Unfettering the political mandate: reflections on political prohibition, the world bank’s role in the protection of human rights and the chad – Cameroon pipeline

Magister Legum - LLMAs a case study, the paper analyzes the Bank’s role in the Chad-Cameroon Petroleum Development and Oil Pipeline project (the project) in which the Bank has been involved since the year 2000. The paper presents the lessons, challenges and implications from this protection of human rights

The case for public-private partnerships in infrastructure capital budgeting

textCivil Infrastructure is needed both in the developed world and in developing countries. However, governments alone can no longer deliver the much needed projects mainly because of lack of money, but also due to the lack of technical skills and a changing type of citizenry. In today’s world, governments have to consult the market place to efficiently and optimally deliver the much needed infrastructure. The case for Public-Private Partnerships being better than the options of government run projects or fully privatized projects is that Public-Private Partnerships offer real advantages in three major areas: 1) risk benefits (financial, legal and project related benefits), 2) management and communication benefits (within the partnership but also importantly between both partners and the general public), and 3) the value addition to the public common good.Engineering Managemen

Hydrocoele: A Silent Disability Affecting Quality of Life in Katakwi District in Uganda

Background: Katakwi district is one of the rural districts in eastern Uganda in Teso Sub Region. The district is heavily infested with filarial worms a major cause for hydrocoele and elephantiasis if the infection is left  untreated. Hydrocoele in Katakwi district are still a big cause of silent morbidity though it’s an operable condition with good outcome. Individuals affected with large hydrocoele are socially withdrawn, with inability to walk and work, leading to severe poverty to the extent that they cannot afford to pay for surgery and basic needs in their lives This is also associated with a negative impact on their sexual lives with broken marriagesMethods: Between 12th and 16th August 2013, a surgical camp was  organized in Teso Sub Region during which free surgery was offered to patients suffering from surgical conditions.Results: A total of 400 patients reported and were screened. Of these, 90 patients were booked for surgery but only 57 patients were operated during the camp. Their ages ranged from 5 to 75 years, of the 57 patients who were operated on, 23 had hydrocoele 5 of them presenting with had bilateral hydrocoele while 3 patients had concurrent hydrocoele and hernia.Conclusion: The prevalence of hydrocoele in Katakwi district is high and it’s a big ccausese of silent morbidity and disability’Key words: Hydrocoele, Surgical cam

Slithering towards uniformity: the international commercial arbitration and conciliation working group of UNCITRAL as a key player in the strengthening and liberalisation of international trade

Magister Legum - LLMThe objective of this study was to examine and review the main features and works of the arbitration and conciliation working group of UNCITRAL while demonstrating their impact on international trade.South Afric

Examining the nexus between Information and Communication Technologies (ICTs) and human rights in Africa : a survey of the key issues

This project explores the linkages between information and communication technology (ICT), governance and human rights in five African countries. It focuses on four areas: privacy rights, access to information, censorship, and freedom of expression, with emphasis on the issue of hate speech. The countries studied were Uganda, South Africa, Rwanda, Nigeria and Morocco. Overall, there is scant literature on ICTs and human rights in Africa and much remains to be done in this field particularly by African institutions and researchers. The report covers objectives, outcomes and outputs of the project

Post-operative complications of stapled versus Ferguson hemorrhoidectomy at Mulago Hospital. A randomized comparative study

Background: Hemorrhoids are a common anorectal condition. New surgical treatments have led to a reappraisal of hemorrhoid disease over the last few decades and despite a range of treatment modalities, the options are limited in their effectiveness and can lead to a number of complications. This study set out to compare post operative complications between stapled haemorrhoidopexy (SH) and Ferguson haemorrhoidectomy (FH) for patients with Grade III and IV in Mulago National Referral and teaching Hospital.Methods: Following ethical approval 48 consenting participants with Grade III/IV hemorrhoids were randomized to either FH or SH under regional anesthesia on 1:1 allocation. Early and short term post-operative complications were analyzed. .Results: We enrolled 24 participants in each arm with equal sex allocation and mean age of 39 years with 100% follow up. There was largely no difference in early and short term complications between FH and SH save for bleeding in the short term follow up which occurred more frequently in the FH group (p-value 0.045). The bleeding was mild and did not require transfusion.Conclusion: There was no major difference in short term complication rates between SH and FH. SH is a safe alternative to FH in Mulago Hospital.Keywords: Ferguson hemorrhoidectomy. Stapled hemorrhoidopexy. Hemorrhoids.PPH, Mulago Hospital, colorectal surger

Clinico-pathological pattern and early post-operative complications of gastro-duodenal perforations at Mulago Hospital Kampala- a prospective cohort study

Background: Gastro-Duodenal Perforations are one of the commonest causes of mortality and morbidity in conditions that require emergency surgery. The main objective of this study was to determine the clinico-pathological pattern and evaluate factors for early post operative complications of Gastro-duodenal perforations in Mulago. Methods: This was a prospective cohort study of patients with gastro-duodenal perforations managed by simple repair between September 2014 and April 2015 in Mulago was studied. Primary/ secondary outcomes were mortality and complications respectively. Data was managed using stata-12 and multivariate analysis using log-binomial regression model. Results: A total of 65 patients were operated for Gastro-duodenal perforations in the study period. 86.2% were male (M: F 6.2:1). Median age was 35 years (range 16- 80 years). 93.9% had gastric perforations. Clinical diagnosis was predicted in 89.3%. H. pyloriwas present in 7.9%. Mortality was 18.5% and complications developed in 58.5%. Age above 35 and presence of   co morbidity predicted mortality (CI 1.22- 21.12, p= 0.009) (CI 1.26- 8.82, p= 0.024) and early post-operative complications (CI 1.03- 2.44, p= 0.031) (CI 1.23- 2.44, p= 0.011) respectively. Conclusion: Gastroduodenal perforations remain a common surgical emergency in Mulago hospital affecting mainly young men below 35 years. Majority are gastric perforations. Mortality and early post-operative complications are high, and increase with age and presence of co morbidity. Keywords: gastro-duodenal perforations, perforated peptic ulcer disease, gastric perforation

The astrocyte α1A-adrenoreceptor is a key component of the neuromodulatory system in mouse visual cortex

Noradrenaline (norepinephrine) is known to modulate many physiological functions and behaviors. In this study, we tested to what extent astrocytes, a type of glial cell, participate in noradrenergic signaling in mouse primary visual cortex (V1). Astrocytes are essential partners of neurons in the central nervous system. They are central to brain homeostasis, but also dynamically regulate neuronal activity, notably by relaying and regulating neuromodulator signaling. Indeed, astrocytes express receptors for multiple neuromodulators, including noradrenaline, but the extent to which astrocytes are involved in noradrenergic signaling remains unclear. To test whether astrocytes are involved in noradrenergic neuromodulation in mice, we employed both short hairpin RNA mediated knockdown as well as pharmacological manipulation of the major noradrenaline receptor in astrocytes, the α1A-adrenoreceptor. Using acute brain slices, we found that the astrocytic α1A-adrenoreceptor subtype contributes to the generation of large intracelular Ca2+ signals in visual cortex astrocytes, which are generally thought to underlie astrocyte function. To test if reduced α1A-adrenoreceptor signaling in astrocytes affected the function of neuronal circuits in V1, we used both patch-clamp and field potential recordings. These revealed that noradrenergic signaling through the astrocyte α1A-adrenoreceptor is important to not only modulate synaptic activity but also to regulate plasticity in V1, through the potentiation of synaptic responses in circuits involved in visual information processing.JW is supported by postdoctoral fellowships and a research grant from the Research Foundation Flanders (FWO) (12V7519N, 1513020N, and 12V7522N). This work was further supported by FWO grants to MGH (1523014N, G066715N, G088415N, and G0C7922N), KU Leuven Research Council grants to MGH (C14/20/071 and CELSA/19/036), as well as a European Research Council Starting Grant (AstroFunc: 281961). MGH is currently the ERA Chair (NCBio) at i3S Porto funded by the European Commission (H2020-WIDESPREAD-2018-2020-6; NCBio; 951923)

An integrated approach to emergency triage assessment and treatment in Uganda

Background: Reducing mortality among patients who present to primary referral facilities in need of emergency care requires efficient triage and immediate correct management known more commonly as Emergency Triage, Assessment and Treatment (ETAT). Integrated Management of Infectious Disease (IMID) training and on-site support (OSS) have been the tools used to build capacity among mid-level practitioners who have been found to be lacking in ETAT skills in the region.Objective: To investigate the use of Integrated Management of Infectious Disease (IMID) training and on-site support (OSS) tools to improve ETAT in health care facilities in rural Uganda.Design: Randomized mixed methods evaluation.Setting: Thirty-six facilities in Uganda were randomized 1:1 to arm A (IMID and OSS) and arm B (IMID alone).Subjects: Two mid-level practitioners, (clinical officers or senior nurses), from each facility participated in offsite IMID training. Staff at 18 facilities in arm A participated in OSS (two days each month of outreach and quality improvement for nine months).Results: Time series data on facility performance of three ETAT indicators were compared over 14 months and data on mortality among pediatric inpatients were compared across arms. Improvements differed across facilities and indicators, but steady improvement in triage occurred in arm A, with convergence across arms in the management of emergency patients. Analysis of baseline indicators and improvements demonstrated that facilities could improve their performance regardless of their starting point.Conclusion: IMID and OSS both improved the management of patients with an acute illness presenting to rural health facilities