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Oxytocin Against a Combination of Oxytocin and Misoprostol in the Prevention of Primary Postpartum Haemorrhage among Grand Multiparous Women at Hoima Regional Referral Hospital
(Kampala International University, 2021-11) Barankunda ,Lyse
Background: Uterotonics differ in their effectiveness in the prevention of primary postpartum hemorrhage (PPH) mostly among the grand multiparous women. This study compared the differences in effectiveness of oxytocin against a combination of oxytocin and misoprostol in the prevention of primary postpartum hemorrhage among grand multiparous women at Hoima regional referral hospital, Mid-Western Uganda. Methods: This was a single blinded, randomized controlled trial from August 2021 to October 2021 at the Department of Obstetrics and Gynecology, Hoima Regional Referral Hospital, Mid-Western Uganda. 196 grand multiparous women (98 in each group) were included to receive either 10IUs of oxytocin intramuscularly or 10 IUs oxytocin intramuscularly plus rectal misoprostol tablets 400mcgs. Outcome measures were the blood loss, duration of third stage of labour, need of additional uterotonics and side effects of the uterotonics. Results: There was a lower blood loss in the group of oxytocin and misoprostol (293.77± 78.60 ml) compared with those who received oxytocin alone (388.34 ± 135.72 ml), p< 0.006), there was a significant difference in the incidence of PPH with lower incidence in the oxytocin plus misoprostol (2.04%) compared to the oxytocin group (14.29%). There was a significant difference in mean duration of the third stage of labour, with lower duration in the combination of oxytocin and misoprostol (7.43±2.31 vs 9.76±3.09, p <0.001) compared to oxytocin alone. There was a significant difference in the need of additional uterotonics found out that women in the oxytocin group required additional uterotonics and the difference was significant (p<0.05). However, the side effects were more in the oxytocin and misoprostol compared to the oxytocin group although statistically non-significant within 24hours (p<0.05). Conclusions: A combination of oxytocin and misoprostol is more effective than intramuscular oxytocin alone in reducing blood loss, minimizing the duration in the third stage of labour and the need for additional uterotonics but similar incidence of side effects.
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Clinical presentation and factors associated with diabetic peripheral neuropathy among adults with Diabetic Mellitus attending Kampala International University Teaching Hospital
(Kampala International University, 2021-08) Munyambalu, Dalton Kambale
Background: Diabetic Peripheral Neuropathy (DPN) is the most common type of Neuropathy and the commonest complication of Diabetes Mellitus contributing to major cause of non traumatic foot amputation which has impact in substantial morbidity and mortality. Early detection of DPN with good glycemic control may prevent foot amputations. Epidemiological data about clinical presentation and factors associated with the development of DPN are not yet known in rural western Uganda. Therefore, the aim of this study is to determine the clinical presentation and factors associated with DPN among adults with Diabetes Mellitus (DM) attending Kampala International University-Teaching Hospital (KIU-TH). Methods and material: A cross-sectional study which recruited 319 known DM patients was conducted in Internal Medicine Department and Diabetic Clinic at KIU-TH from December 2019 to March 2020 and from October to December 2020. Questionnaires were used to obtain clinical and sociodemographic data, neurological exam was done to assess the DPN and blood sample was collected from each participant for the determination of glycemic control (Glycosylated Hemoglobin). Data was analyzed using STATA version 15.0 while bivariate and multivariate logistic regression analyses were done to compare each independent variable with DPN (p value< 0.05). Results: The mean age of study participants was 59.4±13.6 years and females were 197(61.8%). The prevalence of DPN was at 65.8% (95%, CI 60.4-70.9). Pain and paresthesia were the most common clinical presentation of DPN (90%). Factors associated with DPN were DM duration of more than 10 years (aOR 4.6, 95% CI (2.36-8.9) p ˂ 0.0001), use of both oral hypoglycemic agents and insulin (aOR 7.33, 95% CI (1.95-27.5), p = 0.003), and poor glycemic control (aOR 2.0, 95% CI (1.15-3.42), p = 0.013). Conclusion: The prevalence of DPN among DM patients attending KIU-TH was high. The most common Clinical Presentation of DPN among DM patients attending KIU-TH were pain, paresthesia, numbness, muscle weakness, loss of balance and pain less foot ulcers. Study participants who had DM duration of more than 10 years on both oral hypoglycemic agents and insulin with poor glycemic control were at an increased risk of developing DPN. Recommendations: Clinicians should start doing a peripheral neurological exam in all DM patients and awareness of health personnel about factors associated with DPN.
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Assessing the effect of patients’ health literacy levels on early post operative surgical care outcomes at rural based hospitals in Western Uganda
(Kampala International University, 2021-08) Loduk ,Michael
Brief introduction and problem to be addressed: inadequate health literacy exposes patients to poorer surgical outcomes yet currently there is a paucity of studies on health literacy and associated impact on surgical care outcomes. Hence, this study aimed to provide an assessment of the effect of health levels on early postoperative surgical care outcomes at the rural hospital setting. Subject and Methods: we conducted a cross-sectional study where patients of sound minds, aged ≥18 years and seeking surgical care or already received the service were requested to participate in the assessment of their health literacy levels, wellbeing, any presence of surgical wound infection, and whether they had comorbidities and prior encounter with a doctor before the current visit. Major Results: based on the Short Assessment of Health Literacy English (SAHL-E), prevalence of inadequate health literacy among the 244 participants was 79.9% and had a statistically significant association with the early postoperative surgical outcomes of pain severity (correlation coefficient, -.594**, p-value < 0.05), wound infection ( .383**, < 0.05), and patient’s wellbeing (.672**, < 0.05). However, no statistical significance noted with having seen a doctor (-0.040, > 0.05), comorbidity (-0.103, > 0.05) or wound site (0.013, > 0.05). Conclusion and recommendation: health literacy’s strong statistical association with early postoperative surgical outcomes could possibly have a positive predictive value that would help the surgical care teams in mitigating its undesirable effects. So, healthcare providers should therefore embrace early preoperative health literacy evaluation in order to enhance the holistic postoperative patients’ care and improve the record systems. Keywords: Health literacy. Surgical outcomes.
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Outcomes and factors associated with acute kidney injury among children with severe malaria at Kiryandongo General Hospital, Uganda
(Kampala International University, 2021-11) Lokengama Kwambele
Background: Malaria remains one of the leading health problems of the developing world, and acute kidney injury (AKI) is a well-recognized complication of severe malaria in adults; but the clinical importance of AKI in pediatric severe malaria is not well documented. Knowledge of the prevalence, outcomes and factors associated among children with severe malaria is the mainstay strategy, which can help to reduce the burden of AKI among this vulnerable group. Methods: A hospital based prospective cohort and analytic study of children with severe malaria was carried out at Kiryandongo General Hospital. The study involved 350 children with severe malaria attending the study site from August to October 2021. Questionnaires were administered to caretakers to obtain socio-demographic. Medical data was obtained by carrying out a through physical examination followed by laboratory tests. Blood samples were tested for creatinine and blood smear for malaria. Data were analyzed using univariate, bivariate and multivariate logistic regression analyses to determine the prevalence and factors associated with acute kidney injury among children with severe malaria. Result: The mean age of children with severe malaria was 7.0 ± 3.8 years and 54.3 % of them were male.Of the 350 children enrolled in the study with severe malaria, 167 had AKI, giving an overall AKI prevalence of 47.7% (95% CI: 42.5-53.0). The factors that were significantly associated with AKI among children with severe malaria included: caretaker with no formal education (aOR= 21.0, 95% CI: 1.68 – 261.18, p= 0.018); caretaker with primary education level (aOR= 4.5, 95% CI: 1.41 – 14.12, p= 0.011); age of child < 5years (aOR= 1.8, 95% CI: 1.07 – 2.88, p= 0.025); history of receiving NSAIDs (aOR= 5.6, 95% CI: 2.34 – 13.22, p <0.001); moderate anemia (aOR= 3.1, 95% CI: 1.39 – 6.94, p= 0.006) and severe anemia (aOR= 3.8, 95% CI: 1.66 – 8.55, p= 0.002). Sixteen of 167 with AKI died (9%) during follow up and the mean lengh hospital stay was of 5 days. Conclusion: The prevalence of acute kidney injury was high as well as mortality rate of AKI among children with severe malaria still high, in Kiryandongo General Hospital. Acute kidney injury among children with severe malaria was associated with low level of education of caretakers, young age of children (less than 5 years), history of receiving NSAIDs and anemia. The management of severe malaria should include screening for AKI especially in children under five years of age, anaemic and those who have received NSAIDs.
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Workplace Facilities and Teaching Staff Performance in Private Secondary Schools in Iganga Municipality, Uganda
(2026) Muyanda Banuli
This study examined the influence of workplace facilities on teaching staff performance in selected private secondary schools in Iganga Municipality, Uganda. The study was guided by three objectives; to examine the quality of workplace facilities available to teaching staff, to assess the relationship between workplace facilities and teaching performance and to determine the impact of workplace facilities on the quality of work performed by teaching staff. The study was anchored on Facilities Management Theory and Herzberg’s Two-Factor Theory of Motivation. A quantitative correlational survey design was adopted and data were collected from 133 respondents selected through stratified and simple random sampling techniques. Structured questionnaires were used as the main data collection instrument. Data were analyzed using SPSS, employing descriptive statistics, Pearson correlation coefficients, and one-way ANOVA. Descriptive results revealed that key workplace facility indicators such as teacher accommodation (Mean = 12.5), computer access (Mean = 62) and library space (Mean = 72.5) were generally low while other facilities such as sanitation (Mean = 272.3), lighting (Mean = 238), and water access (Mean = 171.6) showed relatively better provision. Pearson correlation analysis indicated a positive but weak and statistically non-significant relationship between overall workplace facilities and teaching performance (r = .057, p = .867) and similarly weak correlations for individual indicators (r = .254, p = .451). However, one-way ANOVA results revealed a statistically significant difference in teaching staff performance across schools grouped by facility quality (F(2, 8) = 62.40, p < .001), indicating that schools with higher-quality facilities recorded better teacher performance outcomes. The study concludes that although individual workplace facilities may not directly predict teaching performance, their collective condition significantly influences teaching quality across different school contexts. It recommends that school administrators and policymakers prioritize investment in infrastructure, particularly housing, lighting, and instructional resources, to create equitable and supportive working environments that enhance teacher productivity and educational effectiveness.