Biomedical subjects

C A Mkony

Publications and source records attributed to C A Mkony.

7 recordsLinked to original sources

PubMed1999

Hydraulic urethral dilatation after optical internal urethrotomy: preliminary report.

OBJECTIVES: To determine the rate of early recurrence of urethral stricture in the first six months in patients who perform hydraulic urethral dilatation(HUD) after optical internal urethrotomy (OIU) and compare the early recurrence rate in patients who perform HUD after OIU with the recurrence rates in patients reported in the literature who undergo OIU without performing HUD. DESIGN: Prospective descriptive case series. SETTINGS: Urology clinic, Muhimbili Medical Centre, Dar es Salaam, Tanzania. SUBJECTS: Patients with symptoms of urethral stricture subsequently radiologically demonstrated to have urethral stricture that was deemed treatable by OIU. INTERVENTIONS: Evaluation included urethrography, renal biochemical profile and urethroscopy at the time of OIU. Patients with strictures no longer than 50 mm, no complete block or marked tortuousness, and no paraurethral sepsis were selected for OIU, urethral catheter for seven days followed by HUD) for one month. RESULTS: During a follow up period of five to seventeen months (mean 10.1 months), only two out of twenty three patients (8.7%) showed clinical evidence of stricture recurrence. The remaining patients reported normal voiding. CONCLUSION: This report suggests that HUD, a cost-free technique, is an effective method for preventing stricture recurrence after OIU. As follow up of these and subsequent patients continue, it is hoped that this not-so-well-known technique will undergo evaluation at other centres in our region.

Adult↗

PubMed1995

Pneumatosis cystoides intestinalis--in Tanzania.

Pneumatosis cystoides intestinalis (PCI) is a rare benign condition affecting portions of the intestinal tract, characterised by: multiple subserosa and submucosal gas cysts, unknown aetiology, and non specific clinical presentation. Its diagnosis is often coincidental. Management of PCI entails that of the associated condition.

Adult↗

PubMed1993

Urinary stone disease in Tanzania: an insight into the magnitude of the problem.

Urolithiasis is generally said to be rare in Africans. Detailed studies of the condition are few in our region. This 2 year prospective study at Muhimbili Medical Centre identified 77 adult patients with urinary stones. Males were affected 3 times more commonly than females and most patients were in the young productive age group. Many patients reached hospital several months or years after the onset of symptoms. However, as in industrial countries, upper urinary tract stones were predominant. Involved kidneys suffered serious damage especially in the presence of obstruction and infection. The only available treatment was outmoded surgery, and long delays were inevitable in the face of overstretched resources, resulting in the sacrifice of kidneys. Urolithiasis is probably not nearly as uncommon as we have been led to believe from impressions and retrospective studies of incomplete records. Therefore, there is a need for more research on the problem in our region.

Adult↗

PubMed1992

Guided dilatation of urethral strictures.

Ten patients with pinhole urethral strictures were treated by introducing a flexible guide wire endoscopically through the stricture then passing flexible hollow dilators over the wire across the stricture. The procedure was successful in 9 out of 10 patients. It inflicts minimal trauma to the urethra and is recommended as a practical substitute for optical urethrotomy where the latter is not available.

Academic Medical Centers↗

PubMed1991

Urinary stone disease in Dar es Salaam.

Forty four adult patients, 34 males and 10 females, with urinary stones were seen over a six-month-period at Muhimbili Medical Centre, Dar es Salaam. Most patients were peasants and semiskilled workers. 8 of the patients were Arabs, which suggests a high predisposition for this race. 12 of the patients had a history of having suffered from bilharzia. There was a high proportion of bladder (and urethral) stones (30%) but upper urinary tract stones were still predominant (70%). Of 20 patients whose stones were available for analysis, 8 were composed of calcium oxalate, 7 of calcium phosphate and 5 of mixed composition. The ratio of stone patients to all hospital admissions of 243 per 100,000 suggests the prevalence of urinary stone disease is comparable to that found in Western countries.

Adult↗

PubMed1989

Percutaneous upper urinary stone surgery.

Fifty-five patients underwent surgery for renal and upper ureteric stones in the department of urology at the Royal Infirmary in Glasgow, Scotland, during a one-year period beginning in October 1986. There were 31 males and 24 females, with a mean age of 47.7 years. The targeted stones were successfully removed in 46 (83.6%) patients. 52.7% of the patients were discharged home within 4 days of operation. Minor perforations of the renal collecting system was the commonest complication, which occurred in 6 patients. Three patients had serious haemorrhage, one of them requiring nephrectomy for bleeding from a torn renal vein. One patient had cardiac arrest on post operative day 3, suffered brain damage, and died on day 10. Percutaneous lithotomy has become a well-established, effective method of treating upper urinary stones. Costly equipment is involved, however, and critical assessment is required in deciding to introduce this technique of stone treatment in a developing country. In those circumstances a gradual assimilation is suggested.

Adult↗

PubMedDate not supplied

A comparison of topical Phenytoin with Silverex in the treatment of superficial dermal burn wounds.

OBJECTIVE: To compare topical diphenylhydantion (Phenytoin) with silver sulphadiazine/chlorhexidine (Silverex) in terms of rate of wound healing, analgesic and antibacterial properties in small to moderate-sized (< 30% TBSA) superficial dermal (second degree) burn wounds. DESIGN: A prospective randomized controlled study. SETTING: Surgical wards, Muhimbili National Hospital from July 2000 to February 2001. SUBJECTS: Sixty four patients with acute burns, 32 in each group. INTERVENTIONS: Study group treated by sprinkling Phenytoin powder and control group by sprinkling Silverex powder on the wounds for 14 days or until the wound epithelialised or was ready for skin grafting. The data collected included demographic characteristics of patients, aetiology of burn injury, circumstances of injury, site and extent of burns, pus discharge and smell from the wound, pain and discomfort from the wound, bacterial cultures of wound swabs, rate of reduction in wound size and outcome of treatment. RESULTS: The study enrolled 33 male and 31 female patients, 69% being children under five years of age. Hot liquids (80%) and open flames (20%) were the only causes of burns. In 97% of patients injury was due to domestic accidents. In half of the patients burns involved the trunk, and 52% of all patients had less than 15% total body surface burnt. Pus discharge was recorded in 59% of Phenytoin-treated and 75% in Silverex-treated patients while foul smell was noted in 19% and 31% of cases respectively. There were more negative bacterial wound cultures in Phenytoin-than Silverex-treated wounds on day five and day 10 of treatment, the difference being statistically significant (p < 0.01 and 0.001 respectively). There was also a statistically significant difference in wound pain in favour of Phenytoin (p < 0.01). There was no statistically significant difference in the rate of healing in the two groups. CONCLUSION: Phenytoin is a cheap and easy-to-use medicament, effective in suppressing burn wound bacteria and relieving pain thereby promoting healing, and may be advocated for the purpose in resource-scarce environments.

Administration, Topical↗