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.

Small gut injuries in blunt abdominal trauma: 18 cases from Uganda

Abstract: Summary Eighteen cases of damage to the jejunum and ileum by blunt injury of the abdomen are described. None was caused by road accidents and there were seven deaths.

Traumatic spondyloptosis of the lumbar spine: a case report.

Abstract: Introduction: Spondyloptosis is the most severe of translation spine injuries. It results in complete disruption of the structural elements of the vertebral column and the adjacent paravertebral soft tissues, culminating in severe biomechanical instability. Although several cases of lumbosacral spondyloptosis have been documented, not many cases of traumatic lumbar spondyloptosis have been published in the literature. Case presentation: We present a case of a 34-year-old man of Nilo-Hamitic ethnicity who presented to our unit with paraplegia following injury from the collapse of a concrete wall. Radiographic images showed spondyloptosis at the fourth lumbar vertebral level. He underwent surgery where decompression, reduction, posterior instrumentation and bone grafting through a posterior approach were done. He started regaining motor power 48 hours postoperatively. He is currently undergoing rehabilitation and is steadily improving, 2 months postoperatively. Conclusions: In limited-resource settings there is a tendency of “skilful neglect” of complex injuries. Where resources allow, surgical reconstruction of spondyloptosis should be attempted irrespective of the severity of the initial neurological deficit because there are chances of neurological improvement.

Coping with TB immune reconstitution inflammatory syndrome

Abstract: The TB immune reconstitution inflammatory syndrome (IRIS) is a relatively frequent complication in HIV–TB-coinfected patients after they start highly active antiretroviral therapy (HAART). There are two forms of TB IRIS: the ‘paradoxical’ type (clinical worsening of a patient on TB treatment) and the ‘unmasking’ type (undiagnosed TB becoming apparent after starting HAART). Their pathogeneses are not fully understood, although, as the name suggests, IRIS following initiation of HAART is accompanied by an increase in immune responses to Mycobacterium tuberculosis. The diagnosis of TB IRIS is mainly clinical; so far there are no laboratory tests able to diagnose or predict TB IRIS. Risk factors for TB IRIS include a low CD4+ lymphocyte count, disseminated TB infection at HAART initiation and a short interval between TB treatment and HAART initiation. TB IRIS complicates the treatment and care for HIV–TB-coinfected patients. In this paper, we discuss some aspects of pathogenesis and options for the treatment ...

A phased approach to implementing the Breast Imaging Reporting and Data System (BI-RADS) in low-income and middle-income countries.

Abstract: Background Successful breast cancer detection programs rely on standardized reporting and interpreting systems, such as the Breast Imaging Reporting and Data System (BI-RADS), to improve system performance. In low-income and middle-income countries, evolving diagnostic programs have insufficient resources to either fully implement BI-RADS or to periodically evaluate the program's performance, which is a necessary component of BI-RADS. This leads to inconsistent breast ultrasound interpretation and a failure to improve performance. Methods The authors applied the Breast Health Global Initiative's phased implementation strategy to implement diagnostic ultrasound and BI-RADS within the context of a limited-resource setting. Results The authors recommended starting with triage ultrasound to distinguish suspicious masses from normal breast tissue and benign masses such as cysts because the majority of health workers performing ultrasounds at this level have minimal breast imaging experience. Transitioning to full diagnostic ultrasound with condensed or full BI-RADS should occur after performance and quality metrics have been met. Conclusions Transitioning through these phases across facilities likely will occur at different times, particularly in rural versus urban settings.