Browsing by Author "Ogwang, D.M."

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    Prostatic Specific Antigen (PSA) Relationship to Patients Age, Prostate Volume and Prostate Histology at St Mary’s Hospital Lacor.
    (East and Central African Journal of Surgery, 2014) Okello, T.R.; Alema, N.O.; Ogwang, D.M.
    The use of PSA for the diagnosis of cancer prostate has remained controversial as well as unreliable because many factors affect PSA levels. Included amongst the many factors that can increase PSA level are riding bicycle, rectal exam, sex, age, serum calcium, prostate inflammation, increased prostate volume. This study was aimed at determining the clinic-patho-radiological finding of patients presenting with enlarged prostate and to determine the PSA profile of all patients presenting with enlarged prostate in St. Mary’s Hospital Lacor. Results: Approximate 135 patients were evaluated in the study and significantly, elderly persons constituted 64.5%, compared with Adult (34.5%) and youth 1%, (P=0.00). Most patients presented with retention of urine (30%), dribbling of urine (23%), hesitancy (16%) and dysuria (13%). When the serum PSA was classified into Low (0.1-2.4ng/ml), Moderate (2.5-3.9ng/ml) and High 4ng/ml and above, we found that 60.7% of the patients had high PSA while 9.6% had moderate and low was 29.6%. PSA correlates positively with patients age (r= 0.24, P=0.005). Prostates volume also correlates positively with serum PSA, (Pearson’s Correlation r=0.275 and P= 0.002). Age and prostate volume also had a significant relation P=0.054 but there was only a very weak relationship between PSA level and Histological diagnosis, (Pearson’s correlation r=0.1). Conclusion: Age and prostate volume significantly correlate with serum PSA, just as age and prostate volume also correlates significantly.
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    Sigmoid Volvulus and Ileosigmoid Knotting at St. Mary’s Hospital Lacor in Gulu, Uganda.
    (East and Central African Journal of Surgery, 2009) Okello, T.R.; Ogwang, D.M.; Kisa, P.; Komagum, P.
    Sigmoid volvulus is a common cause of intestinal obstruction in developing countries where it affects relatively young people. Little is known about this condition in our country and there is yet no literature from an environment like ours (northern Uganda) where civil war has devastated the economy with most of the populace displaced into internally displaced peoples’ camp. The main objective of this study was to determine the demographics, treatment and outcome of sigmoid Volvulus cases seen at Lacor Hospital. Methods: This was both a retrospective and prospective study of patients who presented with sigmoid volvulus at St. Mary’s Hospital Lacor over a period of 61/2 years from 1st January 2002 to 31st July 2008. Medical records of patients who underwent sigmoid surgery was stratified for the following measures; demographic characteristics, presentation to hospital (emergency or elective), operative finding and operative procedure, complication, co-ominous factors and outcome. Similar data was gathered from patients who were prospectively followed up. Data was analyzed using SPSS. Results: A total of 44 patients were studied. Their age ranged from 16 to 80 years with a mean of 52.2years (SD +/- 15.98) and a mode of 60years. There was a preponderance of male (84%) with a male to female sex ratio of 5.3: 1. The disease significantly affected the older males compared with females P=0.032. Approximately 77% of the patients presented acutely and had to undergo emergency surgical intervention, the rest were subacute. About 75% of the patients were treated with primary resection and anastomosis, of which 52.2% were emergency cases. Colostomy was offered to 20.5% and sigmoidoscopic derotation to 4.5%. Overall mortality rate was 15.9% and of the patients who died, 18% had primary resection and anastomosis, while 11% were offered colostomy, (P>0.05). Most of those who died were either the older ones (median age 68years) and/or had co morbid illness such as diabetes mellitus, hypertension, intra-abdominal abscess and cancer. Conclusion: Sigmoid volvulus is relatively rare in our community. It commonly affect males particularly the old. Most of the patients presented acutely, requiring immediate resuscitation and surgical approach. In viable bowel, primary resection and anastomosis of the twisted sigmoid is feasible as it may not adversely affect outcome. Nevertheless colostomy should be considered if the bowel is gangrenous or perforated. Though the disease carries a high mortality, most of the patient who die are either older and/or have co-morbid conditions.