Browsing by Author "Lekuya, Hervé Monka"

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    Adipose-derived stromal vascular fraction (SVF) in scar treatment: a systematic review protocol
    (American Journal of Stem Cells, 2022) Mbiine, Ronald; Wayengera, Misaki; Ocan, Moses; Kiwanuka, Noah; Munabi, Ian; Muwonge, Haruna; Lekuya, Hervé Monka; Kawooya2, Ismael Cephas Nakanwagi3,4, Alison Annet Kinengyere; Joloba, Moses; Galukande, Moses
    Autologous adipose-derived stromal vascular fraction (SVF) is an emerging therapy that is being pioneered as a potential treatment for keloids and hypertrophic scars. Up to this point, there isn’t a cure for keloids and hypertrophic scars yet they comprise the commonest benign skin disorders. Despite published studies reporting potential therapeutic benefits of SVF, their use and efficacy on scar improvement are not clearly described. The aim of this review is to describe the clinical practice involved in harvesting, processing, utilization of SVF, and associated efficacy in scar treatment. Methods: We shall include published clinical articles evaluating the efficacy of SVF on improving scar characteristics and assessment scores among adults with keloids or hypertrophic scars. Article search of Medline/PubMed, Cochrane Library and Embase using Mesh terms of “scars” and “stromal vascular fraction” combined with the Boolean operators (“AND”, “OR”) will be performed by two independent researchers following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) statement. The primary outcome measure will be the mean difference in the Scar characteristics including Scar assessment scores, scar thickness among others. Data synthesis: Descriptive data synthesis and mean differences between treatment arms will be calculated for the primary outcome of the scar assessment scores. In case more than three studies provide consistent characteristics of the scar assessment scores, a meta-analysis will be conducted. Discussion: Evidence obtained from the systematic review will form the foundation upon which further clinical trials research will be conducted in evaluating the efficacy of autologous adipose-derived stromal vascular fraction in keloid and hypertrophic scar. The systematic review has been submitted to the PROSPERO database and is currently under review.
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    Chronic Pain among Children with Cerebral Palsy Attending a Ugandan Hospital: A Cross-Sectional Study
    (Researchsquare, 2021) Bambi, Emma Nsalazi; Mwesige, Angelina Kakooza; Lekuya, Hervé Monka; Kasirye, Philip; Idro, Richard
    Children with cerebral palsy (CP) frequently experience chronic pain. The burden and severity of such pain is often underestimated in relation to their other impairments.Recognition and awareness of this chronic pain among children with CP constitute the cornerstone for caretakers and clinicians to improve the quality of life of those children. This study aimed to determine the prevalence of chronic pain among children with CP, and the factors associated. A cross-sectional study of children with CP, aged 2 – 12 years, attending the CP rehabilitation clinic and Pediatric Neurology Clinic at Mulago Hospital, Uganda from November 2017 to May 2018. A detailed history and clinical examination were performed and the co-morbidities were determined. CP was classified using the Gross Motor Function Classification System (GMFCS), Manual Ability Classification System, Communication Function Classification System (CFCS), and the Eating and Drinking Ability Classification System (EDACS) and documented with the level of impairment in the different domains. Pain was assessed by using the revised Face, Legs, Activity, Consolability, Cry pain scale.A total of 224 children with CP were enrolled. The prevalence of chronic pain was 64.3%. The majority had spastic bilateral CP (77.8%), moderate pain lasting over 6 months, and none of them was on long-term pain management. Epilepsy (60.9%), behavioral problem (63.2%), hearing impairment (66,7%), learning problem (67,6%), dental caries (75%), gastro-esophageal reflux (75%), sleep disorders (79.5%), vision impairment (80%), and malnutrition (90%) were comorbid conditions of chronic pain in children with CP in this study. The factors independently associated with chronic pain among children with CP were the GMFC system level 4 & 5, CFCS level 4 & 5, EDACS level 4 & 5, female children, and caretaker aged more than 30 years.Two-thirds of children with CP attending rehabilitation in this hospital had chronic pain. None was receiving pain management. Chronic pain was associated with the presence of multiple co-morbidities and more severe disability. Rehabilitation and care programs for children with CP should include assessment of pain in routine care and provide interventions for pain relief in children with CP even at an early age.
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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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    Determinants of Knowledge, Attitudes, and Practices of Frontline Health Care Givers During the First Wave of Covid-19 in Africa: a Multi-centers Online Cross-sectional
    (ResearchSquare, 2021) Kamabu, Larrey Kasereka; Lekuya, Hervé Monka; Kasusula, Bienvenu Muhindo; Sikakulya, Franck Katembo; Nganza, Sifa Katungu; Mumbere, Bienfait
    During its first wave in sub-Saharan Africa, there was insufficient understanding of the new pandemic of coronavirus disease 2019 (COVID-19) among frontline health care professionals that has led to a misidentification, and mistreatment of affected patients, with a potential risks of contacting and spreading the disease. This study was carried out to determine the knowledge, attitude, and practices (KAP) of frontline health care givers (HCGs) towards COVID-19 in Africa and their related factors.
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    A Supraclavicular ALK-Positive Anaplastic Large-Cell Lymphoma Initially Misdiagnosed and Yet Successfully Treated with Wide Excision and Adjuvant Chemotherapy: a Case Report
    (SN Comprehensive Clinical Medicine, 2019) Lekuya, Hervé Monka; Wamala Kalanzi, Edris; Mbiine, Ronald; Omoding, Abraham; Rosenwald, Andreas; Lemperle, Gottfried; Bringmann, Gerhard
    ALK-positive Anaplastic Large-Cell Lymphomas (ALCL) are chemo-sensitive cancers; combination of histologic and immunophenotypic or genetic studies remains the main strategy to prevent their unnecessary surgical excision as they canmimic softtissues sarcomas in histology. In sub-Saharan Africa, however, availability and affordability of immunophenotypic studies, especially extended immunohistochemistry (IHC) tests, constitute major limitations for accurate diagnoses. The case presented herein is an example of a heavy surgical management resulting from an initially inaccurate diagnosis, but eventually treated successfully. Case presentation A 15-year-old female patient presented with a 5-month history of a painless right supraclavicular mass. The initial biopsies had conflicting histology reports. In view of its rapid growth, it was first managed surgically, as a high-grade sarcoma stage T4N1M0: a wide “en bloc resection” with primary flap covering was done. Post-operative histology with an extended IHC from the widely resected tissue finally revealed an ALK-positive ALCL, which proved to be sensitive to chemotherapy. An adjuvant chemotherapy of six cycles of CHOP regimen followed with a good response; the patient became clinically stable, and all the investigations that were done, including a PET-CT scan, could not detect any residual active disease. She was still disease-free at 2 years after completion of chemotherapy. Conclusions Although cost-effective, combined histologic and immunophenotypic studies, especially extended IHC tests, can reduce the incidence of misdiagnosed large-cell lymphoma. As exemplified in this present case, obtaining appropriate and sufficient tissue from the tumor could possibly increase the chance of finding an accurate diagnosis.