East and Central African Journal of Surgery最新文献

{"title":"A 10 years trend of peptic ulcer disease and other gastrointestinal disorders in northern Uganda","authors":"T. R. Okello, D. Ogwang, I. Pecorella","doi":"10.4314/ECAJS.V21I2.2","DOIUrl":"https://doi.org/10.4314/ECAJS.V21I2.2","url":null,"abstract":"Background: The changing trend of GI disorders has not been expounded in our setting, there is need to examine the extent to which major endoscopically diagnosed upper GI disorders have changed in the last 10 years (2005 to 2015). Methods: This was a retrospective study in which endoscopically diagnosed GI disorders of Jan-Jun 2005 were compared with 2015 (10 years) for the same period Results: In the 10 years (2005 to 2015), the prevalence of peptic ulcer disease (PUD) reduced from 9.6% to 2.9% (P value 0.000), followed by esophageal varices from 10.3% to 4.0%, and duodenitis from 3.2% to 0.7% respectively. Gastritis increased from 18.4% to 48.2% (P value 0.000), followed by cancer esophagus from 3.2% to 5.1%. Conclusion: As the prevalence of PUD decreases in our community, gastritis increases hence patients with upper GI symptoms tend to suffer gastritis thus clinicians should focus on treating gastritis and eradication of Helicobacter pylori. Keywords: Peptic ulcer disease, Gastritis, GI Disorders","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"199 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124466724","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":"Pattern and treatment outcome of patients with achalasia cardia after Modified Heller’s Myotomy: experience from Ethiopia","authors":"M. Tesfaye, A. Ali, A. Bekele, A. Worku","doi":"10.4314/ecajs.v21i2.4","DOIUrl":"https://doi.org/10.4314/ecajs.v21i2.4","url":null,"abstract":"Background: Although achalasia condition occurs in males and females with equal frequency, there are studies reporting that there is a male predominance even in Ethiopia. There appears to be striking international variations with significant differences between countries with respect to prevalence, occurrence in different sex and age groups and clinical features. The main objective of this study was to determine the pattern of clinical presentation and demographic characteristics and to assess the surgical treatment outcome of patients with achalasia. Methods: This was a 5-year retrospective review of medical records and theatre operation register notes of patients operated for achalasia of cardia  at Tikur Anbessa Specialized Hospital, Addis Ababa. Selected socio- demographic variables, clinical presentations, radiologic imaging, post-operative course and final outcome were recorded on a structured format. Data was entered, cleaned and edited using EPI info version 3.5.1 for windows and analyzed using SPSS version 15 for windows. Frequencies, percentages, Mann-Whitney U test and Chi-square test were applied to describe and compare the difference between sex, age and dysphagia scores. Wilcoxon Signed Ranks test was used to evaluate the surgical treatment outcome after patients underwent Modified Heller’s Myotomy (MHM). Results: A total of 46 patients’ records that were operated for achalasia were reviewed, of whom 56.5% were males, 52.2% were of younger age (52.2%) with a mean of 26.4 years (Range: 14 – 65 years). Thirty eight (82.6%) patients suffered from grade 3-4 dysphagia. Higher dysphagia score, with no significant statistical difference, was predominantly seen among the young (87.5%) and female (95%) patients. Severity of symptoms of dysphagia was significantly reduced after Modified Heller’s Myotomy (P<0.0001) Conclusion: Slight predominance of male sex and younger age group was found among patients operated for achalasia. Modified Heller’s Myotomy was found to be effective in alleviating symptoms of achalasia.","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116795511","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":"Spontaneous pneumothorax in a neonate with TEF and double oesophageal atresia. A case report","authors":"N. Tihitena, F. Temesgen","doi":"10.4314/ECAJS.V21I2.9","DOIUrl":"https://doi.org/10.4314/ECAJS.V21I2.9","url":null,"abstract":"Symptomatic Spontaneous pneumothorax is uncommon disease scenario in term neonates. But pneumothorax can occur in neonates who had CPR or are on mechanical ventilator for different causes of respiratory distress. Congenital double esophageal atresia is a very rare type of esophageal atresia. If only single membranous atresia it can be isolated esophageal membranous atresia or with trachea-esophageal fistula. This type of atresia was not mentioned in gross or Vogt classification. Previously, only a few cases with an obstructing web had been reported and also multiple esophageal atresias. But there is no any documented case report with TEF & multiple esophageal atresia. The choices of treatment vary from ligation of the fistula with excision of the membrane by esophagotomy and/or gastrotomy, thoraco-abdominal approach and end to end anastomoses of the proximal & distal atresia. Here we present a case of a neonate who had developed respiratory distress since birth with a cause of tension spontaneous pneumothorax and managed by a chest tube and also diagnosed to have oesophageal atresia with distal tracheo-esophageal fistula on further evaluation and showing additional distal membranous oesophageal atresia during the thoracotomy. And he was managed accordingly. Keywords: Spontaneous Pneumothorax, esophageal atresia, Membranous atresia, TEF","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131489525","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":"Role of magnetic resonance imaging in assigning sex in an ambiguous genitalia child: a case report","authors":"F. Lyimo, F. Minja, V. Sensa","doi":"10.4314/ECAJS.V21I2.15","DOIUrl":"https://doi.org/10.4314/ECAJS.V21I2.15","url":null,"abstract":"A three years old child with ambiguous genitalia since birth had been referred to Muhimbili National Hospital (MNH),a tertiary referral hospital, in order to be evaluated and assigned sex correctly. Due to periphery location of the referring center, social and economic constraints, the child was not presented earlier. Physical examinations were done followed by imaging studies. Magnetic resonance imaging (MRI) performed, showed female sex which was confirmed by karyotyping. In conclusion, use of MRI plays apotential key role in sex assignment of ambiguous genitalia children.","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125719208","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":"Colostomy for anorectal malformation in a tertiary center in Nigeria","authors":"E. Aiwanlehi, O. Murphy, A. Abraham","doi":"10.4314/ECAJS.V21I2.7","DOIUrl":"https://doi.org/10.4314/ECAJS.V21I2.7","url":null,"abstract":"Background: Anorectal malformations constitute a wide spectrum of congenital anorectal abnormalities ranging from absent anus to anal membranes and fistulae. It is one major indication for the creation of colostomy in early neonatal life. This study was aimed at o describe and highlight the place of colostomy in the management of anorectal malformations. This article also reviews the issues relating to the choice of colostomy in anorectal malformation and common complications. Methods:  The study was a prospective study carried put at a tertiary medical centre in Nigeria. It involved patients with a anaorectal malformation requiring the creation of colostomy. Results: A total of 19 neonates with anorectal malformation was seen over the period. The male to female ratio was approximately 1:2 with a female preponderance. Rectovestibular fistula was the commonest indication in females while recto-urethral fistula was commonest indication in males. Elective colostomy accounted for 78.9%. Conclusion: Anorectal malformation is the commonest indication for the creation of colostomy; this is closely followed by hircshsprungs disease. It is usually a part of the staged repair of anorectal malformation. The use of colostomy is acceptable as important in the initial management of patients with anorectal malformation. This affords the neonates the ability to feed and evacuate from the stoma. Complications are common and not life-threatening. Keywords: Colostomy, congenital, anorectal","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"361 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115923349","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 2-Years Description of Traumatic Brain Injury Admissions in Tikur Anbessa Specialized Hospital","authors":"H. Biluts, B. Hailemichael","doi":"10.4314/ECAJS.V21I2.13","DOIUrl":"https://doi.org/10.4314/ECAJS.V21I2.13","url":null,"abstract":"Background: Traumatic brain injury (TBI) is a nondegenerative, noncongenital insult to the brain from an external mechanical force, possibly leading to permanent or temporary impairment of cognitive, physical, and psychosocial functions, with an associated diminished or altered state of consciousness.This study was aimed at describing the pattern of TBI at TASH during the two- years period. Methods: This is a hospital based retrospective study of patients with traumatic brain injury admitted to TASH in the period between September 2011 and September 2013. Patients’ demographic data, type and, mechanism of injury, Glasgow Coma Scale, length of hospital stays, complications and outcomes were recorded in a pre-formed questionnaire. Data entry and analysis carried out using SPSS version 20.0. The association between categorical variables was calculated using Chi-square test. Results: A total of 201 patients were included in the present study. Male-to-female ratio being 12.4:1 with and mean age 36.1. ± SD 16.2 years. Fight accidents were the major contributor of neurotrauma admissions and operations (53.2%). Seventy-One (35.3%) patients had depressed skull fracture followed by acute epidural hematoma seen in 51(25.4 %). Of the 165 operations performed for patients with head injury, 53 (26.4%) were craniotomy and evacuation of hematoma; 55 (27.4%) elevation of the depressed skull fracture, senior resident involvement as a first surgeon accounted for 79.1%.  83.1 % of the admitted patients’ have shown improvement on the time of discharge and 15.4% died while under neurosurgical care and 70.1% the patients had follow- up least once Conclusion: The preponderance of young patients with head injury involved in a fight injury and motor vehicle accidents has a large impact on society and on the hospital workload Keywords: Traumatic Brain Injury, Tikur Anbessa Hospital","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125488194","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":"Risk factors associated with oesophageal malignancy among Ethiopian patients: a case control study","authors":"A. Shewaye, A. Seme","doi":"10.4314/ECAJS.V21I2.5","DOIUrl":"https://doi.org/10.4314/ECAJS.V21I2.5","url":null,"abstract":"Background: The incidence of Oesophageal cancer is increasing worldwide. Genetics, obesity, smoking, and alcohol consumption are among the known risk factors for this deadly cancer.  Although Oesophageal cancer was noted to be common in Arsi and Bale regions of Ethiopia, the risk factors predisposing to this cancer have not yet been identified or reported to the best of our knowledge. The main objective of this study was to identify the risk factors associated with oesophageal cancer among the study population. Methods: A case-control study where volunteer adult patients aged 18 and above with diagnosis of oesophageal cancer (cases) and non-esophageal cancer patients (controls) were included was conducted in 2015 in Addis Ababa. The patients with dysphagia were referred to Adera Medical and Gastroenterology center from various regions of the country for Endoscopy. Patient data on socio-demographic and socio-economic variables, family history of similar illness and dietary history were collected using a pre specified questionnaire Patients’ clinical features, Endoscopic diagnosis and histology reports were retrieved from patients chart. Data were entered and analyzed using SPSS version 20 software. Frequency tables and figures were used to describe cases and controls. Odds ratio and 95% confidence interval were used to establish the strength and the significance of the association between independent and outcome (development of Esophageal Cancer) variables, respectively. Results: A total of 215 patients were diagnosed to have esophageal cancer at the center during April 1,2014 through March 31, 2015. A total of 115 (55%)of cases were females with a mean age of 50 years while 96 (45%) were males with a mean age of 55 years. Most of the patients were Muslim farmers from rural Arsi and Bale regions of the country where consumption of hot wheat porridge is very common as staple diet. Majority had mid esophageal mass lesion followed by distal and proximal lesions, in 45%, 34%, and 21% of the patients, respectively. Most (88%) of the patients had Esophageal squamous cell cancer (SCC) while the rest 12% had adenocarcinoma on histologic diagnosis. Conclusion: Oesophageal cancer was noted to be more common among the farmers from Arsi and Bale regions of the country. Consumption of hot porridge for long time was noted to be significantly associated with having oesophageal cancer among the farmers from the two regions possibly due to the thermal effect, which could lead to dysplasia and later cancer. Keywords: Oesophageal cancer, Risk factors, Ethiopia","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129012864","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":"Knowledge evaluation and educating diabetic patients on self foot care at diabetic out patients` clinic, Muhimbili National Hospital","authors":"H. Wella, J. Protas","doi":"10.4314/ECAJS.V21I2.20","DOIUrl":"https://doi.org/10.4314/ECAJS.V21I2.20","url":null,"abstract":"Background: Diabetic foot infection, ulcers and amputations remain very common in diabetics worldwide and extremely affect patients’ quality of life. The objective of this survey was to assess the level of knowledge and educate diabetic patients on self foot care at diabetic outpatient clinic at Muhimbili National Hospital Methods: A cross-sectional survey of diabetic patients was conducted at Muhimbili National Hospital at the diabetic outpatient clinic from mid September to mid November 2013 inclusive. Patients who voluntarily consented and determined fit for the study were recruited. Data on subjects` demographic characteristics and status of baseline and post discussion sessions self foot care knowledge were collected and analysed. Results: A total of 115 patients were studied. Females were the majority 60.9% (70) and the mean age was 33.5(SD± 1.8) years, age ranged from 11years to 65 years. A considerable number of patients had poor self foot care knowledge 54(47.0%).Young patients (<30 years) had better knowledge about self foot care. There was a parallel increase in knowledge level of foot care with increasing level of education (P value =0.000). There was a significant improvement in self foot care knowledge level score among participants after foot care education sessions as the mean knowledge score prior education and post education were 5.7(SD±3.6) and 15.6(SD2±.5) respectively (P value = 0.000). Conclusion and recommendation: A considerable number of diabetic patients have poor self foot care knowledge and the level of knowledge on self foot care improved prominently following foot care education session.  Therefore there is a need for establishment and strengthening effective foot care education for diabetic patients at clinics in order to prevent and reduce the incidence of foot infection, ulceration and amputations. Keywords: Diabetic patients, Self foot care knowledge, Self foot care education, Diabetic foot complications","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115497180","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":"Pattern and outcome of elderly admissions into the Intensive Care Unit (ICU) of a low resource tertiary hospital","authors":"A. Owojuyigbe, A. Adenekan, R. Babalola, A. Adetoye, S. Olateju, U. O. Akonoghrere","doi":"10.4314/ECAJS.V21I2.6","DOIUrl":"https://doi.org/10.4314/ECAJS.V21I2.6","url":null,"abstract":"Background: Globally, the population of the elderly is increasing and the greatest increase is occurring in the developing and middle income countries because of falling death rate and high birth rate. The ageing of the population in developing countries may result in increasing requirement for health care facilities including ICU care for the elderly. This study was aimed at assessing the pattern and outcome of elderly patients’ admissions into the ICU of our hospital and identifies the determinants of outcome. Method:  This was a retrospective study covering a 5 year period (January1 st 2010 to 31 st December 2014) in the ICU of a sub-Saharan tertiary hospital. Data was obtained from the review of ICU admission records over this period. We included as elderly patients aged 65years and above. Results: During the period under review, 90 cases were identified but only 62 cases were available for review (68.9%). There were 40 males and 22 females with ages ranging between 65 and 92years. Surgical admissions accounted for 75.8% of admissions while medical admissions were 24.2%.  The overall ICU mortality in the elderly was 58.1%.The major predictors of mortality were: need for endotracheal intubation (p=0.001), mechanical ventilation (p=0.001), vasopressor (p=0.001), electrolyte derangement (p=0.001), sepsis on admission (p=0.001), shock on admission (p=0.001). Conclusion: Elderly patients admitted into the ICU are a population with an increased risk of mortality. The predictors of high risk of death are sepsis on admission, septic shock, need for vasopressor, endotracheal intubation and or mechanical ventilation and the presence of electrolyte derangement. The outcome of this study calls for a need to pay more attention to this rapidly expanding group of the population. Keywords: Elderly, Admission, ICU, low resource hospital","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129614427","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":"Factors affecting the organization and management of emergency mass casualty events public health institutions: Lazio Region ARES experience","authors":"T. Makumbi, G. Bertazzoni","doi":"10.4314/ECAJS.V21I2.10","DOIUrl":"https://doi.org/10.4314/ECAJS.V21I2.10","url":null,"abstract":"Background: Mass Casualty Events also referred to as Disasters, are those occurrences causing damage, ecological disruption, loss of human life or destruction of health and health services on a scale sufficient to warrant an extraordinary response from outside the affected community or area. Methods: The study was carried out in Rome between 2008/2009 while based at Sapienza University Departmento Esperimentale at Policlinico emergency hospital. Data was collected by interviews from key professional informants in the organization and management of disasters in Lazio region referred to as Azienda Regionale di Emergenza Sanitaria (ARES) using interview guides, questionnaires and focused group discussions. Additional data on identified sites and installations was collected by the observational survey method (transect  visits/walks) around Rome installations that the authority considers prone to disasters including tourist parks and public parks, hotels, stadia, train stations and Vaticans. Observations were analyzed qualitatively. This study was approved through the institutional review board of Rome University through the Departimento Medicina Esperimentale and Departmento d’Emergenza Accetazzione (DEA).  Results: Disaster Management was found to be prioritized always and effectively represented for ready intervention by prepared pre- organized multi- agency teams at every site visited. These on- scene project squads comprised a representation from the armed forces, police, fire department, medical and ambulance service all under a unified command of leadership with a specified job description. Factors identified were: Political will, human resource planning, appropriate communication utilization, time management and sufficient preparedness for disasters in Region Lazio. Conclusion: Disaster Management is a necessity since liability to disasters is open to all to humanity around the world. Factors affecting disaster management enable an efficient fore casting and prompt response to avoid worsening that chaotic situation upon disaster intervention in any affected community. Keywords: Disasters, Calamity, Catastrophes, Mass emergency Casualty events, Organization","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125261505","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}