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.

Measurement error of mean sac diameter and crown-rump length among pregnant women at Mulago hospital, Uganda

Abstract: Ultrasonography is essential in the prenatal diagnosis and care for the pregnant mothers. However, the measurements obtained often contain a small percentage of unavoidable error that may have serious clinical implications if substantial. We therefore evaluated the level of intra and inter-observer error in measuring mean sac diameter (MSD) and crown-rump length (CRL) in women between 6 and 10 weeks’ gestation at Mulago hospital. This was a cross-sectional study conducted from January to March 2016. We enrolled 56 women with an intrauterine single viable embryo. The women were scanned using a transvaginal (TVS) technique by two observers who were blinded of each other’s measurements. Each observer measured the CRL twice and the MSD once for each woman. Intra-class correlation coefficients (ICCs), 95% limits of agreement (LOA) and technical error of measurement (TEM) were used for analysis. Intra-observer ICCs for CRL measurements were 0.995 and 0.993 while inter-observer ICCs were 0.988 for CRL and 0.955 for MSD measurements. Intra-observer 95% LOA for CRL were ± 2.04 mm and ± 1.66 mm. Inter-observer LOA were ± 2.35 mm for CRL and ± 4.87 mm for MSD. The intra-observer relative TEM for CRL were 4.62% and 3.70% whereas inter-observer relative TEM were 5.88% and 5.93% for CRL and MSD respectively. Intra- and inter-observer error of CRL and MSD measurements among pregnant women at Mulago hospital were acceptable. This implies that at Mulago hospital, the error in pregnancy dating is within acceptable margins of ±3 days in first trimester, and the CRL and MSD cut offs of ≥7 mm and ≥ 25 mm respectively are fit for diagnosis of miscarriage on TVS. These findings should be extrapolated to the whole country with caution. Sonographers can achieve acceptable and comparable diagnostic accuracy levels of MSD and CLR measurements with proper training and adherence to practice guidelines.

A development study of pulmonary rehabilitation for patients with chronic lung disease in Uganda

Abstract: Background: Chronic lung disease (CLD) is a growing burden in Uganda. There is no useful treatment, but sufferers have poor health status and often are stigmatised. We aimed to test feasibility of a pulmonary rehabilitation (PR) programme in Kampala, Uganda, and adapted traditional PR for patients with post-TB lung disease and COPD. Methods: In a development study, respiratory specialists, nurses and physiotherapists formed a PR team. The exercise regime was based on conventional PR; the education programme covered normal lungs, post TB damage and COPD including breathlessness, exercise, nutrition, smoking and drug treatments. Qualitative and quantitative assessment of the programme included recruitment, retention and outcome measures including exercise capacity and health status questionnaires. Results: In March 2015- December 2015, 4 groups were conducted. In total we screened 193 (Post-TB 113 and 80 COPD) patients, 72 were assessed 46 were suitable and 44 started rehab (17 male; mean age 44 years, range 17-83) with 42 (95%) completing and 39 followed 6 weeks after. Main outcomes in Table 1. Conclusion: PR is feasible and appears effective in CLD and post TB patients in Uganda, but an adequately powered controlled trial is needed to confirm this. PR offers a new and sustainable therapy for the neglected problem of chronic lung disease in low to middle income countries. This study provides patient and stakeholder feedback to inform design and implementation of a full trial planned for Zambia, Kenya and Tanzania.

Renal glycosuria treated as diabetes mellitus: case report.

Abstract: A case of renal glycosuria is reported. A 55 year old female was diagnosed and treated in an upcountry hospital for diabetes mellitus. She developed symptoms of hypoglycaemia while on an oral hypoglycaemic agent, leading to her admission in Mulago Hospital. Persistent glycosuria was noted despite treatment and normal serum glucose. Oral glucose tolerance test and timed urine glucose showed a normal curve but high urine sugar. A diagnosis of renal glycosuria was made, oral hypoglycaemic therapy was stopped, patient improved and was discharged. Though renal glycosuria is a benign condition, mistaken diagnosis for diabetes mellitus puts patients at risk of hypoglycaemia due to treatment. Diagnosis of the condition requires physicians' awareness of its existence in our community and the use of Marbles' criteria obviates confusion with diabetes mellitus though it does not absolutely exclude Fanconi syndrome.