EAS Journal of Medicine and Surgery最新文献

{"title":"Trends in Indications, Intraoperative Findings and Outcome of Relaparotomy after Caesarean Section at a Tertiary Hospital in Eastern Zone Tanzania; Five Years’ Review","authors":"Musa Kakiziba, Tom Kakumbi, Isaac Rugemalila, Stephen Mihungo, Philip Muhochi, Ntoli Mwakibete, Sara Mkono, Peter Kunambi, Furaha August, P. Wangwe, Ali Said","doi":"10.36349/easjms.2024.v06i07.003","DOIUrl":"https://doi.org/10.36349/easjms.2024.v06i07.003","url":null,"abstract":"Background: The increased incidences of caesarean section rate is associated with a number of post-operative complications; one being re-laparotomy which is considered a maternal near-miss. The purpose of a re-laparotomy is to manage complications of the previous surgery such as unsecured hemostasis, manage intraabdominal infection, repairing of iatrogenic damaged organs like bowels, ureters and bladder, relieve intestinal obstruction and maintain intestinal continuity or to carry out delayed curative surgery. In general, second surgery increases not only the morbidity but also the risk of maternal mortality. Methods: The study was cross sectional, conducted at the Department of Obstetrics and Gynecology in MNH. It involved review of medical records of all women who necessitated re-laparotomy following Caesarean Section (CS) that was performed either at MNH or from referring health facilities during the study period. Results: There were 193 relaparotomy cases, 98% were referrals. Atonic uterus and sepsis (septic uterus, pelvic abscess and pus in peritoneal cavity) as intraoperative finding showed statistical significance in our study. Atonic uterus for those women who underwent relaparotomy due to post-partum hemorrhage (PPH) increase from 1(7.7%) in 2017 to 6(14%) in 2021 with an average increase of 2.31 % every year. Number of cases for sepsis (combination of septic uterus, pelvic abscess and pus in peritoneal cavity) was significant decreasing every year from 22(37.3%) in 2018 to 7(16.3%) 2021with an average decrease of 3.15% every year from 2017 to 2021. The number of cases who had hysterectomy as one of the post-operative outcomes was statistically significant decreasing from 44(74.6%) to 26(60.5%) over the study period with an average decrease of 5.89% every year from 2018 to 2021. Conclusion: The most frequent indication for relaparotomy after CS was a burst abdomen. For the women who had relaparotomy due to uncontrollable PPH, the main intraoperative .......","PeriodicalId":507417,"journal":{"name":"EAS Journal of Medicine and Surgery","volume":" 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141675895","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":"Liver Clot: The Rare Post-Extraction Complication Striking within 72 Hours","authors":"Piyush Dua, Lengam Tabing, Debleena Sarkar, Muskan Grover, Aviral Verma","doi":"10.36349/easjms.2024.v06i07.002","DOIUrl":"https://doi.org/10.36349/easjms.2024.v06i07.002","url":null,"abstract":"Oral and Maxillofacial Surgeons may encounter complications while performing major as well as minor surgical procedures, either intraoperatively or postoperatively. Bleeding after a dental extraction is a frequent complication following surgery. This article discusses an uncommon postoperative complication characterized by prolonged bleeding and the formation of a \"liver clot\" coagulum, observed 72 hours following the extraction of root stump in an elderly female during a follow-up visit.","PeriodicalId":507417,"journal":{"name":"EAS Journal of Medicine and Surgery","volume":"71 S316","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141683117","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":"Influence of Health Literacy on Cancer Prognosis; A Case Report of Childhood Fibrosarcoma","authors":"Isabela Magesa, Seth Jotham, S. Mlaga","doi":"10.36349/easjms.2024.v06i07.001","DOIUrl":"https://doi.org/10.36349/easjms.2024.v06i07.001","url":null,"abstract":"Background: Cancer is an emerging global public health threat in low- and middle-income countries, and poor health literacy has resulted into poor outcomes due to late diagnosis and care. Fibrosarcoma is among the rare - highly malignant tumor with poor prognosis when diagnosed late. Its survival rate is estimated to be around 20% in Low- and middle-income countries (LMICs) as compared to more than 80% in high-income countries. Case presentation: Herein we report a case of 14-years-old boy with a relapsing mass in his left hand. It was initially thought to be benign and it was resected, but later confirmed by tissue histopathological examination to be an infantile fibrosarcoma. Limb salvage surgery was not possible only to end up with forearm amputation. Discussion: Health literacy of healthcare workers and community at large has an influence on outcome of cancer treatments, it reduces incidences of late diagnoses as primary physicians will have an increased suspicion for malignancies whenever they encounter such a mass especially in children. Most of fibrosarcoma are deemed unresectable at diagnosis hence necessitating a multimodal approach including preoperative cytoreductive therapy and surgery. Conclusion: Fibrosarcoma has good prognosis when diagnosed early. To prevent unfavorable cancer-related outcomes and to have good oncological outcomes; health literacy on soft tissue sarcomas should be promoted especially at the community level as it is the case in other types of cancers.","PeriodicalId":507417,"journal":{"name":"EAS Journal of Medicine and Surgery","volume":"195 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141682010","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":"Acute Intestinal Intussusception in Children at Somine Dolo Hospital in Mopti","authors":"M. K, Dembélé Ks, D. S, Coulibaly D, M. A, C. B, Coulibaly Os, K. S, D. I, D. K, Balile Bh","doi":"10.36349/easjms.2024.v06i05.001","DOIUrl":"https://doi.org/10.36349/easjms.2024.v06i05.001","url":null,"abstract":"Introduction: It is defined as the penetration of an intestinal segment and its meso into the lumen of the distal segment by a glove-like turning mechanism (invagination sausage) whose perpetuation results in obstruction of the intestinal lumen and the intestinal necrosis. Acute intestinal intussusception (IIA) or intussusception is the most common cause of intestinal obstruction in infants. IIA is primary or idiopathic in 90% and mainly affects infants between 2 months and 2 years with a peak frequency between 6 and 9 months. Objectives: To study acute intestinal intussusception in children aged 0 to 15 years in the general surgery department of the “SOMINE DOLO” hospital in Mopti. Method: This was a retrospective, descriptive study which took place from January 2017 to September 2020 in the general surgery department of the Sominé Dolo Hospital in Mopti. Result: During the study period, 1244 children were operated on including 32 cases of IIA, representing a frequency of 2.57% of surgical interventions. The male gender was in the majority (62.5%) with a sex ratio of 1.7. The average consultation time was 6.2 ± 4.3 days. Infants were the majority in 68.8% of cases and the main reason for consultation was abdominal pain (78.1%). The average treatment time was 2.9 hours. The ileocecocolic form was more frequent in 50% cases. Manual disinvagination was most often performed in 75% and the postoperative course was simple in 56.3%. Conclusion: AII is a common condition in our structure. It mainly affects infants and boys. Patients consult late but early treatment reduces mortality.","PeriodicalId":507417,"journal":{"name":"EAS Journal of Medicine and Surgery","volume":" 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141000265","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 Infections: Frequency, Risk Factors and Management in the General Surgery Department of the Mamou Regional Hospital","authors":"D. Amadou, D. S, K. Mariame, Kaba, M., Konate Lancinet, Camara Emile, Barry, T. I, T. Aboubacar","doi":"10.36349/easjms.2024.v06i02.002","DOIUrl":"https://doi.org/10.36349/easjms.2024.v06i02.002","url":null,"abstract":"Introduction: The general definition of surgical site infections (SSI) includes any infection at the operated site, occurring within 30 days following the procedure or within one year if there has been placement of an implant or 'a prosthesis. Surgical site infection (SSI) represents one of the main healthcare-associated infections (HAI). Material and Methods: The general surgery department of the Mamou Regional Hospital (HRM) served as the setting for our study. This was a prospective, descriptive study lasting 6 months, from May 1 to October 31, 2016. The aim of the study was to help improve surgical site infections in the department. Results: We collected 175 interventions, 27 of which developed an SSI, or 15.42%. The average age of our patients was 33.52 years with extremes of 7 and 82 years, the most affected age group was between 11 and 20 years, i.e. a frequency of 29.63%. Patients in the dirty surgery class were the most represented with a rate of 44.44%. Deep surgical site infection was the most common with 48.15%. Conclusion: Infection of the surgical site remains one of the postoperative complications most feared by surgeons because it ruins the success of the surgical procedure and compromises the functional or vital prognosis. We found an average ISO frequency compared to the African series.","PeriodicalId":507417,"journal":{"name":"EAS Journal of Medicine and Surgery","volume":"38 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139886696","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":"DLPL Sphincter Saving Laser Surgery for Complex Anal Fistula - A Gold Standard Procedure. Study of 40 Cases","authors":"Dr. Kazi Sohel Iqbal, Tanvir Ahmed Shohan, A. M. K. Hasan, Raka Mustary Khan, Tamanna Ahmed, Md. Jamaluddin Md. Jamaluddin, Riditta Mustika, Sourov Hossain","doi":"10.36349/easjms.2024.v06i02.001","DOIUrl":"https://doi.org/10.36349/easjms.2024.v06i02.001","url":null,"abstract":"Introduction: Complex anal fistula (CAF) is a complex condition to treat because of the possibility of recurrence and impoverished continence. DLPL (Distal laser proximal ligation), is a novel approach to treating difficult anal fistula that involves suturing the proximal portion of the fistula tract close to the internal opening and using a diode laser to close the distal part of the fistula tract. This study aimed to evaluate the clinical efficacy and safety of DLPL Sphincter Saving Laser Surgery for Complex Anal Fistula. Aim of the study: The aim of this study was to evaluate the clinical efficacy and safety of DLPL Sphincter Saving Laser Surgery for Complex Anal Fistula - A Gold Standard Procedure in a study of 40 cases. Methods: This study was a prospective observational study that investigated the outcomes of DLPL (Distal Laser Proximal Ligation) for patients with complex anal fistula. The patients met clinical diagnosis of complex anal fistula according to the Parks classification, age of 10 years or more, and failure of previous conservative or surgical treatments. The patients were followed up at 3 and 6 months after the surgery, and assessed using fistulogram, endo anal ultrasound, MRI. Result: The study enrolled 40 patients (35 males and 5 females) with mean age being 31.25 years. 31 (77.50%) patients had non-specified histopathology. 2 (5.00%) patients had Chron’s disease, 2 (5.00%) patients had F.B Granuloma, and 5 (12.50%) patients had Tuberculosis. The patients were assessed using fistulogram, endo anal ultrasound, MRI. After 6 months, the patients were followed up and 38 (95.00%) patients had no recurrence, only 2 (5.00%) patients had recurrence. Conclusion: The results showed high success rate and low complication rate of DLPL for complex anal fistula. Therefore, this study concluded that DLPL is a safe and effective sphincter-saving technique for complex anal fistula, and that it may be considered as a gold standard procedure for this challenging c","PeriodicalId":507417,"journal":{"name":"EAS Journal of Medicine and Surgery","volume":"81 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139828852","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 Infections: Frequency, Risk Factors and Management in the General Surgery Department of the Mamou Regional Hospital","authors":"D. Amadou, D. S, K. Mariame, Kaba, M., Konate Lancinet, Camara Emile, Barry, T. I, T. Aboubacar","doi":"10.36349/easjms.2024.v06i02.002","DOIUrl":"https://doi.org/10.36349/easjms.2024.v06i02.002","url":null,"abstract":"Introduction: The general definition of surgical site infections (SSI) includes any infection at the operated site, occurring within 30 days following the procedure or within one year if there has been placement of an implant or 'a prosthesis. Surgical site infection (SSI) represents one of the main healthcare-associated infections (HAI). Material and Methods: The general surgery department of the Mamou Regional Hospital (HRM) served as the setting for our study. This was a prospective, descriptive study lasting 6 months, from May 1 to October 31, 2016. The aim of the study was to help improve surgical site infections in the department. Results: We collected 175 interventions, 27 of which developed an SSI, or 15.42%. The average age of our patients was 33.52 years with extremes of 7 and 82 years, the most affected age group was between 11 and 20 years, i.e. a frequency of 29.63%. Patients in the dirty surgery class were the most represented with a rate of 44.44%. Deep surgical site infection was the most common with 48.15%. Conclusion: Infection of the surgical site remains one of the postoperative complications most feared by surgeons because it ruins the success of the surgical procedure and compromises the functional or vital prognosis. We found an average ISO frequency compared to the African series.","PeriodicalId":507417,"journal":{"name":"EAS Journal of Medicine and Surgery","volume":"11 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139826752","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":"Clinical Profile, Treatment Modalities and Outcomes among Patients with Upper Aero-Digestive Tract Emergencies at Bugando Medical Centre, Mwanza, Tanzania","authors":"Cecilia Protas, Olivia Kimaro, Alex Donasiano, Samson E Kichiba","doi":"10.36349/easjms.2023.v05i10.008","DOIUrl":"https://doi.org/10.36349/easjms.2023.v05i10.008","url":null,"abstract":"Background: Emergencies of the upper aero-digestive tract emergencies (UADTEs) are common in our setting, can be life threatening, challenging to the otolaryngologists and yet there is a paucity of clinical studies on these emergencies. This study aimed to determine the clinical profile, treatment modalities and outcomes of upper aero- digestive tract emergencies at Bugando Medical Centre (BMC), Mwanza, Tanzania. Methods: Between January and May 2019, a cross sectional study involving patients presenting with a clinical diagnosis of UADTEs was conducted at BMC. Data on socio-demography, clinical presentation, duration of symptoms, time interval between admission and intervention, type of intervention, postoperative complications and length of hospital stay were collected in questionnaire designed for the study. Ethical clearance was obtained from the Joint CUHAS/BMC Research, Ethics and Review Committee. Results: Of 487 ENT emergencies seen during study period, 128 (26.3%) patients had UADTEs. Male outnumbered females by a ratio of 1.5: 1. Their median age at presentation was 5 [range, 2-40] years. The major causes of UADTEs were foreign body ingestion, head & neck tumors and foreign body aspiration and cut-throat injuries that were seen in 56(43.8%), 33(25.8%), 25(19.5%) and (3.9%) respectively. The most frequent presentations were dysphagia 81(63.3%), difficulty in breathing 61(47.7%) and odynophagia 56(43.8). Poor outcome following esophagoscopy was associated with younger age (0-17 years) (p=0.02), prolonged duration to treatment (p=0.04) and low blood oxygen saturation (SPO2) (p=0.04). In addition, delayed duration to treatment (p=0.01) and foreign body ingestion (p=0.001) were significantly associated with prolonged hospital stay. Conclusion: At Bugando Medical Centre, UADTE pose a serious burden and challenge. Peripheral hospitals should be equipped with trained health workers and basic equipment to resuscitate and manage these patients before they are ......","PeriodicalId":507417,"journal":{"name":"EAS Journal of Medicine and Surgery","volume":"10 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139213035","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":"Placenta Accreta Spectrum in Unscarred Uterus: A Case Report in a Tertiary Facility","authors":"Godluck Mlay, Onesmo Augustino, Godfrey Kaizilege, Kahibi Bernard, Kalokosilla Mhando, Oscar Ottoman, Mohamed Muyeka, R. Kiritta, A. Kihunrwa","doi":"10.36349/easjms.2023.v05i10.010","DOIUrl":"https://doi.org/10.36349/easjms.2023.v05i10.010","url":null,"abstract":"Background: Placenta accreta spectrum (PAS) is a broad term that includes placenta accreta, placenta increta, and placenta percreta. The major risk factor is a scarred uterus commonly as a result of prior cesarean delivery, myomectomy, or uterine instrumentation. We report a case of placenta increta in the absence of identifiable risk factors. Case presentation: A 22-year-old, para 2 living 2, presented with postpartum hemorrhage due to retained placenta post vaginal delivery at a gestational age of 38 weeks and 4 days, manual removal of placenta was attempted general anesthesia without success; necessitating explorative laparotomy where the placenta was found deeply invading into the myometrium. Intractable bleeding necessitated supracervical hysterectomy. Histopathological results later revealed placenta increta. Conclusion: PAS in an unscarred uterus in the absence of other identifiable risk factors is quite uncommon; however, carries high maternal morbidity and mortality. This case serves as an eye opener on the need to evaluate for radiological features of PAS during antenatal visits even in low-risk group.","PeriodicalId":507417,"journal":{"name":"EAS Journal of Medicine and Surgery","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139213185","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":"Stage at Presentation and Factors Associated with Late Diagnosis of Head and Neck Malignancies at Bugando Medical Center, Mwanza, Tanzania","authors":"Alex Donasiano, Cecilia Protas, Peter Rambau, Beda Likonda","doi":"10.36349/easjms.2023.v05i10.006","DOIUrl":"https://doi.org/10.36349/easjms.2023.v05i10.006","url":null,"abstract":"Background: Head and neck malignancies are often diagnosed at a late stage in sub-Saharan Africa including Tanzania, thus resulting in a generally poor prognosis. The reason for this sad experience is not known. This study was undertaken in our local setting, to describe the stage at presentation and factors associated with late diagnosis of head and neck malignancies at Bugando Medical Centre, Mwanza, Tanzania. Methods: This was analytical cross sectional study involving all patients confirmed to have head and neck malignances at Bugando Medical Center from February to June 2019. Results: Out of 60 patients enrolled in the study, 35(58.3%) were males and 25(41.7%) were female making a male to female of 1.4:1. The mean age was 56 [range, 12-89] years. Majority of patients, 44(73.3%) presented with advanced (late) stage of the disease, with stage III been the most prevalent stage accounting for 49.3% of cases. Only one (1.7%) patient had stage I tumor involving the oral cavity. Distant metastasis was documented in only 16.7% of cases. The oropharynx was the most common anatomical site for head and neck malignancies (n=18, 30%). Patients with oropharyngeal malignancies were associated with late-stage presentation whereas those with laryngeal malignancies were associated with early-stage presentation. Patient-related factors such as rural residence (p-value = 0.048) and use of local herbs (p-value = 0.001) were significantly associated with advanced (late) tumor stage at presentation. The level of health care facility first visited (p-value = 0.876) and the number of referrals (p-value =0.579) were not significantly associated with late stage at presentation. Conclusion: This study demonstrated that the head and neck malignancies are not uncommon at Bugando Medical Center and the majority of patients present late with advanced stage cancer. Therefore, increasing awareness among rural residence regarding head and neck malignancies and their symptoms, and training ......","PeriodicalId":507417,"journal":{"name":"EAS Journal of Medicine and Surgery","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139237007","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}