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Open Journal of Ophthalmology 2024年第3期14卷 204-207页

作者： Husna Msangi Annamary Stanslaus Hussein Msuma Salha Omary Milka Mafwiri Department of Ophthalmology Temeke Regional Referral Hospital Dar-es-salaam Tanzania Department of Surgery and Urology Temeke Regional Referral Hospital Dar-es-salaam Tanzania Department of Paediatric and Child Health Temeke Regional Referral Hospital Dar-es-salaam Tanzania Department of Ophthalmology Muhimbili University of Health and Allied Sciences Dar-es-salaam Tanzania

Congenital eversion of the upper eyelids is a rare condition, the exact cause of which remains unknown. It is more frequently associated with Down’s syndrome and black babies. If diagnosed early and treated properly, the condition can be managed without surgery. We report a case of non syndromic congenital bilateral severe upper eyelid eversion in otherwise normal 3 days old neonate of African descent (Tanzanian), born by vaginal delivery. The case was conservatively managed by lubricants, antibiotics and eyelid patching. We report this case because from the best of our knowledge it has never been documented here at our hospital and Tanzania before.

关键词： Upper Eyelid Eversion Congenital Ectropion Conservative Management

National guidelines for the diagnosis and treatment of hilar cholangiocarcinoma

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World Journal of Gastroenterology 2024年第9期30卷 1018-1042页

作者： Faisal Saud dar Zaigham Abbas Irfan Ahmed Muhammad Atique Usman Iqbal Aujla Muhammad Azeemuddin Zeba Aziz Abu Bakar Hafeez Bhatti Tariq ali Bangash Amna Subhan Butt Osama Tariq Butt Abdul Wahab Dogar Javed Iqbal Farooqi Faisal Hanif Jahanzaib Haider Siraj Haider Syed Mujahid Hassan Adnan Abdul Jabbar Aman Nawaz Khan Muhammad Shoaib Khan Muhammad Yasir Khan Amer Latif Nasir Hassan Luck Ahmad Karim Malik Kamran Rashid Sohail Rashid Mohammad Salih Abdullah Saeed Amjad Salamat Ghias-un-Nabi Tayyab Aasim Yusuf Haseeb Haider Zia Ammara Naveed Department of Hepatopancreatic Biliary Surgery&Liver Transplant Pakistan Kidney and Liver Institute&Research CentreLahore 54000Pakistan Department of Hepatogastroenterology and Liver Transplantation Dr.Ziauddin University HospitalKarachi 75600SindhPakistan University of Aberdeen Aberdeen B243FXUnited Kingdom Department of Pathology Pakistan Kidney and Liver Institute&Research CentreLahore 54000Pakistan Department of Gastroenterology&Hepatology Pakistan Kidney and Liver Institute&Research CentreLahore 54000Pakistan Department of Radiology Aga Khan UniversityKarachi 74800Pakistan Department of Oncology Hameed Latif HospitalLahore 54000Pakistan Division of Hepatopancreatic Biliary Surgery&Liver Transplantation Shifa International HospitalIslamabad 44000Pakistan Department of Hepatopancreatic Biliary Surgery&Liver Transplant Shaikh Zayed Hospital and Post Graduate Medical InstituteLahore 54000Pakistan Department of Medicine Aga Khan University HospitalKarachi 74800Pakistan Department of Liver Transplant Pir Abdul Qadir Shah Jeelani Institute of Medical SciencesGambat 66020Pakistan Department of Medicine&Gastroenterology Lifecare Hospital and Research CentrePeshawar 25000Khyber PakhtunkhwaPakistan Department of Hepatopancreatobiliary&Liver Transplant Bahria International HospitalLahore 54000Pakistan Department of Surgery Hepatopancreatobiliary&Liver TransplantDow University of Health SciencesKarachi 74800Pakistan Department of Gastroenterology Hepatology&NutritionPir Abdul Qadir Shah Jeelani Institute of Medical SciencesGambat 66020Pakistan Department of Oncology Dr.Ziauddin HospitalKarachi 74800Pakistan Department of Radiology Rehman Medical InstitutePeshawar 25000Pakistan Army Liver Transplant Unit Pak Emirates Military HospitalRawalpindi 46000Pakistan Department of Gastroenterology Sindh Institute of Urology and TransplantationKarachi 75500Pakistan Rashid Nursing Home and Cancer Clinic Rashid Nursing Home and Cancer ClinicRawalpindi 46000Pakistan Department of Gastroentero

A consensus meeting of national experts from all major national hepatobiliary centres in the country was held on May 26,2023,at the Pakistan Kidney and Liver Institute&Research Centre(PKLI&RC)after initial consultations with the *** Pakistan Society for the Study of Liver Diseases(PSSLD)and PKLI&RC jointly organised this *** effort was based on a comprehensive literature review to establish national practice guidelines for hilar cholangiocarcinoma(hCCA).The consensus was that hCCA is a complex disease and requires a multidisciplinary team approach to best manage these *** coordinated effort can minimise delays and give patients a chance for curative treatment and effective *** diagnostic and staging workup includes high-quality computed tomography,magnetic resonance imaging,and magnetic resonance *** cytology or biopsy utilizing endoscopic retrograde cholangiopancreatography is a mainstay for ***,histopathologic confirmation is not always required before *** ultrasound with fine needle aspiration of regional lymph nodes and positron emission tomography scan are valuable adjuncts for *** only curative treatment is the surgical resection of the biliary tree based on the Bismuth-Corlette *** patients with unresectable hCCA can be considered for liver *** chemotherapy should be offered to patients with a high risk of *** use of preoperative biliary drainage and the need for portal vein embolisation should be based on local multidisciplinary *** with acute cholangitis can be drained with endoscopic or percutaneous biliary *** chemotherapy with cisplatin and gemcitabine has shown improved survival in patients with irresectable and recurrent hCCA.

关键词： Hilar cholangiocarcinoma Bismuth-Corlette classification Memorial Sloan Kettering Cancer Centre Staging Preoperative biliary drainage Portal vein embolisation Surgical resection Hepatectomy

Seroprevalence of SARS-COV-2 Exposure among “High-Risk” Populations (Healthcare Workers, People Who Attend Markets, and School Children) in Zanzibar

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Advances in Infectious Diseases 2024年第1期14卷 34-55页

作者： Ame Masemo Solomon Mwakasungula Khamis Kheir Erick Mgina Nahya Khamis Irabi Kassim Bihila Bakar Khamis Salim Sarah Mswata Kibwana Omar Theckla Kazimoto Linzy Elton Honorati Masanja Mayassa ally Zanzibar Health Research Institute Binguni Zanzibar Ifakara Health Institute Bagamoyo Tanzania National Institute for Medical Research Muhimbili Centre Dar es Salaam Tanzania Binguni Public Health Laboratory Binguni Zanzibar Department of Microbiology Mnazi Mmoja Hospital Stone Town Zanzibar Centre for Clinical Microbiology Royal Free Hospital Campus University College London London UK

In Zanzibar, from the start of the pandemic in March 2020 to the time of sampling in December 2020, SARS-CoV-2 seroprevalence data was limited. We conducted a seroprevalence study to evaluate the magnitude of SARS-CoV-2 exposure among healthcare workers, school children, and people who attended general markets in Zanzibar. The objectives of the study were to analyse the total antibodies from selected higher-risk population groups in order to determine magnitude in SARS CoV-2 exposure. Blood samples were collected from eligible and consented participants (adults and children), and their serum was analyzed for total antibodies against SARS-CoV-2 using ELISA. A questionnaire was used to collect participants’ demographic and clinical data. The overall SARS-CoV-2 seroprevalence across all age groups was 33%, and a higher seroprevalence was observed in the 40 - 49 years’ age group relative to other ages as well as in those who attended markets. A runny nose (18.8% of participants) was the most frequently reported SARS-CoV-2 infection-related symptom. Multivariable analysis showed significantly higher odds of infection in people living in urban districts. The findings provide insight into SARS-CoV-2 infection among school children, health workers, and people who attended markets in Zanzibar in the early stages of the pandemic. Exposure in these groups might have been influenced by infection and prevention strategies taken by the government, as well as shopping behavior, school overcrowding, and population density in urban settings. The study had methodological limitations, including cross-sectional design. Further, well-designed, longitudinal studies are recommended to understand exposure and transmission at a population level.

关键词： SARS-CoV-2 Seroprevalence Zanzibar ELISA COVID-19

Satisfaction of Chronic Illness Patients at Felege Hiwot Referral hospital, Bahir dar City, Northwest Ethiopia

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Open Journal of Epidemiology 2014年第4期4卷 217-223页

作者： Molla Gedefaw Fisseha Setargie Worku Awoke GAMBY College of Medicine and Health Sciences Bahir Dar Ethiopia College of Medicine and Health Sciences Bahir Dar University Bahir Dar Ethiopia

Introduction: Patient satisfaction is a popular way of evaluating quality of health care given in health facilities. This study was done to assess the level of chronic illness Patients’ Satisfaction in Felege Hiwot Referral hospital, Bahir dar City, Ethiopia. Method: Cross-sectional study was conducted by involving 415 patients using systematic sampling method at Felege Hiwot referral hospital, Bahir dar City, Ethiopia from 1st September, 2012 to 2nd November, 2012. Structured questionnaire was data collection tool. The questionnaire was prepared in English. It was translated to Amharic and back to English. Discrepancies in the translation were resolved by mutual agreement with the research team. Pre-testing was done prior to the actual data collection process on a sample of 20 respondents and modified accordingly. The study was approved by ethics review board of Bahir dar University. The collected data were checked for completeness and consistency before being coded, entered and analyzed using SPSS version 19. Result: The overall level of satisfaction of chronic illness patients in this hospital was 242 (58.3%) which is lower as compared to other local studies in Ethiopia. More than 40% of the patients were not satisfied with the service. Conclusion and Recommendations: The current level of patients’ satisfaction in the hospital is totally unacceptable care for a referral hospital situated in the capital city of a region in which more than 20 million people reside. Therefore, there is a need to revisit care given to chronic illness patients, and appropriate strategy should be designed to address the lifelong care needs of patients with chronic illness in our set up.

关键词： Satisfaction Chronic Illness Ethiopia

Chandelier-assisted scleral buckling using wide angle viewing contact lens for pseudophakic retinal detachment repair

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International Journal of Ophthalmology(English edition) 2019年第4期12卷 627-633页

作者： Ashraf Ahmed Nossair Wael Ahmed Ewais Sherif Ahmed Eissa Department of Ophthalmology Faculty of Medicine Cairo University dar El Oyoun hospital

AIM: To evaluate a modified technique for scleral buckling(SB) in pseudophakic retinal detachment(RD).METHODS: A retrospective non-comparative study included 21 consecutive eyes with uncomplicated pseudophakic RD that was repaired by chandelier assisted SB using wide angle viewing(WAV) contact lens. Segmental tire alone was used in 5 eyes(23.81%), and combined with encircling band in 7 eyes(33.33%). Radial sponge alone was used in 3 eyes(14.29%) and combined with encircling band in 6 eyes(28.57%).RESULTS: Primary success rate was(90.48%). External drainage of subretinal fluid was performed in 8 eyes(38.1%). Intraoperative complications included vitreous prolapse at chandelier sclerotomy site in 4 eyes(19.05%) and localized subretinal hemorrhage at drainage site in one eye(4.76%). No case of intraocular lens(IOL) displacement, retinal incarceration or iatrogenic retinal tear was detected. Postoperative complications included choroidal detachment in one eye(4.76%), elevated intraocular pressure in 2 eyes(9.52%), epiretinal membrane formation in one eye(4.76%) and proliferative vitreoretinopathy in 3 eyes(14.29%). Mean postoperative corrected distance visual acuity was 0.7±0.3 logMAR units. CONCLUSION: Chandelier-assisted SB using WAV contact lens is a reliable technique for repairing selected cases of simple pseudophakic RD.

关键词： buckling pseudophakia rhegmatogenous detachment

Prevalence and Factors Associated with Mortality among Chest Injury Patients Admitted at Muhimbili National hospital in dar es Salaam, Tanzania

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International Journal of Clinical Medicine 2021年第9期12卷 364-376页

作者： Janeth Stanslaus Masuma Respicious Lwezimula Boniface Edwin Rwebugisa Lugazia Muhimbili University of Health and allied Sciences (MUHAS) Dar es Salaam Tanzania Muhimbili Orthopaedic Institute (MOI) Dar es Salaam Tanzania Injury Control Centre Tanzania (ICCT) Dar es Salaam Tanzania Jakaya Kikwete Cardiac Institute Dar es Salaam Tanzania

Introduction: Accidents represent a significant proportional of non-communicable disease in the current century, and chest injury is common. However, management and outcome of these injuries is poor in low resource setting like Tanzania. The aim of this study was to determine the prevalence and factors associated with mortality among chest injury patients at a tertiary level health facility in Tanzania. Method: A prospective Cross-Sectional study of chest injuries among trauma patients attended at Muhimbili National hospital between September 2019 and February 2020. Results: A total of 282 trauma patients were seen, out of which 51/282 (18.1%) sustained chest injury. Road Traffic Crashes were the leading cause of chest injury 41/51 (80.4%). Majority 17/51 (33.3%) presented with lung contusion, followed by pneumohemothorax and rib fractures each 8/51 (15.7%). Most of the patients 27/51 (52.9%) were managed by tube thoracostomy and 42.1% conservatively. Mortality was 11/51 (21.6%). Independent factors associated with mortality were: Associated injuries (Odds Ratio (OR) 0.07, 95% CI 0.01 - 1.16, p = 0.02), Multimodal analgesia (Odds Ratio (OR) 0.22, 95% CI 0.05 - 0.98, p = 0.05), more than 24 hours to treatment (Odds Ratio (OR) 5.53, 95% CI 1.25 - 24.3, p = 0.02), Bilateral chest involvement (Odds Ratio (OR) 4.61, 95% CI 1.12 - 18.7, p = 0.02), and Invasive ventilation (Odds Ratio (OR) 31.5, 95% CI 4.47 - 53.8, p = 0.00). Conclusion: Chest injuries prevail significantly among trauma patients in Tanzania, mostly due to road traffic crashes. Injury preventive measures especially for road traffic crashes need to be reinforced, and establishment of chest injury management protocol in Tanzania.

关键词： Chest Injury Road Traffic Crashes Tanzania

Safety and efficacy of ultrasound ciliary plasty as a primary intervention in glaucoma patients

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International Journal of Ophthalmology(English edition) 2019年第4期12卷 597-602页

作者： Magda A.Torky Yousif A al Zafiri Sherein M.Hagras Abeer M.Khattab Rania M.Bassiouny Tharwat H.Mokbel Department of Ophthalmology Faculty of Medicine Mansoura University Department of Ophthalmology Dar AlS hifa Hospital

AIM: To evaluate the safety and the efficacy of the ultrasound ciliary plasty(UCP) on the intraocular pressure(IOP) control in glaucomatous eyes without previous glaucoma ***: A retrospective study included patients with primary and secondary glaucoma who underwent UCP in dar al shifa hospital, Kuwait between January 2017 to June 2018. High-intensity focused ultrasound procedures were performed under peribulbar anesthesia using the 2^(nd) generation probe with 8 s duration of each of the 6 shots. Complete ophthalmologic examinations were scheduled pre-treatment, and at 1 d, 1 wk, 1, 3, 6 and 12 mo posttreatment. Primary outcomes were the IOP reduction and success rates at 12 mo, while the secondary outcomes were the occurrence of vision threatening complications and visual ***: The records of 62 eyes of 62 patients were analyzed with mean age of 63.8 y(67.7% males). There was statistically significant reduction in the mean IOP from 35.2±8.3 mm Hg before treatment to 20.6±8.7 mm Hg at 12^(th) month(Palified success was achieved in 77.4% of eyes at 12 mo. No major intra-or posttreatment complications were ***: Second-generation UCP prove to be effective in reducing IOP in naive glaucoma patients with lower success rates in cases of neovascular and uveitic glaucomas.

关键词： ultrasound ciliary plasty glaucoma intraocular pressure

小儿针式腔镜腹股沟疝修补术的一项简化新技术

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世界核心医学期刊文摘（儿科学分册） 2006年第9期2卷 46-47页

作者： Shalaby R.Y. Fawy M. Soliman S.M. Dorgham A. 俞晓梅 dar al-shifa hospital P.O. Box 3390Safat 13034Kuwait

Background:Needlescopic techniques have been used recently in repairing inguinal hernias (IHs),which made this type of surgery more feasible and less invasive. The technique is being developed further. Objective:The objective of this study was to describe and assess the results that can be achieved by using a new simplified technique (Reverdin needle) in needlescopic inguinal herniorrhaphy in children. Patients and Methods:all patients with symptomatic IH confirmed by clinical examination were subjected to elective needlescopic herniorrhaphy. One hundred fifty patients with 186 groin hernias,from 2 hospitals in Egypt and Saudi Arabia,in the period from October 1999 to May 2002,were assigned to needlescopic inguinal herniorrhaphy using Reverdin needle. Reverdin needle was used to insert a purse-string suture around the internal inguinal ring to be tied extracorporeally. Results:A total of 186 inguinal hernial defects in 150 children were repaired successfully. There were 130 males and 20 females with a mean age of 20.58± 21 months (range,8-96 months). Right-sided IH was present in 86 patients (57.33% ); among these patients,an opened internal inguinal ring was found and repaired in 12 cases (8% ). Left-sided IH was present in 30 (20% ),bilateral hernia in 19 cases (12.67% ),and recurrent IH in 20 cases (10% ). The mean duration of surgery was 8.7± 1.18 minutes for unilateral and 12.35 ± 2 minutes for bilateral hernia repair. There were no intraoperative or postoperative complications. The mean hospital stay was 6± 1.21 hours. Conclusion:The new technique had all the advantages of needlescopic herniorrhaphy in children (less invasive,less pain,short hospital stay) combined with the advantages of reduced operating time,simplicity,and feasibility. It may be preferable to the intracorporeal suturing and knot tying. However,it needs long-term follow-up.

关键词：腹股沟疝修补术腔镜缝合针双侧疝单侧疝腹股沟内环荷包缝合手术时间术后并发症

Understanding Laboratory Methods and Their Impact on Antimicrobial Resistance Surveillance, at Muhimbili National hospital, dar es Salaam, Tanzania

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Advances in Microbiology 2014年第1期4卷 33-38页

作者： Peter Nyasulu Mabula Kasubi Respicious Boniface Jill Murray Department of Microbiology Central Pathology Laboratory Muhimbili National Hospital Dar es Salaam Tanzania Department of Public Health School of Health Sciences Monash University Ruimsig South Africa School of Public Health Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa Muhimbili Orthopaedic Institute Muhimbili National Hospital Dar es Salaam Tanzania School of Public Health Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa

The study sought to describe laboratory methods and blood culture procedures and their impact on antimicrobial resistance surveillance among nosocomial bacteria. We conducted a systematic audit of blood culture procedures and practices in the Department of Microbiology, Central Pathology Laboratory at Muhimbili National hospital, between 19th and 23rd March 2012. A total of 25 -30 blood culture specimens were received each day as an indication of low volumes of blood culturing at this site. More blood culture requests came from the neonatal unit of the hospital, and were performed manually with high culture negative specimens. The laboratory performed antibiotic susceptibility testing as per the CLSI guidelines. No vancomycin resistance was ever reported at this site. all blood culture results were entered into the JEEVA laboratory information system, where results could be accessed by clinicians in the wards and data could be retrieved to assess patterns of antimicrobial resistance. Blood culture data entry system lacked quality control checks hence numerous errors and missing data were observed. Our results support the relevance of having improved laboratory procedures and good quality blood culture since surveillance of antimicrobial resistance primarily depends on good laboratory procedures, good quality and reliable blood culture data. This would essentially minimise imprecise estimates of rates of antimicrobial resistance at this hospital.

关键词： Antimicrobial Resistance Microbiology Surveillance Laboratory Tanzania

Nursing Practice on Post-Operative Wound Care in Surgical Wards at Muhimbili National hospital, dar-es-Salaam, Tanzania

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Open Journal of Nursing 2019年第8期9卷 870-890页

作者： Adela A. Mwakanyamale Anna Mary A. Mukaja Mathew D. Ndomondo Joan P. Zenas Ambroce M. Stephen Elizabeth Z. Mika Department of Medical and Surgical Nursing Faculty of Nursing Hubert Kairuki Memorial University Dar-es-Salaam Tanzania Department of Fundamentals of Nursing and Basic Sciences Hubert Kairuki Memorial University Dar-es-Salaam Tanzania

Background: Postoperative wound healing has been a problem which causes high mortality in the developing world;postoperative wound has been reported to cause devastating consequences and a measurable mortality. There is a limited number of published studies in Tanzania investigating Nursing practice on post-operative wound care in surgical wards at Muhimbili National hospital, dar-es-Salaam, Tanzania. This study assesses nursing practice on postoperative wound care by nurses in surgical wards at Muhimbili National hospital. Methods: A cross-sectional study of surgical nurses was carried out through the use of randomly selected surgical wards at Muhimbili National hospital in Tanzania from September 2011 to July 2013. A multistage cluster sampling technique was used to obtain a suitable number of study participants. Data collection was done using a checklist from a convenient sample of 71 nurses in selected surgical wards. Results: The result indicates that a big number of the participants were female (76.5%) and those of the age group 25 to 34 years were 40.8%. Participants exceeding a half of the selected sample reported to have poor post-operative wound care practice (57.7%). In comparison, male participants scored higher, and had better practice than their female counterparts, however, there was no considerable difference in the scores (P = 0.803). During set-up and preparation phase, the washing of hands before starting and after the completion of procedure was taken into consideration by less than half of the participants (49.3%). all participants did not ensure the environment is clean and take into account the patient’s privacy through the use of screen or even closing the room. The report shows that nurses take into consideration putting on clean gloves during the removal of the old dressing (99%), the use of sterile gloves during wound dressing was taken into consideration by most of the nurses (63%). Good practice was noted in applying dressing solution as

关键词： Wound Post-Operative Care Wound Dressing Infection