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Search Results: 1 - 10 of 9832 matches for " Patrick Byanyima "
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CASE REPORT: Menstruation in an unusual place: A case of thoracic endometriosis in Kampala, Uganda
Rosemary Kusaba Byanyima
African Health Sciences , 2001,
Abstract: While pelvic endometriosis is relatively common, thoracic menstruation is rare. A report of what is believed to be the first case of thoracic endometriosis in Uganda is given. A 34 year old female was complaining of on and off chest pain mainly on the right side. Clinically she had signs of pleural effusion and 500 mls of altered blood were tapped from her right pleural space. Worried about a possibility of a malignant process, an urgent chest CT scan was performed. A right posterior pleural mass and pleural effusion were found. A pleural biospy was taken and confirmed at histology as endometrial tissue. She did well on surgical excision and hormonal therapy. This was a rare case of endometriosis which shows the usefulness of imaging in the patient work up. African Health Sciences 2001 1(2):97-98
Oral Antimicrobial Rinse to Reduce Mycobacterial Culture Contamination among Tuberculosis Suspects in Uganda: A Prospective Study
Nelson Kalema, Saskia Den Boon, Adithya Cattamanchi, J. Lucian Davis, Alfred Andama, Winceslaus Katagira, Charles Everett, Nicholas Walter, Patrick Byanyima, Sylvia Kaswabuli, William Worodria, Laurence Huang
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0038888
Abstract: Rationale Contamination by bacterial or fungal organisms reduces the effectiveness of mycobacterial culture for diagnosis of pulmonary tuberculosis (TB). We evaluated the effect of an anti-microbial and an anti-fungal oral rinse prior to expectoration on culture-contamination rates. Methods We enrolled a consecutive random sample of adults with cough for ≥2 weeks and suspected TB admitted to Mulago Hospital (Kampala, Uganda) between October 2008 and June 2009. We randomly assigned patients to oral rinse (60 seconds with chlorhexidine followed by 60 seconds with nystatin) vs. no oral rinse prior to initial sputum collection. Uganda National Tuberculosis Reference Laboratory technicians blinded to the method of sputum collection (with or without oral rinse) processed all sputum specimens for smear microscopy (direct Ziehl-Neelsen) and mycobacterial culture (Lowenstein-Jensen media). Results Of 220 patients enrolled, 177 (80%) were HIV-seropositive (median CD4-count 37 cells/uL, IQR 13–171 cells/uL). Baseline characteristics were similar between patients in the oral-rinse (N = 110) and no oral-rinse (N = 110) groups. The proportion of contaminated cultures was significantly lower in the oral-rinse group compared to the no oral-rinse group (4% vs. 15%, risk difference ?11%, 95% CI ?18 to ?3%, p = 0.005). Oral rinse significantly reduced the proportion of contaminated cultures among HIV-infected patients (3% vs. 18%, risk difference ?14%, 95% CI ?23 to ?6%, p = 0.002) but not HIV-uninfected (6% vs. 4%, risk difference 2%, 95% CI ?12 to +15%, p = 0.81) patients. However, the proportion of smear-positive specimens (25% vs. 35%, p = 0.10) and culture-positive specimens (48% vs. 56%, p = 0.24) were lower in the oral-rinse compared to the no oral-rinse group, although the differences were not statistically significant. Conclusions Oral rinse prior to sputum expectoration is a promising strategy to reduce mycobacterial culture contamination in areas with high HIV prevalence, if strategies can be devised to reduce the adverse impact of oral rinse on smear- and culture-positivity.
Low Prevalence of Pneumocystis pneumonia (PCP) but High Prevalence of Pneumocystis dihydropteroate synthase (dhps) Gene Mutations in HIV-Infected Persons in Uganda
Steve M. Taylor, Steven R. Meshnick, William Worodria, Alfred Andama, Adithya Cattamanchi, J. Lucian Davis, Samuel D. Yoo, Patrick Byanyima, Sylvia Kaswabuli, Carol D. Goodman, Laurence Huang, International HIV-associated Opportunistic Pneumonias (IHOP) Study
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0049991
Abstract: Pneumocystis jirovecii pneumonia (PCP) is an important opportunistic infection in patients infected with HIV, but its burden is incompletely characterized in those areas of sub-Saharan Africa where HIV is prevalent. We explored the prevalence of both PCP in HIV-infected adults admitted with pneumonia to a tertiary-care hospital in Uganda and of putative P. jirovecii drug resistance by mutations in fungal dihydropteroate synthase (dhps) and dihydrofolate reductase (dhfr). In 129 consecutive patients with sputum smears negative for mycobacteria, 5 (3.9%) were diagnosed with PCP by microscopic examination of Giemsa-stained bronchoalveolar lavage fluid. Concordance was 100% between Giemsa stain and PCR (dhps and dhfr). PCP was more prevalent in patients newly-diagnosed with HIV (11.4%) than in patients with known HIV (1.1%; p = 0.007). Mortality at 2 months after discharge was 29% overall: 28% among PCP-negative patients, and 60% (3 of 5) among PCP-positive patients. In these 5 fungal isolates and an additional 8 from consecutive cases of PCP, all strains harbored mutant dhps haplotypes; all 13 isolates harbored the P57S mutation in dhps, and 3 (23%) also harbored the T55A mutation. No non-synonymous dhfr mutations were detected. PCP is an important cause of pneumonia in patients newly-diagnosed with HIV in Uganda, is associated with high mortality, and putative molecular evidence of drug resistance is prevalent. Given the reliability of field diagnosis in our cohort, future studies in sub-Saharan Africa can investigate the clinical impact of these genotypes.
Camurati-Engelmann's disease: a case report
Rosemary Kusaba Byanyima, Jennifer Batuuka Nabawesi
African Health Sciences , 2002,
Abstract: Camurati-Engelmann's disease is a rare condition worldwide. No cases have been documented in Uganda. A 26 year old female presented with a history of grinding pain in the limbs for over 20 years. Strong painkillers would temporally relieve the pain. She had an asthenic stature with generalised reduction in muscle bulk. Plain x-rays revealed the characteristic symmetrical thickening and sclerosis of the diaphyses of the appendicular skeleton and skull base, which is pathognomonic of Camurati-Engelmann's disease. Involvement of the metaphyses of these long bones as well as the metacarpal bones makes this an unusual case. African Health Sciences 2002; 2(3) 118-120
Structural findings at hysterosalpingography in patients with infertility at two private clinics in Kampala, Uganda
Elsie Kiguli-Malwadde, Rosemary K Byanyima
African Health Sciences , 2004,
Abstract: Introduction: Hysterosalpingography (HSG) is still a commonly used investigation in the evaluation of the female genital tract and the main indication for HSG is infertility. Objective: The purpose of this study was to find the pathology detected at HSG in patients with infertility in our setting. Materials and Methods: A retrospective review of 289 consecutive patients who underwent hysterosalpingography using ionic water-soluble contrast media was done at 2 private x-ray units in Kampala. Clinical notes and radiological findings were analysed for demographic data, uterine status, tubal and pelvic pathology. Results: The commonest age group seen was 26–30yrs. Most were of low parity. Secondary infertility was commoner than primary infertility. Abnormal findings at hysterosalpingography were found in 83.4%. The commonest finding was tubal blockage. Conclusion: The commonest pathology found on HSG in women presenting with infertility in Kampala is tubal blockage possibly secondary to chronic pelvic inflammation. The fact that secondary infertility is common points to pelvic infection complicating mismanaged pregnancies, septic abortions or sexually transmitted infections. A study toestablish associated factors is recommended. Key Words: Hysterosalpingography, Infertility African Health Sciences Vol.4(3) 2004: 178-181
Umbilical artery doppler flow patterns in high-risk pregnancy and foetal outcome in Mulago hospital  [PDF]
P. Komuhangi, R. K. Byanyima, E. Kiguli-Malwadde, C. Nakisige
Case Reports in Clinical Medicine (CRCM) , 2013, DOI: 10.4236/crcm.2013.29141

Objective: To demonstrate the flow patterns and factors associated with adverse foetal outcome in high-risk pregnancy at Mulago Hospital using Doppler ultrasound of the foetal umbilical artery. Design: Cross-sectional descriptive study. Setting: Mulago National Referral Hospital, Kampala Uganda. Study Subjects: One hundred and ninety-two patients in a 4-month period (December 2008-April 2009). Results: Maternal age was 16 to 41 years. Twenty-one foetuses had abnormal flow patterns (12 had reduced end-diastolic flow, 8 had AEDF and 1 had RF). Prematurity was associated with abnormal flow patterns. 11 out of 12 foetuses with reduced end-diastolic flow survived. Of the foetuses with AEDF, 3 survived but were admitted to the neonatal special care unit while 5 died. One foetus had RF and was a stillbirth. Eighteen foetuses were delivered after an obstetric intervention. Conclusions: 1) The prevalence of abnormal flow patterns is 10.9%. 2) Abnormal flow patterns, low biophysical profile score, premature delivery, low birth weight and low Apgar score are related to adverse foetal outcome. 3) A low biophysical profile score is related to AEDF/RF. 4) Foetuses of low parity mothers are more likely to have abnormal flow patterns. Recommendation: Umbilical artery Doppler Biophysical profile scores should be done in high-risk pregnancy.



Coarctation of aorta presenting as acute haemorrhagic stroke in a 14-year old. A case report.
J Opio, E Kiguli-Malwadde, RK Byanyima
African Health Sciences , 2008,
Abstract: No African Health Sciences Vol. 8 (4) 2008: pp. 256-258
Utilisation of obstetric sonography at a peri-urban health centre in Uganda
AG Mabuuke, E Kiguli-Malwadde, F Businge, RK Byanyima
Pan African Medical Journal , 2010,
Application of Case Report-Writing in the Training of Radiology Post Graduate Students at Makerere University.
E Kiguli-Malwadde, MG Kawooya, RO Omara, S Bugeza, R Byanyima, Z Muyinda, H Kisembo
East and Central African Journal of Surgery , 2011,
Abstract: Background: Postgraduate medical education is much sought after and has become an issue of global significance, appeal and dimensions. The Radiology postgraduate training at Makerere University has been in existence since 1980. As part of their training students are required to write up 30 cases with the help of their lecturers. Methods: We set out to evaluate the role of case report writing in the training of Radiology postgraduate students. A document analysis of 22 case report sets was done. Questionnaires with closed and open ended questions were administered to the 10 Radiologists and 6 students to get their opinions and ideas on the process and how it could be improved. The quantitative data was analyzed by a statistician and focused on the closed-ended statements. The qualitative data was analyzed by the authors with the help of a qualitative expert. Results: The radiologists and students agreed that case report writing helped students acquire a wide range of competences. They also agreed that it is a reliable and valid method of assessment and has a positive impact on learning. The respondents identified problems that were encountered in the process. They have problems identifying cases that are fully worked up and also their work was made challenging because of poor technology, limited access to references and high cost of producing the cases. The cases exposed the students to a wide range of cases and investigations in radiology and helped them integrate Clinical Medicine and Radiology. Conclusion: Case report writing is a good way of training and assessing post graduate students. It is motivational and also helps them acquire a wide range of competences specifically ability to write scientific articles.
Current knowledge, attitudes and practices of expectant women toward routine sonography in pregnancy at Naguru health centre, Uganda
Mubuuke Aloysius Gonzaga,Elsie Kiguli-Malwadde,Businge Francis,Byanyima Rosemary
Pan African Medical Journal , 2009,
Abstract: BACKGROUND: Ultrasound has become a routine part of care for pregnant women in Uganda, being one of a range of techniques used in screening. However, it differs from most others because it allows women to view their babies. Routine obstetric sonography is now globally recognized as one of the ways through which maternal mortality can be reduced. This study aimed at finding out the knowledge, attitudes and practices of pregnant women towards prenatal sonography at Naguru Health Centre, Uganda. METHODS: Exploratory -descriptive study using interviewer-administered questionnaires. Thematic analysis was employed for qualitative data and bivariate, multivariate and logistic regression analysis was used for quantitative data. RESULTS: Three themes emerged; Knowledge, Attitude and Practices. Women’s knowledge, attitude and practices of obstetric sonography were influenced mainly by their biosocial factors like gravidity, education level and occupation. All women expressed concern that obstetric sonography could lead to cancer. CONCLUSION: Obstetric sonography is highly appreciated as being vital for antenatal care. However, there is need for mothers and health care providers to be well informed about the safety and specific purposes of obstetric sonography and what it can and cannot achieve.
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