The prevalence overexpression of C-Erbb-2 oncoprotein in carcinoma of the Prostate-Mulago Hospital

Background: Over expression of C-erbB-2 a Human epidermal growth factor has been reported in several human carcinomas including prostate cancer. In prostate cancer studies have for it to have a prognostic role and to predict likelihood of resistance in hormonal therapy. The oncoprotein receptors are now being looked at as possibility of prognostic predictor at the same time as a target for therapy in cancers.Objective: To determine the prevalence of over expression of C-erbB-2 oncoprotein receptor using Immunohistochemistry in Mulago Hospital. Material and Methods: Biopsy samples were taken from patients suspected to have prostate cancer convectional histology (Hand E) done. The tumours in the Confirmed slides were then graded as well differentiated, moderately differentiated and poorly differentiated. Immunohistochemistry staining was done using avidin-biotin method. To standardize the staining, the manufacturer (DAKO) supplied both positive and negative control. A well defined scoring system based upon the number of C-erbB-2 on the cell surface was applied. The score ranges from score 0 to +3, over expression is defined as score equal or greater than +2.Results: over expression was seen in 18 out of 40 cases. Stastistically there was no association between histological grades and over expression. But most of the patients that over expressed CerbB-2 were either moderately differentiated or poorly differentiate 14 of the 18 positive cases.Conclusion and Recommendation: Immunohistochemistry which is cheap and easy to use can be used in our setting to analyse the level of C-erbB-2. Its important that long term follow up of the patients with over expression is needed to further ascertain if this outcome is deemed significant

Knowledge, attitude and practices of staffs towards Post-exposure Prophylaxis for HIV infection at Mulago Hospital in Uganda

The use of anti-human immunodeficiency virus (HIV) drugs after occupational exposure to HIV is a proven method of preventing some HIV infection and there is record that these drugs are being used in treatment of post exposure infection to HIV. This then raises the issues of the impact of such treatment on the staffs. The objective of the study was to asses the level of knowledge attitudes and practices of (PEP) against HIV among surgical staffs. 190 questionnaires were sent to staffs in the department of surgery but One twenty nine (68%) was returned. Questionnaires contained items related to awareness of occupational exposure to HIV and 0.77% had experience of its use in the department and 100% noted that there was no specific policy in relation to PEP in the Surgery Department at mulago Hospital. In relation to attitude staff believe strongly that PEP reduces risks to HIV infection but were also not willing to test for HIV after exposure

Surgical reconstruction of Northern Uganda war victims.

Background: Aid groups estimate that since 1086 when the war conflicts in Northern Uganda started, over 30,000 people have died in the insurgency and over 20,000 people have remained maimed. Arising from the conflict, innocent civilians have had their limbs, lips, eyes, ears, noses, breasts, fingers and toes cut off.Patients and Methods: Between 2004 and 2005, a total of 34 victims of the Northern Uganda war, underwent reconstructive surgery. Most of the patients were treated from the local hospitals of Lira, Gulu and Kitgum.Results: Between 2004 and 2006, the Plastic Surgery team of Mulago hospital rehabilitated 34 victims of the northern war. Of these 23 were females and 11 were males. Most of these people had suffered severe disfigurements which necessitated multiple staged reconstructive procedures on them. The majority of the reconstructive operations were on the lips despite the fact that many victims had also suffered from mutilation of other body parts.Conclusion: Effects of the insurgency on individuals, families and communities included: Increased burden on health care delivery Hospital capacity overwhelmed with few doctors and nurses available Increased number of traumatised people Increased number of war causalities Population maimed with body parts cut off Increased dependency of local population on hand outs from government and relief agencies.Hence the need to strive for peaceful resolution of the Northern Uganda war conflict

Determinants and time to blood transfusion among thermal burn patients admitted to Mulago Hospital

Abstract Background Blood transfusion, a practice under re-evaluation in general, remains common among thermal burn patients due to the hematological alterations associated with burns that manifest as anemia. Today advocacy is for restrictive blood transfusion taking into account individual patient characteristics. We went out to identify the parameters that may determine transfusion requirement and the time to blood transfusion for thermal burn patients in Mulago Hospital in order to build statistics and a basis to standardize future practice and Hospital protocol. Methods 112 patients with thermal burns were enrolled into a prospective cohort study conducted in the Surgical Unit of the Accidents and Emergency Department and Burns Unit of Mulago Hospital. Relevant data on pre-injury, injury and post-injury factors was collected including relevant laboratory investigations and treatment modalities like surgical intervention. Patients were clinically followed up for a maximum period of 28 days and we identified those that were transfused. Results 22.3% of patients were transfused. The median time to transfusion was 17 days from time of injury and varied with different patient characteristics. The median pre-transfusion hemoglobin (Hb) level was 8.2 g/dL. Transfusion was significantly related to; admission to the intensive care unit (p = 0.001), a body mass index (BMI) 20 (p = 0.049), pre-existing illness (p = 0.046), and white blood cell (WBC) count 12,000/μL (p = 0.05). Conclusion Pre-existing illnesses, a low BMI, TBSA of >20%, admission to the intensive care unit and abnormalities in the WBC count are useful predictors of blood transfusion among thermal burns patients admitted to Mulago Hospital. The precise time to transfusion from time of burns injury cannot be generalized. With close monitoring of each individual patient lies the appropriateness and timeliness of their management

The Prevalence Overexpression Of C-Erbb-2 Oncoprotein In Carcinoma Of The Prostate- Mulago Hospital

Background: Over expression of C-erbB-2 a Human epidermal growth factor has been reported in several human carcinomas including prostate cancer. In prostate cancer studies have for it to have a prognostic role and to predict likelihood of resistance in hormonal therapy. The oncoprotein receptors are now being looked at as possibility of prognostic predictor at the same time as a target for therapy in cancers. Objective: To determine the prevalence of over expression of C-erbB-2 oncoprotein receptor using Immunohistochemistry in Mulago Hospital. Material and Methods: Biopsy samples were taken from patients suspected to have prostate cancer convectional histology (Hand E) done. The tumours in the Confirmed slides were then graded as well differentiated, moderately differentiated and poorly differentiated. Immunohistochemistry staining was done using avidin-biotin method. To standardize the staining, the manufacturer (DAKO) supplied both positive and negative control. A well defined scoring system based upon the number of C-erbB-2 on the cell surface was applied. The score ranges from score 0 to +3, over expression is defined as score equal or greater than +2. Results: over expression was seen in 18 out of 40 cases. Stastistically there was no association between histological grades and over expression. But most of the patients that over expressed C-erbB-2 were either moderately differentiated or poorly differentiate 14 of the 18 positive cases. Conclusion and Recommendation: Immunohistochemistry which is cheap and easy to use can be used in our setting to analyse the level of C-erbB-2. Its important that long term follow up of the patients with over expression is needed to further ascertain if this outcome is deemed significant

Knowledge, Attitude and Practices of Staffs towards Post-exposure Prophylaxis for HIV Infection at Mulago Hospital in Uganda.

The use of anti-human immunodeficiency virus (HIV) drugs after occupational exposure to HIV is a proven method of preventing some HIV infection and there is record that these drugs are being used in treatment of post exposure infection to HIV. This then raises the issues of the impact of such treatment on the staffs. The objective of the study was to asses the level of knowledge attitudes and practices of (PEP) against HIV among surgical staffs. 190 questionnaires were sent to staffs in the department of surgery but One twenty nine (68%) was returned. Questionnaires contained items related to awareness of occupational exposure to HIV and 0.77% had experience of its use in the department and 100% noted that there was no specific policy in relation to PEP in the Surgery Department at mulago Hospital. In relation to attitude staff believe strongly that PEP reduces risks to HIV infection but were also not willing to test for HIV after exposure

Attitude of Nurses in Mulago Hospital Burns Unit to HIV/AIDS Burns Patients

Background: Immunodeficiency syndrome (HIV) and the Acquired Immunodeficiency Syndrome (AIDS) have constituted a major challenge and concern worldwide. This is especially of concern among the health workers who take care of these patients. To prevent occupational HIV infection in health professionals, a comprehensive knowledge about HIV/AIDS is very essential. Methods: This study was carried out to assess the attitude of Nurses working in burns units to HIV/AIDS burns patients. In a cross sectional descriptive studies 41 questionnaires were distributed among nurses working in the unit and only 30 questionnaires were filled and returned. Result: 87.5% believed the prevalence of HIV was high in Uganda 68.8% said they could be infected while taking care of the patient , 100% that all burns patients should be screened for HIV. 37.5% believed knowledge of the HIV status would affect the professional duty to them but would still dress with precautions. Conclusion/Recommendations: There is need to educate and teach nurses to adhere to the universal precaution against blood born diseases as a matter of routine and not only in those that turn out HIV positive

Surgical Reconstruction of Northern Uganda War Victims.

Background: Aid groups estimate that since 1086 when the war conflicts in Northern Uganda started, over 30,000 people have died in the insurgency and over 20,000 people have remained maimed. Arising from the conflict, innocent civilians have had their limbs, lips, eyes, ears, noses, breasts, fingers and toes cut off. Patients and Methods: Between 2004 and 2005, a total of 34 victims of the Northern Uganda war, underwent reconstructive surgery. Most of the patients were treated from the local hospitals of Lira, Gulu and Kitgum. Results: Between 2004 and 2006, the Plastic Surgery team of Mulago hospital rehabilitated 34 victims of the northern war. Of these 23 were females and 11 were males. Most of these people had suffered severe disfigurements which necessitated multiple staged reconstructive procedures on them. The majority of the reconstructive operations were on the lips despite the fact that many victims had also suffered from mutilation of other body parts. Conclusion: Effects of the insurgency on individuals, families and communities included: · Increased burden on health care delivery · Hospital capacity overwhelmed with few doctors and nurses available · Increased number of traumatised people · Increased number of war causalities · Population maimed with body parts cut off · Increased dependency of local population on hand outs from government and relief agencies. Hence the need to strive for peaceful resolution of the Northern Uganda war conflict

Surgical Reconstruction of Northern Uganda War Victims.

Background: Aid groups estimate that since 1086 when the war conflicts in Northern Uganda started, over 30,000 people have died in the insurgency and over 20,000 people have remained maimed. Arising from the conflict, innocent civilians have had their limbs, lips, eyes, ears, noses, breasts, fingers and toes cut off. Patients and Methods: Between 2004 and 2005, a total of 34 victims of the Northern Uganda war, underwent reconstructive surgery. Most of the patients were treated from the local hospitals of Lira, Gulu and Kitgum. Results: Between 2004 and 2006, the Plastic Surgery team of Mulago hospital rehabilitated 34 victims of the northern war. Of these 23 were females and 11 were males. Most of these people had suffered severe disfigurements which necessitated multiple staged reconstructive procedures on them. The majority of the reconstructive operations were on the lips despite the fact that many victims had also suffered from mutilation of other body parts. Conclusion: Effects of the insurgency on individuals, families and communities included: · Increased burden on health care delivery · Hospital capacity overwhelmed with few doctors and nurses available · Increased number of traumatised people · Increased number of war causalities · Population maimed with body parts cut off · Increased dependency of local population on hand outs from government and relief agencies. Hence the need to strive for peaceful resolution of the Northern Uganda war conflict