Dietary Risk Factors for Colorectal Cancer in an Indigenous East African Population| Chapter 4 | Perspective of Recent Advances in Medical Research Vol. 2

 Introduction: Low-proceeds countries in East Africa have a lower occurrence of colorectal cancer (CRC) than well-paid countries; however, the occurrence has steadily raised in the last few decades. In East Africa, the extent at which point genetic and incidental factors, particularly digestive factors, help the aetiology of CRC is unclear. Therefore, the objective of our study search out determine the connection between abstinence from food factors and CRC in an indigenous populace in East Africa.Methods: We conducted a case-control study and inducted 128 cases and 256 controls, block matched for age (±5 age) and sex. Data concerning diet were obtained from all the participants utilizing an interview-based inquiry. The potential dietary risk determinants and protective determinants evaluated contained the type, frequency of meat exhausted and the type and frequency of fibre snacks consumed. The commonness was either 4x and above/week or 2-3x/period or 1x/week or never. Ordinal and dependent logistic regression analyses were used to decide the odds percentages associated with the various risk and protective determinants.Results: The mean age (SD) was 53.5(16.2) years and the male:female ratio was 1:1 for all the shareholders. The most significant risk determinants included devouring of boiled beef 2-3x/temporal length of event or entity's existence (aOR:1.63; p<0.001) and consumption of deep-fried chicken 2-3x/week (aOR: 2.60; p=0.027). Consumption of extreme fibre foods, containing:- cassava for ≥4x/week (aOR: 0.40; p=0.016), millet for 1x/period (aOR: 0.49; p=0.034) and for ≥4x/week (aOR:0.32; p=0.001), undetailed lie for ≥4x/week (aOR:0.30; p=0.003), and potatoes 2-3x/period (aOR: 0.44; p=0.041), were protective against CRC.Conclusions: The use of cooked core increases the risk of CRC, while the intake of extreme-fibre foods grant permission reduce the risk of CRC among Ugandans. We approve nutritional instructional programmes to increase public awareness concerning the protective part of a high fibre diet and to limit the intake of barbecued meat in our native East African population.

Author(s) Details:

Richard Wismayer,
Department of Surgery, Masaka Regional Referral Hospital, Masaka, Uganda and Department of Surgery, Faculty of Health Sciences, Habib Medical School, IUIU University, Kampala, Uganda and Department of Pathology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.

Julius Kiwanuka,
Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.

Henry Wabinga,
Department of Pathology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.

Michael Odida,
Department of Pathology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda and Department of Pathology, Faculty of Medicine, Gulu University, Gulu, Uganda.

Please see the link here: https://stm.bookpi.org/PRAMR-V2/article/view/9013

Study about Informed Consent for Surgical Care in East Africa | Chapter 20 | New Horizons in Medicine and Medical Research Vol. 3

 In the industrialised world, one of the pillars of ethical surgical practise is informed surgical consent. Pre-operative surgical consent has only been studied by a few researchers in low-income developing countries. After the surgeon caring for the patient has supplied the essential information, the patient has the right to make an autonomous and independent decision regarding his or her surgical treatment during the informed consent procedure. The Lisbon Declaration of the World Medical Association (WMA) promotes patient autonomy and decision-making independence. Factors including familial and cultural history, education, religion, and socioeconomic status can all influence informed consent in surgical practise. Few studies have looked at surgeons' consent practises in East Africa in order to describe optimal surgical practises and find areas for development in the region. The authors' personal experiences with surgical consent among Ugandan surgeons, as well as the specific issues faced in East Africa, were the focus of this review. In Uganda, the administration and documentation of informed consent are still lacking. Better medical ethics education and communication skills training are required in medical schools. Refresher training in medical ethics and communication skills may be required for fully trained surgeons.

Author(S) Details

Richard Wismayer
Department of Surgery, Masaka Regional Referral Hospital, Masaka, Uganda and Department of Surgery, Habib Medical School, IUIU University, Kampala, Uganda and Department of Pathology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.


View Book:- https://stm.bookpi.org/NHMMR-V3/article/view/6349

Inguinal Hernia Repairs in a Rural Setting in East Africa: A Clinical Approach| Chapter 01 | Issues and Developments in Medicine and Medical Research Vol. 3

 In the poor world, inguinal hernias are a leading source of morbidity and mortality. Due to the late presentation of inguinal hernias and the lack of availability and cost of mesh and laparoscopy in resource-constrained settings in rural Africa, clinical care of inguinal hernias may represent a therapeutic challenge to the surgeon. There is a scarcity of data and literature on the surgical treatment of inguinal hernias in our setting. Inguinal hernia affects 3% of women and 27% of men over their lifetime, with rates declining after 45 years of age. The goal of this study was to look at the clinical profile and results of inguinal hernia repair patients at our institution.

Methods: From April 1, 2008, to July 31, 2012, a descriptive retrospective study was conducted on all patients 15 years of age who had an inguinal hernia repair. The patients were evaluated on the surgical ward after surgery and again three months later at the surgical out-patient clinic. The following data were obtained using a pretested questionnaire: age, sex, recurrence of hernia, post-operative pain, and post-operative complications. Physical examination was performed to check for post-operative recurrence and evidence of haematomas, seromas, or acute wound sepsis that necessitated surgery.

The results of 158 patients who had an inguinal hernia repaired with the Modified Bassini method were studied. The average age was 44.84. The male to female ratio was 3.65:1, with males outnumbering females. 4 (2.53%) of patients had emergency inguinal hernia repairs, while the majority of patients, 154 (97.47%), had elective inguinal hernia repairs. 1(0.63 percent) seroma, 1(0.63 percent) haematoma, 1(0.63 percent) necrotizing fasciitis, and 1(0.63 percent) enterocutaneous fistula were among the morbidities. Overall, 3.16 percent of patients had complications.

Conclusions: Patients with inguinal hernias in rural Africa should be encouraged to present early with inguinal hernia signs and symptoms. Elective inguinal hernia surgery, regardless of the kind of repair, will reduce morbidity and death associated with this frequent condition in East Africa.

Author(S) Details

Richard Wismayer
Department of Surgery, St. Joseph’s Maracha Hospital, West Nile, Uganda and Department of Surgery, Habib Medical School, IUIU University, Kampala, Uganda.

View Book:- https://stm.bookpi.org/IDMMR-V3/article/view/5462

Assessment of History and Challenges Ahead for General Surgery Training in East Africa | Chapter 8 | Issues and Developments in Medicine and Medical Research Vol. 1

 The history of surgical training in East Africa is highlighted in this article. The difficulties encountered in developing a recognised General Surgery training curriculum are discussed. The global supply of surgically trained health practitioners is outstripped by the global burden of surgical disease. In developing low-income nations, the disparity between the burden of surgical disease and the low number of skilled staff is even more obvious. As surgical subspecialization gains traction, general surgery is being left in referral facilities with little employees. As a result, the provision of essential general surgery management, which is the job of the general surgeon, is subpar. The surgeon may or may not perform the surgical procedure as an emergency. In order to close the gap, more general surgeons will need to be trained. Specialist surgeons should also be trained as general surgeons initially, as this will enable them to respond to a general surgical emergency when practising as specialists and will equip them with a good overall awareness of general surgery demands.

Author(S) Details

Richard Wismayer
Department of Surgery, IUIU University, Habib Medical School, Kampala, Uganda and Department of Surgery, Masaka Regional Referral Hospital, Masaka, Uganda.

View Book:- https://stm.bookpi.org/IDMMR-V1/article/view/5046

Assessment of History and Challenges Ahead for General Surgery Training in East Africa | Chapter 8 | Recent Developments in Medicine and Medical Research Vol. 13

 The history of surgical training in East Africa is highlighted in this article. The difficulties encountered in developing a recognised General Surgery training curriculum are discussed. The global supply of surgically trained health practitioners is outstripped by the global burden of surgical disease. In developing low-income nations, the disparity between the burden of surgical disease and the low number of skilled staff is even more obvious. As surgical subspecialization gains traction, general surgery is being left in referral facilities with little employees. As a result, the provision of essential general surgery management, which is the job of the general surgeon, is subpar. The surgeon may or may not perform the surgical procedure as an emergency. In order to close the gap, more general surgeons will need to be trained. Specialist surgeons should also be trained as general surgeons initially, as this will enable them to respond to a general surgical emergency when practising as specialists and will equip them with a good overall awareness of general surgery demands.

Author(S) Details

Richard Wismayer
Department of Surgery, IUIU University, Habib Medical School, Kampala, Uganda and Department of Surgery, Masaka Regional Referral Hospital, Masaka, Uganda.

View Book:- https://stm.bookpi.org/IDMMR-V1/article/view/5046

A Retrospective Study on Mesenteric Venous Thrombosis in a Referral Hospital in East Africa | Chapter 8 | New Frontiers in Medicine and Medical Research Vol. 15

Introduction: The superior mesenteric vein is the most prevalent location of thrombosis development in acute mesenteric venous thrombosis, which is a rare disorder. The Virchow trinity of endothelial damage, stasis, and hypercoagulability is usually disrupted in patients who are prone to this illness. The acute variant is characterised by intestinal ischaemia, making it difficult to diagnose before intestine gangrene occurs. A delayed diagnosis due to poor investigative ability results in patients suffering from acute renal failure and a high mortality rate, according to the limited experience with this ailment in the East African region. As a result, the goal of this research was to describe the presentation and treatment of four patients with mesenteric venous thrombosis in an East African referral hospital, followed by a review of the aetiology, clinical characteristics, and management of this illness.

Methods: Over the course of 18 months, a descriptive retrospective review of four patients was performed. From the patients' clinical files, demographic and clinical data were collected, and manual analysis was performed using a spreadsheet.

Four cases were identified over the course of 18 months. Acute symptoms persisted for 5 to 21 days in all patients, indicating a delay in diagnosis. Short bowel syndrome and severe renal failure killed two patients within 30 days of surgery. Two patients survived short bowel syndrome complications and one patient survived severe renal injury that necessitated dialysis.

This brief case series is characterised by a delay in the diagnosis of acute MVT. As a result, all of the cases had gangrenous bowel, which contributed to the high fatality rate. Anticoagulation prevents the spread of a clot in the veins, which is linked to a lower risk of death and recurrence. To avoid bowel with dubious viability, thrombolysis and thrombectomy might be considered in some cases. The mortality rate from MVT has reduced over the last four decades, and it now stands at 10-20%, however there isn't enough data in East Africa to make this determination.

Author (S) Details

Richard Wismayer

Department of Surgery, Masaka Regional Referral Hospital, Masaka, Uganda and Department of Surgery, Habib Medical School, IUIU University, Kampala, Uganda.

View Book :- https://stm.bookpi.org/NFMMR-V15/article/view/3868