Naggalama Hospital

Leukocytoclastic vasculitis (LCV) is a disease secondary to infections, malignancies, or drug exposure, although its pathogenesis remains unclear. Secondary LCV from different causes in the same patient has been rarely reported. We present a case of LCV secondary to pancreatic cancer that remained in remission for one year post-surgery, after which the patient suffered from a subdiaphragmatic abscess caused by Escherichia coli, followed by recurrence of LCV. This case suggests that patients with acquired hyposplenism may be susceptible to developing LCV as a manifestation of underlying disease. Careful evaluation of the underlying disease is important to avoid inappropriate immunosuppressive treatment.

Introduction Preclinical animal experiments and initial feasibility studies in humans have shown encouraging outcomes using the novel Saccular Endovascular Aneurysm Lattice (SEAL™) system for the treatment of both ruptured and unruptured wide‐neck intracranial aneurysms (IAs). The SEAL™ Interventional Pivotal IDE PMA Trial (SEAL™ IT) is designed to assess the safety and efficacy of the SEAL™ in patients with saccular IAs. This ongoing, prospective, multicenter trial includes three study arms and will enroll a total of 279 participants with wide‐neck bifurcation (WNBA), sidewall (SW), or acutely ruptured IAs across 50 U.S. sites. Methods Eligibility requirements include patients aged 20‐80 years with a wide‐neck saccular intracranial aneurysm (2‐19 mm) deemed suitable for treatment with the SEAL™ Intrasaccular Device (SID). Participants receive treatment using the SEAL™ device (Galaxy Therapeutics Inc.) and are monitored at discharge, and again at 3, 6, and 12 months, followed by yearly assessments for up to 5 years. The primary efficacy outcome is defined as complete aneurysm occlusion at 12 months without evidence of parent vessel stenosis or the need for retreatment, as determined by an independent core laboratory. Key safety outcomes include neurological death within 12 months, stroke occurring within the first 30 days, and ipsilateral stroke between 30 days and 1 year. Results As of submission, 163 WNBA, 58 WNSW, and 33 ruptured for a total of 254 patients (76.3% female; mean age 61.7 ± 11.3) have been enrolled at 50 sites. Mean aneurysm width was 5.2 ± 2.1, neck size of 3.7 ± 1.4, and neck‐to‐dome ratio of 1.4 ± 0.32. SEAL Arc was used in 63.6% and SEAL Base in 36.4%. Technical device success rate is 100% for WNBA, 94.8% WNSW, and 97.0% ruptured. The interim complete occlusion rate for the primary group is 84.5% at most recent date based on available imaging. Conclusion Preliminary data for the SEAL™ intrasaccular device is promising; Safety and effectiveness updates will be presented at the SVIN Conference.

Introduction: Continuous glucose monitoring (CGM) is unaffordable in sub-Saharan Africa, and providers rely heavily on hemoglobin A1c (A1c) to guide insulin adjustment. The relationship between A1c and mean glucose (MG) varies between individuals and populations. We assessed this relationship in Ugandan youth of age 4-26 years with type 1 diabetes, and evaluated whether calculation of the personalized A1c (pA1c), which only requires a brief initial sensor wear, is clinically useful. Materials and Methods: CGM data were averaged across three blinded sensor wears (31-41 days). We calculated individual apparent glycation ratios using A1c after the second sensor, and applied these to A1cs collected after the third sensor to determine pA1c. Participants were evaluated for clinical factors that influence red blood cell (RBC) lifespan (malaria, G6PD deficiency, sickle-cell trait, hemolysis, iron deficiency). Results: Patients across the A1c spectrum experienced substantial time in both hyper- and hypoglycemia; average coefficient of variation was 44%. MG was >250 mg/dL (13.9 mmol/L) in 50% of participants, and 55% of participants spent ≥4% time with glucose <70 mg/dL (3.9 mmol/L). There was considerable variability in the A1c-MG relationship. The pA1c more accurately represented MG by significantly reducing variation in this relationship (R2 = 0.84 vs. 0.40; r = 0.92 vs. 0.63), but MG is not useful in individuals with the wide glucose fluctuations seen in this population. Clinical factors did not impact the A1c-MG relationship. Conclusions: Neither the measured A1c nor the calculated pA1c provided reliable guidance for insulin adjustment in this population. No matter how accurately MG is measured or estimated, it is just an average, with limited clinical application in individuals with wide glycemic variation. These measures cannot replace the information available from CGM about glycemic excursion, daily glucose patterns, or percent time in various glucose ranges. Our data suggest that it is essential to find a way to make CGM at least periodically affordable in low-resource settings.

Global Heart is the official and primary publication of the World Heart Federation, offering a platform for the dissemination of knowledge on research, developments, trends, solutions and public health programmes in the area of cardiovascular disease. Global Heart welcomes research results, points of view and educational material on the prevention, treatment and control of cardiovascular disease with a special focus on low and middle-income countries which are facing the brunt of epidemiological transition.Global Heart strongly encourages authors to adhere to CONSORT, STROBE, STARD, and PRISMA guidelines for reporting of clinical trials, observational studies, diagnostic test accuracy papers, and systematic reviews or meta-analyses. Authors are required for submission to download and complete the appropriate Equator Network checklist: http://www.equator-network.org/.

Background: Postpartum IUD can control 98% of unwanted pregnancies and abortions worldwide, but many postpartum mothers have not utilized it which leads to maternal mortality and morbidity. The purpose of the study was to determine the factors contributing to the low uptake of PPIUD in youth aged 18-35 years at Mukono General Hospital, Mukono district. Methodology: This study used a cross-sectional design and employed a quantitative approach to data collection. The study was carried out at Mukono General Hospital, Mukono district. The study population comprised of postpartum mothers aged 18-35 years. The sample size of 30 postpartum mothers who participated in this study was sampled using a simple random sampling procedure. A self-administered questionnaire was used for data collection and analysis using the SPSS program. Results: The study established that the individual-related factors included misconceptions (70%), and poor attitudes toward IUD utilization (57%). Furthermore, socio-economic-related factors included the wide utilization of herbal medicine in communities (63%). Finally, the health facility-related factors included the negative attitude of health workers (60%) and long waiting hours for services (60%). Conclusion: It was found that most postpartum mothers didn’t take PPIUD due to; misconceptions, poor attitude, utilization of herbal medicine, negative attitude of health workers, and long waiting hours for services. Recommendation: To increase the awareness of IUD utilization benefits among postpartum mothers.

Introduction Syphilis infection among pregnant women has been and still is a threat in Uganda and the world at large. The objectives of the study aimed at assessing the prevalence of syphilis among pregnant women attending antenatal care clinics at Jinja Regional Referral Hospital. Study method A descriptive cross-sectional study of quantitative approaches was conducted among a simple random sample of 85 pregnant women from September to October 2023. A questionnaire was used to collect information about the demographic factors and various risk factors associated with syphilis infection. The blood samples collected were tested for syphilis using the Rapid Plasma Reagan (RPR) test and results were analyzed using Microsoft Excel, and presented in the forms of tables, graphs, and pie charts. Results Results from the study revealed that syphilis prevalence among pregnant women was 10.6%, with a history of sexually multiple sexual partners being the most significant risk factor. The age group that was mostly affected by syphilis infections among the participants was 25-29 years old. Conclusions Conclusively, according to the results of this study, syphilis prevalence among pregnant women still showed high percentages. History of multiple sexual partners was the most prevalent factor associated with syphilis infection, with the most positive cases being 25-29 years old. Recommendations Much emphasis should be put on point care Tests (POCTS) for all pregnant mothers at each of their antenatal care visits, awareness about prevention and control of syphilis and other STIs to the public, and effective health education programs to females at childbearing age about the health benefits of full antenatal care services.

Background Hepatitis B virus (HBV) is a viral infection comprised by the presence of hepatic leucocytes HBVs in the cytoplasm of the hepatocytes. Hepatitis B viral infection attacks the liver and causes acute and chronic disease. Method A cross-sectional study was carried out at Rukunyu Hospital Kamwenge to determine the prevalence of hepatitis B virus infection among HIV patients aged 15 - 35 years old on 111 respondents. Quantitative data collection was used, and the questionnaires were given to the consented participants to fill out for current data collection for new cases. A laboratory medical book register was requested from laboratory staff for old cases to find the prevalence of HBV. Results A total of 111 HIV patients were tested for HBV of which 23 HIV patients tested positive and 88 tested negative.Socio demographically, most of participants were females 63(56.8%) and males being 48(43.2%) Married participants being 61(55.0%) , single 27(24.3%) , divorced were 14(12.6%) participants and last being widow/widower 9(8.1%). The majority of the participants had started and reached at least in secondary level, however, some few were ongoing students and the prevalence of Hepatitis B virus among HIV patients was high in the age group of 26-30 years old. Conclusion The prevalence of Hepatitis B was highest among the ages of 26-30 years old, the prevalence and treatment challenges are still the biggest problem due to risk factors of HBV infection such as having multiple sex partners, sharing of clothes, blood transfusion, and intravenous injections seen to bring added risks. Recommendation As per the research study findings, there is a need for further research to be done such as setting up more health centers or hospitals to provide HBV screening among patients living with HIV to curb the HBV spread.