Browsing by Author "Ogwang, Martin David"

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    Factors affecting mortality after traumatic brain injury in a resource-poor setting
    (BJS Open, 2019) Okidi, Ronald; Ogwang, Martin David; Okello, Tom Richard; Ezati, Daniel; Kyegombe, W.; Nyeko, D.; Scolding, N. J.
    Background: Traumatic brain injury (TBI) is a major cause of long-term disability and economic loss to society. The aim of this study was to assess the factors affecting mortality after TBI in a resource-poor setting. Methods: Chart review was performed for randomly selected patients who presented with TBI between 2013 and 2017 at St Mary’s Hospital, Lacor, northern Uganda. Data collected included demographic details, time from injury to presentation, and vital signs on arrival. In-hospital management and mortality were recorded. Severe head injury was dened as a Glasgow Coma Scale score below 9. Results: A total of 194 patient charts were reviewed. Median age at time of injury was 27 (i.q.r. 2–68) years. The majority of patients were male (M : F ratio 4⋅9 : 1). Some 30⋅9 per cent of patients had severe head injury, and an associated skull fracture was observed in 8⋅8 per cent. Treatment was mainly conservative in 94⋅8 per cent of patients; three patients (1⋅5 per cent) had burr-holes, four (2⋅1 per cent) had a craniotomy, and three (1⋅5 per cent) had skull fracture elevation. The mortality rate was 33⋅0per cent; 46 (72 per cent) of the 64 patients who died had severe head injury. Of the ten surgically treated patients, seven died, including all three patients who had a burr-hole. In multivariable analysis, factors associated with mortality were mean arterial pressure (P = 0⋅012), referral status (P = 0⋅001), respiratory distress (P = 0⋅040), severe head injury (P = 0⋅011) and pupil reactivity (P = 0⋅011). Conclusion: TBI in a resource-poor setting remains a major challenge and affects mainly young males. Decisions concerning surgical intervention are compromised by the lack of both CT and intracranial pressure monitoring, with consequent poor outcomes
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    Incidental cholecystocolonic fistula in obstructive jaundice
    (Wiley, 2021) Okidi, Ronald; Ogwang, Martin David; Natumanya, Robert; Mukalazi, Abraham; Kyomuhendo, Tracy; Okello, Tom Richard
    Cholecystocolonic fistula is a rare condition often diagnosed intraoperatively, requiring an adequate set of knowledge and skills to allow safe intraoperative change of prior planned surgery and alleviate significant morbidity.
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    Short-term outcomes of laparotomy in the two teaching hospitals of gulu university, northern uganda.
    (Archives of Clinical Gastroenterology, 2020) Amone, D; Okello, Tom Richard; Okot, C; Kitara, DL; Mugabi, P; Ogwang, Martin David
    Purpose: The purpose of this study was to examine the clinical indication for laparotomy, the intra-operative fi ndings and the 30 days post-operative outcome of laparotomy in Gulu university teaching hospitals. Methods: Using an approved protocol, a six month descriptive longitudinal study was conducted on patients undergoing laparotomy in the two main Gulu University teaching hospitals of St. Mary’s Hospital Lacor and Gulu regional referral. Using a sample size of 66, cases were recruited consecutively, clerked, investigated and conventionally prepared for surgery. Intra-operative diagnosis was ascertained as well as the operative procedure and post-operatively the patients were followed up for 30 days complications including death. Results: Overall, the mean age was 35.04yrs (SD+/- 16.522), but there were more males (59.4%) than females (40.6%). There was a statistically signifi cant positive correlation between the clinical diagnosis and the intraoperative fi ndings (r = 0.405, P value = 0.001). Within the 30days, the most frequent complication observed was surgical site infection (SSI) (20%, n=13), followed by wound dehiscence (17.2%, n=11), crude mortality rate was 15.6%, (n=10) and complication requiring emergency reoperation (10.9%, n=7). Ileal perforations tended to have bad outcomes. Age of patient was found to be a signifi cant factor in determining the outcome. Conclusion: Descriptive longitudinal study on both elective and emergency laparotomy is possible in our setting. Whereas patients’ age is an important factors in determining outcome and ileal perforation tend to do better if prioritized with ileostomy, overall the 30days mortality rate for laparotomy was 15.6%.