Biomedical subjects

K A Mteta

Publications and source records attributed to K A Mteta.

5 recordsLinked to original sources

PubMed2006

Iatrogenic ureteric and bladder injuries in obstetric and gynaecologic surgeries.

OBJECTIVE: To review iatrogenic ureteric and urinary bladder injuries from obstetric and gynaecological surgeries treated in the urology department analysing; ureteric anatomy, aetiologic factors, diagnosis, treatment and outcomes. DESIGN: A retrospective study. SETTING: Institute of Urology, Kilimanjaro Christian Medical Center (KCMC), Moshi, Tanzania. SUBJECTS: Twenty three women were treated for iatrogenic ureteric and bladder injuries secondary to obstetric and gynaecological procedures in the department of urology between June 1994 and July 2004. RESULTS: Hysterectomy was the leading cause of ureteric injuries contributing to nine (47.4%) of the 19 ureteric injuries. Caesarian sections were the second leading cause and contributed 6(31.6%) of 19 ureteric injuries. Vesical vaginal fistula (VVF) repairs lead to two (10.5%) ureteric injuries one of which was bilateral. There was a case each (5.3%) from ovarian cystectomy and forceps delivery. There were only three cases of intra-operative diagnosis of ureteric injuries. There were four bladder injuries half of which came from hysterectomy. The leading definitive urological treatment for ureteric injury was ureteric re implantation and all kidneys were saved. CONCLUSION: Iatrogenic ureteric and bladder injuries from gynaecologic surgeries are globally rare but are liable to occur due to the inherent ureteric anatomic factors in the pelvis. Intra-operative diagnosis of injury is a rare feature. The practical principles to prevent and repair ureteric injuries have been presented and discussed. The true risk to the patient lies in delayed, missed diagnosis and inadequate treatment. Endourologic techniques offer an alternative diagnostic and treatment method for women previously injured in open pelvic surgeries.

Adult↗

PubMed2005

Complex therapy for hepatic trauma.

OBJECTIVE: To investigate the optimal surgical management of patients with hepatic trauma. DESIGN: A retrospective analysis of 197 patients treated for hepatic trauma in the two hospitals from January 1980 to January 2001. SETTING: Qilu and Dodoma Hospital in China and Tanzania respectively. PATIENT INTERVENTIONS: Two patients died before surgery, seven patients were treated conservatively, while 188 patients underwent various surgical interventions under the principles of damage control surgery including initial laparotomy, resuscitation phase and definitive surgery. RESULTS: The overall mortality was 15.3% (30/197). The leading cause of death was the triad of coagulopathy, hypothermia and metabolic acidosis. CONCLUSION: Patients with major exanguinating injuries will not survive complex procedures such as formal hepatic resection or complex procedures such as formal hepatic resection or pancreaticoduodenectomy. The operating team must undergo a radical shift in their "surgical ideology" if the patient is to survive such devastating injuries. The central principle of damage control surgery is that patients died of the triad of coagulopathy, hypothermia and metabolic acidosis. Damage control surgery can be thought of in three distinct phases: initial truncated laparotomy, resuscitation phase and definitive operation.

Acidosis↗

PubMed2000

Urinary diversion in children with mainly exstrophy and epispadias: alternative to primary bladder closure.

OBJECTIVE: To review the long term outcome of children who underwent urinary diversion for various non-malignant conditions and to assess the suitability of urinary diversion as an alternative treatment to primary bladder closure in cases of bladder exstrophy epispadias complex. DESIGN: A retrospective study. SETTING: Institute of Urology, Moshi, Tanzania. SUBJECTS: Fifteen children who underwent urinary diversion for various non-malignant conditions between 1985 and 1997. RESULTS: Fifteen children underwent urinary diversion for: exstrophy epispadias complex (n = 12) neurogenic bladder (n = 2) and trauma (n = 1). Seven children underwent Mainz pouch II diversion, six had classical ureterosigmoidostomy and two had appendicovesicostomy. One patient with a solitary kidney developed ureteral stenosis at the implantation site and was undiverted. Metabolic acidosis was well compensated with none of the patients requiring sodium bicarbonate supplements. All the patients except one were continent. CONCLUSION: We conclude that continent urinary diversion in children offers a viable alternative method for children with bladder exstrophy epispadias complex.

Adolescent↗

PubMed1994

Thoracic empyema in Dar es Salaam, Tanzania.

A review of 114 thoracic empyema cases attended in the thoracic unit of the Muhimbili Medical Centre from July 1986 to July 1990 is presented. 87.7% of the cases were males. Their ages ranged from 9 to 79 years with a mean of 32 years. Tuberculosis was the major cause accounting for 63.2% of all the cases. 53.4% of the patients underwent either open chest drainage decortication or thoracoplasty. The duration of hospital stay ranged from 2-8 months with a mode around 3.5 months. A 7% mortality was noted.

Adolescent↗

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↗