Browsing by Author "Ongom, Peter"

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    Aetiology and Presentation of Intestinal Obstruction among Patients Presenting to a Tertiary Hospital in Uganda
    (Int J Crit Care Emerg Med, 2016) Nakanwagi, Arlene Muzira; Kijjambu, Stephen C.; Ongom, Peter; Luggya, Tonny Stone
    Intestinal Obstruction is the impairment of normal flow of intestinal contents from mouth to anal canal with aetiology that varies depending on various factors. Understanding aetiology of a country’s surgical services has proven to aid better planning for its emergency surgical conditions. Mulago, which is Uganda’s National Referral Hospital, is resource constrained with a surgical burden of 33% due to acute abdomen with Intestinal Obstruction. This study aimed to determine the current presentation pattern and etiological factors of Intestinal Obstruction at Mulago. Ethical approval was got, from Makerere University School of Medicine IRB, to carry out a prospective observational study among surgical patients admitted to Mulago Hospital’s surgical wards and units. All patients admitted to the hospital for the study period that fitted the inclusion criteria, with suspected partial or complete Intestinal Obstruction or those with confirmed diagnosis intraoperatively were consented and enrolled. Results: We recruited 110 with 79 (71.8%) males and 31 (28.2%) females. Paediatric patients of 0-12 years were 45 (41.0%) and 65 (59%) were adults above 13 years. We had 50% that presented after 72 hrs of symptoms, 24.6% of these were initially managed in a health centre and only 7.3% of the participants presented within 24 hours. The commonest symptoms that presented were colicky abdominal pain, vomiting, abdominal distension and relative constipation. Hernias were the commonest cause of Intestinal Obstruction in adults followed by gut volvulus then adhesions and tumours while in the paediatric group had intussusceptions as the most common aetiological factor followed by Anorectal malformations and then congenital atresia plus stenosis as third commonest cause of in children respectively. Hernias followed by intestinal volvulus were the commonest adult aetiology while intussusceptions followed by Anal Rectal Malformations were the commonest paediatric aetiology of intestinal obstruction. In Mulago hospital with colicky abdominal pain, abdominal distension and vomiting as the commonest presenting symptoms with males the predominantly affected sex.
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    Outcomes of Management of Intestinal Obstruction at an Urban Tertiary Hospital in Sub Saharan Africa: a cross‑sectional study
    (BMC surgery, 2021-11-30) Nakanwagi, Arlene Muzira; Kijjambu, Stephen C.; Ongom, Peter; Luggya, Tonny Stone
    Intestinal obstruction (IO) is a common cause of acute abdomen globally, it remains challenging as it increases surgical financial expenditure while also causing major morbidity. Clinically it presents with nausea, vomiting, colicky abdominal pain and cessation of bowel movements or passage flatus and stool. Diagnosis, especially in resource limited settings, can be clinical but is usually confirmed radiologically. We studied the current diagnosis, management and outcomes of IO in Mulago Hospital. This was a prospective study done at all the surgical units of Mulago from January to May 2014 to assess general diagnosis and management of IO. Ethical approval was got in line with Helsinki declaration, we used pretested and validated questionnaires to collect data. Informed consent was got with eligible and consenting/assenting patients that fitted the inclusion criteria of age and presenting with suspected intestinal obstruction. Uni-variate and bi-variate variables analysis was done plus measures of association. We enrolled 135 patients, excluded 25 and recruited 110 patient. We had more males than females i.e. 71.8% males and 28.2% females. Colicky abdominal pain, abdominal distension, and vomiting were commonest symptoms, then abdominal distension, increased bowel sounds and abdominal tenderness were the commonest signs. Most patients’ (51%) were diagnosed radiologically with a lesser number clinically diagnosed. “Dilated bowel loops” was the commonest radiological sign. Surgery was the main stay of management at 72.7% while 27.3% were conservatively managed. Postoperatively the bowels opened averagely on the 3rd post-operative day (POD) with return of bowel sounds occurring on 5th POD. Most discharges (73%) occurred by the 7th POD. Unfavourable outcomes were prolonged hospital stay followed by wound sepsis (surgical site infection) and then Mortality. This study noted that In Mulago we mostly diagnosed patients radiologically with most surgically managed and which is similar to regional practices. Postoperatively bowel opening happening on third POD with return of bowel sounds on fifth POD. Prolonged hospital stay followed by wound sepsis and then mortality were commonest unfavorable management outcomes.
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    Red blood cell folate as a risk factor for breast cancer among patients at a tertiary hospital in Uganda: a case control study
    (World journal of surgical oncology, 2014) Rukundo, Gideon; Galukande, Moses; Ongom, Peter; Fualal, Jane O.
    Folate has been shown to play a complex but unclear role in carcinogenesis, with some studies showing that low folate intake protects against early carcinogenesis while high folate intake promotes advanced carcinogenesis. Other studies have shown that high folate is associated with decreased breast cancer risk and overall survival, yet others found no such association. This study therefore sought to determine the association between red blood folate levels and breast cancer among women seen at a tertiary Ugandan hospital. Methods: A case control study was conducted where female patients with a histological diagnosis of breast cancer were recruited as cases, and females without cancer attending other surgical clinics as controls. Demographics and social behavior data were collected and 5mls of blood drawn for laboratory testing of red blood cell (RBC) folate, serum vitamin B12 and RBC count. Ethical approval was obtained. Results: In this study, a total of 145 women were recruited as 72 cases and 73 controls. The odds of having breast cancer among women with normal folate levels compared to those with low folate levels were 1.4 (95% CI 0.7 to 2.9) P = 0.290. Ninety participants (63%) had low RBC folate and 53 participants (37%) had normal RBC folate. Thirty five (45%) of the women from a rural setting had normal folate levels compared to 18(28%) women from an urban setting.