Direct vision internal urethrotomy in 459 urethral stricture patients at Mulago Hospital, Kampala

Four hundred and fifty nine patients seen with simple urethral strictures between 1990 and 1998 underwent direct vision  urethrotomy.. The procedure was successful in 441 patients and failed in only 18 patients. Postoperative complications included fever in 31 patients, urethral bleeding in 14 and epididymitis in 17 patients. The average  hospital stay for patients who did not develop  complications was 3 days. In  conclusion, direct vision internal urethrotomy can be used to treat simple urethral  strictures. It is an easy and short procedure and only associated with minor complications.Keywords: Direct vision, internal, urethrotomy, urethral and strictur

Histopathological findings in post-inflammatory urethral strictures treated at Mulago hospital, Kampala, Uganda

The predominant risk factor for recurrence of urethral stricture after surgical  treatment is the extent of scarring and other related pathological findings in the affected segment of the urethra. In this study, 107 patients with post inflammatory urethral strictures aged between 23-79 years seen between 1996 and 1998 underwent a two-staged urethroplasty. During the first stage, incisional biopsies were taken from four areas namely the stricture itself, the segments proximal and distal to the stricture and the peri-urethral tissues surrounding the stricture. All the  four biopsies for each patient were subjected to histological examination. The  main histological finding was non-specific chronic inflammation and fibrosis. In the stricture part there was moderate diffuse chronic inflammation. In proximal segment, severe chronic inflammation with  ulceration of stratified squamous pithelium and urinary pockets werc the predominant  histological findings. It1 the distal segment, mild chronic inflammati( )11 dominated. Lastly, in the periurethral tissues there was fibrosis interspersed with chronic mild inflammation

Assessment of the luck associated with settlement predictions that are based on elastic theory

This paper deals with quantifying the uncertainty associated with settlement predictions that are based on elastic theory. Because of spatial soil variability, deterministic solutions cannot provide information about the likely error of the prediction. Accordingly, it is only through luck that a particular deterministic prediction coincides with the observed settlement.William S. Kaggwa, Mei T. Cheong, and Mark B. Jaks

The sonographic pattern of diseases presenting with scrotal pain at Mulago hospital, Kampala, Uganda

Background: Scrotal pain is a common presentation in the male patient. There is a wide overlap of symptoms and signs making differentiation at clinical diagnosis difficult. Ultrasound has been documented to improve the accuracy of diagnosis of scrotal diseases. This study was aimed at determining the sonographically detectable diseases in patients with scrotal pain, describe their sonographic appearances and to relate the diseases to the sociodemographic and clinical characteristics of the patients presenting at Mulago hospital.Patients and Methods: This was a Cross sectional descriptive study done at Mulago Hospital, between May 2003 and March 2004. Consecutive patients with scrotal pain referred for ultrasound evaluation and consented were scanned using an ATL HDI 1500 machine model 2000 with a 5-12 MHz linear probe.Results: Of the seventy-three patients, 19 had acute epididymitis, 19 chronic nonspecific epididymitis, 12 testicular torsion, and 7 tuberculous epididymo-orchitis diagnosed at ultrasound. The entire epididymis was more often involved and there was no significant difference in pattern of involvement in acute and tuberculous epididymitis except that the frequency of calcifications was significantly higher in tuberculous  epididymo-orchitis lesions than in those of either acute epididymitis  (p=0.0017) or chronic epididymitis (p=0.0017).Testicular torsion was more  common in adolescents and young adults. Acute epididymitis was seen in all age-groups and was associated with anomalies of the genitourinary tract at the extremes of age and sexual activity in young adults. Clinical assessment had low accuracy in diagnosis of cause of scrotal pain.Conclusion: Scrotal ultrasound gave added information in the diagnosis of patients with scrotal pain. This expedites proper patient management and reduces morbidity. Infections and testicular torsion are the commonest cause of scrotal pain at Mulago hospital. Tuberculous epididymo-orchitis is still a problem at Mulago Hospital

Incentives and South Africa's automotive industry performance : a system dynamics approach

Investment in robotic automotive manufacturing and inherent electronics has played a pivotal role in the growth and competitiveness of the South African automotive industry. Government's offering of incentives was intended to lessen the cost of local industry’s expensive, but necessary investment. Despite the growth, industry trade balance has been declining systematically. To explain the apparent contradiction in industry performance, a model of South Africa’s automotive incentives – including the Productive Asset Allowance (PAA) and the Import-Export Complementation (IEC) – was developed. Model simulations reveal that, while the IEC had a significant effect on the industry trade balance, the role of the PAA in this regard is trivial. Ultimately, the study reveals that combining strictly investment incentives with other ‘non-investment’ incentives can have unintended consequences for the local automotive industry.http://www.saiee.org.za/DirectoryDisplay/DirectoryCMSPages.aspx?name=Publications#id=1588&dirname=ARJ&dirid=337am2016Graduate School of Technology Management (GSTM

Assessing the influence of root reinforcement on slope stability by finite elements

This paper aims to investigate the effect of root reinforcement on slope stability using finite element methods. It is well recognised that plant roots can improve the shear strength of soils by their high tensile strength and closely spaced root matrix system. The increase in soil shear strength due to root reinforcement is considered as an increase in apparent soil cohesion, called root cohesion, cr. In this paper, a freely available (http://www.inside.mines.edu/~vgriffit/slope64) finite element code called slope64 described by Griffiths and Lane (Géotechnique 49(3):387–403, 1999) is used to model the effect of root reinforcement on slope stability. The root cohesion is added directly to the soil cohesion for the soil elements that are reinforced by plant roots. The results from the finite element analyses demonstrate that the factor of safety of a slope increases when the effect of root reinforcement is taken into consideration. A series of stability charts are developed which can be used for assessing the influence of root reinforcement on slope stability.Y. H. Chok, M. B. Jaksa, W. S. Kaggwa and D. V. Griffith

Modelling the effects of vegetation on stability of slopes

The document attached has been archived with permission from the copyright holder.It is well understood that vegetation influences slope stability in two ways: through hydrological effects and mechanical effects. Hydrological effects involve the removal of soil water by evapotranspiration through vegetation, which lead to an increase in soil suction or a reduction in pore-water pressure, hence, an increase in the soil shear strength. The shear strength of the soil is also increased through the mechanical effects of the plant root matrix system. The density of the roots within the soil mass and the root tensile strength contribute to the ability of the soils to resist shear stress. The effects of soil suction and root reinforcement has been quantified as an increase in apparent soil cohesion. This paper investigates the effects of vegetation on the stability of slopes using the finite element method. Two key vegetation-dependent parameters have been incorporated in the finite element slope stability analysis, namely, apparent root cohesion (cR) and depth of root zone (hR). Parametric studies were performed to assess the sensitivity of the stability of a slope to the variation in the key vegetation and soil parameters. Results show that vegetation plays an important role in stabilising shallow-seated failure of slopes, and significantly affects stability

Probabilistic analysis of multi-layered soil effects on shallow foundation settlement

The document attached has been archived with permission from the copyright holder.The results of a preliminary investigation into the effects of multi-layered soil on foundation settlement are reported in this paper. In this study, the settlement of a square pad footing placed on two-layered soil profile is examined. Using a combination of Finite Element Method (FEM) analyses and random fields simulation, probabilistic analyses of the settlement of footing founded on two-layered soil profile is established through Monte Carlo simulation. The Young’s modulus field has been simulated via Local Average Subdivision method (LAS) with a fixed mean, various coefficients of variation and spatial correlation structures. The coefficients of variation and spatial correlation structures in each layer are set to be different. It is assumed that the boundary between two soil layers is abrupt as may be represented by faults and geological unconformities in the soil mass. The results of the analyses indicate a modest decrease in the coefficient of variation of settlement of the 2-layered soil profile compared to the settlement of the uniform single layer soil mass

Influence of site investigations on the design of pad footings

The document attached has been archived with permission from the copyright holder.The reliability of foundations is greatly influenced by uncertainties associated with the geotechnical model on which their design is based. In turn, the geotechnical model is derived from a site investigation whose scope is largely dictated by financial constraints, rather than the variability of the ground. This paper seeks to quantify the influence of the scope of site investigations on the design of pad footings. This is achieved by simulating geotechnical profiles, where the soil properties vary from location to location in a random yet continuous and realistic fashion. The simulated soil profiles are generated using random field theory, which makes use of three statistical parameters: the mean, variance and the scale of fluctuation – which is a measure of the randomness of the geotechnical property in question. The methodology involves generating a geotechnical profile by simulating a 3D random field to know soil properties at each point in detail. A site investigation is then simulated by sampling from the 3D random field. By using the sampled values, a pad footing is designed to conform to a serviceability criterion, as would be achieved in practice. A benchmark design is also undertaken making use of the complete knowledge of the soil profile. This design is achieved using a numerical process involving a 3D finite element analysis. Both designs are undertaken on numerous different simulated soil profiles in a Monte Carlo analysis. A comparison of the two designs provides failure and over-design probabilities for a series of site investigation plans. It was observed that the probability of failure and overdesign decreased with an increasing site investigation scope, as expected. The results provide information to estimate the relative benefit of conducting various scopes of site investigations

Care seeking and treatment of febrile children with and without danger signs of severe disease in Northern Uganda: results from three household surveys (2018-2020)

Identification, stabilization, and prompt referral of children with signs of severe febrile disease (danger signs) in rural communities are crucial for preventing complications and death from severe malaria, pneumonia, and diarrhea. We set out to determine the treatment-seeking practices and treatment patterns for children < 5 years of age with an acute febrile illness, with or without danger signs of severe disease, in a highly malaria-endemic area of northern Uganda. Three household surveys were conducted from November through December each year in 2018, 2019, and 2020. Overall, 30% of the children in the study were reported to have had a WHO-classified danger sign including convulsions, unconsciousness/unusually sleepy, inability to feed or drink, and vomiting everything. Only half of the children in this study sought care from a health provider. However, significantly more children with danger signs of severe disease sought and received treatment and diagnostics from a health provider, compared with those without danger signs (adjusted odds ratio: 1.6, 95% confidence interval: 1.2-2.0; P < 0.01). In the total population studied, care seeking in the public sector was 26% and similar to care seeking in the private sector (24%). Community health workers were used as the first source of care by 12% of the children. Approximately 38% of the children who were reported to have danger signs of severe disease requiring prompt referral and treatment did not seek care from a health provider. Understanding and addressing barriers to accessing healthcare could contribute to better treatment seeking practices