossification in 5% of patients and superficial infections in 4% of patients.

Conclusion

The modified lateral approach provides a better visualization of the hip, the dissection of the muscles is not involved and the retention of the posterior capsule prevents it from dislocation and provides extra stability.

Recommendation

A lateral modified approach should be considered for performing total hip replacement surgery irrespective of the indication as the complications reported in this study are comparatively lesser than the other approaches used.

PAIN MANAGEMENT OF PATIENTS WITH CHRONIC RENAL FAILURE: A CASE STUDY OF PATIENTS IN A PRIVATE RENAL FACILITY IN KWAZULU-NATAL.

Shamanie Shamanie — 2024-09-01

Background

Pain management in chronic kidney disease patients is extremely complicated. An estimated 82% of patients with chronic kidney disease have moderate to severe pain. The purpose of this study was to investigate the types, frequency, and severity of pain experienced by patients with chronic kidney disease, as well as to suggest strategies that patients and staff could use to manage the patient's pain.

Methods

At the Durban Kidney and Dialysis Centre, 60 patients were given questionnaires to assess their level of pain severity and management control. The participants were subjected to inclusion and exclusion criteria. The patient's medical records were examined. The research was carried out between September 2017 and March 2018. For analysis, relevant statistical methods were used. Patients were all on hemodialysis and averaged 57 years old.

Results

According to the findings of this study, most patients reported pain symptoms during dialysis, and 72.3% of the pain experienced was moderate to severe, indicating that pain is a major symptom burden in this patient population.

Conclusion

Both patients and staff would benefit from learning about different types of pain management therapies (both pharmacological and non-pharmacological), as well as the long-term consequences of pain going undiagnosed and untreated.

Recommendations

The results show that pain is a major symptom burden but the use of analgesics is under-prescribed. Pain management, interventions, and strategies should be a research priority because pain is a valid and considerable health concern in the increasing CKD patient population.