Browsing by Author "Okedi, Francis Xaviour"

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    Factors associated with severity and anatomical distribution of diabetic foot ulcer in Uganda: a multicenter cross-sectional study
    (BMC Springer Nature, 2023-03-10) Bienfait Mumbere, Vahwere; Ssebuufu, Robinson; Namatovu, Alice; Kyamanywa, Patrick; Ntulume, Ibrahim; Mugwano, Isaac; Pius, Theophilus; Sikakulya Katembo, Franck; Okedi, Francis Xaviour; Mulumba, Yusuf; Jorge, Soria; Agaba, Gidio; Nasinyama, George William
    Diabetic foot ulcer (DFU) is a devastating complication of diabetes mellitus (DM) that is associated with increased mortality, morbidity, amputation rate and economic burden. This study aimed at identifying the anatomical distribution and factors associated with severity of DFU in Uganda. This was a multicenter cross-sectional study conducted in seven selected referral hospitals in Uganda. A total of 117 patients with DFU were enrolled in this study between November 2021 and January 2022. Descriptive analysis and modified Poisson regression analysis were performed at 95% confidence interval; factors with p-value<0.2 at bivariate analysis were considered for multivariate analysis. The right foot was affected in 47.9% (n=56) of patients, 44.4% (n=52) had the DFU on the plantar region of the foot and 47.9% (n=56) had an ulcer of >5 cm in diameter. The majority (50.4%, n=59) of patients had one ulcer. 59.8% (n=69) had severe DFU, 61.5% (n=72) were female and 76.9% had uncontrolled blood sugar. The mean age in years was 57.5 (standard deviation 15.2 years). Primary (p=0.011) and secondary (p<0.001) school educational levels, moderate (p=0.003) and severe visual loss (p=0.011), 2 ulcers on one foot (p=0.011), and eating vegetables regularly were protective against developing severe DFU (p=0.03). Severity of DFU was 3.4 and 2.7 times more prevalent in patients with mild and moderate neuropathies (p<0.01), respectively. Also, severity was 1.5 and 2.5 higher in patients with DFU of 5–10 cm (p=0.047) and in those with >10 cm diameter (p=0.002), respectively. Most DFU were located on the right foot and on the plantar region of the foot. The anatomical location was not associated with DFU severity. Neuropathies and ulcers of >5 cm diameter were associated with severe DFU but primary and secondary school education level and eating vegetables were protective. Early management of the precipitating factors is important to reduce the burden of DFU.
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    Pain assessment following open hemorrhoidectomy under local anesthesia versus saddle block: a multicenter randomized controlled trial
    (BMC Springer Nature, 2023-05-12) Sikakulya, Franck Katembo; Ssebuufu, Robinson; Okedi, Francis Xaviour; Baluku, Moris; Lule, Herman; Kiyaka, Sonye Magugu; Kyamanywa, Patrick
    There is disparity in evidence on pain assessment post open hemorrhoidectomy (OH) using local anesthesia and its use in developing countries compared to developed countries. Therefore, we conducted this study to assess the occurrence of postoperative pain following open hemorrhoidectomy under local anesthesia versus saddle block for uncomplicated 3rd or 4th degree hemorrhoids. This was a prospective equivalence randomized, double blind controlled trial conducted from December 2021 to May 2022 among patients with primary uncomplicated 3rd or 4th degree hemorrhoids. Pain severity was assessed at 2, 4 and 6 h post open hemorrhoidectomy using visual analogue scale (VAS). Data was analysed using SPSS version 26 at a p<0.05 as statically signifcant using visual analogue scale (VAS). We recruited 58 participants in this study who underwent open hemorrhoidectomy under local anesthesia or saddle block (29 participants per group). The sex ratio was of 1.15 of female to male and a mean age of 39±13. VAS was found to be diferent at 2 h post OH compare to other time of pain assessment but not statically signifcant by area under the cover (AUC) (95% CI=486–0.773: AUC=0.63; p=0.09) with a none signifcance by Kruskal–Wallis’s test (p:0.925). Local anesthesia was found to be having a similar pain severity occurrence in post operative period among patients undergoing open hemorrhoidectomy for primary uncomplicated 3rd or 4th degree hemorrhoids. Close monitoring of pain in postoperative period is mandatory especially at 2 h to assess need of analgesia.