Browsing by Author "Sereke, Senai Goitom"

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    Aortic Knob Diameter in Chest Radiographs of Healthy Adults in Uganda
    (Informa UK Limited, 2022-03) Magera, Steven; Sereke, Senai Goitom; Okello, Emmy; Ameda, Faith; Erem, Geoffrey
    Background The burden of cardiovascular diseases, such as aortic and degenerative diseases, grows in the aging population. Chest radiograph still plays an important role in the diagnosis of cardiovascular diseases. Aortic knob diameter in chest radiographs can be used to evaluate early changes of the aortic structure and together with clinical and laboratory findings. This study was aimed at determining the mean values of aortic knob diameter among healthy adults in Uganda. Methods We conducted a descriptive cross-sectional study in three selected hospitals in Kampala Uganda. All participants had normal chest radiographs without radiological evidence of cardiovascular disease. Chest radiograph findings extracted included aortic knob diameter, aortic arch diameter, transverse heart diameter, and transverse thoracic diameter. All films were independently examined by two experienced radiologists. Results We analyzed chest radiograph findings of 294 participants, of which 204 (69.4%) were male. Aortic knob diameter increased with age (p – 0.000). The mean aortic knob diameter of males was higher than for females (3.14±0.34cm versus 2.77±0.37cm, p – 0.000). The mean aortic knob diameter on the digital screen was higher than plain films (3.03±0.393cm versus 2.96±0.392cm, p – 0.000). Aortic knob diameter positively correlated with age (p – 0.000) and aortic arch diameter (p – 0.000). Aortic knob diameter also correlated positively with a transverse thoracic diameter (p – 0.05), transverse heart diameter (p – 0.05), and cardiothoracic ratios (p – 0.05). Conclusion The aortic knob diameter was higher in males and there was a positive correlation with age, aortic arch diameter, transverse heart diameter, and transverse thoracic diameter. Aortic knob diameter measurements should be done on digital rather than printed x-ray films.
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    COVID-19, HIV-Associated Cryptococcal Meningitis, Disseminated Tuberculosis and Acute Ischaemic Stroke: A Fatal Foursome
    (Infection and Drug Resistance, 2021) Bongomin, Felix; Sereke, Senai Goitom; Okot, Jerom; Katsigazi, Ronald; Kiiza Kandole, Tadeo; Oriekot, Anthony; Olum, Ronald; Atukunda, Angella; Baluku, Joseph Baruch; Nakwagala, Frederick
    Several viral, bacterial and fungal co-infections have been associated with increased morbidity and mortality among patients with COVID-19. We report a fatal case of severe COVID-19 pneumonia in a patient with a recent diagnosis of advanced HIV disease complicated by cryptococcal meningitis, disseminated tuberculosis and acute ischemic stroke. Case Presentation: A 37-year-old Ugandan woman was diagnosed with HIV infection 8 days prior to her referral to our center. She was antiretroviral naïve. Her chief complaints were worsening cough, difficulty in breathing, fever and altered mental status for 3 days with a background of a 1-month history of coughing with associated drenching night sweats and weight loss. The reverse transcriptase–polymerase chain reaction for SARS-CoV-2 of her nasopharyngeal swab sample was positive. Chest radiograph demonstrated military pattern involvement of both lungs. The serum and cerebrospinal fluid cryptococcal antigen tests were positive. Urine lipoarabinomannan and sputum GeneXpert were positive for Mycobacterium tuberculosis. Computed tomography of the brain showed a large acute ischemic infarct in the territory of the right middle cerebral artery. Regardless of the initiation of treatment, that is, fluconazole 1200 mg once daily, enoxaparin 60 mg, intravenous (IV) dexamethasone 6 mg once daily, oral fluconazole 1200 mg once daily, IV piperacillin/tazobactam 4.5 g three times daily and oxygen therapy, the patient passed on within 36 hours of admission. Conclusion: Co-infections worsen COVID-19 outcomes.