Browsing by Author "Kebba, Naomi"

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    An Unusual Occurrence of Penetrating Aortic Arch Injury by a Ball‑point Pen: a case report and review of the literature
    (Journal of Cardiothoracic Surgery, 2022-12-12) Ariaka, Herbert; Magala, John Paul; Kebba, Naomi; Kabuye, Ronald; Namirembe, Stella Magara; Nalule, Miriam
    Aortic arch injuries account for about 8% of thoracic aortic injuries. Penetrating zone I neck injuries account for 18% of vascular injuries in the neck and have great potential to traverse to involve thoracic vascular structures as well. The hard and soft signs of vascular injury facilitate triage of patients on an individual basis. We present a case of a ball-point pen traversing through zone I of the neck and causing penetrating aortic arch injury with minimal mediastinal haemorrhage. We present a polytrauma patient who was admitted with traumatic brain injury and a ball-point pen lodged above the sternal notch in zone I of the neck following a road traffic accident. He underwent mediastinal exploration via a median sternotomy. The ball-point pen was found penetrating the anterior wall of the aortic arch and resting in its lumen. The ball-point pen was successfully explanted and primary repair of the penetrating aortic arch injury was done. He had an uneventful recovery without any added secondary neurological complications. Penetrating aortic arch injuries are rare compared to injuries of the ascending aorta and descending aorta. They require a high index of suspicion, rapid investigation and urgent intervention in view of their high associated fatality. The ball-point pen in this case assumed the shape of a plug which acted as a seal at the site of injury preventing catastrophic exsanguination.
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    Design, implementation and long-term follow-up of a context specific trauma training course in Uganda: Lessons learned and future directions
    (The American Journal of Surgery, 2020) Ullrich, Sarah J.; Kilyewala, Cathy; Lipnick, Michael S.; Cheung, Maija; Namugga, Martha; Muwanguzi, Peter; DeWane, Michael P.; Muzira, Arlene; Tumukunde, Janat; Kabagambe, Monica; Kebba, Naomi; Galukande, Moses; Mabweijano, Jacqueline; Ozgediz, Doruk
    The Kampala Advanced Trauma Course (KATC) was developed in 2007 due to a locally identified need for an advanced trauma training curriculum for the resource-constrained setting. We describe the design, implementation and evaluation of the course.The course has been delivered to over 1,000 interns rotating through surgery at Mulago National Referral Hospital. Participants from 2013 to 2016 were surveyed after completion of the course.The KATC was developed with local faculty and includes didactic and simulation modules. Over 50% of survey respondents reported feeling confident performing and teaching 7 of 11 course skills and felt the most relevant skill was airway management(30.2%). Participants felt least confident managing head trauma(26.4%). Lack of equipment(52.8%) was identified as the most common barrier to providing trauma care.Providers are confident with most skill sets after taking the KATC. Minimal dependence on instructors from high-income countries has kept the course sustainable and maximized local relevance.