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Laframboise, J., and E. Cafarelli. "Differential effects of voluntary and involuntary activation on contractile characteristics of two human muscles." Journal of Applied Physiology 76, no. 3 (1994): 1400–1402. http://dx.doi.org/10.1152/jappl.1994.76.3.1400.
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To compare the maximal rate of rise of torque (MRRT) of quadriceps femoris and adductor pollicis during voluntary and involuntary contractions, subjects performed voluntary isometric contractions as rapidly as possible over the full range of force-producing capacity. Involuntary contractions were evoked with single shocks and with trains of 10 pulses at 100 Hz at increasing voltages applied directly to the femoral and ulnar nerves. There were linear relationships between MRRT and absolute torque in both muscles during involuntary and voluntary contractions. At the same absolute torque, quadriceps femoris had a higher MRRT than adductor pollicis when both were voluntarily activated (P < 0.05). However, there was no difference in MRRT between these muscles during stimulated contractions. Compared with involuntary tetanic contractions, MRRT during voluntary contractions was the same in quadriceps femoris and was less in adductor pollicis (P < 0.05). These observations suggest that in activating some muscles, such as adductor pollicis, the central nervous system may adopt the strategy of a more gradual excitation to make the contractions more task appropriate.
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Park, YR, EM Kim, YJ Lee, SG Yeo, and CK Park. "Multiplex real-time reverse transcription polymerase chain reaction for differential detection of H5, N1, and N8 genes of highly pathogenic avian influenza viruses." Veterinární Medicína 62, No. 4 (2017): 211–20. http://dx.doi.org/10.17221/179/2016-vetmed.
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Rapid and differential diagnosis of highly pathogenic avian influenza virus (HPAIV) subtype H5 is essential for the effective prevention and control of outbreaks caused by this pathogen. In this study, we describe a one-step multiplex real-time reverse transcription polymerase chain reaction (mRRT-PCR), using H5-, N1-, and N8-specific primers and probes, for differential detection of two HPAIVs (H5N1 and H5N8) and other H5-subtype AIVs. Using the mRRT-PCR assay, we were able to detect H5N1, H5N8, and other H5-subtype AIVs in a one-tube reaction, with high specificity; furthermore, using an in silico PCR program, we confirmed that this assay can detect nearly all H5, N1, and N8 genes of AIVs currently available in the Influenza Sequence Database. The limit of detection of the assay was determined to be as low as 100 copies/reaction for each target gene, and was comparable to limits of detection of previously reported mRRT-PCR assays. Thus, the mRRT-PCR assay described here can serve as a rapid and reliable differential diagnostic tool for the monitoring and surveillance of H5N1, H5N8, and other H5-subtype AIVs in countries where these pathogens are problematic.
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Passant, John. "The Minerals Resource Rent Tax." Accounting Research Journal 27, no. 1 (2014): 19–36. http://dx.doi.org/10.1108/arj-08-2013-0058.
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Purpose – The purpose of this paper is to look at the recent history of proposals to tax resource rents in Australia, from Australia’s Future Tax System Report (the “Henry Tax Review”) through to the proposed Resource Super Profits Tax (“RSPT”) and then the Minerals Resource Rent Tax (“MRRT”). The process of change from Henry to the RSPT to the MRRT can best be understood in the context of the Australian Labor Party (ALP) as a capitalist workers’ party. The author argues that it is this tension in the ALP, the shift in its internal balance further towards capital and the lack of class struggle, that has seen Labor preside over what the father of rent tax in Australia, Ross Garnaut, describes as a “problematic” tax. Design/methodology/approach – Qualitative research using Marxist tools. Findings – The paper argues that the poor health of the MRRT is a consequence of the nature of the Labor Party as a capitalist workers’ party, the shifts in power and influence within its material constitution and in essence the ascendency of capital in the capitalist workers’ party. Originality/value – A very original approach to understanding the nature of the MRRT in Australia.
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Akhlaghi, Nahid Mohammadzadeh, Laleh Mohammadian Bajgiran, Amirali Naghdi, Elaheh Behrooz, and Zohreh Khalilak. "The minimum residual root thickness after using ProTaper, RaCe and Gates-Glidden drills: A cone beam computerized tomography study." European Journal of Dentistry 09, no. 02 (2015): 228–33. http://dx.doi.org/10.4103/1305-7456.156833.
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ABSTRACT Objective: The aim of this study was to evaluate the minimum residual root thickness (MRRT) of the danger zone after preflaring of the mesio-buccal (MB) canal of mandibular first molars using ProTaper, RaCe and Gates-Glidden (GG) drills as coronal shapers by cone beam computerized tomography (CBCT). Materials and Methods: In this experimental study, the initial CBCT scans of 75 MB canals of mandibular first molars were provided within 1, 2, 3 and 4 mm of the furcation level. The samples were divided into three groups. The samples of ProTaper and RaCe groups were prepared up to F2 and #25.04 as the master apical file (MAF), respectively. The coronal preparation of the samples in the GG group was done using GG drills #2, #3 and #4 and canals were prepared till MAF # 25. After obtaining the postinstrumentation images, the MRRT and the amount of removed dentin were analyzed by t-test and ANOVA statistical analyses. Results: The GG drills removed significantly more dentin than RaCe at all the sections (P < 0.05) and more than ProTaper at 3 mm from the furcation. Statistically there was no significant difference between ProTaper and RaCe groups (P > 0.05). There was no significant difference in MRRT between the groups (P > 0.05). The mean MRRT was not < 0.75 mm at all sections. Conclusion: Based on the results of this study, when an appropriate root thickness is initially present, all of the instruments that were investigated may safely be used as coronal shapers in MB canals of mandibular first molars.
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J Doe, Matthew, Emmanuel Bua, John SO Obbo, Fred Bisso, and Peter Olupot-Olupot. "Upper gastrointestinal endoscopy findings in Mbale Regional Referral Hospital, Eastern Uganda: a 10-year retrospective analysis." African Health Sciences 21, no. 2 (2021): 919–26. http://dx.doi.org/10.4314/ahs.v21i2.54.
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Background: Endoscopy is required for formal diagnosis of many upper gastrointestinal (UGI) conditions including oe- sophageal cancer (OC). There is a paucity of data on endoscopy findings in East Africa as access to testing is challeng- ing for patients. We describe the findings of 10 years of UGI endoscopy in Mbale Regional Referral Hospital (MRRH).
 Method: Records of patients that underwent UGI endoscopy in MRRH, November 2009 – March 2019 were retrospective- ly analysed. Indication, macroscopic findings, histology and patient demographics were retrieved. Sub-group analyses were performed on those with a histological diagnosis of oesophageal cancer.
 Results: 833 eligible patients received single UGI procedures during the study period. Mean age was 54.8 years, range 16-93 years and 56.9% of patients were male. The main indication was dysphagia (42%) and the most common findings OC (34%) and gastritis (28%). 151 patients had histologically proven OC with a median age of 60 years and a 2:1 male to female ratio. 145/151 (96%) of samples tested revealed squamous cell carcinoma (SCC).
 Conclusion: Those undergoing endoscopy in MRRH are most commonly male patients presenting in their 5th decade with dysphagia. There is a high proportion of significant findings including gastritis, peptic ulcer disease, and oesophageal cancer.
 Keywords: Gastrointestinal; OGD; LMIC; oesophageal cancer.
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Kahn, Charles E., Brad Genereaux, and Curtis P. Langlotz. "Conversion of Radiology Reporting Templates to the MRRT Standard." Journal of Digital Imaging 28, no. 5 (2015): 528–36. http://dx.doi.org/10.1007/s10278-015-9787-3.
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Kornetzky, N., F. Güttler, A. Heinrich, et al. "IHE-MRRT konforme strukturierte Befundung von konventionellen Röntgen-Thorax-Aufnahmen." RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren 189, S 01 (2017): S1—S124. http://dx.doi.org/10.1055/s-0037-1600176.
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Mpiima, Derrick Paul, George Wasswa Salongo, Henry Lugobe, et al. "Association between Prior Chlamydia trachomatis Infection and Ectopic Pregnancy at a Tertiary Care Hospital in South Western Uganda." Obstetrics and Gynecology International 2018 (2018): 1–5. http://dx.doi.org/10.1155/2018/4827353.
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Background. Increase in the number of ectopic pregnancy is attributed to increase in the incidence of pelvic infections. Chlamydia trachomatis is responsible for most of the sexually transmitted bacterial infections. If undetected and untreated, the infection can ascend to the upper genital tract and cause pelvic inflammatory disease (PID) and related sequelae (ectopic pregnancy and tubal factor infertility). Objective. To determine the association between prior Chlamydia trachomatis infection and ectopic pregnancy at Mbarara Regional Referral Hospital (MRRH). Methods. This was an unmatched case-control study carried out at MRRH involving 25 cases and 76 controls. Serological evidence of prior chlamydial infection was determined by testing for the presence of Chlamydia immunoglobulin G antibodies in their blood. Logistic regression was used to determine the association between prior Chlamydia trachomatis infection and also the factors associated with ectopic pregnancy. The significant level of <0.05 was used. Results. Chlamydia antibodies were found in 60% of patients with ectopic pregnancy and 26.3% of the controls (p=0.002). The presence of Chlamydia antibodies was associated with a fourfold risk of ectopic pregnancy. Conclusion. There was a strong association between prior Chlamydia trachomatis infection and ectopic pregnancy.
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Pinto dos Santos, Daniel, G. Klos, R. Kloeckner, R. Oberle, C. Dueber, and P. Mildenberger. "Development of an IHE MRRT-compliant open-source web-based reporting platform." European Radiology 27, no. 1 (2016): 424–30. http://dx.doi.org/10.1007/s00330-016-4344-0.
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Abdelgadir, Jihad, Cyrus Elahi, Jacquelyn Corley, et al. "Trends in neurosurgical care in Western Uganda: an interrupted time series analysis." Neurosurgical Focus 45, no. 4 (2018): E15. http://dx.doi.org/10.3171/2018.7.focus18270.
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OBJECTIVEIn addition to the rising burden of surgical disease globally, infrastructure and human resources for health remain a great challenge for low- and middle-income countries, especially in Uganda. In this study, the authors aim to explore the trends of neurosurgical care at a regional referral hospital in Uganda and assess the long-term impact of the institutional collaboration between Mulago National Referral Hospital and Duke University.METHODSAn interrupted time series is a quasi-experimental design used to evaluate the effects of an intervention on longitudinal data. The authors applied this design to evaluate the trends in monthly mortality rates for neurosurgery patients at Mbarara Regional Referral Hospital (MRRH) from March 2013 to October 2015. They used segmented regression and autoregressive integrated moving average models for the analysis.RESULTSOver the study timeframe, MRRH experienced significant increases in referrals received (from 117 in 2013 to 211 in 2015), neurosurgery patients treated (from 337 in 2013 to 625 in 2015), and operations performed (from 61 in 2013 to 173 in 2015). Despite increasing patient volumes, the hospital achieved a significant reduction in hospital mortality during 2015 compared to prior years (p value = 0.0039).CONCLUSIONSThis interrupted time series analysis study showed improving trends of neurosurgical care in Western Uganda. There is a steady increase in volume accompanied by a sharp decrease in mortality through the years. Multiple factors are implicated in the significant increase in volume and decrease in mortality, including the addition of a part-time neurosurgeon, improvement in infrastructure, and increased experience. Further in-depth prospective studies exploring seasonality and long-term outcomes are warranted.
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Shiota, Kohei. "Remarkable Speed-up Plan of the International Container Transportations by the MRTH Container Ships and its Feasibility Studies." Journal of the Japan Society of Naval Architects and Ocean Engineers 16 (2012): 173–80. http://dx.doi.org/10.2534/jjasnaoe.16.173.
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Ngonzi, J., R. Hutchinson, I. Walker, et al. "O497 REDUCING MATERNAL MORTALITY THROUGH IMPROVEMENTS IN PERI-OPERATIVE OBSTETRIC CARE AT MBARARA REGIONAL REFERRAL HOSPITAL (MRRH), UGANDA." International Journal of Gynecology & Obstetrics 119 (October 2012): S437. http://dx.doi.org/10.1016/s0020-7292(12)60927-8.
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Ssedyabane, Frank, Diaz Anaya Amnia, Ronald Mayanja, et al. "HPV-Chlamydial Coinfection, Prevalence, and Association with Cervical Intraepithelial Lesions: A Pilot Study at Mbarara Regional Referral Hospital." Journal of Cancer Epidemiology 2019 (January 10, 2019): 1–7. http://dx.doi.org/10.1155/2019/9092565.
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Background. Human Pappilloma Virus (HPV) is the necessary cause of cervical cancer. A number of risk factors are believed to influence the role of HPV in the development of cervical cancer. This is so because majority of HPV infections are cleared and only a few are able to result into cancer. Chlamydia trachomatis (CT) is considered a potential cofactor in the development of cervical intraepithelial neoplasia (CIN), although different studies have produced contradicting information (Silins et al., 2005, Bellaminutti et al., 2014, and Bhatla et al., 2013). The objective of this cross-sectional study was to determine the prevalence and association of HPV-Chlamydial coinfection with cervical intraepithelial lesions and other risk factors for cervical intraepithelial lesions at a hospital in south western Uganda (MRRH). Methods. The study included 93 participants, with an age range of 25 to 80 years, from whom cervical specimens were collected and enrolment forms were completed upon consent. Experienced midwives collected one cervical smear and two endocervical swabs from each participant. The swabs were used for HPV DNA and Chlamydia trachomatis antigen testing. Data was entered in Microsoft excel and analysed using STATA 12 software. With the help of spearman’s correlation at the 0.05 level of significance, bivariate and multivariate analysis were done by logistic regression, to determine associations of risk factors to cervical lesions. Results. The results showed the prevalence of HPV-Chlamydial coinfection to be 8.6% (8/93). Positive Pap smear results were found in 60.22% (56/93) participants, most of whom had low grade squamous intraepitherial lesion (LSIL) (54.84%). HPV-Chlamydial coinfection showed a significant correlation with a positive cytology result and only relatively significantly correlated with LSIL grade of cytological positivity. HPV was found to be the risk factors associated with cervical intraepithelial lesions at MRRH. Conclusion. HPV, Chlamydia, and HPV-Chlamydial coinfection are prevalent infections and there is a likelihood of association between HPV-Chlamydial coinfection and with cervical intraepithelial lesions. This study recommends general sexually transimitted infections (STIS) screening for every woman that turns up for cervical cancer screening and a larger study, probably a multicentre study.
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Ngonzi, J., F. Bajunirwe, G. Mugyenyi, P. Mukasa, and F. Khan. "O498 PREDICTORS AND PATTERNS OF HIV SEROSTATUS DISCLOSURE AMONG HIV POSITIVE PREGNANT WOMEN AT MBARARA REGIONAL REFERRAL HOSPITAL (MRRH), WESTERN UGANDA." International Journal of Gynecology & Obstetrics 119 (October 2012): S437—S438. http://dx.doi.org/10.1016/s0020-7292(12)60928-x.
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Sundararajan, K., A. Flabouris, Alexander Keeshan, and Tracey Cramey. "Documentation of limitation of medical therapy at the time of a rapid response team call." Australian Health Review 38, no. 2 (2014): 218. http://dx.doi.org/10.1071/ah13138.
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Objectives The aims of the present study were to: (1) describe the documentation process of limitation of medical therapy (LMT) orders at the time of a rapid response team (RRT) call; and (2) compare documented LMT orders not associated with an RRT call (control, Group 1) with LMT orders documented at the time of an RRT call (Group 2). Methods A descriptive study, over a 6-month period (February–August 2011), involving the review of the medical records of patients prospectively identified as either Group 1 or Group 2. Results There were 994 RRT calls; of these, 50 patients (5%) had an LMT order documented by the RRT. A cardiac arrest was the trigger for the RRT for six patients (12%). Patients in Group 1 (n = 50) and Group 2 were of similar median age (80.5 vs 78.5 years; P = 0.30), LMTs were recorded at a similar time of day (15 : 30 vs 15 : 55 hours; P = 0.52) and day of the week (weekend: 32% vs 35%; P = 0.72). Comparing group 2 with Group 1, the RRT was less likely to document a not-for-resuscitation (NFR; 31 (62%) vs 49 (98%); P < 0.01) or a not-for-ICU (NFICU; 18 (36%) vs 41 (82%); P < 0.01) order, but more likely to document a not-for-RRT call (NFRRT; 31 (62%) vs 22 (44%); P = 0.04) and modified RRT calling criteria (MRRT; 4 (8%) vs 0 (0%); P = 0.04) orders. For Group 2 compared with Group 1 orders, involvement of the patient in the decision making process (9 (18%) vs 25 (50%); P < 0.01) or the next of kin (29 (58%) vs 45 (90%); P < 0.01) was documented less often. Conclusions Documentation of LMT orders at the time of an RRT call is less likely to include documented involvement of patients or their next of kin, and is more likely to be an NFRRT or MRRT order. These findings have implications for overall clinical governance. What is known about the topic? RRT are not infrequently involved in documenting LMT orders. What does this paper add? This is the first study in Australasia to look into the timing and circumstances surrounding the issuing of a NFR order during an RRT call. The study findings clarify the type of LMT orders documented by RRT and to what extent patients, their carers and senior medical staff are involved. What are the implications for practitioners? Our findings indicate that, in the setting of a rapid response system, there is a need to consider beyond the narrow interpretation of the NFR order, when a NFRRT may also be appropriate. This will require standardisation of such nomenclature, and training and education of those involved in documenting and interpreting such orders. Equally, it will require a different approach to the discussion with patients and their carers as to what the implications of an NFRRT order are. The findings also have significant implications as to the senior medical oversight of LMT, in particular for RRT, for whom it is their first encounter with such patients. Finally, the findings suggest that consideration be given to better delineating the documentation of the role of nursing staff when setting LMT orders.
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Omoding, Daniel, and Joel Bazira. "Isolation and Antibiotic Susceptibility Testing ofHaemophilus influenzaefrom Nasopharynx of Children under Five Years Attending Maternal and Child Health Clinic in Mbarara Regional Referral Hospital." Canadian Journal of Infectious Diseases and Medical Microbiology 2019 (March 3, 2019): 1–4. http://dx.doi.org/10.1155/2019/6542919.
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Background. H. influenzaeremains an organism of a major public health challenge worldwide despite the availability of the Hib vaccine, particularly among children under 5 years. Information on the current carriage status and antibiotic susceptibility is key on proper health-care provision. Therefore, we conducted a study to determineH. influenzaecarriage rate and antibiotic susceptibility testing of the isolates among the children.Methods. This was a cross-sectional study conducted between January and May 2018, among clinically healthy children under five years attending Maternal and Child Health (MCH) Clinic in Mbarara Regional Referral Hospital (MRRH). We carried out standard microbiology methods to culture, isolate, and identifyH. influenzae, and then, we tested for their susceptibility to commonly used antibiotics following the CLSI standards.Results. Of the 248 participants included in the study, 116 (46.77%) were females and 132 (53.23%) males and 78 (31.45%) were below the age of 3 months. Fifty one of the study participants hadH. influenzaein their nasopharynx, which represents 20.56% carriage (95% CI 15.49 to 25.63). There was a general high susceptibility of the isolates to the antimicrobial agents commonly used. There was 100% susceptibility to ciprofloxacin and imipenem antibiotic agents, though 6 (11.76%) and 4 (7.84%) of the isolates showed resistance to chloramphenicol and ampicillin, respectively.Conclusion. The high burden presented byH. influenzaeand the resultant impact on child health require much attention to prevention of infections associated with the organism. A well-funded molecular study focusing on typing the isolates would determine the impact of the vaccine, given the carriage rates are still high.
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Agaba, David Collins, Richard Migisha, Rosemary Namayanja, et al. "Prevalence and Associated Factors of Metabolic Syndrome among Patients with Severe Mental Illness Attending a Tertiary Hospital in Southwest Uganda." BioMed Research International 2019 (November 11, 2019): 1–8. http://dx.doi.org/10.1155/2019/1096201.
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Globally, the prevalence of metabolic syndrome (MetS) and its components which are the major cardiovascular disease (CVD) risk factors, is higher among patients with severe mental illness (SMI) compared to the general population. This is mainly due to the deleterious lifestyles characterized by physical inactivity, excessive alcohol consumption, smoking, and unhealthy diets common among patients with SMI as well as due to cardiometabolic effects of psychotropic medications. Despite these conditions being highly prevalent among patients with SMI, little attention is given to these conditions during routine reviews in the mental health clinics in most low-income countries including Uganda. The main objective of this study was to determine the prevalence and associated factors of MetS among patients with SMI at Mbarara Regional Referral Hospital (MRRH), a tertiary hospital in southwestern Uganda. Through a cross-sectional study at the mental health clinic of the hospital, we recruited 304 patients with SMI and evaluated them for MetS using the National Cholesterol Education Programme Adult Treatment Panel III (NCEP ATP III) criteria. We defined the prevalence of MetS as the proportion of patients meeting the NCEP ATP III criteria. We used logistic regression to evaluate associations between MetS and independent variables. We included a total of 302 (44.37% male, 55.63% female) patients with a diagnosis of SMI in the analysis. The prevalence of MetS was 23.51% (95% CI 18.84–28.71). At multivariable logistic regression, age >40 years and long duration of mental illness (>10 years) were significantly associated with MetS. The prevalence of MetS is high among patients with psychiatric disorders, and thus metabolic screening, especially among the high-risk groups, is critical.
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Mulisya, Olivier, Drucilla J. Roberts, Elizabeth S. Sengupta, et al. "Prevalence and Factors Associated with Hydatidiform Mole among Patients Undergoing Uterine Evacuation at Mbarara Regional Referral Hospital." Obstetrics and Gynecology International 2018 (2018): 1–7. http://dx.doi.org/10.1155/2018/9561413.
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Objective. We sought to determine the prevalence of and factors associated with hydatidiform molar gestations amongst patients undergoing uterine evacuation at Mbarara Regional Referral Hospital (MRRH), Mbarara, Uganda. Methods. This was a cross-sectional study carried out from November 2016 to February 2017. All patients admitted for uterine evacuation for nonviable pregnancy were included. The study registered 181 patients. Data were collected on sociodemographics, medical conditions, obstetrics, and gynecological factors. The evacuated tissue received a full gross and histopathologic examination. Cases of pathologically suspected complete hydatidiform mole were confirmed by p57 immunohistochemistry. Data were analyzed using STATA 13. Results. The prevalence of hydatidiform mole was 6.1% (11/181). All detected moles were complete hydatidiform moles, and there were no diagnosed partial hydatidiform moles. Clinical diagnosis of molar pregnancy was suspected in 13 patients, but only 69.2% (9/13) were confirmed as molar pregnancies histologically. Two cases were clinically unsuspected. Factors that had a significant relationship with complete hydatidiform mole included maternal age of 35 years and above (aOR 13.5; CI: 1.46–125.31; p=0.00), gestational age beyond the first trimester at the time of uterine evacuation (aOR 6.2; CI: 1.07–36.14; p=0.04), and history of previous abortion (aOR 4.3; CI: 1.00–18.57; p=0.05). Conclusion. The prevalence of complete hydatidiform mole was high at 6.1%. Associated risk factors included advanced maternal age (35 years and above), history of previous abortions, and gestational age beyond the first trimester at the time of evacuations. Recommendations. We recommend putting in place capacity to do routine histopathological examination of all products of conception especially those at high risk for a molar gestation either by clinical suspicion or by risk factors including advanced maternal age, advanced gestational age, and history of previous abortion because of high prevalence of complete mole.
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Ali, Mahad, Richard Migisha, Joseph Ngonzi, et al. "Risk Factors for Obstetric Anal Sphincter Injuries among Women Delivering at a Tertiary Hospital in Southwestern Uganda." Obstetrics and Gynecology International 2020 (May 14, 2020): 1–7. http://dx.doi.org/10.1155/2020/6035974.
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Background. Obstetric anal sphincter injuries (OASIS) arise from perineal trauma during vaginal delivery and are associated with poor maternal health outcomes. Most OASIS occur in unattended deliveries in resource-limited settings. However, even in facilities where deliveries are attended by skilled personnel, a number of women still get OASIS. Objectives. To determine the incidence and risk factors for obstetric anal sphincter injuries among women delivering at Mbarara Regional Referral Hospital (MRRH). Methods. We conducted an unmatched hospital-based case control study, with the ratio of cases to controls of 1 : 2 (80 cases and 160 controls). We defined a case as a mother who got a third- or fourth-degree perineal tear after vaginal delivery while the controls recruited were the next two mothers who delivered vaginally without a third- or fourth-degree perineal tear. A questionnaire and participants’ medical records review were used to obtain sociodemographic and clinical data. We estimated the incidence of OASIS and performed univariable and multivariable logistic regression to identify the associated risk factors. Results. The cumulative incidence for OASIS during the study period was 6.6%. The risk factors for OASIS were 2nd stage of labour ≥1 hour (aOR 6.07, 95%CI 1.86–19.82, p=0.003), having episiotomy performed during labour (aOR 2.57, 95%CI 1.07–6.17, p=0.035), perineum support during delivery (aOR 0.03, 95%CI 0.01–0.12, p<0.001), and monthly income of >50,000 shillings (aOR 0.09, 95%CI 0.03–0.28, p<0.001). Conclusions and Recommendations. The risk factors for obstetric anal sphincter injury were prolonged second stage of labour and performing episiotomies during deliveries while higher monthly income and perineum support during delivery were protective. We recommend routine support to the perineum during delivery. Care should be taken in mothers with episiotomies, as they can extend and cause OASIS.
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Bunck, Alexander Christian, Bettina Baeßler, Christian Ritter, et al. "Structured Reporting in Cross-Sectional Imaging of the Heart: Reporting Templates for CMR Imaging of Cardiomyopathies (Myocarditis, Dilated Cardiomyopathy, Hypertrophic Cardiomyopathy, Arrhythmogenic Right Ventricular Cardiomyopathy and Siderosis)." RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren 192, no. 01 (2019): 27–37. http://dx.doi.org/10.1055/a-0998-4116.
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Backround Structured reports have numerous benefits through standardizing the way imaging findings are reported and communicated. Nevertheless, the adoption of structured reports in everyday radiological practice is still limited. In view of the irrefutable benefits, various national and international radiological societies have started initiatives which aim at promoting a broader use of structured reports. Up to now, no consented templates in German language existed for the reporting of cross-sectional imaging studies of the heart. Method Upon invitation of the working group for Cardiovascular Imaging of the German Society of Radiology a panel of radiologists, cardiologists, pediatric cardiologists and cardiothoracic surgeons, experts on the field of cardiovascular imaging and structured reporting, met for two interdisciplinary consensus meetings at the University Hospital Cologne in 2018. The aim of these meetings was to develop and agree on templates for the reporting of MR and CT studies of various cardiovascular disease entities. Results During the meetings the panel of experts developed and reached consensus on 11 different templates for the structured reporting of the following: myocarditis, dilated cardiomyopathy, hypertrophic (obstructive) cardiomyopathy, arrythmogenic right ventricular cardiomyopathy, siderosis, ischemia and vitality imaging, tetralogy of Fallot, aortic coarctation, coronary CT and CT for Transcatheter Aortic Valve Implantation (TAVI) planning. The first five templates are presented in this publication and are currently being transferred to a HTML 5/IHR MRRT compatible format. Subsequently, the templates will be made available for free use on the website www.befundung.drg.de. Conclusion For the first time, consented templates in German language for the structured reporting of cross-sectional imaging studies of the heart are presented. These templates are aimed at providing a constant level of high reporting quality and increasing the efficiency of the generation and communication of imaging reports. Key points: Citation Format
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Kitya, David, Maria Punchak, Jihad Abdelgadir, Oscar Obiga, Derek Harborne, and Michael M. Haglund. "Causes, clinical presentation, management, and outcomes of chronic subdural hematoma at Mbarara Regional Referral Hospital." Neurosurgical Focus 45, no. 4 (2018): E7. http://dx.doi.org/10.3171/2018.7.focus18253.
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OBJECTIVECauses, clinical presentation, management, and outcomes of chronic subdural hematoma (CSDH) in low- and middle-income countries are not well characterized in the literature. Knowledge regarding these factors would be beneficial in the development and implementation of effective preventive and management measures for affected patients. The authors conducted a study to gain a better understanding of these factors in a low-income setting.METHODSThis prospective study was performed at Mbarara Regional Referral Hospital (MRRH) in Uganda between January 2014 and June 2017. Patients of any age who presented and were diagnosed with CSDH during the aforementioned time period were included in the study. Variables were collected from patients’ files at discharge and follow-up clinic visits. The primary outcome of interest was death. Secondary outcomes of interest included discharge Glasgow Coma Scale (GCS) score, ICU admission, wound infection, and CSDH recurrence.RESULTSTwo hundred five patients, the majority of whom were male (147 [72.8%]), were enrolled in the study. The mean patient age was 60.2 years (SD 17.7). Most CSDHs occurred as a result of motor vehicle collisions (MVCs) and falls, 35.6% (73/205) and 24.9% (51/205), respectively. The sex ratio and mean age varied depending on the mechanism of injury. Headache was the most common presenting symptom (89.6%, 173/193), whereas seizures were uncommon (11.5%, 23/200). Presenting symptoms differed by age. A total of 202 patients underwent surgical intervention with burr holes and drainage, and 22.8% (46) were admitted to the ICU. Two patients suffered a recurrence, 5 developed a postoperative wound infection, and 18 died. Admission GCS score was a significant predictor of the discharge GCS score (p = 0.004), ICU admission (p < 0.001), and death (p < 0.001).CONCLUSIONSTrauma from an MVC is the commonest cause of CSDH among the young. For the elderly, falling is common, but the majority have CSDH with no known cause. Although the clinical presentation is broad, there are several pronounced differences based on age. Burr hole surgery plus drainage is a safe and reliable intervention. A low preoperative GCS score is a risk factor for ICU admission and death.
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Ergas, Henry, and Robson Alexander. "Revenue Allocation under the MRRT: Economic Aspects." SSRN Electronic Journal, 2012. http://dx.doi.org/10.2139/ssrn.2174688.
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El-Ghazouly, A., M. Elhabiby, and N. El-Sheimy. "Multiresolution real-time (MRRT) code-smoothing technique." Journal of Applied Geodesy 5, no. 3-4 (2011). http://dx.doi.org/10.1515/jag.2011.017.
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Pinto dos Santos, D. "Mainz Radiology Reporting Engine, browser-basierte strukturierte Befundung nach IHE-MRRT." RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren 188, S 01 (2016). http://dx.doi.org/10.1055/s-0036-1581234.
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Cortes, Robert A., Adam B. Weinberger, Griffin A. Colaizzi, et al. "What Makes Mental Modeling Difficult? Normative Data for the Multidimensional Relational Reasoning Task." Frontiers in Psychology 12 (May 6, 2021). http://dx.doi.org/10.3389/fpsyg.2021.668256.
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Relational reasoning is a complex form of human cognition involving the evaluation of relations between mental representations of information. Prior studies have modified stimulus properties of relational reasoning problems and examined differences in difficulty between different problem types. While subsets of these stimulus properties have been addressed in separate studies, there has not been a comprehensive study, to our knowledge, which investigates all of these properties in the same set of stimuli. This investigative gap has resulted in different findings across studies which vary in task design, making it challenging to determine what stimulus properties make relational reasoning—and the putative formation of mental models underlying reasoning—difficult. In this article, we present the Multidimensional Relational Reasoning Task (MRRT), a task which systematically varied an array of stimulus properties within a single set of relational reasoning problems. Using a mixed-effects framework, we demonstrate that reasoning problems containing a greater number of the premises as well as multidimensional relations led to greater task difficulty. The MRRT has been made publicly available for use in future research, along with normative data regarding the relative difficulty of each problem.
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Muhumuza, Joy, Richard Migisha, Joseph Ngonzi, Musa Kayondo, and Godfrey Mugyenyi. "Risk factors for postpartum intrauterine device expulsion among women delivering at a tertiary Hospital in Uganda: a prospective cohort study." Contraception and Reproductive Medicine 6, no. 1 (2021). http://dx.doi.org/10.1186/s40834-021-00153-w.
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Abstract Background Postpartum intrauterine device (PPIUD) use refers to intrauterine device (IUD) insertion after delivery but within 48 h of birth. In Uganda, the general use of modern methods of contraception is low with < 1% of the women adopting the IUD as a method of contraception. An important limiting factor to increased uptake of immediate postpartum IUD insertion may be its expulsion rates which vary widely. There is minimal documentation PPIUD expulsion rates and factors associated with PPIUD expulsion during puerperium in Uganda. Objective We aimed to determine the proportion of TCu380A (copper) intrauterine devices expelled by 6 weeks postpartum, and identify risk factors for expulsion among women delivering at Mbarara Regional Referral Hospital (MRRH) in southwestern Uganda. Methods We conducted a prospective cohort study from September 1, 2014 to January 31, 2015 at MRRH. We administered a structured questionnaire to all participants, to capture data on their baseline demographic, clinical and obstetric characteristics. We followed up women who accepted the PPIUD insertions at 6 weeks post insertion for any IUD expulsion. We fit multivariable log binomial regression models to identify risk factors for IUD expulsion. Results We enrolled 167 women who had PPIUDs inserted. Of the144 women who returned at 6 weeks for follow up, 13 (9%; 95%CI:4.9–15%) of them had the IUDs expelled. In the multivariable model, the significant risk factors for PPIUD expulsion were: IUD insertion more than 10 min post-delivery (aRR 8.1, 95%CI 1.26–51.98, p = 0.027) and bloody lochia flow of ≥15 days (aRR 8.5, 95%CI 1.47–48.47, p = 0.017). Conclusion The cumulative expulsion rate of postpartum IUDs among women delivering at MRRH was low and comparable to expulsion rates in interval insertions. Longer duration from delivery to IUD insertions and longer duration of bloody lochia flow were key risk factors for postpartum IUD expulsion. More emphasis should be put on prenatal counseling for postpartum family planning to allow for postplacental IUD insertions, which are associated with lower expulsion rates.
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"The Prevalence, Risk Factors, and Bacterial Profile of Cesarean Surgical Site Infections at a University Teaching Hospital in South Western Uganda." International Journal of Women’s Health Care 5, no. 1 (2020). http://dx.doi.org/10.33140/ijwhc.05.01.02.
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Introduction: The single most important risk factor for post-partum maternal infection is Cesarean section (C/S) with a 5-20-fold greater risk for infection compared to a vaginal delivery. Post Cesarean wound infection is diagnosed in 2.5 to 16 percent of patients. Early wound infections (in the first 24 to 48 hours) are usually due to group A or B beta-hemolytic streptococcus and are characterized by high fever and cellulitis while later infections are likely due to Staphylococcus epidermises or aureus, Escherichia coli, or Proteus species. Objectives: To determine the prevalence, risk factors and bacterial profile of wound sepsis following Cesarean at Mbarara Regional Referral Hospital (MRRH). Methods: A cross sectional study of mothers who delivered by Cesarean at MRRH was conducted. Mothers were recruited consecutively until the sample size was achieved. The main dependent variable was wound sepsis confirmed by a positive culture for microorganisms. Results: Of the 359 mothers recruited in the study, 54 (15.5%) developed Cesarean wound sepsis. The risk factors associated with post Cesarean wound sepsis were severe anemia, lack of preoperative antibiotics use, poor antenatal attendance, mothers referred from peripheral health facilities, abnormal Body Mass Index (BMI), diabetes mellitus, more than five vaginal examinations, prolonged rupture of membranes before C/S, and prolonged labour. Staphylococcus aureus was isolated in 48.2% of all the septic cases and most of the bacterial isolates were susceptible to ceftriaxone, ceftazidime, ciprofloxacin and nalidixic acid and resistant to penicillin. Conclusion: The prevalence of post Cesarean wound sepsis is high with staphylococcus aureus being the most common bacteria isolated in infected wounds. Most of the bacteria were susceptible to third generation cephalosporins and quinolones. Antibiotics use was protective against developing wound sepsis.
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Owokuhaisa, Judith, and Joel Bazira. "Antimicrobial Resistance of Neisseria gonorrhoeae Isolated from Out Patients Presenting with Urethral and Vaginal Discharges at Mbarara Regional Referral Hospital." Journal of Advances in Medicine and Medical Research, August 16, 2019, 1–7. http://dx.doi.org/10.9734/jammr/2019/v30i530198.
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Background: Gonococcus is one of the most common sexually transmitted diseases in developing countries and it has become a global health burden, hence a need for effective treatment. However, there is growing trend of antimicrobial resistant strains, in many parts of the world, to the previously effective antimicrobials thus creating serious health concerns.
 Setting: Mbarara Regional Referral Hospital -South-Western Uganda.
 Objectives: 1) To determine the prevalence of gonococcus among out patients presenting with urethral and vaginal discharges at MRRH.
 2) To determine the level of antimicrobial resistance of gonococcus based on phenotypic methods at MRRH.
 Design: The study was cross sectional and enrolled 189 participants presenting with urethral and vaginal discharges. The urethral and endo cervical swab samples collected were cultured on Chocolate media supplemented with 5%-10% carbondioxide in candle jar (inoculated plates were placed in a jar and a burning candle placed in the same jar, then closed, by the time the candle went off, that 5%-10% carbondioxide atmosphere would have been created). Isolates obtained were identified according to the laboratory standard operating procedures. Drug Sensitivity Test (DST) on confirmed Neisseria gonorrheae isolates was performed using the Kirby Bauer technique. The colonies of the test organism were emulsified in peptone water and then inoculated on prepared sterile chocolate agar and the following discs were applied to it (Ceftriaxone discs (30µg), Erythromycin (15ug), Ciprofloxacin (10ug) and Penicillin (10IU). The plates were incubated at 37°C for 24- 48 hours under 5% carbon dioxide atmospheres. The Zone of inhibition was seen around an antibiotic disc to which the organism was sensitive.
 Results: Out of the 189 participants whose urethral swabs and Endo cervical swabs were cultured, 89 were positive cultures (47%), out of which 25 (28%) were found to have gonococcal infection, 64 (72%) patients had other micro-organisms. The prevalence of Neisseria Gonorrhoeae was 13%. In total, 4% of the isolates were resistant to Ceftriaxone, 28% to Ciprofloxacin, 68% to Erythromycin and 80% to Penicillin. A high percentage of resistance was observed against Penicillin (80%) and Erythromycin (68%).
 Conclusion: Adults aged 18 years and above who present at Mbarara Regional Referral Hospital with urethral or vaginal discharges are more likely to have a Neisseria gonorrhoeae which is resistant to Penicillin and Erythromycin.
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Edson, Tayebwa, Kisitu Kyengera, Baguma Andrew, and Bazira Joel. "Chronic Osteomyelitis among Children Attending Orthopedic Services at Mbarara Regional Referral Hospital: Prevalence, Etiological Agents and Their Drug Susceptibility Patterns." Microbiology Research Journal International, September 3, 2019, 1–14. http://dx.doi.org/10.9734/mrji/2019/v28i530144.
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Background: This cross-sectional study was conducted to determine prevalence, causative agents and their drug susceptibility patterns of chronic osteomyelitis children among 766 children attending orthopedic services at Mbarara Regional Referral Hospital between October 2016 and June 2017.
 Methods: Seventy-four consented patients were consecutively enrolled and their demographic characteristics, clinical and radiological data collected. Superficial and deep bone pus swabs were collected and processed as per standard operative procedures. Susceptibility testing was done using the Kirby Bauer disc diffusion technique. Data was analyzed using Stata version 13.0.
 Results: The prevalence of children with COM was 9.7%. The female: Male ratio was 1:1.2 with a mean age of 11 years. The most infected bone was the tibia followed by the femur. The common clinical presentations were chronic bone pain and discharging sinus tracts whereas the most imminent radiological features were sequestrum and involcrum. Pus swabs were taken off from both the discharging sinuses and the deep intra osseous abscesses for culture and sensitivity studies. The concordance rate of the microorganisms between the superficial and the deep swabs was 62.5%. Staphylococcus aureus was the most predominant microorganism isolated (85%). All the microorganism isolates were sensitive to gentamycin. However, all Staphylococcus aureus isolated were resistant to penicillin.
 Conclusion: Prevalence of Chronic osteomyelitis among children with orthopedic conditions presenting to MRRH is high. The isolated microorganisms are resistant to antibiotics we commonly use in our settings.
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Kayondo, Musa, Verena Geissbüehler, Richard Migisha, et al. "Risk factors for recurrence of pelvic organ prolapse after vaginal surgery among Ugandan women: a prospective cohort study." International Urogynecology Journal, July 28, 2021. http://dx.doi.org/10.1007/s00192-021-04930-8.
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Abstract Introduction and hypothesis This study was aimed at determining the recurrence rate and risk factors for the recurrence of pelvic organ prolapse (POP), at 1 year post-vaginal reconstructive surgery in a resource-limited setting. Methods We enrolled women who underwent vaginal surgery for POP at the urogynecology unit of Mbarara Regional Referral Hospital (MRRH) in southwestern Uganda between December 2018 and February 2020. The surgeries that were performed include anterior colporrhaphy for cystocele, posterior colporrhaphy for rectocele, vaginal hysterectomy with vault suspension for uterine prolapse, and cervicopexy in those with uterine prolapse where uterine-sparing surgery was desired. The women were followed up for a period of 1 year after surgery. Pelvic examinations in lithotomy position under maximum strain were carried out to assess for recurrence using the Pelvic Organ Quantification (POP-Q) system. Recurrence was defined as a prolapse of ≥POP-Q stage II. Descriptive analyses and multivariate log binomial regression were performed to determine risk factors for recurrence. Results Of the 140 participants enrolled, 127 (90.7%) completed the follow-up at 1 year. The recurrence rate was 25.2% (32 out of 127). Most (56.3%) of the recurrences occurred in the anterior compartment and in the same site previously operated. Women aged <60 years (RR = 2.34; 95% CI: 1.16–4.72; p = 0.018) and those who had postoperative vaginal cuff infection (RR = 2.54; 95% CI: 1.5–4.3; p = 0.001) were at risk of recurrence. Conclusion Recurrence of POP was common. Younger women, and those with postoperative vaginal cuff infection, were more likely to experience recurrent prolapse after vaginal repair.
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Mariki, Grace A., and Jaffu O. Chilongola. "Risk Factors for Placental Malaria and Birth Weight Outcome among Pregnant Women Attending Mawenzi Regional Referral Hospital, Moshi North Eastern Tanzania." International Journal of TROPICAL DISEASE & Health, July 13, 2020, 46–53. http://dx.doi.org/10.9734/ijtdh/2020/v41i830310.
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Objective: This study aimed to determine the Prevalence and Risk Factors for Placental Malaria and its associated effects on Pregnancy Outcome among Pregnant Women in Mawenzi Regional Referral Hospital in Kilimanjaro Region.
 Methodology: This was a hospital based cross-sectional study. We derived our study sample from previous survey of 700 pregnant women who attended labor ward at MRRH between 2018- 2019 in which we obtained study subjects by random sampling. The study included 350 subjects. We extracted data from the dataset using data extraction sheet and was analyzed using IBM SPSS software version 24. Chi–square was performed and we accepted an error of 5% level P<0.05 was the cut off for statistical significance.
 Results: The prevalence of PM was 7.1% among the pregnant women in the study area. Primigravida had more cases of PM (11%) as compared to multigravida (2.7%). Pregnant women who had gestation age below 37 weeks attributed more cases of PM (9.6%) as compared to 6.7% of PM infections in pregnant women at gestation age of 37 weeks and above. Low birth-weight was estimated at 32% of all subjects who were identified with PM as compared to 6.2% of subjects without placental malaria and their difference was statistically significant (P<0.001). Gestational age of less than 37 weeks was associated with LBW with proportion of 21% among women with PM and it has strong statistical significance of P (<0.001). The use of bed nets was associated with PM among the non-user at 28% P (<0.001).
 Conclusion: PM is still a major public health problem in low malaria endemic areas and the groups at risk are women who are Primigravida, women not using bed nets and women who gives birth at gestation age of <37 weeks. We recommend more studies on PM in low endemic.
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Kimweri, Davis, Julian Ategeka, Faustine Ceasor, Winnie Muyindike, Edwin Nuwagira, and Rose Muhindo. "Incidence and risk predictors of acute kidney injury among HIV-positive patients presenting with sepsis in a low resource setting." BMC Nephrology 22, no. 1 (2021). http://dx.doi.org/10.1186/s12882-021-02451-6.
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Abstract Background Acute kidney injury (AKI) is a frequently encountered clinical condition in critically ill patients and is associated with increased morbidity and mortality. In our resource-limited setting (RLS), the most common cause of AKI is sepsis and volume depletion. Sepsis alone, accounts for up to 62 % of the AKI cases in HIV-positive patients. Objective The major goal of this study was to determine the incidence and risk predictors of AKI among HIV-infected patients admitted with sepsis at a tertiary hospital in Uganda. Methods In a prospective cohort study, we enrolled adult patients presenting with sepsis at Mbarara Regional Referral Hospital (MRRH) in southwestern Uganda between March and July 2020. Sepsis was determined using the qSOFA criteria. Patients presenting with CKD or AKI were excluded. Sociodemographic characteristics, physical examination findings, and baseline laboratory values were recorded in a data collection tool. The serum creatinine and urea were done at admission (0-hour) and at the 48-hour mark to determine the presence of AKI. We performed crude and multivariable binomial regression to establish the factors that predicted developing AKI in the first 48 h of admission. Variables with a p < 0.01 in the adjusted analysis were considered as significant predictors of AKI. Results Out of 384 patients screened, 73 (19 %) met our inclusion criteria. Their median age was 38 (IQR 29–46) years and 44 (60.3 %) were male. The median CD4 T-cell count was 67 (IQR 35–200) cells, median MUAC was 23 (IQR 21–27) cm and 54 (74.0 %) participants were on a regimen containing Tenofovir Disoproxil Fumarate (TDF). The incidence of AKI in 48 h was 19.2 % and in the adjusted analysis, thrombocytopenia (Platelet count < 150) (adjusted risk ratio 8.21: 95 % CI: 2.0–33.8, p = 0.004) was an independent predictor of AKI. Conclusions There is a high incidence of AKI among HIV-positive patients admitted with sepsis in Uganda. Thrombocytopenia at admission may be a significant risk factor for developing AKI. The association of thrombocytopenia in sepsis and AKI needs to be investigated.
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Editorial Team, IIIT. "Editorial Note." American Journal of Islam and Society 2, no. 2 (1985). http://dx.doi.org/10.35632/ajis.v2i2.2769.
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The members of the editorial staff of the AJISS were very encouraged bythe response from readers after the release of Volume 2, Number 1 of thejournal. Apparently many readers were impressed by the new name and thenew format. Some readers see the new name of the journal as a challengeto Muslim social scientists to take a stand on important human issues andto conduct their research and analyses within an Islamic framework. One readerreminded me of an article written by James M. Gustafson on “Man In Lightof Social Science and the Christian Faith.” Apparently this Christian authorwas concerned about some of the same philosophical and epistemological issuesthat stir us in this journal. This is to say, as a Christian thinker, Gustafsonclaims the right “to interpret man from the Christian perspective as well,and. . .sees things in this light that the lights from the social science do notexpose.” Regardless of how some of the social scientists in the academic communityview statements like that of Gustafson’s, the fact remains that thosewho believe in a sublunar world (Dunya) and a transcendenA world (al-Akhira)will always adopt critically the methods and research findings of the secularsocial science.In this volume we have a number of interesting and infromative articlesthat raise a host of issues about the Islamic experience. The lead article iswritten by Roger Garaudy, a French Muslim who takes a critical look at theWestern philosophical tradition from the perspective of a Muslim student ofhuman knowledge. His analysis is a part of the beginning of Western Muslimattempts to probe deeply into their own intellectual tradition in light of theirunderstanding of their Muslim intellectual heritage. Following Garaudy’s paperare several other papers dealing with Ibn Hazem, Amir Ali, Ibn Khaldun andMawlana Mawdudi. The Ibn Hem’s piece treats us to a careful analysisthinker’s thought on Qiyas in Islamic law; Amir Ali’s article addresses theMuslim thinkers views of Islam early in this century; the Ibn Khaldun essaygives us an alaysis of the North African Muslim’s under.,tanding of perceptiontheories of his time; the Mawdudi piece treats us to a careful analysisof the Pakistani Muslim writer’s tafsir of the Holy Qur’an. The article of Z.I.Ansari provides an analysis of the life and activities of Imam Mrith DeenMuhammad, the successor of the late Honorable Elijah Muhammad and oneof the leading MusIim figures in America today ...