Browsing by Author "Nuwagaba, Julius"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Cytoreductive Surgery for Giant Locally Advanced Intra Abdominal Tumors in Uganda
    (Journal of Surgical Case Reports, 2022) Okello, Michael; Nuwagaba, Julius; Ddungu, Henry; Okuku, Fred Machyo
    Cytoreductive surgery is removal of tumor as much as possible when complete resection is impossible because of advanced disease. It is a management option for giant intra-abdominal tumors with pressure symptoms. We present three patients who underwent cytoreductive surgery for giant intra-abdominal tumors between May 2019 and November 2021. Patient 1 had a gastrointestinal stromal tumor (GIST) involving stomach, spleen and transverse colon. En bloc resection of the GIST with the involved viscera was done. Patient 2 had a liposarcoma measuring 25.8 × 19.6 × 15.3 cm infiltrating the stomach, spleen and the left hemidiaphragm. Involved viscera and liposarcoma were resected en bloc. Patient 3 had a liposarcoma measuring 40 × 35 × 12 cm and encasing the left ureter. Mass was excised together with part of the left ureter and left ureter reconstructed. Giant intra-abdominal tumors are rare. Involvement of adjacent structures may necessitate multivisceral resections with or without organ reconstruction.
  • Thumbnail Image
    Item
    Patients’ Involvement in Decision-Making During Healthcare in a Developing Country: A Cross- Sectional Study
    (Patient preference and adherence, 2021) Nuwagaba, Julius; Olum, Ronald; Bananyiza, Ali; Wekha, Godfrey; Rutayisire, Meddy; Kato Agaba, Keneth; Chekwech, Gaudencia; Nabukalu, Jalidah; Nanyonjo, Genevieve Gloria; Namagembe, Robinah; Nantongo, Sylvia; Lubwama, Margaret; Besigye, Innocent; Kiguli, Sarah
    Patient autonomy and participation have a significant impact on patient satisfaction and compliance with treatment. We aimed to establish and describe the level of shared decision-making (SDM) among the patients in a developing country. Uganda is a low resource country with a 2019 GDP of 35.17 billion US dollars. In some regions, over 60% of Ugandans live below the national poverty line and most of them depend on the underfunded health care system. Methods: A cross-sectional, quantitative study was carried out among the outpatients attending Kisenyi Health center IV, Kampala, Uganda. An interviewer-administered questionnaire with a 5-point Likert scale was used to assess patients’ SDM. All statistical analysis was performed using STATA 15 software. Results: A total of 326 patients participated in this study. Majority of the participants were females (n=241, 73.9%) and aged 18–35 years (n=218, 66.9%). Only 22 (7%) of the participants knew the name of their consulting doctor. Most of the participants, 84% were given enough time to narrate their symptoms. Overall, only 11.3% (n=37) of the participants had adequately participated in SDM. The overall mean score of participation in SDM was 2.7 (SD:0.8). Participants who knew the name of their consulting doctor were approximately 11 times more likely to participate in SDM (OR: 10.7, 95% CI: 4.2–27.0, P<0.0001). Conclusion: The majority of patients attending Kisenyi Health Center IV did not adequately participate in SDM. Continued medical education should be organized for healthcare professionals to promote SDM.