Browsing by Author "Muwonge, Haruna"
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Item A descriptive prospective study of sports medicine practices for athletes in Uganda(African Health Sciences, 2021) Lubega, Samuel K.; Makubuya, Timothy; Muwonge, Haruna; Lambert, MikeBackground: Many international sporting organizations have recommended practices to reduce the risk of injury. These practices include screening for injury, having appropriate emergency medical care, and protocols for managing injury before return-to-play. The extent of the uptake of these practices in a developing country such as Uganda, is unknown. Methodology: Using a descriptive case study approach, this investigation focused on a sample of injured athletes (n= 75) in Uganda from four main sports associations (football, athletics, basketball and rugby). The data were collected through observations and interviews after the injury. Using a best medical practice framework the phases of emergency, intermediate, rehabilitative, and return-to-sports participation were described. Result: Nine conditions/types of injury were included. The results revealed a lack of specific pre-season screening or re-turn-to-play readiness for all the injured athletes. Further, there was a lack of application of best practice principles for most of the injury types. For athletes who received medical care, the results show inconsistencies and inadequacies from the acute stage of the injury to return-to-sports participation. Conclusion: This study identified barriers such as up-to-date knowledge among the sports resource providers; the gaps for appropriate and adequate specific facilities for managing injured athletes, and policies to mandate care of injured athletes. These barriers detract from applying best medical practices.Item 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, MosesAutologous 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.Item Comparison of the Hyperglycemic Control of M. oleifera Leaves Aqueous Extract and Glibenclamide Tablets in Alloxan Monohydrate Induced Diabetic Rats(Asian Journal of Research in Medical and Pharmaceutical Sciences, 2019) Kasolo, Josephine N.; Namaganda, Agnes; Nfambi, Joshua; Kimuli, Ivan; Muwonge, Haruna; Okullo, IsaacDiabetes being one of the commonest non-communicable diseases worldwide has no cure. The available hypoglycemic drugs are costly, and have associated long-term side effects. M. oleifera leaves are used in many countries in Africa and Asia to treat diabetes. The study compared the hyperglycemic control of M. oleifera leaves aqueous extract and Glibenclamide tablet in alloxan monohydrate induced diabetic rats. Methods: Twenty-four female Wistar albino rats, made diabetic using alloxan monohydrate, received either M. oleifera extract, glibenclamide or distilled water were delivered intragastric. The mean body weight and mean fasting blood sugar were measured over a period of 28 days. Results: Rats that received distilled water had a mean fasting blood sugar of 329.3+44.9 mg/dl at the beginning, which increased to 448.0+189.9 mg/dl on day 14; all the rats were dead by day 21. The rats that received M. oleifera had blood sugar 443.4+134.7 mg/dl at the beginning, dropped to 166.5+162.79 mg/dl by day 14, and to 88.7+41.0 mg/dl by day 28. Rats that received glibenclamide had blood sugar 517.6+139.3mg/dl at the beginning, dropped to 209.0+201.9 mg/dl on day 14, and to 89.7+42.85 mg/dl on day 28. The blood sugar of the M. oleifera and glibenclamide groups reached normal level by day 21 and remained within the normal range up to day 28. Conclusion: Moringa oleifera leaves aqueous extract has similar pattern to glibenclamide tablet in causing hypoglycemia to alloxan monohydrate induced diabetic rats.Item Green synthesis and characterization of iron‑oxide nanoparticles using Moringa oleifera: a potential protocol for use in low and middle income countries(BMC Research Notes, 2022) Kiwumulo, Henry Fenekansi; Muwonge, Haruna; Ibingira, Charles; Lubwama, Michael; Kirabira, John Baptist; Tamale Ssekitoleko, RobertGreen synthesized iron(III) oxide ( Fe3O4) nanoparticles are gaining appeal in targeted drug delivery systems because of their low cost, fast processing and nontoxicity. However, there is no known research work undertaken in the production of green synthesized nano-particles from the Ugandan grown Moringa Oleifera (MO). This study aims at exploring and developing an optimized protocol aimed at producing such nanoparticles from the Ugandan grown Moringa. Results: While reducing ferric chloride solution with Moringa oleifera leaves, Iron oxide nanoparticles ( Fe3O4-NPs) were synthesized through an economical and completely green biosynthetic method. The structural properties of these Fe3O4- NPs were investigated by Ultra Violet–visible (UV–Vis) spectrophotometry, X-ray diffraction (XRD), energy dispersive X-ray spectroscopy (EDX) and scanning electron microscopy (SEM). These nanoparticles exhibited UV–visible absorption peaks at 225 nm (nm) for the sixth dilution and 228 nm for the fifth dilution which indicated that the nanoparticles were photosensitive and the SEM study confirmed the spherical nature of these nanoparticles. The total synthesis time was approximately 5 h after drying the moringa leaves, and the average particle size was approximately 16 nm. Such synthesized nanoparticles can potentially be useful for drug delivery, especially in Low and Middle Income Countries (LMICs).Item Low Back Pain Effects, Management and Coping Strategies among Pregnant Women Attending Antenatal Clinic in Eastern Uganda: A Cross- Sectional Study.(Research Square, 2021) ZAVUGA, Robert; Waako, Susan; Twimukye, Moses; Mugambe, Richard K; Isunju, John Bosco; Muwonge, Haruna; Masete, Ivan; Kusasira, Stephen; Guwatudde, David17AbstractBackgroundDespite Low back pain (LBP) being one of the most common complaints among pregnant women,healthcare workers write it off as a normal experience of the pregnancy, thus remaining untreated. It isknown to affect the daily functionality of many pregnant women in activities including those that involvesitting, walking, standing and lifting. The inadequacy of information on LBP among pregnant women inUganda may have led to the unavailability of obstetric guidelines for its diagnosis and management. Thisstudy established the effects of LBP effects on daily performance, management and coping strategiesamong pregnant women attending an antenatal clinic in Eastern Uganda.MethodsThis was a cross-sectional study that enrolled 341 pregnant women attending antenatal care. Theprimary outcome measure was LBP. The study enrolled pregnant women who reported having LBP andcorrectly located the site of the pain using the pain and body chart as having LBP. Data onsociodemographic characteristics, pain intensity, functional disability, effects of LBP on dailyperformance, management and coping strategies were collected.ResultsOf the 341 respondents, (105, 30.8%) reported LBP. Majority of the women with LBP (71, 67.6%) hadminimal disability with an Owestry Disability Index (ODI) score of 0-20%. The activities that were mostaffected with mild interference on daily routine activities were lifting 81%, standing 74%, personal care74% and traveling 74%. Majority of the respondents (80, 76.19%) reported their LBP during the Antenatalcare (ANC) visits at the hospital and of these 62 (79.49%) were given painkillers, 13 (16.67%) receivedcounselling and patient education, 3 (3.85%). For the respondents who did not receive any treatment fromthe ANC visits, the majority (23, 60.53%) used herbs and others used self-medication (5, 13.16%)ConclusionLBP affects most of the daily functional activities of pregnant women with minimal and moderatedisability. Although the disability is not severe, it affects their quality of life and productivity. The pregnant women managed their LBP mainly by conservative means of treatment, especially by the use ofpharmacological management and rest from activities.Item Nutritional supplement practices of professional Ugandan athletes: a crosssectional study(Journal of the International Society of Sports Nutrition, 2017) Muwonge, Haruna; Zavuga, Robert; Kabenge, Peninnah A.; Makubuya, TimothyThe use of nutritional supplements (NS) places athletes at great risk for inadvertent doping. Due to the paucity of data on supplement use, this study aimed to determine the proportion of Ugandan athletes using nutritional supplements and to investigate the athletes’ motivation to use these supplements. Methods A cross-sectional study was conducted in which an interviewer-administered questionnaire was used to collect data from 359 professional athletes participating in individual (boxing, cycling, athletics) and team (basketball, rugby, football, netball, and volleyball) sports. The data were categorized, and a Chi-square test was used for statistical analysis. Results Of the 359 athletes, 48 (13.4%) used nutritional supplements. Carbohydrate supplements, energy drinks, vitamin and mineral supplements, fish oils, and protein supplements were the most common supplements used by athletes. NS use was significantly more common among athletes who played rugby and basketball (X 2 = 61.101, p < 0.0001), athletes who had played the sport for 5-10 years (X 2 = 7.460, p = 0.024), and athletes who had attained a tertiary education (X 2 = 33.377, p < 0.0001). The athletes’ occupation had no bearing on whether they used supplements. Nutritionists/dieticians, retail stores and pharmacies were the most common sources of NS products, whereas health practitioners, online media and teammates were the most common sources of information regarding NS. Most athletes used NS to improve their physical performance and health. Conclusions Compared to NS use by athletes elsewhere, NS use among Ugandan athletes was low. However, determinants of athlete NS use in the current study (category of sport and duration of time spent playing the sport) are similar to those reported elsewhere.Item Reversal Effects of N-Acetyl Cysteine on Moringa oleifera Leaves-Induced Sub-Acute Hepatotoxicity in Wistar Albino Rats(Neuroscience & Medicine, 2019) Kasolo, Josephine N.; Namaganda, Agnes; Bbosa, Godfrey S.; Muwonge, Haruna; Lukande, Robert; Nfambi, Joshua; Kimuli, Ivan; Okullo, IsaacM. oleifera is a highly valued medicinal plant used widely from time immemorial to treat various ailments. However, with continued un-standardized use of the plant leaves, studies have reported organ toxicity to the liver, kidney and the heart. As communities continue to use M. oleifera leaves for its medicinal and nutritional values, there is need to find an antidote for its hepatotoxicity. Aim: The study established the reversal effect of N-Acetyl Cysteine (NAC) on M. oleifera aqueous leaf extract-induced hepatotoxicity in Wistar albino rats. Methods: Twenty-four (24) rats received a toxic dose (8.05 g/kg bwt) of M. oleifera leaf extract for 28 days to cause sub-acute hepatotoxicity. They were divided into 4 groups of 6 rats each. Group I received 1 ml normal (control group), Group II received 1000 ng/kg NAC, Group III received 1200 mg/kg NAC and Group IV received 1500 mg/kg NAC. Another group of 6 rats (Group V) received 0.75 mg/kg Paracetamol to cause hepatotoxicity. Group V (a positive control) received the prescribed clinical dose of 1200 mg/kg NAC which reverses the hepatotoxicity. All the NAC doses were given once a day intragastric for 7 days. On days: 1, 3 and 7 of receiving NAC, liver serum enzymes and bilirubin were measured. On day 7 the animals were sacrificed and liver tissue harvested for histopathology analysis. Results: A dose of 8.05 g/kg of M. oleifera leaf extract and 0.75 mg/kg Paracetamol were able to induce hepatotoxicity in Wister albino rats in 28 days. The M. oleifera extract induced hepatotoxic rats treated with NAC at doses of 1000 mg/kg, 1200 mg/kg and 1500 mg/kg, had a reduction in mean serum liver enzymes, plus reduced mean serum bilirubin levels. The liver histopathological analysis showed reduced inflammation after treatment with NAC for 3 and 7 days in the M. oleifera and paracetamol induced hepatotoxic rats. Conclusion: NAC can reverse M. oleifera leaf aqueous extract-induced sub-acute hepatotoxicity in Wistar Albino rats.Item 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, MosesAutologous 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.Item A systematic review of modeling and simulation approaches in designing targeted treatment technologies for Leukemia Cancer in low and middle income countries(Mathematical Biosciences and Engineering, 2021) Fenekansi Kiwumulo, Henry; Muwonge, Haruna; Ibingira, Charles; Kirabira, John Baptist; Tamale Ssekitoleko, RobertVirtual experimentation is a widely used approach for predicting systems behaviour especially in situations where resources for physical experiments are very limited. For example, targeted treatment inside the human body is particularly challenging, and as such, modeling and simulation is utilised to aid planning before a specific treatment is administered. In such approaches, precise treatment, as it is the case in radiotherapy, is used to administer a maximum dose to the infected regions while minimizing the effect on normal tissue. Complicated cancers such as leukemia present even greater challenges due to their presentation in liquid form and not being localised in one area. As such, science has led to the development of targeted drug delivery, where the infected cells can be specifically targeted anywhere in the body.Item The Effects of Manual Therapy and PRIMFIT Unstable Surface Balance Training on Walking Gait Cycle Post an Acute Grade 3 Inversion Ankle Sprain: A Case Study(Sports Injr Med: JSIMD, 2018) Poremba, Arie V.; Makubuya, Timothy; Muwonge, HarunaThis case demonstrates the effectiveness of a rehabilitation product and protocol that incorporates manual therapy and unstable surface training. The purpose of this case study was to evaluate the effect of a four- week unstable training protocol using PRIMFIT product in conjunction with manual physical therapy on walking gait in a 17- year old, grade 3 ankle sprain with multiple ligament tears. A PRIMFIT protocol was designed and performed bi-weekly under supervision of a physical therapist and also bi-weekly by the patient independently. Patient’s walking gait was tested once a week using an OPTOGAIT System. The patient demonstrated significant clinical and statistical improvement in all gait and time parameters measured by OPTOGAIT system, as well as increased ankle mobility, decreased swelling and markedly decreased pain. For this patient, a combination of manual therapy techniques, PRIMFIT product and rehabilitation Exercises were able to significantly improve and normalize walking gait in addition to eliminating swelling and pain. However, further research is needed with additional cases, especially those with similar or other injuries to develop the efficacy of the PRIMFIT product and protocol.Item Unique Circulating microRNA Profiles in Epidemic Kaposi’s Sarcoma(Research Square, 2020) Muwonge, Haruna; Kasujja, Hassan; Atugonza, Carolyne; Kasolo, Josephine; Lugaajju, Allan; Nfambi, Joshua; Damani, Ali Moses; Sembajwe, Larry Fred; Kimuli, Ivan; Nakazzi, Faith; Nakanjako, Damalie; Kateete, David Patrick; Bwanga, FreddieThe Human herpesvirus 8 (HHV-8), causes Kaposi's sarcoma (KS). Kaposi sarcoma in HIV/AIDS patients is referred to as epidemic KS, and is the most common HIV-related malignancy worldwide. Lack of a diagnostic assay to detect latent and early stage disease has increased disease morbidity and mortality. Serum miRNAs have previously been used as potential biomarkers of normal physiology and disease. In the current study, we profiled the unique serum miRNAs in patients with epidemic KS to generate baseline data to aid in developing a miRNA-based non-invasive biomarker assay for Epidemic KS. This was a comparative cross-sectional study involving 27 patients with epidemic KS, and 27 HIVpositive adults with no prior diagnosis, or clinical manifestation of KS. DNA and RNA were isolated from blood and serum collected from study participants respectively. Nested PCR for circulating HHV-8 DNA was performed on the isolated DNA, whereas miRNA library preparation and sequencing for circulating miRNA was performed on the RNA samples. The miRge2 pipeline and EdgeR were used to analyze the sequencing data.