An evaluation of 605 endoscopic examination in a rural setting, Lacor Hospital in Northern Uganda

Introduction: The aim of this study was to evaluate the profile of esophagogastroduodenal (EGDS) diseases diagnosed by upper endoscopy in a rural area of Uganda in a retro-protective study of 605 patients. Results: The mean age of patients with digestive symptoms was 39.7yrs (SD +/-16.11) and female gender predominated by 60% compared to the male (P value 0.000). Peasant farmers were the commonest group with GI symptoms requiring EGDS compared to the rest 72.1% v 27.9%. Epigastric pain was the commonest indication (58%) for EGDS, followed by chest pain (11%), abdominal pain (8.8%), dyspahgia (7.6%) and hematemesis (7.3%). The commonest endoscopy finding was gastritis (47.9%) followed by esophagitis (14.4%), cancer esophagus (5.1%), esophageal varicose (4%), PUD (2.3%), gastric cancer (1%). However 19.5% of patients had normal EGDS. There was a significant correlation between the outpatient diagnosis and endoscopy finding (P value 0.01, r = 0.144) and between endoscopy finding and histology findings (P value 0.001, r = 0.236). H. pylori was positive in 53% of patients with gastritis. Conclusion: Gastritis is the commonest lesion (47.9%) of which 53% have H pylori and Cance

Barriers and factors affecting personal protective equipment usage in St. Mary’s Hospital Lacor in Northern Uganda

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

Barriers and factors affecting personal protective equipment usage in St. Mary’s Hospital Lacor in Northern Uganda

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 useMethods: 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 useResults: 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 PPEConclusion: This study provides a baseline for measuring the effectiveness of interventions to improve compliance

Inflammatory pseudotumor of the liver: a case report and review of the literature

<p>Abstract</p> <p>Introduction</p> <p>Inflammatory pseudotumor of the liver represents a fairly uncommon pathology. Although it is a benign tumor, the correct diagnosis can be missed.</p> <p>Case presentation</p> <p>We report the case of a 55-year-old Caucasian man, who presented with a one-month history of abdominal pain and weight loss. He was diagnosed with a primary liver tumor by computed tomography and magnetic resonance imaging. Alpha-fetoprotein levels ranged within normal limits. A right posterior sectorectomy was performed. Histopathology revealed an inflammatory pseudotumor of the liver. Our patient remains in good condition one year later.</p> <p>Conclusion</p> <p>Although inflammatory pseudotumor of the liver is usually a benign process, controversy regarding its management still exists. With this case report we review the existing literature and consider hepatectomy as a safe treatment approach.</p

CMV retinitis in China and SE Asia: the way forward

AIDS-related CMV retinitis is a common clinical problem in patients with advanced HIV/AIDS in China and Southeast Asia. The disease is causing blindness, and current clinical management, commonly characterized by delayed diagnosis and inadequate treatment, results in poor clinical outcomes: 21% - 36% of eyes with CMV retinitis are already blind at the time the diagnosis is first established by an ophthalmologist. CMV retinitis also identifies a group of patients at extraordinary risk of mortality, and the direct or indirect contribution of extra-ocular CMV disease to AIDS-related morbidity and mortality is currently unmeasured and clinically often overlooked. The obvious way to improve clinical management of CMV retinitis is to screen all patients with CD4 counts < 100 cells/μL with indirect ophthalmoscopy at the time they first present for care, and to provide systemic treatment with oral valganciclovir when active CMV retinitis is detected. Treatment of opportunistic infections is an integral part of HIV management, and, with appropriate training and support, CMV retinitis screening and treatment can be managed by the HIV clinicians, like all other opportunistic infections. Access to ophthalmologist has been problematic for HIV patients in China, and although non-ophthalmologists can perform screening, sophisticated ophthalmological skills are required for the management of retinal detachment and immune recovery uveitis, the major complications of CMV retinitis. CMV retinitis has been clinically ignored, in part, because of the perceived complexity and expense of treatment, and this obstacle can be removed by making valganciclovir affordable and widely available. Valganciclovir is an essential drug for developing successful programs for management of CMV retinitis in China and throughout SE Asia

Vitamin C and infectious diseases

Non peer reviewe

Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

Eye Pathology. An illustrated guide.

This book is a comprehensive, in-depth, and up-to-date resource on eye pathology that will be of great practical value for ophthalmic and general pathologists and ophthalmologists. Congenital abnormalities, inflammatory conditions, infections, injuries, degenerative diseases, and tumors are all covered with the aid of more than 700 images. In the case of tumors, the wide variety of neoplasms that occur in the eyelid, conjunctiva, retina, uveal tract, lacrimal gland and sac, orbit, and optic nerve are comprehensively reviewed, and the most recent knowledge on the relation between genetics and prognosis is presented. Entries on specific diseases are organized in a standard way, with information on etiology, epidemiology, clinical presentation, pathological characteristics, differential diagnosis, therapy, and prognosis. The authors are all recognized experts and members of the European and American ophthalmic pathology societies.