Browsing by Author "Kyamanywa, Patrick"

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    Local Anesthesia Versus Saddle Block for Open Hemorrhoidectomy: Cost-Analysis From a Randomized, Double Blind Controlled Trial.
    (Kabale University, 2024) Sikakulya, Franck Katembo; Ssebuufu, Robinson; Okedi, Xaviour Francis; Baluku, Moris; Lule, Herman; Kiyaka, Sonye Magugu; Muhumuza, Joshua; Selamo, Fabrice Molen; Bassara, Godefroy Nyenke; Waziri, Musa Abbas; Kithinji, Stephen Mbae; Mugisho, Munyerenkana Leocadie; Byamungu, Pahari Kagenderezo; Munihire, Jeannot Baanitse; Vahwere, Bienfait Mumbere; Kiswezi, Ahmed; Kyamanywa, Patrick
    Background Despite the benefits attributed to the use of local anesthesia (LA) for open hemorrhoidectomy (OH) in developed countries, this technique is still not considered as the first-line technique in low-income countries such as Uganda; therefore, we aimed to compare the cost of OH under LA versus Saddle block among patients with 3rd or 4th-degree hemorrhoids. Methods This trial was conducted from December 2021 to May 2022 among patients with primary uncomplicated 3rd or 4th degree hemorrhoids. The operating time and direct costs in (US$) including medical and non-medical were recorded. We analyzed the cost in the two groups (local anesthesia versus saddle block) using SPSS version 23.0. Results Findings of fifty-eight patients were analysed including 29 participants per group. There was a significant difference in operating time and cost among the two groups (p<0.05). The mean operating time was 15.52±5.34(SD) minutes versus 33.72±11.54 min for OH under LA and SB respectively. The mean cost of OH under LA was 57.42±8.90 US$ compared to 63.38±12.77US$ in the SB group. Conclusion The use of local anesthesia for OH was found to have less operating time with high-cost effectiveness. Being affordable, local anesthesia can help to increase the turnover of patients who would otherwise wait for the availability of anesthesia providers. Policymakers should emphasize its applicability in low-income settings to help in the achievement of 2030 global surgery goals. Trial registration Pan African Clinical Trials Registry, PACTR202110667430356. Registered on 08/10/2021.
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    Malnutrition Amongst HIV Adult Patients in Selected Hospitals of Bushenyi District in Southwestern Uganda.
    (Kabale University, 2020) Odwee, Ambrose; Keneth Iceland, Kasozi; Acup, Christine Amongi; Kyamanywa, Patrick; Ssebuufu, Robinson; Obura, Richard; Agaba, Jude B.; Makeri, Danladi; Kirimuhuzya, Claude; Sasirabo, Olivia; Bamaiyi, Pwaveno H.
    Background: Malnutrition is an important clinical outcome amongst HIV patients in developing countries and in Uganda, there is scarcity of information on its prevalence and risk factors amongst HIV adult patients. Methods: A cross-sectional study amongst 253 HIV patients in Bushenyi district assessed their nutritional status using the body mass index (BMI) and mid-upper arm circumference (MUAC), and a questionnaire was used to identify major risk factors. Results: The mean age of the study participants was 38.74 ± 0.80 yrs, while females and males were 52.2% and 47.8% respectively. Prevalence of malnutrition was 10.28% (95% CI: 6.82 – 14.69) in the study. Major socio-economic factors associated with malnutrition were being female, unemployed, dependent and with many family members. Patients with opportunistic infections, low adherence to HAART, and stage of HIV/AIDS had a higher risk of malnutrition Discussion: In rural communities, a majority of malnourished patients are elderly and these were identified as priority groups for HIV outreach campaigns. The current policy of prioritizing children and women is outdated due to changing disease dynamics, thus showing a need to revise extension service provision in rural communities. Conclusions: Malnutrition is a threat in HIV adult patients in rural communities of Uganda. Keywords: Malnutrition, HIV Adult PPatients, Bushenyi District,Uganda.
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    Pain Assessment Following Open Hemorrhoidectomy Under Local Anesthesia Versus Saddle Block: A Multicenter Randomized Controlled Trial.
    (Kabale University, 2024) Sikakulya, Franck Katembo; Ssebuufu, Robinson; Okedi, Xaviour Francis; Baluku, Moris; Lule, Herman; Kiyaka, Sonye Magugu; Kyamanywa, Patrick
    Background There is a disparity in evidence on pain assessment post open hemorrhoidectomy (OH) using local anes- Thesia and its use in developing countries are different from those in 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. Methods 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 analyzed using SPSS version 26 at a p<0.05 as statically significant using the visual analog scale (VAS). Results 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 different at 2 h post-OH compared to other times of pain assessment but not statically significantly by area under the cover (AUC) (95% CI=486–0.773: AUC=0.63; p=0.09) with a significance by Kruskal–Wallis’s test (p:0.925). Conclusion Local anesthesia was found to have a similar pain severity occurrence in the post-operative period among patients undergoing open hemorrhoidectomy for primary uncomplicated 3rd or 4th-degree hemorrhoids. Close monitoring of pain in the postoperative period is mandatory especially at 2 h to assess the need of analgesia. Trial registration Pan African Clinical Trials Registry, PACTR202110667430356. Registered on 8th October, 2021.