Browsing by Author "Gerald Tumusiime"

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    A Secondary Analysis to Determine Variations of Dental Arch Measurements With Age and Gender Among Ugandans
    (BMC, 2015) Hilda Okori; Pricilla S. Apolot; Erisa Mwaka; Gerald Tumusiime; William Buwembo; Ian G. Munabi
    Background: Dental arch dimensions are useful in dental practice and in forensic odontology. Local data is essential because ethnic differences exist in dental arch dimensions. In the Ugandan population no studies had been done on dental arch dimensions. The objective of the current study was to determine the variations in dental arch dimensions with age and gender in a sample of dental casts from the Ugandan population. Method: This was a secondary analysis of dental casts previously prepared using mandibular and maxillary arch impressions of 220 children (85 boys and 135 girls) aged 12–17 years recruited from schools in Kampala, Uganda. Dental arch dimensions for the maxilla and mandibular casts were taken using a digital vernier calliper. The data was analysed using the means based independent samples t test to obtain the descriptive statistics with regression analy- sis being used to obtain the regression coefficients and constants using STATA 12. Results: The overall maxillary dimensions were significantly smaller in females than males by 1.50 mm (95 % CI −2.91 to −0.09, P = 0.04), controlling for age group. The overall dimensions of the mandible were also smaller in younger participants, though this was not statistically significant. Conclusion: From this study we observed significant differences in arch dimensions between males and females that are of forensic value for this population. There is need for more study of the differences in arch dimensions with age using a larger and more age diverse study population. Keywords: Dental arch, Dimensions, Age, Anatomy, Forensic odontology, Gender
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    Ileosigmoid Knotting in Pregnancy: A Case Report Seen in Uganda
    (COSECSA/ASEA Publication, 2013-12) David Mutiibwa; Gerald Tumusiime
    Ileo-sigmoid knotting (ISK) refers to the intertwining of the ileum and the sigmoid colon. The incidence of ISK is not known but generally occurs in areas with high incidence of sigmoid volvulus such as Africa, Asia, Middle East, and South America. ISK is more common in adult males, particularly the old. ISK in pregnancy is not common but if it occurs, early surgical intervention is necessary to avert its associated morbidity and mortality. Normal pregnancy complaints may cloud the clinical picture of ISK and efforts to avoid radiological investigations may contribute to diagnostic delay. We report a case of a pregnant mother in her second trimester who was admitted at Mbarara Regional Referral Hospital with features of intestinal obstruction and exploratory laparotomy revealed ISK with gangrenous bowel. After surgery, she recovered very well, carried her pregnancy to term and delivered normally.
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    Impact of High Human Genetic Diversity in Africa on Immunogenicity and Efficacy of RTS, S/AS01 Vaccine
    (Springer, 2023-04-21) Stephen Tukwasibwe; Isaac Ssewanyana; Gerald Mboowa; Ivan Sserwadda; Joaniter; Nankabirwa; Emmanuel Arinaitwe; Isaac Ssewanyana; Yoweri Taremwa; Gerald Tumusiime; Moses R. Kamya; Prasanna Jagannathan; Annettee Nakimuli
    In modern medicine, vaccination is one of the most effective public health strategies to prevent infectious diseases. Indisputably, vaccines have saved millions of lives by reducing the burden of many serious infections such as polio, tuberculosis, measles, pneumonia, and tetanus. Despite the recent recommendation by the World Health Organization (WHO) to roll out RTS,S/AS01, this malaria vaccine still faces major challenges of variability in its efficacy partly due to high genetic variation in humans and malaria parasites. Immune responses to malaria vary between individuals and populations. Human genetic variation in immune system genes is the probable cause for this heterogeneity. In this review, we will focus on human genetic factors that determine variable responses to vaccination and how variation in immune system genes affect the immunogenicity and efficacy of the RTS,S/AS01 vaccine.
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    Morphometry of the Proximal End of Dry Adult Human Femora from the East African Population: A CrossSection Study
    (Austin Publishing Group, 2021-08-24) Gerald Tumusiime; Gonzaga Gonza Kirum; John Kukiriza
    Introduction: Proximal femur morphometry is important in the stability of the hip joint, the design of implants for hip replacement and forensic identification of unknown human remains. This study aimed at determining the proximal femur morphometry and factors associated with their variation. Materials and Methods: This was a cross-sectional study of the proximal end of 333 dry human femora from persons aged 20 to 75 years from the East African population. All the femora were observed macroscopically for the presence of the third trochanter, and the age, sex and nationality documented. The femoral head and neck circumferences were measured using a tape measure and the neck-shaft angle and the angle of anteversion measured using a goniometer. Data were entered in an Excel sheet and exported to STATA 14 for analysis. Univariate, bivariate and multivariable analyses were performed. A p-value of less than 0.05 was considered statistically significant. Results: Of the 333 dry femora, 7.21% (24/333) had a third trochanter. The mean femoral head circumference was 134.91 ± 8.91 mm, the mean neckshaft angle was 118 ± 6 degrees, the mean angle of anteversion was 17 ± 4 degrees, the mean femoral neck circumference was 91.71 ± 7.40 mm. Statistical significance was achieved between each of the proximal femur measurements and: sex, nationality and third trochanter status. Conclusion: The morphometry of the proximal femur varies with age, sex and nationality. These variations are pertinent in the design of tailored proximal femur implants, assessing the risk of fractures, forensic practice and regional comparisons. Keywords: Immplants; Morphometry; Neck-shaft angle; Proximal femur; Third trochanter
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    Surgical Mortality at a Mission Hospital in Western Uganda
    (College of Surgeons of East Central and Southern Africa, 2010-08) Gerald Tumusiime
    Background: Audit of Surgical mortality seeks to focus on improvement in the process of surgical care and not on individual surgical ability. Audit of surgical mortality was conducted to establish the factors associated with the surgical deaths in Virika Hospital to propose ways of improvement. Methods: The study was conducted in Virika Mission Hospital in Western Uganda, a 155 bed capacity hospital with a surgical bed capacity of 32 located in rural Uganda.Individual case file review of the fourty three surgical deaths from 1st July 2008 to 31st June 2009 was conducted. Additional data was retrieved from hospital admission register, operation registers, and death certificate books. Results: The operation death rate was 1.3%, all were emergencies, and 82.6% were done under general anaesthesia and17.4% died on table. The laparotomy death rate was 12.5%, Herniorrhaphy 0.9%, drainage of pus 1.4% and wound suture 0.4%. Surgery was delayed due to lack of blood in only one case but there was no record of lack of any resource for delaying surgery. Surgical conditions were: Injuries 39.5%, Intestinal perforations 30.2%, Intestinal obstruction 20.9% and others 9.3%. The hospital had no high dependency unit and no intensive care unit. No postmortem was conducted in all cases. Conclusion: Overall the Audit identified client, provider, administrative and community-related factors that need to be addressed collectively to reduce surgical mortality in Virika hospital.Audit of surgical mortality should be part of the health workers’ general approach to making more information available in a meaningful way for continuous improvement of surgical services.
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    The Number and Determinants of Nutrient Foramina Among Dry Human Femur Bones From the East African Population: A Cross-Section Study
    (BMC, 2021) Gerald Tumusiime; Gonzaga Gonza Kirum; John Kukiriza
    Background: Nutrient foramina form important landmarks on the femur and other bones as the portal of entry for nutrient arteries. Nutrient arteries are important sources of blood supply for growing bones; and their variations may be due to congenital or acquired causes. These variations are important in anatomical comparisons, orthopaedic surgical practice and forensic medicine. Aims: This study aimed at establishing the number and determinants of the nutrient foramina among dry human femur bones from the East African population. Materials and methods: This was a cross-section study of 333 dry femur bones from the East African population, at the Galloway osteological collection of Makerere University college of health sciences. The number of nutrient foramina on the shaft of each femur, the corresponding demographic, clinical and morphometric characteristics were documented. Data were entered in an Excel sheet and exported to STATA 14 for analysis. Univariate, bivariate and multivariable analyses were performed to obtain the summary statistics and the measures of association. At all levels of analysis, a p-value of less than 0.05 was considered statistically significant. Results: Of the 333 femurs, 291 (87.4%) were from males; and 137(50.15%) were right femurs. The age ranged from 20 to 75 years with a mean age of 35 (SD± 12) years. Nutrient foramina ranged from one to four; mean of 1.4 (SD±0.5) and median of 1 (IQR: 1 to 2). Of the 333 femurs, 199 (59.8%) had one foramen, 129 (38.7%) had two foramina, four femurs had three foramina and one femur had four foramina. There was a statistically significant association between the number of nutrient foramina and the femur’s: mid-shaft circumference (p=0.014; 95%CI: 0.003 to 0.028), nationality (p=0.016; 95%CI: -0.284 to -0.030) and sex (p=0.012; 96% CI: -0.405 to -0.050). Conclusion: Nutrient foramina among femurs from the East African population range from one to four per femur, with predominantly one foramen. The key determinants of the number of foramina are: mean mid-shaft circumference, nationality and sex. These findings are significant in anatomical comparisons; forensic and orthopaedic practices. KEY WORDS: Nutrient foramina, dry human femur, East African population, morphometric characteristics.
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    The Potential of Solanum Aethopicam Supplementation to Reduce the Anthropometric and Biochemical Risk Factors for Non-communicable Diseases Among Older Persons in Mukono Municipality, Uganda: A Before-and-After Study
    (BMC, 2023-10-06) Gerald Tumusiime; Elizabeth Kizito Balyejusa; Anthony Kkonde; Mildred Julian Nakanwagi; Stephen Tukwasibwe; Catherine Ndagire; Martin Mutambuka
    Background: Non-communicable diseases contribute to over 70% of all deaths globally with the majority of the deaths in low and middle-income countries. Although increased vegetable consumption is a cost-effective intervention to mitigate the burden of non-communicable diseases, little is known about African indigenous vegetables to guide their consumption, especially among older persons. This study, aimed at exploring the potential of dietary Solanum aethopicam Shum supplementation in the reduction of the risk of non-communicable diseases among older persons aged 50 years and above in Mukono municipality,Uganda. Methods: This was a before-and-after study of 100 community-dwelling older persons aged 50 years and above residing in cosmopolitan Mukono Municipality in central Uganda. The meal of each participant was supplemented with 375g of Solanum aethiopicum Shum per day for four weeks. Anthropometric and biochemical parameters were collected at baseline and at the end of the four weeks. All measurements were taken in the morning after an overnight fast. Data was entered into an Excel sheet and transferred to STATA software for analysis. All data was summarized in tables and texts. Results: Of the 100 older persons aged 50 to 88 years (mean 63 ± 10), 60% were females and on average, males were older than females. Based on the body mass index, five percent were underweight, 40% were normal, and 55% were overweight or obese at baseline. After supplementation with Solanum aethiopicum Shum, three percent were normal, 44% were normal and 53% were overweight or obese. Also, there was a mean reduction in the participants’ weight, body mass index, mid-upper arm circumference, abdominal girth, hip circumference, and C-reactive protein. Conclusion: The results suggest that supplementation of the older persons’ diet with Solanum aethiopicum Shum improves their nutrition status, and leads to a reduction in the mean weight, body mass index, mid-upper arm circumference, abdominal girth, hip circumference, and C-reactive protein levels. Dietary supplementation with Solanum aethiopicum Shum should be promoted as a potential strategy to reduce the risk of non-communicable diseases among older persons.