Mulago Hospital

About: Mulago Hospital is a healthcare organization based out in Kampala, Uganda. It is known for research contribution in the topics: Population & Health care. The organization has 542 authors who have published 545 publications receiving 34804 citations.

Hyperglycemia in severe traumatic brain injury patients and its association with thirty-day mortality: a prospective observational cohort study in Uganda

Abstract: Background Traumatic brain injury (TBI) is a growing public health concern that can be complicated with an acute stress response. This response may be assessed by monitoring blood glucose levels but this is not routine in remote settings. There is a paucity of data on the prevalence of hyperglycemia and variables associated with mortality after severe TBI in Uganda. Objective We aimed to determine the prevalence of hyperglycemia in patients with severe TBI and variables associated with 30-day mortality at Mulago National Referral Hospital in Uganda. Methods We consecutively enrolled a cohort 99 patients patients with severe TBI. Serum glucose levels were measured at admission and after 24 h. Other study variables included: mechanism of injury, CT findings, location and size of hematoma, and socio-demographics. The main outcome was mortality after 30 days of management and this was compared in patients with hyperglycemia more than 11.1 mmol/L to those without. Results Most patients (92.9%) were male aged 18-30 years (47%). Road Traffic Collisions were the most common cause of severe TBI (64.7%) followed by assault (17.1%) and falls (8.1%). Nearly one in six patients were admitted with hyperglycemia more than 11.1 mmol/L. The mortality rate in severe TBI patients with hyperglycemia was 68.8% (OR 1.47; 95% CI [0.236-9.153]; P = 0.063) against 43.7% in those without hyperglycemia. The presence of hypothermia (OR 10.17; 95% CI [1.574-65.669]; P = 0.015) and convulsions (OR 5.64; 95% CI [1.541-19.554]; P = 0.009) were significant predictors of mortality. Conclusion Hypothermia and convulsions at admission were major predictors of mortality in severe TBI. Early hyperglycemia following severe TBI appears to occur with a tendency towards high mortality. These findings justify routine glucose monitoring and could form the basis for establishing a blood sugar control protocol for such patients in remote settings.

Interventions for male involvement in pregnancy and labour: A systematic review

Abstract: Male involvement in pregnancy and labour care has been shown to improve maternal and newborn outcomes. Nevertheless, it continues to be low, especially in low income countries. Several interventions have been suggested for supporting male involvement in reproductive health and maternity care, but no assessment has been made in terms of their effectiveness. The objective of this review was to summarise and evaluate the current evidence related to male partner involvement in maternal health. Three databases were searched electronically. This review included two randomised controlled trials and two observational studies. Two interventions emerged from the review: facility-based couple health education and workplace-based health education. These interventions showed positive outcomes regarding the presence of partners during antenatal visits, postpartum visits, childbirth, and the initiation of breastfeeding within one hour of birth among others. More rigorous research is needed into strategies for, and the e...

Severe falciparum malaria associated with massive pulmonary embolism

Abstract: Falciparum malaria is known to cause alterations in the coagulation cascade, including disseminated intravascular coagulation. Microthrombotic complications are the best described; however, a number of cases of thrombosis involving larger vessels have been published in the literature. Herein, we describe the case of a woman with malaria associated with massive pulmonary embolism.

Pancreatic exocrine function in African patients

Abstract: 1. 1. African subjects in Uganda had a normal response to a secretin-pancreozymin test of exocrine pancreatic function. 2. 2. Patients with pancreatic lithiasis had gross impairment of both fluid volume and bicarbonate output during the test; in addition, 4 patients with diabetes mellitus without lithiasis had abnormal responses. 3. 3. 7 of 10 patients with protein calorie malnutrition had moderately impaired exocrine function. 4. 4. The significance of these findings, and the need for a suitable test of exocrine pancreatic function in children, are discussed.