Causes and Patterns of Peritonitis at St. Francis Hospital Nsambya, Kampala - Uganda

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Peritonitis outcome prediction using mannheim peritonitis index at St.Francis Hospital Nsambya, Kampala - Uganda

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Clinical presentation and outcome of neurosurgical conditions at Butare Teaching Hospital, Rwanda

Background: Neurosurgical services have only been introduced in Rwanda recently. Consequently little information about spectrum of neurosurgical conditions in th country is available. This descriptive prospective study was aimed at determining the pattern, causes and outcome of management of neurosurgical conditions seen in Butare University Teaching Hospital (BUTH) in Rwanda.Methods: The study population consisted of 152 patients admitted at BUTH with neurosurgical conditions between October 1 2007 and May 31 2008. Patients were grouped into different neurosurgical conditions according to their clinical presentations. . Information collected included age, gender, cause and severity of injury, the time interval between injury Glasgow Coma Score, GOS scales were used to assess head injured patients.Results: The majority (70.4%) of patients came from rural areas. Their ages ranged from 15 days to 78 years with a mean of 31.98+/-18.75 years. The Male to female sex ratio was 2:1. Most (73.0%) of the patients suffered from trauma with 67.6% of them sustaining head injury and 32.4%, spinal trauma. Motor Vehicle crashes were the major cause of traumatic injuries (20% in spinal trauma and 70.7% of head trauma). Only 23% of the patients had CT scan performed. Only 12% of patients with traumatic brain injury (TBI) had CT scan.. A total of 78.7% of all head injuries were admitted in the first 24 hours following trauma. A significant number (44.4%) of spinal cord injury presented late (up to 7 days before referral to a neurosurgeon) and stayed longer in the hospital (52.7% up to 3 months). Laminectomy and fixation was the most common spinal operative procedure (58.7%) followed by discectomy (34.8%). The commonest cranial operation was for posttraumatic intracranial haemorrhage (41.4%) followed by surgery for depressed fracture (37.9%). One child had a shunt procedure for hydrocephalus. Good recovery was associated with GCS >13 on admission (P<0.001). The overall mortality rate was 13.2%. The mortality among patients admitted with GCS <8 was 52.4%.Conclusion: Neurological injuries were the most commonly seen conditions mainly in head injuries. This study confirms that neurosurgical procedures can still be done with fair results using very little equipment. Providing basic equipment to national neurosurgeons, however, and training them to work in an adverse environment remains a big challenge

HIV/AIDS among surgical patients in Butare University Teaching Hospital

Background: Despite the increasing number of patients with the human immunodeficiency virus (HIV) infection particularly in Sub-Saharan Africa, surgical experience with these patients remains limited. A prospective review of 165 surgical patients admitted over a period of 3 months from 20th September to 20th December 2006 was undertaken. The main objective of the study was to determine the frequency HIV among these patients and associated surgical conditions.Methods: This 3-months prospective study was undertaken at Butare Teaching Hospital Rwanda over a 3-months period starting from 20th September 2007. A total of 165 patients who after counseling gave an informed consent had their blood collected for HIV screening. Data obtained was analyzed using Epidata and SPSS 11.5. P value was P value equal to 0.05 or less was considered as statistically significant.Results: The patients’ ages ranged from 6 to 86 years with a mean of 35.2 years. The sex ratio M: F was 2.11:1. The HIV seroprevalence was 6.7%. The majority of HIV positive patients were female (54.5%) and the most affected age range was 30-39 years. Only 2 (22.2 %) affected patients were on ARV therapy. Eight of the HIV patients had musculoskeletal sepsis (72.72 %). Associated surgical diseases included infection of osteosynthetic material in, chronic osteomyelitis, Pyomyositis and osteonecrosis of the head of femur associated with pyomyositis.Conclusion: With a prevalence of 6.6%, HIV/AIDS is a real and significant problem in surgical practice and patients with HIV admitted to a surgical department require special consideration if their surgical management is to be effective. Surgeons and other health-care workers who are potentially exposed to blood and body fluids must take appropriate precautions to avoid getting infected with HIV. We found no statistically significant difference in the surgical pathologies between HIV-positive and HIV-negative patients

Contemporary art in Uganda: a nexus between art and politics

Abstract The nexus between Uganda’s contemporary art and politics forms the overarching theme of this thesis. The trajectory of Uganda’s contemporary art as a political expression has been retraced. The different political dispensations which have shaped Uganda’s political art have been analysed. The political postures and visual symbols Uganda’s contemporary artists have engaged have been analysed in the context of the wider socio-political discussions which have shaped, and been shaped by, the country. It has been contended that different political epochs have invited response from Uganda’s artists since the early- 1940s. Whereas this debate has been attempted by varied scholars, it has not been rigorously pursued. Formalist discourses seeking to prioritise formal aesthetics have been engaged; conclusions that after 1986 contemporary Ugandan art[ists] became apolitical have been made. With emphasis on two contemporary artists—Fred Kato Mutebi and Bruno Sserunkuuma—this formalist reading has been decentred; the socio-political relevance of Uganda’s contemporary art has been retraced and prioritised. It has been argued that although initially depoliticised through colonial modernity, Uganda’s contemporary artists have been sensitive to the socio-political conditions affecting their space and time; issues of governance and service delivery have preoccupied them albeit in different but often complementary ways

Optimization of cascaded regenerative links based on phase sensitive amplifiers

We develop an analytical method for optimizing phase sensitive amplifiers for regeneration in multilevel phase encoded transmission systems. The model accurately predicts the optimum transfer function characteristics and identifies operating tolerances for different signal constellations and transmission scenarios. The results demonstrate the scalability of the scheme and show the significance of having simultaneous optimization of the transfer function and the signal alphabet. The model is general and can be applied to any regenerative system

Phase-encoded signal regeneration exploiting phase sensitive amplification

We discuss recent advances in phase-sensitive amplification technology and review its application to the regeneration of multi-level phase-encoded signals

Simple geometric interpretation of signal evolution in phase-sensitive fibre optic parametric amplifier

Visualisation of complex nonlinear equation solutions is a useful analysis tool for various scientific and engineering applications. We have re-examined the geometrical interpretation of the classical nonlinear four-wave mixing equations for the specific scheme of a phase sensitive one-pump fiber optical parametric amplification, which has recently attracted revived interest in the optical communications due to potential low noise properties of such amplifiers. Analysis of the phase portraits of the corresponding dynamical systems provide valuable additional insight into field dynamics and properties of the amplifiers. Simple geometric approach has been proposed to describe evolution of the waves, involved in phase-sensitive fiber optical parametric amplification (PS-FOPA) process, using a Hamiltonian structure of the governing equations. We have demonstrated how the proposed approach can be applied to the optimization problems arising in the design of the specific PS-FOPA scheme. The method considered here is rather general and can be used in various applications

Using electronic medical records to understand the impact of SARS-CoV-2 lockdown measures on maternal and neonatal outcomes in Kampala, Uganda.

Kawempe National Referral Hospital (KNRH) is a tertiary facility with over 21,000 pregnant or postpartum women admitted annually. The hospital, located in Kampala, Uganda, uses an Electronic Medical Records (EMR) system to capture patient data. Used since 2017, this readily available electronic health record (EHR) has the benefit of informing real-time clinical care, especially during pandemics such as COVID-19. We investigated the use of EHR to assess risk factors for adverse pregnancy and infant outcomes that can be incorporated into a data visualization dashboard for real time decision making during pandemics. This study analysed data from the UgandaEMR collected at pre-, during- and post-lockdown timepoints of the COVID-19 pandemic to determine its use in monitoring risk factors for adverse pregnancy and neonatal outcomes. Logistic regression models were used to identify the risk factors for adverse pregnancy and maternal outcomes including prematurity, obstetric complications, still births and neonatal deaths. Pearson chi-square test was used for pair-wise comparison of the outcomes at the various stages of the pandemic. Data analysis was performed in R, within the International COVID-19 Data Alliance (ICODA) workbench. A visualisation dashboard was developed based on the risk factors, to support decision making and improved healthcare delivery. Comparison of pre-and post-lockdown variables showed an increased risk of pre-term birth (adjusted Odds Ratio (aOR = 1.67, 95% confidence interval (CI) 1.38-2.01)); obstetric complications (aOR = 2.77, 95% CI: 2.53-3.03); immediate neonatal death (aOR = 3.89, 95% CI 2.65-5.72) and Caesarean section (aOR = 1.22, 95% CI 1.11-1.34). The significant risk factors for adverse outcomes were younger maternal age and gestational age <32weeks at labour. This study demonstrates the feasibility of using EHR to identify and monitor at-risk subpopulation groups accessing health services in real time. This information is critical for the development of timely and appropriate interventions in outbreaks and pandemic situations

Injection locking-based pump recovery for phase-sensitive amplified links

An injection locking-based pump recovery system for phase-sensitive amplified links, capable of handling 40 dB effective span loss, is demonstrated. Measurements with 10 GBd DQPSK signals show penalty-free recovery of a pump wave, phase modulated with two sinusoidal RF-tones at 0.1 GHz and 0.3 GHz, with 64 dB amplification. The operating power limit for the pump recovery system is experimentally investigated and is governed by the noise transfer and phase modulation transfer characteristics of the injection-locked laser. The corresponding link penalties are explained and quantified. This system enables, for the first time, WDM compatible phase-sensitive amplified links over significant lengths