Factors associated with Diarrhea among Children under Five Years at Paediatric Ward Masaka Regional Referral Hospital in Masaka District. A Cross-sectional Study.

Background:  Diarrhea accounts for 9% of all child deaths worldwide, It is the leading cause of death among children under the age of five worldwide. Methodology:  The cross-sectional study was carried out on all caretakers of children under five years at Masaka regional referral hospital. The Questionnaire was used to collect data and was analyzed using a tally, the sample size of 62 respondents also was analyzed using frequency tables graphs, and pie charts.  Results:  The study revealed that only (38.7%) of the respondents defined diarrhea as the passing of watery stool 3 or more times a day, (61.3%) could not define diarrhea as WHO recommends, majority of 74.2% of the respondents had good knowledge of contaminated food/water as the cause of diarrhea in children under five years, 59.7% had good knowledge on general weakness, failure to feed, irritability, vomiting everything as the consideration to their children for treatment, 22.5% of the respondents had poor knowledge on treatment of diarrhea at home, 41.9% respondents had poor knowledge on what is needed to make ORS, 17.7% respondents had poor knowledge on how to prevent diarrhea in their children, 21% respondents poor attitude on exclusive breastfeeding. Conclusion:  mothers had poor knowledge of the definition of diarrhea but a good knowledge of the causes of diarrhea among children under five years and identify the danger signs. Recommendation: Therefore the study recommends the need for continuous health education of the caretakers on how to treat diarrhea at home, requirements to make ORS, how to prevent diarrhea in the children, and how to breastfeed the children when they get diarrhea

Free flap surgery at Mengo Hospital, Uganda - A review of the first 19 consecutive microvascular free tissue transfers

Background: Microvascular free tissue transfer is an important method for reconstructing complex surgical and traumatic defects, allowing single stage reconstruction in most instances. This study reviews the first 19 consecutive free tissue transfer (free flap) reconstructions at Mengo hospital, Department of Plastic and Reconstructive surgery.Methods: A retrospective review of the first 19 surgical reconstructions using microvascular free tissue (free flap) transfer techniques from 2005 to date was done.Results: 10 males and 8 females have had surgical reconstructions with free flaps during this period. Average age of patients was 23yrs, ranging from 7 years to 42 years. The majority of reconstructions were in the head and neck region (n=14, 74%) followed by lower limb (n=3, 16%) and upper limb reconstructions (n=2, 10%). Indications for reconstructions using free flaps included extensive loss of scalp, extensive loss of soft tissue following open tibial fractures, bomb blast injuries to the face, Noma,  Romberg’s disease, ameloblastoma. Overall flap survival rate of 79%. Head and neck reconstructions flap survival rate of 83.3%; lower limb and upper limb free flap survival rates of 33.3% and 100% respectively

Poland syndrome with dextrocardia: Case report

Poland syndrome is a rare congenital condition presenting with typical features including an absent costosternal head of pectoralis major and ipsilateral brachysyndactyly. There are many clinical variations of the syndrome including rib defects, absence of shoulder girdle muscle and breast hypoplasia or agenesis. Dextrocardia is rarely associated with Poland Syndrome with only 22 cases being previously reported in the worldwideliterature. Whereas ‘c1assical’ Poland syndrome is predominantly right sided, all cases associated with dextrocardia have been left sided. We report a further case of left sided Poland syndrome with dextrocardia which might have important implications for the understanding of the pathogenesis of this unusual condition

Comparing Banana Leaf Dressing and Vaseline Gauze Dressing for Split-Thickness Skin Graft Donor Sites in a Ugandan Hospital

Introduction: This study compared the effectiveness of banana leaf dressing (BLD) with the commonly used Vaseline gauze dressing (VGD) on split-thickness skin graft (SSG) donor sites. VGD is not completely nonadherent and is associated with pain on removal. BLD is smooth, non-adherent, pain-free and available. Methods: In this prospective study, consecutive patients were dressed with either BLD or VGD. Ease of applying and removing the dressings was scored. Pain scores were taken on postoperative days 3, 5, 7, 9 and 10. On day 10, the dressing was changed, epithelialization recorded and a swab taken for microbial culture. Average cost of each dressing was calculated. Results: There was no significant difference between postoperative pain scores with either dressing (p=0.992). BLD patients had less pain on  dressing change (p=0.006). Both dressings were easy to apply; BLD was easier to remove (p=0.000). Wounds with BLD re-epithelialized faster (p=0.0158). 40% of wounds grew no organism on microbial culture, 25% grew Staphylococcus aureus and 35% grew unusual organisms (p=0.482). VGD was 4 times more expensive than BLD (p=0.000). Conclusion: Banana leaf dressing is effective and highly recommended for dressing SSG donor sites.Keywords: Split-thickness skin graft, Donor sites, Banana leaf dressing, Vaseline gauze dressin

A Quality Management Approach to Implementing Point-of-Care Technologies for HIV Diagnosis and Monitoring in Sub-Saharan Africa

Technology advances in rapid diagnosis and clinical monitoring of human immunodeficiency virus (HIV) infection have been made in recent years, greatly benefiting those at risk of HIV infection, those needing care and treatment, and those on antiretroviral (ART) therapy in sub-Saharan Africa. However, resource-limited, geographically remote, and harsh climate regions lack uniform access to these technologies. HIV rapid diagnostic tests (RDTs) and monitoring tools, such as those for CD4 counts, as well as tests for coinfections, are being developed and have great promise in these settings to aid in patient care. Here we explore the advances in point-of-care (POC) technology in the era where portable devices are bringing the laboratory to the patient. Quality management approaches will be imperative for the successful implementation of POC testing in endemic settings to improve patient care

Decentralisation and development: the contradictions of local government in Uganda with specific reference to Masindi and Sembabule districts

Decentralisation is the process through which Central Government transfers authority and functions to sub-national units of the Government and it traces its origin in Uganda from the “ bush” period (1981 – 1986) when Resistance Committees were established by the NRM/A in the Luwero triangle. The Mamdani Commission Report of 1987 on the Local Government system in Uganda recommended devolution of powers. Subsequently, decentralisation was launched in 1992, constitutionalised by the 1995 Constitution, and operationalised by the Local Governments Act (LGA) in 1997. Among the services devolved were education and health, which this study used as case studies to illustrate whether decentralisation has enhanced development in Uganda during the period 1993 – 2006. The study used both primary and secondary data in analysing the linkage between decentralisation and development in the two selected districts in Uganda, namely Masindi and Sembabule. Primary data was collected through interviews, questionnaires and focus group discussions while secondary data was gathered through a literature survey of relevant textbooks, newspapers, reports, legislation and journals. The findings of the study established that if decentralisation is properly planned and implemented it can make a meaningful contribution to enhancing development. However, since decentralisation is a process and not a once-off project, it evolves from one stage to another and, as it does so, it also unfolds new challenges and contradictions that need to be effectively addressed. These challenges include aspects relating to the legal framework, as well as political, fiscal and administrative decentralisation. The study recommended mitigation measures to enhance the efficiency, effectiveness, accountability, transparency, and subsequently the quality of services delivered (development) under decentralised local governance in Uganda

Klason Method: An Effective Method for Isolation of Lignin Fractions from Date Palm Biomass Waste

Klason lignin extraction method is one of the robust techniques for isolation of lignin from lignocellulosic palm biomass waste for future production of High Value Chemicals (HVCs). To elucidate the mechanism of hemicellulose and cellulose glycosidic bond distraction, lignocellulos

Investigation of Nonisothermal Combustion Kinetics of Isolated Lignocellulosic Biomass: A Case Study of Cellulose from Date Palm Biomass Waste

The efficient and high yielding acid-base and Organosolv methods were studied for cellulose isolation from date palm lignocellulose waste biomass and thereafter analyzed for nonisothermal kinetic and thermodynamic parameter determination using model-free methods. The structural and chemical characterization of the isolated celluloses revealed structures and functional groups characteristics of cellulose. Thermal decomposition analysis revealed one major peak with average mass loss of 72.51 ± 0.7% and 55.82 ± 1.1% for the acid-base and Organosolv method, respectively. This occurred in the temperature region between 250 and 350°C associated with cellulose degradation and contrasted with the three peaks detected in the original biomass. The kinetic and thermodynamic results revealed a strong relationship between the average activation energy and average change in enthalpy with a difference of 5.23 and 147.07 kJmol−1 for Organosolv and acid-base methods, respectively. The Gibbs’s free energy results revealed that Organosolv cellulose pyrolysis would reach equilibrium faster in KAS, Starink and FWO models with average ΔG values of 115.80 ± 36.62, 115.89 ± 36.65, and 119.45 ± 37.98 kJmol−1, respectively. The acid-base method for FWO model gave negative entropy values. The Malek method revealed the acid-base and Organoslv cellulose pyrolysis mechanism as (gα=−ln1−α14) and (gα=−ln1−α13), characterized by random nucleation and growth, respectively