High velocity missile injuries of the liver

A prospective study of 15 consecutive patients admitted with high velocity missile  liver injuries of the liver was done at Lacor hospital between November 1996 and May 1997. Operative findings, treatment offered and factors influencing morbidity and mortality were noted. All patients were followed up for two months  postoperatively. Fourteen patients sustained gun shot wounds while one was injured by a bomb blast fragment. Ages ranged from 2 to 33 years (mean 24.4 years). Two patients sustained liver injury alone while the rest had other associated visceral injuries as well. Grade I, II and III liver injuries were seen in 7, 5 and 2 patients respectively. One patient had a bullet perforation of the liver and could not be classified on this scale. Six patients received blood transfusion. Four patients (270) developed complications. One had a sub-hepatic abscess while the other three had wound infections. 'ItYo patients died, one of exsanguination and the other of septic shock. High velocity missile injuries of the liver are associated with high transfusion needs and morbidity both of which can be minirnised by a policy of conservative surgery.Key words: high velocity missile, injuries, liver

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

Prostatic Specific Antigen (PSA) Relationship to Patients Age, Prostate Volume and Prostate Histology at St Mary's Hospital Lacor

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Sigmoid Volvulus and Ileosigmoid Knotting at St. Mary’s Hospital Lacor in Gulu, Uganda

Background: Sigmoid volvulus is a common cause of intestinal obstruction in developing countries where it affects relatively young people. Little is known about this condition in our country and there is yet no literature from an environment like ours (northern Uganda) where civil war has devastated the economy with most of the populace displaced into internally displaced peoples’ camp. The main objective of this study was to determine the demographics, treatment and outcome of sigmoid Volvulus cases seen at Lacor Hospital.Methods: This was both a retrospective and prospective study of patients who presented with sigmoid volvulus at St. Mary’s Hospital Lacor over a period of 61/2 years from 1st January 2002 to 31st July 2008. Medical records of patients who underwent sigmoid surgery was stratified for the following measures; demographic characteristics, presentation to hospital (emergency or elective), operative finding and operative procedure, complication, co-ominous factors and outcome. Similar data was gathered from patients who were prospectively followed up. Data was analyzed using SPSS.Results: A total of 44 patients were studied. Their age ranged from 16 to 80 years with a mean of 52.2years (SD +/- 15.98) and a mode of 60years. There was a preponderance of male (84%) with a male to female sex ratio of 5.3: 1. The disease significantly affected the older males compared with females P=0.032. Approximately 77% of the patients presented acutely and had to undergo emergency surgical intervention, the rest were subacute. About 75% of the patients were treated with primary resection and anastomosis, of which 52.2% were emergency cases. Colostomy was offered to 20.5% and sigmoidoscopic derotation to 4.5%. Overall mortality rate was 15.9% and of the patients who died, 18% had primary resection and anastomosis, while 11% were offered colostomy, (P>0.05). Most of those who died were either the older ones (median age 68years) and/or had co morbid illness such as diabetes mellitus, hypertension, intra-abdominal abscess and cancer.Conclusion: Sigmoid volvulus is relatively rare in our community. It commonly affect males particularly the old. Most of the patients presented acutely, requiring immediate resuscitation and surgical approach. In viable bowel, primary resection and anastomosis of the twisted sigmoid is feasible as it may not adversely affect outcome. Nevertheless colostomy should be considered if the bowel is gangrenous or perforated. Though the disease carries a high mortality, most of the patient who die are either older and/or have co-morbid conditions

Building capacity for sustainable research programmes for cancer in Africa

Cancer research in Africa will have a pivotal role in cancer control planning in this continent. However, environments (such as those in academic or clinical settings) with limited research infrastructure (laboratories, biorespositories, databases) coupled with inadequate funding and other resources have hampered African scientists from carrying out rigorous research. In September 2012, over 100 scientists with expertise in cancer research in Africa met in London to discuss the challenges in performing high-quality research, and to formulate the next steps for building sustainable, comprehensive and multi-disciplinary programmes relevant to Africa. This was the first meeting among five major organizations: the African Organisation for Research and Training in Africa (AORTIC), the Africa Oxford Cancer Foundation (AfrOx), and the National Cancer Institutes (NCI) of Brazil, France and the USA. This article summarizes the discussions and recommendations of this meeting, including the next steps required to create sustainable and impactful research programmes that will enable evidenced-based cancer control approaches and planning at the local, regional and national levels