Browsing by Author "Emmanuel, Othieno"

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Malignant mixed mullerian tumor:
(Elsevier Ltd on behalf of Surgical Associates Ltd., 2022-05-20) Emmanuel D, Morgan; Tonny, Okecha; James J., Yahaya; Emmanuel, Othieno
Abstract: Introduction: Malignant mixed Mullerian tumor (MMMT) is an exceedingly rare and aggressive tumor which occurs predominantly in postmenopausal women though it has been reported rarely in premenopausal women. Case presentation: A 54-year old nulliparous postmenopausal female presented with a 3-month history of vaginal bleeding, mild lower abdominal pain and weight loss. Ultrasound revealed markedly enlarged uterus with a hyper-echoic solid and cystic mass and a right adnexal complex mass. Total abdominal hysterectomy and bilateral salpingioopherectomy were done. Histopathological features were consistent with MMMT. The patient is currently stable after 6 cycles of adjuvant chemotherapy which consisted of paclitaxel and carboplatin. Clinical discussion: MMMT of the uterus is rare, high-grade neoplasms comprising only 1–2% of uterine cancers and 3–5% of all uterine malignancies. This tumor may arise in the ovaries, fallopian tubes and vagina. Histologically, MMMT is a biphasic tumor composed of both epithelial (carcinoma) elements and mesenchymal (sarcoma) elements; though, which component is responsible for the tumor’s aggressive biological behavior remains undetermined. Conclusion: MMMT is a rare and aggressive tumor which is commonly seen in postmenopausal women with high rate of recurrence therefore, Radical surgery and close follow-up is mandatory since the role of chemoradiotherapy remains unclear in the management of patients with this tumor. Both stage of the tumor and myometrial invasion are considered as potential prognostic factors.
Treatment success rate and associated factors among drug susceptible tuberculosis individuals in St. Kizito Hospital, Matany, Napakdistrict, Karamoja region.
(PLOS One Publishers, 2024-05-14) Ronald, Opito; Keneth, Kwenya; Saadick Mugerwa, Ssentongo; Mark, Kizito; Susan, Alwedo; Baker, Bakashaba; Yunus, Miya; Lameck, Bukenya; Eddy, Okwir; Lilian, Angwech Onega; Andrew, Kazibwe; Emmanuel, Othieno; Fred, Kirya; Peter, Olupot‑Olupot
Background Tuberculosis (TB) is the leading cause of death among infectious agents globally. An estimated 10million people are newly diagnosed and 1.5 million die of the disease annually. Uganda is among the 30highTB-burdened countries, with Karamoja having a significant contribution of the disease incidence in the country. Control of the disease in Karamoja is complex because a majority of the at-risk population remains mobile; partly because of the nomadic lifestyle. This study, therefore, aimed at describing the factors associated with drug-susceptible TB treatment success rate (TSR) in the Karamoja region. Methods This was a retrospective study on case notes of all individuals diagnosed with and treated for drug-susceptible TB at St. Kizito Hospital Matany, Napak district, Karamoja from 1 2020 to 31 st st Jan December 2021. Data were abstracted using a customized data abstraction tool. Data analyses were done using Stata statistical software, version 15.0. A chi-square test was conducted to compare treatment success rates between the years 2020 and 2021, while Modified Poisson regression analysis was performed at a multivariable level to determine the factors associated with treatment success. Results We studied records of 1234 participants whose median age was 31(IQR: 13–49) years. Children below 15 years of age accounted for 26.2% (n = 323). The overall treatment success rate for the study period was 79.3%(95%CI; 77.0%-81.5%), with a statistically significant variation in 2020 and 2021, 75.4% (422/560) vs 82.4% (557/674) respectively, (P = 0.002). The commonest reported treatment outcome was treatment completion at 52 %(n = 647) and death at wasat10.4%(n=129). Older age, undernutrition (Red MUAC), and HIV-positive status were significantly associated with lower treatment success: aPR = 0.87(95% CI; 0.80–0.94), aPR = 0.91 (95%CI; 0.85–0.98) and aPR = 0.88 (95%CI; 0.78–0.98); respectively. Patients who were enrolled in 2021 had a high prevalence of treatment success compared to those enrolled in 2020, aPR = 1.09 (95%CI; 1.03–1.16). Conclusion TBTSR in Matany Hospital was suboptimal. Older age, poor nutrition, and being HIV-positive were negative predictors of treatment success. We propose integrating nutrition and HIV care into TB programming to improve treatment success