Incidence of Cleft Deformities among Neonates in Mulago National Referral hospital, Uganda

Background: Cleft deformities (lip and palate) have been reported to be the most common congenital craniofacial anomaly in several settings. In Uganda, though two previous studies were conducted to determine the incidence of cleft lip and palate, the estimates obtained from those studies may not be precise given the study settings. This study was undertaken to establish the incidence of cleft deformities and provide data to plan forbetter management of these deformities. The Setting was the labour wards at Mulago National Referral Hospital, Kampala Uganda. The main objective of this study was to determine the incidence of cleft deformities (lip and palate) among neonates born between February 2008 and February 2009Methods: Cross-sectional study of all neonates who were born in Mulago Hospital. We examined all new born children and determined the presence or absence of cleft lip and/palate. Socio-demographic data and risk factors such as smoking, alcohol consumption, infections and exposure to drugs such as anti-convulsants and steroids were collected.Results: Among twelve thousands seven hundred and thirteen neonates born in Mulago hospital between February 2008 and February 2009, seventeen neonates presented with cleft lip with or without cleft palate: this gives an incidence of 1.34 per 1000 newborns or 134 in 100,000 newborns.Conclusion: The incidence of neonatal cleft deformities seems to lie between what was previously reported in 1961 and 1996 in Uganda

Surgical reconstruction of Northern Uganda war victims.

Background: Aid groups estimate that since 1086 when the war conflicts in Northern Uganda started, over 30,000 people have died in the insurgency and over 20,000 people have remained maimed. Arising from the conflict, innocent civilians have had their limbs, lips, eyes, ears, noses, breasts, fingers and toes cut off.Patients and Methods: Between 2004 and 2005, a total of 34 victims of the Northern Uganda war, underwent reconstructive surgery. Most of the patients were treated from the local hospitals of Lira, Gulu and Kitgum.Results: Between 2004 and 2006, the Plastic Surgery team of Mulago hospital rehabilitated 34 victims of the northern war. Of these 23 were females and 11 were males. Most of these people had suffered severe disfigurements which necessitated multiple staged reconstructive procedures on them. The majority of the reconstructive operations were on the lips despite the fact that many victims had also suffered from mutilation of other body parts.Conclusion: Effects of the insurgency on individuals, families and communities included: Increased burden on health care delivery Hospital capacity overwhelmed with few doctors and nurses available Increased number of traumatised people Increased number of war causalities Population maimed with body parts cut off Increased dependency of local population on hand outs from government and relief agencies.Hence the need to strive for peaceful resolution of the Northern Uganda war conflict

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

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

Mapping the medical outcomes study HIV health survey (MOS-HIV) to the EuroQoL 5 Dimension (EQ-5D-3L) utility index

10.1186/s12955-019-1135-8Health and Quality of Life Outcomes1718

Attitude of Nurses in Mulago Hospital Burns Unit to HIV/AIDS Burns Patients

Background: Immunodeficiency syndrome (HIV) and the Acquired Immunodeficiency Syndrome (AIDS) have constituted a major challenge and concern worldwide. This is especially of concern among the health workers who take care of these patients. To prevent occupational HIV infection in health professionals, a comprehensive knowledge about HIV/AIDS is very essential.Methods: This study was carried out to assess the attitude of Nurses working in burns units to HIV/AIDS burns patients. In a cross sectional descriptive studies 41 questionnaires were distributed among nurses working in the unit and only 30 questionnaires were filled and returned.Result: 87.5% believed the prevalence of HIV was high in Uganda 68.8% said they could be infected while taking care of the patient , 100% that all burns patients should be screened for HIV. 37.5% believed knowledge of the HIV status would affect the professional duty to them but would still dress with precautions.Conclusion/Recommendations: There is need to educate and teach nurses to adhere to the universal precaution against blood born diseases as a matter of routine and not only in those that turn out HIV positive

The role of lip adhesion in the treatment of cleft lips

Background:Wide complete cleft lips, if repaired under tension result in a tight lip with inadequate lip elements, often with a thin vermilion and a whistle deformity. This is made worse by the inextensible, excessive scar tissue that results. In case of bilateral complete clefts, the problems are even more severe as seen by the dystrophic and dyschromic scar tissue. This combined by large alar bases and an almost absent columella make the picture very unaesthetic Though lip adhesion has been proved to diminish the cleft width, some authors have questioned its benefits as exaggerated and others like, George Scrimshaw, has called it "a passing fad". This study was done to show the effectiveness of lip adhesion and to reassert its importance in the treatment of wide clefts. Methods:Twenty-two patients were treated with lip adhesion (LA) between May 2000 and May 2003 in the Department of Plastic Surgery Cisanello Hospital, Pisa, Italy. The indication for LA was presence of a wide alveolar cleft (gap>7mm) with severely malpositioned maxillary segments. LA was performed at an average age of 6 weeks and final cheiloplasty at average age of 9 weeks. Photographs and impressions were taken prior to the operations. Results: LA achieved a reduction in the cleft width of 64.1% for unilateral complete clefts after 42.8 days and for bilateral clefts percentage reduction was 64.1: 70%. Conclusion: LA converts a complete wide cleft lip to an incomplete cleft in both unilateral and bilateral clefts. Although this adds an operative procedure to the usual lip repair, it makes the definitive closure simpler and easier with less need for secondary operations

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

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

Improving patient care by virtual case discussion between plastic surgeons and residents of Uganda and the Netherlands

Introduction: Traditional on-site missions of plastic surgeons from “high-income countries” in “low- and middle-income countries” are often limited in time and lack proper follow-up. Regular digital collaboration could lead to a more impactful and durable exchange of knowledge for plastic surgeons and residents in both settings. Aims: The aim of this study was to evaluate the satisfaction of the first twelve months of weekly digital meetings, explore advantages/disadvantages, and to provide tools for similar initiatives. Methods: Weekly meetings started from August 2021. An encrypted digital connection allowed residents and plastic surgeons from Uganda and the Netherlands to discuss cases for educational purposes, where treatment options were considered. After twelve months, a survey was sent to participants from both countries to indicate the meetings’ strengths, weaknesses, and possible improvements. Results: A total of 18 participants responded to the questionnaire (ten plastic surgeons, six residents, and two researchers). The strengths of the meetings were the accessibility of the meetings, knowledge exchange and practice for residents’ final exams. Possible improvements included having a clear format for patient discussion, a session moderator and better internet connectivity. Moreover, a database to assess the impact of the given intervention on the patient cases by evaluating postoperatively (e.g. three months), could further improve clinical care. Conclusions: Virtual patient discussions subjectively contributed to medical education at both locations. Improved digital infrastructure and a collaborative database could further maximize learning capacity. Furthermore, digital proctoring is a promising way to establish sustainable collaborations between high- and low-resource countries.</p