East and Central African Journal of Surgery最新文献

{"title":"Barriers and factors affecting personal protective equipment usage in St. Mary’s Hospital Lacor in Northern Uganda","authors":"T. Okello, Kansime Kansime, J. Odora, J. Apio, I. Pecorella","doi":"10.4314/ECAJS.V22I1.8","DOIUrl":"https://doi.org/10.4314/ECAJS.V22I1.8","url":null,"abstract":"Background: To protect health workers (HCWs) from risky occupation exposure, CDC developed the universal precautions (Ups) including Personal Protective Equipment (PPEs). However compliance to it by HCWs has remained poor even in high-risk clinical situation. The objective of this study was to identify and describe the factors that influence a HCWs’ decision to wear PPEs and the barriers that exist in preventing their use Methods: A cross-sectional survey was carried out in the St. Mary’s Hospital Lacor in all the wards to collected quantitative information as well as qualitative and observational data on PPE use Results: Out of the total 59 respondents, 2% do not know the purpose of PPE, 23.7% do not know how to don and doff PPEs, 13.6% do not use PPE even when indicated and 10% are not using an appropriate PPE. The main barriers relates to poor fitting and weak domestic gloves, few of aprons, frequent stock out and inadequate PPE as well as lack of training in PPE Conclusion: This study provides a baseline for measuring the effectiveness of interventions to improve compliance.","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129644577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pin tract infection after uniplanar external fixation of open fractures at a national, teaching and referral hospital","authors":"R. Mohammed, E. Atinga, F. C. Sitati, E. Gakuya","doi":"10.4314/ecajs.v22i1.6","DOIUrl":"https://doi.org/10.4314/ecajs.v22i1.6","url":null,"abstract":"Background: Pin tract infection is the most common complication of external fixation accounting for 43% of complications. The presence of a pin tract infection leads to subsequent pin loosening and fixation failure. It also delays conversion of an external fixator to internal fixation until clearance of the infection is achieved. The incidence of pin tract infections in our setting is not known. This study was aimed at determining the incidence and microbe profile of pin tract infection in patients who have undergone uniplanar external fixation following open fractures at Kenyatta National Hospital. Methods: Consecutive sampling of patients who had undergone uniplanar external fixation at Kenyatta National Hospital (KNH) was done between September 2016 and December 2016. 73 patients were recruited. Data concerning presence of pin tract infection was collected. Patients with discharging sinuses had a culture and sensitivity done while those with major pin tract infection had immediate x-rays done to rule out radiological changes. Results: Incidence of pin tract infection was 87.7% (64 of 73 patients). Staphylococcus aureus (30.2%) and coagulase negative staphylococci (16.3%) were the commonest causative organisms. Conclusion: The incidence of pin tract infection after uniplanar external fixation is high. Better surgical technique and pin-site care is recommended. Staphylococcus aureus is the leading cause of pin site infection.","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131094137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A one-year retrospective study on the pattern of death found at autopsy at Forensic Pathology Department, Menelik II Hospital in Addis Ababa, Ethiopia","authors":"E. E. Solano, Y. O. Mayedo, M. Seyoumk","doi":"10.4314/ECAJS.V22I1.13","DOIUrl":"https://doi.org/10.4314/ECAJS.V22I1.13","url":null,"abstract":"Background: The main objectives of this study were to determine the magnitude, manner and modalities of natural and unnatural deaths among deaths brought to the Forensic Pathology Department. Menelik II Hospital, for post mortem examination and secondary to find the remedial measures that may have influence on the incidence of preventable deaths. Methods: This retrospective study was conducted in the Department of Forensic Pathology at Menelik II Hospital, Addis Ababa, Ethiopia. From January 1 st , 2014 to December 31 st , 2014. The Study material was collected from Forensic Pathology Department of Menelik II Hospital, postmortem reports. A total of 4206 cases of deaths were done postmortem examination during the one-year study period. All these cases were grouped according to age, gender, manners and modalities of natural and unnatural deaths. The data collected was analyzed. Results: Out of total 4206 cases, the male to female ratio 3:1. The age group most commonly involved was 16-30 years (41,5%) followed by 31-55 years (38,3%). Only 7.8% were in the under 15years age group. The commonest mode of death in all age groups put together was accident in 1615 (38.4%) followed by natural death in 1156 (27.5%), homicidal deaths accounted for 698 (16.6%) followed by suicide in 508 (12%). In 229 (5.4%) of the cases the manner of death remained undetermined. Among 698 homicidal deaths, blunt weapon injury accounted for 61.4% and bullet injury were in 15.4%. Among the accidental deaths, road traffic injuries were 1092 (67.6%), followed by fall accident in 170 (10.5%). Hanging was the preferred modality of suicide (88.4%), followed by poisoning 51 (10%). Natural death accounted for 1190 (27.5%) and cardiac disease was the most predominant 453 (38%), followed by respiratory disease 240 (20.2%). Conclusion: Our study concludes that unnatural deaths exceeded enormously the natural deaths. Accident was the most dominant manner of death among the unnatural deaths. Road Traffic Accident was the commonest modality among accidental deaths. Fatalities caused by blunt weapon injuries were the commonest mode of homicide; whereas hanging was the preferred modality of suicide. Cardiovascular diseases were the leading  causes of natural deaths. Most deaths are preventable, so concerned bodies are expected to take action of prevention and increase the public awareness of the real situation and the causes of both natural and unnatural deaths and subsequently make an impact in the decrement of death rate in our societies.","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"127 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125853844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prostatic Cyst with Bladder Outlet Obstruction Symptoms. Case Report","authors":"A. Tefera, M. E. S. Marcillán","doi":"10.4314/ecajs.v22i1.17","DOIUrl":"https://doi.org/10.4314/ecajs.v22i1.17","url":null,"abstract":"The prostatic cysts are uncommon lesions usually detected incidentally. The incidence is reported as less than 1% most often occurs as small & asymptomatic lesions located medially in the gland, when they get a big size causes different lower urinary tract symptoms. Only 5% are symptomatic. The symptoms depend on the size & location of the lesion. Minimal access surgery (endoscopic) is recommended for its treatment. We present a case with the diagnosis of Prostatic cyst at the bladder neck treated with transurethral resection of the lesion. Histopathological investigation revealed benign prostatic cyst. At six months of follow up the patient remains free of symptoms. Keywords: Prostatic Cyst, Bladder outlet obstruction, transrectal ultrasound (TRUS), Transurethral Resection of the Prostate (TURP)","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125505315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical site infection among patients undergone orthopaedic surgery at Muhimbili Orthopaedic Institute, Dar es Salaam, Tanzania","authors":"A. Kisibo, V. Ndume, A. Semiono, E. Mika, A. Sariah, J. Protas, H. Landolin","doi":"10.4314/ecajs.v22i1.7","DOIUrl":"https://doi.org/10.4314/ecajs.v22i1.7","url":null,"abstract":"Background: The aim of this study was to determine prevalence and factors associated with surgical site infection at Muhimbili Orthopedic Institute. \u0000Method: This was a cross-sectional study conducted at Muhimbili Orthopaedic Institute (MOI) in Dar es Salaam, from August, 2015 to October 2015. Convenience sampling technique was used to recruit postoperative patients for this study. Standardized questionnaires were used to obtain demographic, social, and clinical information from respondents. Determination of the relationship between outcome and exposure variables was done using chi square test. Multivariate logistic regression was used to measure the association after controlling for confounders. Odds ratio corresponding to 95% confidence interval with a p value of ≤ 0.05 was considered significant. \u0000Results: Out of 300 study participants 75(25.0%) had surgical site infection. This was highly determined by more than 2 hours length of surgical procedure (AOR= 1.4; 95%CI 1.14-6.69; P value=0.05), none prophylactic use of antibiotics (AOR= 3.4; 95%CI 1.6-7.78; P value=0.03), more than one week stay before surgery (AOR=3.3; 95%CI 2.24-3.34; P value =0.00). \u0000Conclusion: The overall prevalence of surgical site infection at Muhimbili Orthopedic Institute was high. This was associated with more than 2 hours length of surgery, lack of prophylaxis use, and pre-operative hospital stay. \u0000https://dx.doi.org/10.4314/ecajs.v22i1.7 \u0000  \u0000This work is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source (including a link to the formal publication), provide a link to the Creative Commons license, and indicate if changes were made.","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130384030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of primary mucocutaneous histoplasmosis presenting as a non-healing and disfiguring upper lip ulcer","authors":"David Muchuweti, R. Makunike-Mutasa, Edwin G. Muguti, G. Nyandoro","doi":"10.4314/ecajs.v22i1.14","DOIUrl":"https://doi.org/10.4314/ecajs.v22i1.14","url":null,"abstract":"BA 27-year-old female patient presented with a non-healing disfiguring upper lip ulcer for 10 months. At the time of presentation 50% of her lip had been eroded. She had had several consultations and had been on several antibiotic courses without improvement. Histopathological evaluation of an incisional biopsy specimen revealed that she had histoplasmosis. This prompted an HIV test, as this disease is common in immunocompromised patients. Once the diagnosis was clinched she was commenced on Itraconazole with complete resolution of the ulcer. Antiretroviral therapy was also initiated. Keywords: HIV, Histoplasmosis, Histoplasma Capsulatum , mucocutaneous, ulcer, immunocompromised, Itraconazole","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"87 23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126302511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A cross section study to correlate fine needle aspiration cytology and histopathology in the diagnosis of parotid tumoursat four major hospitals in Zambia","authors":"S. Kazuma, L. Mucheleng'anga, R. Zulu, H. Hanna","doi":"10.4314/ECAJS.V22I1.12","DOIUrl":"https://doi.org/10.4314/ECAJS.V22I1.12","url":null,"abstract":"Background: Needle Aspiration Cytology (FNAC) is cheap, simple, quick, minimally invasive procedure that is widely used for preoperative diagnosis of Parotid tumours. Methods: Twenty five patients were prospectively studied over a two-year period at four major hospitals in Zambia. FNAC was done using a 10cc syringe and 20-22G needles for sample collection and specimen staining was done with papanicolaou stain. Histopathology was assessed with Haematoxylin and Eosin (HE positive and negative predictive values of 95.7% and 100% respectively and a likelihood ratio of 3. All Parotid tumours were neoplastic with 76% benign and 24% malignant tumours on histopathology. FNAC accurately diagnosed 68% benign and 20% malignant tumours. Conclusion: This study found that FNAC correlates well with histopathology in the diagnosis of parotid tumours. FNAC is useful in the preoperative assessment of Parotid tumours as it provides a preoperative diagnosis that influences management by either avoiding surgery (inflammatory lesion) and limiting the extent of surgery for benign and malignant Parotid tumours.","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"302 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121464687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilataral peripheral gangrene following malaria parasitaemia at Butare University Hospital - a case report","authors":"Ahmed Kiswezi Kazigo","doi":"10.4314/ECAJS.V22I1.15","DOIUrl":"https://doi.org/10.4314/ECAJS.V22I1.15","url":null,"abstract":"In many parts of the East African region malaria is endemic, while in other parts it is hyper-endemic. While all the four species of the plasmodium parasite (vivax, ovale, malaria& falciparum), are prevalent in E Africa, it is the Plasmodium falciparum that is most aggressive and rampant. In this region malaria is still by far among the top three disease burdens accounting for high morbidity and mortality rates across all age groups. Whereas there are many complications associated with severe malaria, peripheral gangrene leading to amputation of limbs is so rare and unbelievable. The following is a summarized report of two cases with bilateral peripheral gangrene seen at Butare University Teaching Hospital, following severe malaria between August and October 2015. In both cases several investigations were carried out to rule out other possible causes of limb ischemia and gangrene. Keywords: Peripheral gangrene; Plasmodium falciparum parasitaemia; Amputation","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114239160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of an accelerated Ponseti protocol for the treatment of talipesequinovarus in Nigeria","authors":"G. Ibraheem, O. Adegbehingbe, O. Babalola, S. Agaja, B. Ahmed, A. Olawepo, M. Medubi","doi":"10.4314/ECAJS.V22I1.4","DOIUrl":"https://doi.org/10.4314/ECAJS.V22I1.4","url":null,"abstract":"Background: The commonest congenital musculoskeletal deformity worldwide is talipes equino varus (CTEV). Of the various treatment methods available, the most acceptable treatment currently for CTEV worldwide is serial manipulation and casting using the Ponseti technique. The Ponseti technique consists of weekly manipulation and casting for an average of six to eight weeks followed by bracing of the feet till school age. Some studies have shown evidence that more frequent casts may have similar outcomes with weekly casts using the Ponseti method. This study compared the efficacy of management of idiopathic CTEV using an accelerated protocol of twice weekly casts, with the standard weekly Ponseti protocol. Methods: The study was a randomized case control study with a group of patients undergoing an accelerated casting protocol involving twice weekly casts compared with another group who went through the normal weekly Ponseti protocol. Results: A total of 45 feet in 28 patients were studied. The study showed a significantly shorter treatment period in the accelerated protocol (39 days) compared with the standard protocol (52 days); with no significant increase in the number of casts needed for treatment. Conclusions: A twice weekly Ponseti casting protocol enables completion of the casting period earlier than the standard Ponseti method. Keywords: Talipes equinovarus; Ponseti treatment; Accelerated Ponseti Protocol; Serial Casting","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123019926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Exceptional Case of Spontaneous Fistulization of an Intrahepatic Biliary Cyst in to the Colon, Operated Tikur Anbessa Specialized Hospital, Ethiopia - A Case Report","authors":"N. Seyoum, F. Getachew","doi":"10.4314/ECAJS.V22I1.16","DOIUrl":"https://doi.org/10.4314/ECAJS.V22I1.16","url":null,"abstract":"Biliary cysts are congenital cystic dilatations of the extrahepatic and/or intrahepatic biliary tree. Intrahepatic cysts constitute less than 1% of the biliary cysts. Complications of these cysts include cholangitis, livercirrhosis, liver abscess andcholangiocarcinoma. In intrahepatic cysts the complications can also be related to compression of adjacent viscera, infection of the cyst's contents or perforation of the cyst. Spontaneous fistulization of a biliary cyst into hollow abdominal organsis a rare complication. We report an exceptionalcase in whom an intrahepatic biliary cyst spontaneouslyfistulized into hepatic flexure of the colon. Patient presented to our hospital with 02 months history of abdominal pain, weight loss, and 02 weeks of jaundice. Thecommunication with colon was diagnosed by CT scan before surgery. But, surgical intervention was required for the complete diagnosis. Postoperatively, patientrecovery was uneventful. \u0000https://dx.doi.org/10.4314/ecajs.v22i1.16 \u0000  \u0000This work is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source (including a link to the formal publication), provide a link to the Creative Commons license, and indicate if changes were made.","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130624309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}