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المؤلفون: Massinde Anthony
المصدر: International Journal of Case Reports in Medicine. :1-6
مصطلحات موضوعية: Surgical repair, medicine.medical_specialty, Foley, business.industry, Urinary retention, Fistula, medicine.disease, Prolonged labour, Surgery, Catheter, medicine.anatomical_structure, medicine, medicine.symptom, business, Complication, Pelvis
الوصف: Chronic urinary retention is uncommon among women; in fact, it is even rarely described among patients with obstetric fistulae. A 27-year-old woman presented with history of failure to control urine for 9 months following neglected, prolonged labour. She had cesarean delivery in her first pregnancy. Examination revealed a suprapubic, cystic mass arising from the pelvis. A defect was identified on anterior vaginal wall close to the urethral meatus. Sonographic findings show distended bladder, hence, the diagnosis of chronic urinary retention with urethro-vaginalfistula. She was repaired successfully; however, 21 days post-operatively she was recatheterized after showing retention on removal of Foley. After one additional month with the catheter, she was cured and discharged in good condition. Obstetric fistulae complicated with urinary retention can occur, and surgical repair does in fact seem to have a good outcome if prolonged catheterization is taken into consideration.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::9e9ef0de309cffefeedf234a97491581Test
https://doi.org/10.5171/2013.340925Test -
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المؤلفون: Albert Kihunrwa, Fidelis Mbunda, Anthony N. Massinde, Phillipo L Chalya, Joseph B Mabula, Japhet M Gilyoma
المساهمون: None
المصدر: Tanzania Journal of Health Research; Vol 18, No 1 (2016)
مصطلحات موضوعية: medicine.medical_specialty, Blood transfusion, biology, Cross-sectional study, business.industry, medicine.medical_treatment, Blood transfusions, practice, surgery, Tanzania, General Medicine, biology.organism_classification, Surgery, Cross matching, Tanzania, medicine, business, Elective Surgical Procedure
الوصف: Background: Preoperative over-ordering of blood for surgical intervention, in excess of the actual and anticipated needs is a common practice in many developing countries. This can be decreased by simple means of changing the blood cross matching and ordering schedule depending upon the type of surgery performed. The aim of this study was to assess the blood transfusion practice in surgery at Bugando Medical Centre in northwestern Tanzania.Methods and Patients: This was a prospective cross sectional study among patients undergoing major operations at Bugando Medical Centre. We evaluated blood ordering and transfusion practices in emergency and elective surgical procedures at our centre and calculated different indices such as cross-match to transfusion ratio (C/T ratio), transfusion probability (% T) and transfusion index (TI). Next Maximal Surgical Blood Ordering System (MSBOS) was estimated for each procedure.Results: The overall blood utilization was only 28.2% at our centre, consisting of 17.1% in the elective operations and 26.9% in the emergency operations. Significant blood utilization was nil in most of the routine elective cases suggesting cross-matching of blood to be a culture than necessity. Generally, the overall blood transfusion of the requested blood as indicated by indices of C/T ratio, %T, TI and MSBOS were 3.5, 28.7%, 0.33 and 0.45, respectively. The overall CT ratio, %T, Ti and MSBOS in the elective operations were 5.8, 15.9%, 0.2 and 0.3, respectively. In the emergency operations, the overall CT ratio, %T, Ti and MSBOS were 3.7, 22%, 0.32 and 0.48, respectively.Conclusion: This study demonstrated that over-ordering of blood in excess of the actual needs is a common practice in our setting. Blood ordering pattern needs to be revised and over-ordering of blood should be minimized. This can be possible by the estimation of MSBOS for each procedure and requisition as calculated.
وصف الملف: application/pdf
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ac2f935e77f5a4e9f9f8801bb7b65fecTest
https://doi.org/10.4314/thrb.v18i1.2Test -
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المساهمون: None
المصدر: Tanzania Journal of Health Research; Vol 14, No 2 (2012)
مصطلحات موضوعية: Adult, medicine.medical_specialty, Cervical polyp, medicine.medical_treatment, Uterus, Mixed Tumor, Mullerian, Uterine Cervical Neoplasms, Hysterectomy, medicine, Humans, Malignant mixed mullerian tumour, cervix, uterine prolapse, Tanzania, Vaginal bleeding, Cervix, Gynecology, business.industry, Uterine prolapse, General Medicine, medicine.disease, Surgery, medicine.anatomical_structure, Vagina, Female, Uterine cavity, medicine.symptom, business
الوصف: Malignant mixed Mullerian tumour is a rare gynaecological tumour commonly presenting with vaginal bleeding, abdominal pain or mass in the uterine cavity, cervix or vagina. The neoplasms are commonly seen in postmenopausal women although it has been observed in younger women. Ovaries and the corpus of the uterus are commonly involved, whereas involvement of the cervix and vagina is rare. A 37 year-old Tanzania lady para 7 with a previous history of two genital polypectomies presented with history of recurrent vaginal mass which was associated with abnormal vaginal bleeding and foul smelling discharge. Vaginal examination revealed a prolapsed uterus with giant fungating cervical mass which was ulcerated, friable, and bled easily on touch. Impression was grade three uterine prolapse with infected cervical polyp/ cervical sarcoma. Excision of the tumour through trans-vaginal hysterectomy was performed, no lymphadenopathy was found, no adnexa abnormalities, and no involvement of the vaginal wall. Histological diagnosis of Malignant mixed Mullerian tumour of the cervix was made. Patient recovery was unremarkable; however she was lost to follow up. The patient’s mass was initially suspected to be prolapsed uterus with decubitus ulcer but the histological results were of a malignant condition. Lack of clear management guidelines for some rare mixed tumours remain a challenge for clinicians in low resource settings.
وصف الملف: application/pdf
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e083c5b9d46b25b963c0216051453568Test
https://pubmed.ncbi.nlm.nih.gov/26591738Test -
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المصدر: World Journal of Emergency Surgery : WJES
مصطلحات موضوعية: Abdomino-pelvic operations, medicine.medical_specialty, Reconstructive surgery, Ureteric injuries, Injury & Accidents, urologic and male genital diseases, Tanzania, High morbidity, Ureter, Surgical site, medicine, Lost to follow-up, Outcome, biology, business.industry, Tertiary care hospital, biology.organism_classification, Management, Surgery, medicine.anatomical_structure, Iatrogenic, Emergency Medicine, Presentation (obstetrics), business, Research Article
الوصف: Background Iatrogenic ureteric injuries are rare complications of abdomino-pelvic surgery but associated with high morbidity and even mortality. There is paucity of data regarding iatrogenic ureteric injuries in Tanzania and Bugando Medical Centre in particular. This study describes our experience in the management and outcome of ureteric injuries following abdomino-pelvic operations outlining the causes, clinical presentation and outcome of management of this condition in our local setting. Methods This was a retrospective descriptive study of patients with iatrogenic ureteric injuries following abdomino-pelvic operations that were managed in Bugando Medical Centre between July 2004 and June 2014. Results A total of 164 patients (M: F = 1: 1.6) were studied. Of these, 154 (93.9%) were referred to Bugando Medical Centre having had their initial surgeries performed at other hospitals, whereas 10 (6.1%) patients sustained ureteric injuries during abdomino-pelvic surgery at Bugando Medical Centre. The median age at presentation was 36 years. The most common cause of iatrogenic ureteric injuries was total abdominal hysterectomy occurring in 69.2% of cases. The distal ureter was more frequently injured in 75.6% of cases. Suture ligation was the commonest type of injury accounting for 36.6% of patients. One hundred and sixteen (70.7%) patients had delayed diagnosis but underwent immediate repair. Ureteroneocystostomy was the most frequent reconstructive surgery performed in 58.0% of cases. Of the 164 patients, 152 (92.7%) were treated successfully. Twelve (7.3%) patients died in hospital. The main predictors of deaths were delayed presentation, deranged renal function tests on admission, missed ureteric injuries and surgical site infections (P
وصف الملف: application/pdf
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7cf01ae6dcef977dc7c0296e1c181fe7Test
https://doi.org/10.1186/s13017-015-0011-zTest -
5
المصدر: BMC Research Notes
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Abdominal fascial closure, Adolescent, Incisional hernia, medicine.medical_treatment, Human Resources, Abdominal fascia, Tanzania, General Biochemistry, Genetics and Molecular Biology, Postoperative complications, Young Adult, Suture (anatomy), Practices, Laparotomy, Abdomen, medicine, Humans, Vicryl, Child, Prolene, Aged, Aged, 80 and over, Medicine(all), Sutures, Wound dehiscence, business.industry, Tertiary Healthcare, Biochemistry, Genetics and Molecular Biology(all), Suture Techniques, General Medicine, Fascia, Elective midline laparotomy, Middle Aged, medicine.disease, Surgery, Fasciotomy, medicine.anatomical_structure, Elective Surgical Procedures, Female, business, Research Article
الوصف: Background The optimal strategy of abdominal wall closure after midline laparotomy has remained an issue of ongoing debate. This study was undertaken to describe our own experiences with abdominal fascial closure following elective midline laparotomy and compare with what is described in literature. Methods This was a descriptive prospective study of patients who underwent elective midline laparotomy at Bugando Medical Centre between March 2009 and February 2014. Results A total of 872 patients (M:F = 2.8:1) were studied. The median age was 38 years. The fascia closure was performed with a continuous and interrupted sutures in 804 (92.2%) and 68 (7.8%) patients, respectively. Mass closure and layered closure were performed in 842 (96.6%) and 30 (3.4%) patients, respectively. Monofilament sutures were applied for fascia closure in 366 (42.0%) patients, multifilament sutures in 506 (58.0%) patients. Non-absorbable sutures were chosen in 304 (34.9%) patients, slowly absorbable sutures in 506 (58.0%), and moderately absorbable sutures in 62 (7.1%) patients. Sutures used for fascial closure were vicryl 464 (53.2%), nylon 250 (28.7%), prolene 62 (7.1%), PDSII 54 (6.2%) and silk 42 (4.8%). Sutures with the strength of 0 were used in 214 (24.4%) patients, with strength of 1 in 524 (60.1%) patients, and with strength of 2 in 134 (15.4%) patients. The mean time required for massive closure of the midline incision was 8.20 ± 6.12 min whereas in layered closure, the mean time required for closure was 12.22 ± 7.11 min and this was statistically significant (p = 0.002). Mass closure was significantly associated with low incidence of wound dehiscence and incisional hernia (p
وصف الملف: application/pdf
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8e6bde202eb56dae74ccb7d3ec10ef3bTest
http://digitallibrary.ihi.or.tz/3299Test/ -
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المؤلفون: Anthony N. Massinde, Nnhandi Ngwalida, Balthazar Gumodoka
المساهمون: none
المصدر: Tanzania Journal of Health Research; Vol 13, No 2 (2011); 115-116
مصطلحات موضوعية: Adult, medicine.medical_specialty, animal structures, medicine.medical_treatment, vulva, oedema, pregnancy, management, Tanzania, Vulva, Blood loss, Pregnancy, Poor wound healing, Edema, Humans, Medicine, Childbirth, Caesarean section, Vulval oedema, Cesarean Section, urogenital system, business.industry, Obstetrics, fungi, Pregnancy Outcome, General Medicine, medicine.disease, female genital diseases and pregnancy complications, Surgery, Pregnancy Complications, medicine.anatomical_structure, Gestation, Female, Vulvar Diseases, Pregnancy, Multiple, business
الوصف: Massive vulval oedema is not common during pregnancy, but when it develops, it often is associated with patient discomfort and management challenges. Two pregnant women presented to Bugando Medical Centre in Mwanza, Tanzania, with massive swelling of the vulva at 39 weeks and 32 weeks of gestation. Both women were found to have multiple gestations. Despite medical management, there was no resolution of the oedema. In both cases, vulval oedema subsided after being delivered by caesarean section. Major vulval oedema during pregnancy is a serious issue. If not treated appropriately, it can lead to major complications of increased blood loss and poor wound healing. Abdominally delivery is the preferred mode of delivery at our institution for massive vulval oedema.
وصف الملف: application/pdf
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a21b4fc8a43afad3d98ea942a427854bTest
https://doi.org/10.4314/thrb.v13i2.63346Test -
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المصدر: Obstetrics and gynecology. 114(2 Pt 2)
مصطلحات موضوعية: Adult, medicine.medical_specialty, Pregnancy, Ectopic pregnancy, business.industry, Obstetrics, medicine.medical_treatment, Obstetrics and Gynecology, Calcinosis, medicine.disease, Surgery, medicine.anatomical_structure, Fetus, Lithopedion, Laparotomy, Pregnancy, Abdominal, medicine, Abdominal pregnancy, Abdomen, Gestation, Humans, Female, business, Abdominal surgery
الوصف: BACKGROUND:: Abdominal pregnancy is a rare life-threatening variant of ectopic pregnancy and thus its diagnosis and management remain controversial. CASE:: A multigravida was admitted for complaints of abdominal swelling that had been occurring for 2 years and symptoms of pregnancy in the 3 months before admission. Radiologic studies revealed a live intraabdominal pregnancy at 15 weeks of gestation with a concurrent lithopedion of advanced gestation. The patient underwent laparotomy removing both fetuses; the placenta was left in situ. She was discharged 1 week later in good condition. CONCLUSION:: The case of a concurrent lithopedion of advanced gestation and a live intraabdominal ectopic pregnancy was successfully managed.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::48253ed99b4a4a33701c48087449c3beTest
https://pubmed.ncbi.nlm.nih.gov/19622960Test -
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المؤلفون: Anthony N. Massinde, Albert Kihunrwa
المصدر: Annals of Medical and Health Sciences Research
مصطلحات موضوعية: medicine.medical_specialty, Debridement, medicine.diagnostic_test, Fistula, business.industry, medicine.medical_treatment, Urinary incontinence, Physical examination, Case Report, General Medicine, medicine.disease, Surgery, Developing countries, Prolonged exposure, Foreign body, Vesico-Vaginal Fistula, medicine.anatomical_structure, Vagina, Medicine, medicine.symptom, business
الوصف: Foreign body is a rare cause of vesico-vaginal fistula most often reported in developed countries. In developing countries obstructed labor is the commonest cause of fistula. A nulliparous 19-year-old female presented with a 3-week history of a foreign body in the vagina causing urinary incontinence and offensive vaginal discharge. Her guardian allegedly inserted the foreign body after she refused a pre-arranged marriage. A plastic container was removed from the vagina under general anesthesia. A large vesico-vaginal fistula was discovered, which was successfully surgically repaired. We recommend urgent removal of the foreign body, preferably under general anesthesia. However, if the history or physical examination reveals prolonged exposure, repair of the fistula should be delayed to allow for adequate debridement in order to prevent any life-threatening complications.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5515ea74753db304e918304659de2eb5Test
http://europepmc.org/articles/PMC3793460Test
