Journal Articles (Medical School)

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Browsing Journal Articles (Medical School) by Subject "Analysis"

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    An Analysis of the Short Term Outcomes of Laparotomy Among Surgeons in Mulago Hospital Using POSSUM Scoring System
    (International Research Journals, 2011-09-01) Kitara, Lagoro David; Kakande, Ignatius; Mugisa, D. Didas
    More than 600 laparotomy operations are conducted in Mulago National Referral Hospital (MNRH) every year. However, there are no criteria for judging the outcomes (morbidity and mortality) and comparing the short-term outcomes of these operations among surgeons in the Department of Surgery. The Physiological Operative Severity Score for the enumeration of Morbidity and Mortality (POSSUM) was used to analyze the short-term outcomes of laparotomy among surgeons in MNRH. A cross-sectional study was conducted using 76 consecutively recruited patients who underwent emergency and elective laparotomy. POSSUM scoring system was used and patients followed-up to 30th post-operative day. Day-care surgeries, patients who died on table before induction of anesthesia, and patients below 13 years of age were excluded from the study. Informed consent and assent was obtained from each patient before surgery and ethical approval was obtained from the research and review committee of Makerere University Medical School. There were 51 emergencies (67.1%) and 25 (32.9%) electives. 13 patients (17.1%) were operated by consultants, 8 (10.5%) by registrars and 55 (72.4%) by senior residents. Short-term outcome (morbidity) among the surgeons was: consultants (t= -0.081, p=0.243), registrars (t= -0.039, p=0.368), and senior residents (t= -0.041, p=0.362). Mortality outcomes for surgeons were consultants (t= -0.012, p=0.460), registrar (t=.-0.012, p=0.460) and senior residents (t= 0.087, p=0.228). POSSUM successfully analyzed the short-term outcomes of laparotomy among surgeons in MNRH. All the surgeons were performing well within the predictive power of Possum.
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    The Specialist Surgeon Workforce in East, Central and Southern Africa: A Situation Analysis
    (Springer, 2016-01-01) O’Flynn, Eric; Andrew, Judith; Hutch, Avril; Kelly, Caitrin; Jani, Pankaj; Kakande, Ignatius; Derbew, Miliard; Tierney, Sean; Mkandawire, Nyengo; Erzingatsian, Krikor
    Background In East, Central and Southern Africa accurate data on the current surgeon workforce have previously been limited. In order to ensure that the workforce required for sustainable delivery of surgical care is put in place, accurate data on the number, specialty and distribution of specialist-trained surgeons are crucial for all stakeholders in surgery and surgical training in the region. Methods The surgical workforce in each of the ten member countries of the College of Surgeons of East, Central and Southern Africa (COSECSA) was determined by gathering and crosschecking data from multiple sources including COSECSA records, medical council registers, local surgical societies records, event attendance lists and interviews of Members and Fellows of COSECSA, and validating this by direct contact with the surgeons identified. This data was recorded and analysed in a cloud-based computerised database, developed as part of a collaboration programme with the Royal College of Surgeons in Ireland. Results A total of 1690 practising surgeons have been identified yielding a regional ratio of 0.53 surgeons per 100,000 population. A majority of surgeons (64 %) practise in the main commercial city of their country of residence and just 9 % of surgeons are female. More than half (53 %) of surgeons in the region are general surgeons. Conclusions While there is considerable geographic variation between countries, the regional surgical workforce represents less than 4 % of the equivalent number in developed countries indicating the magnitude of the human resource challenge to be addressed.