Browsing by Author "Alenyo, Rose"

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    Degloving injuries with versus without underlying fracture in a sub-Saharan African tertiary hospital: a prospective observational study
    (Journal of orthopaedic surgery and research, 2018) Lekuya, Hervé Monka; Alenyo, Rose; Bangirana, Alexander; Mbiine, Ronald; Galukande, Moses
    Degloving injuries are surgical conditions in which an extensive portion of skin and subcutaneous tissue is detached from the underlying fasciae, muscles, or bone surface. Frequently, there is an association of fracture underlying the degloved area. We aimed to compare the short-term outcomes of degloving injuries with and without underlying fracture.
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    Incidence and risk factors of acute kidney injury in severely burned patients in Mulago Hospital, Uganda - a prospective cohort
    (International Journal of Burns and Trauma, 2022) Wandabwa, Joel; Kalyesubula, Robert; Najjingo, Irene; Nalunjogi, Joanitah; Ssekitooleko, Badru; Mbiine, Ronald; Alenyo, Rose
    Acute Kidney Injury (AKI) is associated with increased mortality among severely burned patients. According to World Health Organization (WHO) 11 million people suffer from burns worldwide and burns contribute to 180,000 deaths yearly. Majority of these burns occur in the Low and Middle-Income Countries. Currently there is no published data on the incidence, risk factors and outcomes of AKI among patients with severe burns in Uganda. Early screening and treatment of patients at risk of developing AKI has been shown to improve survival. We therefore carried out a study to determine the incidence and risk factors of AKI in Uganda. Methods: This was a prospective cohort study that consecutively included patients with severe burns admitted in Mulago National Referral Hospital burns unit between February and May 2018. Patients were followed up for 14 days and AKI was assessed according to the KIDGO criteria. The incidence of AKI was expressed as a proportion. Kaplan Meier graph was used to estimate the median survival of patients with or without AKI. The risk factors for AKI were assessed using cox proportion hazard regression analysis. Results: Of the 147 patients screened, 92 met the inclusion criteria but 2 declined to participate in the study. Of the study participants, 48 (53.3%) were male, 47 (52.2%) were aged 3 years and below, the median TBSA was 17 (IQR; 13-23), 58 (69.9%) had low albumin levels and 16 (18.6%) had inhalation burns. The incidence of AKI was found to be 34.4% (95% CI; 25.9-45.9) with a mortality of 11.76% (95% CI; 6.37-20.73). Total burn surface area HR=3.10 (95% CI; 1.39 to 6.94 P=0.003) was the only independent risk factor for AKI. Conclusion: The incidence and mortality rate of AKI in patients with severe burns was found to be high. Having burns greater than 18% TBSA was an independent risk factor for AKI. Therefore, patients with burns greater than 18% should be assessed regularly for AKI so that treatment is instituted early should it occur.
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    Intra-abdominal hypertension in severe burns: prevalence, incidence and mortality in a sub-Saharan African hospital
    (International journal of burns and trauma, 2017) Mbiine, Ronald; Alenyo, Rose; Kobusingye, Olive; Kuteesa, Job; Nakanwagi, Cephas; Monka Lekuya, Hervé; Kituuka, Olivia; Galukande, Moses
    Severe burns have been shown to be a risk factor for developing intra-abdominal hypertension (IAH). Fluid resuscitation practices used in burns management further predispose patients to intra-abdominal hypertension. The mortality associated with IAH in severe burns is estimated to be more than 74.5% once organ dysfunction occurs. Despite 95% of all burns occurring in Low and Middle income countries (LMIC), there is paucity of published data on this topic in sub-Saharan Africa. Objectives: To determine the prevalence, incidence, organ dysfunction and mortality of intra-abdominal hypertension among severe burns patients. Methods: A prospective cohort study was conducted over a 6 months period in the Burns Unit of Mulago National Referral Hospital. Patients of all age groups with burns ≥25% and 20% in adults and children respectively were recruited and followed up for 7 days or until death occurred. Patients with burns older than 48 hours were excluded. The outcome variables were intra-abdominal pressure, organ dysfunction and seven day mortality. Results: Of all the 335 burns patients admitted, 64 patients met the inclusion criteria. The overall prevalence of IAH was 57.8% while the prevalence in the children and adults was 54.5% and 61.3% respectively. The incidence of IAH was 13.1 cases/100 person days with the incidence in adults being twice that of the children. The one week mortality of patients with IAH was 82.6% with the risk of dying being 3.34 (p=0.0035) and seven day survival being less than 50%. Conclusion: One in two patients with severe burns exceeding 20% or 25% in children or adults respectively developed IAH. Adults had a higher prevalence and incidence of IAH. Mortality associated with IAH exceeded 80%.
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    Presentation and Challenges Associated with Management Of Children with Craniofacial Anomalies at Kiruddu Regional Referral Hospital: A Case Series Reflecting On Current Service Provision.
    (East and Central African Journal of Surgery, 2024) Adelaida, Elisamehe Mghase; Romani, Sabas; Opegu, Moses Titus; Muzinda, Owen; Seif, Nuru; Wandabwa, Joel; Najjingo, Irene; Alenyo, Rose
    Craniofacial anomalies encompass a wide range of congenital malformations affecting the head and face, creating substantial medical, social, and psychological challenges for children and their families. In low-resource settings like Uganda, managing these conditions is especially difficult due to limited access to multidisciplinary specialized care. The shortage of Craniofacial Surgeons and inadequately equipped healthcare facilities further complicate the delivery of proper treatment. This study presents three cases of children with craniofacial anomalies attended at Kiruddu Regional Referral Hospital in Uganda, highlighting the significant gaps in care and the pressing need for enhanced medical resources in East Africa.
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    Safety and feasibility of autologous adipose-derived stromal vascular fraction in the treatment of keloids: a phase one randomized controlled pilot trial
    (American Journal of Stem Cells, 2023) Mbiine, Ronald; Kayiira, Anthony; Wayengera, Misaki; Guyton, Munabi Ian; Kiwanuka, Noah; Alenyo, Rose; Wamala Kalanzi, Edris; Muwonge, Haruna; Nakanwagi, Cephas; Joloba, Moses; Galukande, Moses
    Autologous adipose-derived stromal vascular fraction (SVF) has been described to have therapeutic benefits in the treatment of keloids. However, most of the evidence on its efficacy is based on observational studies the majority of which are conducted in high-income countries and yet the highest burden of keloids is in low- and middle-income countries (LMICs). Objectives: We set out to determine the safety and feasibility of using autologous adipose derived stromal vascular fraction in the treatment of keloids in LMICs. Methods: In this phase II randomized controlled pilot clinical trial conducted in the Plastic Surgery Unit of Kirruddu National Referral Hospital in Kampala Uganda, 8 patients were assigned a 1:1 ratio to either SVF or triamcinolone acetonide (TAC) arms. In the SVF arm, a median (Inter quartile range) amount of stromal cell infiltration of 2.7×106 (11×106) was administered, while the controls received 10 mg/ml TAC at a ratio of 1:1 TAC to keloid volume. Primary endpoints were adverse event development based on the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 tool and feasibility assessment based on ≥ 70% recruitment feasibility and ≥ 80% interventional feasibility rates. Results: The participants’ mean age was 27.9 (±6.5) years, with a female predilection of 5 (63%). Overall, no adverse events were reported in the SVF arm, while ulceration in a single patient in the TAC arm, which was a grade II adverse event, was reported. Recruitment feasibility of 80% and interventional feasibility with 100% completion were reported. Conclusion: Based on our findings, an autologous adipose-derived stromal vascular fraction is feasible and safe for the treatment of keloids in LMICs.
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    Upper extremity functions, social relationships, and factors associated with poor quality of life in patients with burns at kiruddu hospital
    (International journal of burns and trauma, 2022) Osman, Kamaludin D.; Alenyo, Rose; Mbiine, Ronald; Murithi, Benard M.; Sheikdon, Abdirizak A.
    Burn is the major cause of disability in developing countries, and most burn patients have burns involving the upper limbs. Upper limb burns can result in scarring, contractures, and weakness, leading to limitation of wide range of movements and social well-being, hence reducing the quality of life. General objective: To determine the quality of life among patients with burns of the upper limbs at KNRH. Methods: This cross-sectional study recruited 108 participants of 5 years and above during their first six months post-discharge from Kiruddu National Referral Hospital with burns to upper limbs. Recruitment was consecutive from the burns unit clinic following ethical approval from the School of Medicine Research and Ethics Committee (SOMREC). Participants were given a burn-related QOL questionnaire. Data were then entered into Epidata 4.2 and imported into STATA 15.1 for analysis. Factors associated with poor quality of life were determined by modified Poisson regression to generate prevalence ratios with 95% confidence intervals. Results: A total of 108 participants were recruited for the study; 97 (89.8%) were adults and responded to the adult QOL questionnaire, while the rest were pediatrics. The mean age of the adults was 28 years (SD=8.6), while the median age of the pediatrics was eight years (IQR=6-10), and 61.1% were male. The upper extremity function (physical) quality of life was good, while the social relationship quality of life was poor. The factors associated with poor quality of life were degree (deep) of burns, multiple surgeries, age above 55 years, and being divorced. Conclusions: There is generally poor upper extremity function or physical QOL among adults and children, while there is generally good social relationship QOL among adults and children.