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Item Prevalence, predictors and obstetrics outcomes of preterm premature rupture of membranes among pregnant women admitted at IRRH(The University of Dodoma, 2023) Titus, Peter ValentinoBackground: Preterm premature rupture of membranes (PPROM) is one of the main recognized causes of preterm deliveries and a significant contributor to maternal and fetal morbidity and mortality. As such, details describing those affected and their outcomes may prove important in mitigating its occurrence and effects. The burden of and hierarchical information on the predictors of PPROM in this setting is inadequately established. Objective: This study's objective was to determine the prevalence, predictors and obstetric outcomes following PPROM at Iringa regional referral hospital (IRRH). Methodology: Hospital based cross-sectional study was carried out from September 2022 to January 2023. Participants in this study were 384 pregnant women who were admitted in the IRRH antenatal ward. The diagnosis of PPROM was confirmed by sterile speculum examination, and data were collected using questionnaires that the researcher provided. Logistic regression analysis was done after descriptive statistics, with the level of significance set at 0.05 Results: Among the 384 participants, 32 had PPROM giving a prevalence of 8%. There were 98 babies delivered premature, of which PPROM accounted for 32.6%. The independently significant predictors with statistically increased risks of PPROM was attending antenatal clinic (ANC) less than 4 times (AOR = 4.14, 95% CI: 1.57 – 10.91, p = 0.004), having urinary tract infection when pregnant (AOR = 19.10, 95% CI: 6.42 – 56.24, p = <0.001), genital tract infections when pregnant (AOR = 8.12, 95% CI: 1.77 – 37.20, p = 0.007), vaginal bleeding when pregnant (AOR = 9.79, 95% CI: 1.93 – 49.61, p = 0.006) and having a history of previous PPROM (AOR = 6.61, 95% CI: 1.99 – 21.91, p = 0.002). According to the study, 87.5% (n = 28) of the babies born to women who experienced PPROM had adverse outcomes, as did 44% (n = 14) of the women who experienced PPROM. Conclusion: The prevalence found is high compared to global. Predictors found were such as genitourinary infections and vaginal bleeding during pregnancy, attending ANC less than 4 times and previous history of PPROM. PPROM was also found to be more associated with adverse outcomes. We recommend improvements on ANC service use, screening, early diagnosis, and treatment of these predictors during pregnancyItem Prevalence and factors associated with cholelithiasis in children with sickle cell disease attending the sickle cell clinic at Dodoma Regional Referral Hospital(The University of Dodoma, 2023) Mfugale ZipolaBackground: Cholelithiasis also known as Gallstones are a common consequence of chronic hemolysis in Sickle Cell Disease (SCD) and its variants. In our settings majority of children comes with cholecystitis which is one of the complication of cholelithiasis, but the real burden of cholelithiasis is not well. The purpose of this study was to determine the prevalence of cholelithiasis and associated factors in children with SCD in Dodoma. Methods: This was a hospital based cross-sectional study of 180 children aged 2 to 17years, from January 2023 to June 2023 (a period of 6 months) at Dodoma Regional Referral Hospital. Socio-demographic, clinical and laboratory data were collected using a semi structured questionnaire. Cholelithiasis was defined as curvilinear echogenic structures casting acoustic shadow in the liver which moved with a change in scan position by using a Phillips HD3 general purpose ultrasound scanner. Data analysis was done using SPSS version 25 and statistical significance was assumed for factors with p-value<0.05. Results: A total of 180 children were enrolled. Most of the enrolled children were males 112(62.22%). The mean age was 6.89±3.8 years ranging from 2 to 17 years. The prevalence of cholelithiasis was 12.22% (22 children) and age range between 10-17 years (AOR=6.831, CI [1.360, 34.326], p-value =0.0197), female sex AOR= 9.471, CI [2.271, 39. 507], p-value =0.0197), blood transfusion more than once in the past one year (AOR=5.959, CI [1.689, 21.023], p-value 0.0055), family history of gallstones (AOR=15.244, CI [1.565, 148.487], p-value 0.0190) and hepatomegaly (AOR=16.778, CI [3.140,89.655],p-value 0.0010) were factors independently associated with Cholelithiasis. Conclusion: Cholelithiasis is a common complication warranting regular screening among children with SCD attending clinic in Dodoma. Female sex, children aged between 10-17 years, blood transfusion more than once in a year, those with family history of gallstones and presence of hepatomegaly were more likely to have cholelithiasisItem Prevalence, predictors and obstetrics outcomes of preterm premature rupture of membranes among pregnant women admitted at IRRH(The University of Dodoma, 2023) Titus, Peter ValentinoBackground: Preterm premature rupture of membranes (PPROM) is one of the main recognized causes of preterm deliveries and a significant contributor to maternal and fetal morbidity and mortality. As such, details describing those affected and their outcomes may prove important in mitigating its occurrence and effects. The burden of and hierarchical information on the predictors of PPROM in this setting is inadequately established. Objective: This study's objective was to determine the prevalence, predictors and obstetric outcomes following PPROM at Iringa regional referral hospital (IRRH). Methodology: Hospital based cross-sectional study was carried out from September 2022 to January 2023. Participants in this study were 384 pregnant women who were admitted in the IRRH antenatal ward. The diagnosis of PPROM was confirmed by sterile speculum examination, and data were collected using questionnaires that the researcher provided. Logistic regression analysis was done after descriptive statistics, with the level of significance set at 0.05 Results: Among the 384 participants, 32 had PPROM giving a prevalence of 8%. There were 98 babies delivered premature, of which PPROM accounted for 32.6%. The independently significant predictors with statistically increased risks of PPROM was attending antenatal clinic (ANC) less than 4 times (AOR = 4.14, 95% CI: 1.57 – 10.91, p = 0.004), having urinary tract infection when pregnant (AOR = 19.10, 95% CI: 6.42 – 56.24, p = <0.001), genital tract infections when pregnant (AOR = 8.12, 95% CI: 1.77 – 37.20, p = 0.007), vaginal bleeding when pregnant (AOR = 9.79, 95% CI: 1.93 – 49.61, p = 0.006) and having a history of previous PPROM (AOR = 6.61, 95% CI: 1.99 – 21.91, p = 0.002). According to the study, 87.5% (n = 28) of the babies born to women who experienced PPROM had adverse outcomes, as did 44% (n = 14) of the women who experienced PPROM. Conclusion: The prevalence found is high compared to global. Predictors found were such as genitourinary infections and vaginal bleeding during pregnancy, attending ANC less than 4 times and previous history of PPROM. PPROM was also found to be more associated with adverse outcomes. We recommend improvements on ANC service use, screening, early diagnosis, and treatment of these predictors during pregnancy.Item Indications for temporary stoma creation and early outcome of stoma closure at University of Dodoma teaching hospitals(2023) Kizigina SimbaBackground There are many published studies which focused on indications of temporary stoma creation as well as predictors of complications following stoma closure. Despite stoma closure being commonly performed procedure in our local settings, yet postoperative complications as well as underlying predictors for those complications are inadequately addressed. Therefore, this study analyses on the indications for stoma creation and early outcome of stoma closure. It also explores the relationship between the indications for stoma creation and early outcomes of stoma closure. Objective The aim of this study was to determine the indications for temporary stoma creation and early outcome of stoma closure. Methodology The study was prospective, analytical study done UDOM teaching hospitals from June 2021 to August 2022. The structured questionnaire was used as a tool for data collection. The information was obtained from patients, case notes or register book. Convenient sampling technique was used to select clients. Clavien-Dindo tool was used for grading severity of post-operative complications, chi-square, binary and multivariate logistic regression were used to establish association between predictor and outcome variables. SPSS was used for analysis. Results A total of 194 subjects were enrolled in this study. There were 140 males (72.2%) and 54 females (27.8%) with male to female ratio of 3:1. Colostomy was the leading type of stoma created 133(68.6%), followed by ileostomy 61(31.4%). Commonest indications for colostomy were sigmoid volvulus 75(56.4%) and colo-rectal carcinoma 43(32.3%). Ileostomy was commonly indicated in enteric perforation 24(39.4%) and ileal trauma 20(32.8%). Overall post-stoma closure complications were noted in 78(40.2%), colostomy contributed 60(30.9%) and ileostomy 18(9.3%). The noted post-operative complications were deep and organ/space SSI 52(26.8%), anastomotic leak and enterocutaneous fistula 21(10.8%) and intestinal obstruction 05(2.6%). ClavienDindo tool showed 78(40.2%) unfavorable and 08(4.1%) favorable outcomes. Multivariate logistic regression showed hypo-albuminemia (p=0.002) a significant early outcome predictor of stoma closure. Conclusion Hypo-albuminemia was shown to be important prognostic indicator for complications following stoma closure. The stomas were commonly indicated in sigmoid volvulus and enteric ileal perforation, and predominant post stoma closure complications were surgical site infection.Item Adenoid cystic carcinoma of the nasal cavity—the great mimicker of chronic rhinitis: A rare case report with literature review(Edorium Journals, 2019) Yahaya, James; Abraham, ZephaniaIntroduction: Adenoid cystic carcinoma (ACC) of the nasal cavity is one of the rarest malignant entities reported in the literature with the known incidence of up to 5%. It commonly poses a diagnostic challenge due to lack of diagnostic suspicion index because of its rarity and especially when it is associated with a long history of benignity. Adenoid cystic carcinoma is a tumor of salivary glands even though it is not frequent. Moreover, it can rarely occur in other body parts, such as nose, paranasal sinuses, lungs, uterine cervix, and many others. Case Report: We present a case of an 18-year-old boy with a diagnosis of ACC of the nasal cavity. The patient had a 10-year history of long-standing chronic inflammatory condition presenting as rhinitis. However, after a period of two years later following the initial diagnosis, the tumor became aggressive and it presented with ulceration, causing erosion of the nasal bone as well as auto-exenteration of the right eye. Conclusion: Adenoid cystic carcinoma involving the nose and other paranasal sites ought to be deemed as a tumor with sometimes long-standing history of benignity which needs high index of suspicion for being able to detect it in order to improve outcome of the patients.Item Prevalence and factors associated with continual opioid use among patients attending methadone clinic at Mwananyamala hospital, Dar es Salaam, Tanzania(Elsevier, 2019) Ripanda, Asha Shabani; Srivastava, Bajarang Bal Lal; Vuai, Said Hamad; Nyundo, Azan ATrends of continual drug use while under treatment have been reported worldwide. This paper assesses opioid use among patients receiving treatment in a methadone clinic for opioid addiction. A total of 126 urine samples were analyzed using LC–MS/FTMS. About 16% of patients were found to have a high prevalence level of opioids use. Prevalence level was significantly associated with the duration of treatment (p = 0.0121) and age (p = 0.0328). About 125/126 patients were found to have remnants of opioids of abuse. Therefore, measures should be taken to overcome continual use of opioids among clients.