Management of advanced gallbladder adenocarcinoma: A case report and review of treatment strategies.

Introduction And Importance: Gallbladder cancer (GBC) is a rare but aggressive malignancy, accounting for most biliary tract cancers. It typically presents at an advanced stage, leading to a poor prognosis, with a mean survival of six months and a five-year survival rate of 17.6 %.

Extent and pattern of symptom relief following surgical castration in patients with advanced prostate cancer treated at a tertiary referral hospital in Tanzania: a prospective cohort study.

Background: Advanced prostate cancer leads to many symptoms, notably bone pain and lower urinary tract symptoms (LUTs); however, the degree and duration of pain relief, changes in LUTs severity and underlying factors associated with the extent of symptom relief remain inadequately understood. Surgical castration has proven effective in relieving both bone pain and urinary symptoms for metastatic prostate cancer patients.

Objective: To determine the extent and pattern of symptom relief in advanced prostate cancer patients following surgical castration at Muhimbili National Hospital (MNH).

Breast cancer molecular subtype classification according to immunohistochemistry markers and its association with pathological characteristics among women attending tertiary hospitals in Tanzania.

Background: Breast cancer immunohistochemistry is a biological characteristic of the tumour which has a role to diagnose molecular subtype, prognosticate and guide treatment and is categorised into 4 subtypes. Data in Tanzania was lacking and was based off data extrapolated from studies in Western Africa thus hypothesizing that women of African ancestry predominately develop Triple Negative Breast Cancer (TNBC).

Methods: A retrospective cross-sectional study was carried out at two tertiary referral hospitals on participants who were recruited from the cancer registries from 2015 to 2022.

Rare clinical scenario and surgical approach for traumatic obstructed Spigelian hernia with penetrating scrotal injury: A case report.

Introduction And Importance: Traumatic Spigelian hernias, an unusual subtype of traumatic abdominal wall hernias (TAWH). This case highlights the individualized surgical management of Spigelian hernia depending on the presentation, history, and existence of concurrent intra-abdominal injuries. This case report, presented in line with the SCARE criteria, highlights a case of obstructed Spigelian hernia.

Postoperative Complications and Factors Associated with Surgical Site Infection at Muhimbili National Hospital, Dar es Salaam, Tanzania: A cross-Sectional study.

Background: Postoperative complications are a leading cause of morbidity and mortality to surgical patients. Different complications are encountered in clinical practice, however surgical site infection (SSI) appears to be the most common. To date, limited published information is known pertaining to the patterns of postoperative complications and factors associated with SSI among patients operated on in other hospitals in Tanzania and referred to Muhimbili national hospital for further management.

Successful posterior urethroplasty with gracilis muscle flap interposition and a VY gluteal flap of the perineal wound gap following abdominal-perineal resection: A case report.

Unlabelled: An iatrogenic urethral perineal fistula can cause challenging problems for surgical reconstruction. In most cases, treatment is performed in three steps: double-diversion urinary and intestinal diversion, closure, and diversion. The augmented posterior urethroplasty interposition with a gracilis muscle function flap for the repair of the perineal gap was successful.

Assessing the accuracy of the revised Cardiac Risk Index compared to the American Society of Anaesthesiologists physical status classification in predicting Pulmonary and Cardiac complications among non-cardiothoracic surgery patients at Muhimbili National Hospital: a prospective cohort study.

Background: The Revised Cardiac Risk Index (RCRI) and the American Society of Anaesthesiologists (ASA-PS) classification system are two commonly used tools for preoperative risk assessment. This study aimed to assess the accuracy of RCRI compared to the ASA-PS classification system in preoperative risk assessment for pulmonary and cardiac problems among non-cardiothoracic surgery patients admitted at Muhimbili National Hospital (MNH).

Methods: This was a prospective cohort study design conducted from August 2022 to April 2023 among 184 patients of 18 years and above admitted at MNH for elective non-cardiothoracic surgery.

Clinical characteristics and management of patient with portal hypertension at tertial level hospital in Tanzania.

Background: Portal hypertension is a common diagnosis in Sub-Saharan African countries, with the majority of patients presenting late. This study aimed to understand Clinical characteristics, aetiology, the treatment offered in our setting, and factors associated with portal hypertension at a tertiary-level hospital, in Tanzania.

Methodology: A prospective cross-sectional observational single hospital-based study was conducted at MNH, from May 2021 to April 2022.

Surgical management of huge paratesticular rhabdomyosarcoma in a 20-year-old male: Case report and literature review.

Early diagnosis and aggressive treatment of testicular rhabdomyosarcomas including surgery and chemotherapy significantly reduce local recurrence and improve survival rates in young adults with metastases. Adjuvant chemotherapy is highly recommended to enhances prognosis and survival outcomes.

Wandering Spleen in a 47-year-old female treated by non-operative conservative management. Case report and literature review.

Introduction: Wandering spleen (WS) is a rare clinical condition found in less than 0.5 % of splenectomies and is characterized by ectopic location of the spleen within the abdomen or pelvis. It is always caused by excessive mobility brought on by the ligamentous laxity of its peritoneal attachments.

Incidental actinomycosis in a 44-year-old female during total abdominal hysterectomy for abnormal uterine bleeding: A case report.

Actinomycosis, a rare chronic bacterial infection caused by Actinomyces species, presents diagnostic challenges due to diverse clinical presentations. This report presents a case of peritoneal actinomycosis incidentally discovered during a total abdominal hysterectomy in a 44-year-old female with refractory abnormal uterine bleeding and a history of long-term intrauterine contraceptive device use. The patient presented with persistent abnormal uterine bleeding despite conservative management.

Surgical excision of acquired urethral diverticulum and single-stage urethroplasty for a 32-year-old male. Case report and literature review.

Introduction: Urethral diverticulum (UD) is a saccular dilatation of the urethral wall, continuous with the true urethral lumen. It is categorized etiologically into congenital and acquired. The etiology of an acquired urethral diverticulum is thought to be secondary to trauma.

Assessment of the Surgical Oncology Case Volume Within the Public Sector in Tanzania.

Purpose: Surgery provides vital services to diagnose, treat, and palliate patients suffering from malignancies. However, despite its importance, there is little information on the delivery of surgical oncology services in Tanzania.

Methods: Operative logbooks were reviewed at all national referral hospitals that offer surgery, all zonal referral hospitals in Mainland Tanganyika and Zanzibar, and a convenience sampling of regional referral hospitals in 2022.

A rare case report of ectopic-adrenal paraganglioma with inferior vena cava infiltration. Case report and literature review.

Introduction And Importance: Phaeochromocytomas are neuroendocrine neoplasms arising from chromaffin cells of the adrenal medulla and are known as intra-adrenal paragangliomas. On the contrary, paragangliomas are non-epithelial neuroendocrine neoplasms that produce other peptide hormones such as norepinephrine, epinephrine, and dopamine. In a setting with limited resources, such a condition may result in inaccurate diagnosis and treatment, which may lose a patient life if left untreated.

"A successful reconstruction of remnants of corporal bodies and penile urethra after Total Glans Penis amputation following surgical circumcision in a 5-year-old boy". A case report and literature review.

Introduction And Importance: Circumcision is the most common surgical procedure done in boys. Its complication varies from minor to severe. In most of African countries circumcision is often performed by traditional circumcisers.

Prolonged retention of gauze sponge resulting in ileocolic fistula, a rare complication following cesarean section; case report.

Introduction And Importance: Retained gauze sponge is a medical legal issue with significant clinical implications with catastrophic complications. We report a case of a female who presented with chronic right iliac fossa pain only to be found to have a retained gauze sponge causing bowel fistulisation. We describe our experience on diagnostic formulation and work up and subsequent operative intervention.

Gall bladder schistosomiasis diagnosed incidentally post laparoscopic cholecystectomy: A case report.

Introduction And Importance: Schistosomiasis is a neglected tropical disease caused by parasitic worms of the genus Schistosoma. It primarily affects the intestines, liver, and urinary tract however, rare cases have been reported where the parasite invades other organs. This case report presents an incidental finding of schistosomiasis, upon histopathology evaluation, in a patient who underwent laparoscopic cholecystectomy for symptomatic gallstone disease with recurrent attacks of cholecystitis.

Factors Influencing the Health-Related Quality of Life Among Lower Limb Amputees: A Two-Center Cross-Sectional Study.

Background: Limb amputation is among the commonly performed surgical procedures known to have a significant impact on health-related quality of life (HRQoL). Nonetheless, factors influencing the HRQoL among amputees have not been extensively explored. We therefore conducted a study aiming at determining factors influencing the HRQoL among lower limb amputees.

A Genomic Analysis of Esophageal Squamous Cell Carcinoma in Eastern Africa.

Background: Esophageal squamous cell carcinoma (ESCC) comprises 90% of all esophageal cancer cases globally and is the most common histology in low-resource settings. Eastern Africa has a disproportionately high incidence of ESCC.

Methods: We describe the genomic profiles of 61 ESCC cases from Tanzania and compare them to profiles from an existing cohort of ESCC cases from Malawi.

Preoperative waiting time and outcomes of non-traumatic emergency abdominal surgeries: Insights from a zonal referral hospital in northern Tanzania, a reference for health centers with similar capacities.

Background: Non-traumatic emergency abdominal surgeries are common in most healthcare settings. To a significant extent, the outcomes of treatment are determined by the promptness of surgical interventions. However, the in-hospital waiting time which reflects perioperative promptness remains largely unexplored in developing countries.

Report from the first Tanzania Liver Cancer Conference: a call for action to unite in the fight against liver cancer in Sub-Saharan Africa, 17-18 March 2023, Dar es Salaam, Tanzania.

The first Tanzania Liver Cancer Conference (TLCC2023) took place on 17-18 March 2023 in Dar es Salaam, Tanzania with the aim of raising awareness among healthcare providers on the problem that liver cancer poses to the Tanzanian population and the urgent need to address this important issue. The conference focused on the following agenda items: 1) to build awareness among local healthcare providers on the status of liver cancer in Tanzania and the available diagnostic and management options, 2) to update Tanzanian healthcare providers on the current standard of care for liver cancer provided in developed countries and recent advancements in liver cancer care and 3) to promote an inclusive and multidisciplinary approach in research and the clinical care of patients with liver cancer in Tanzania. TLCC2023 was preceded by community-facing pre-conference activities, including screening 684 community members for hepatitis B virus free of charge.

Successful open surgery repair of isolated right diaphragmatic rupture in 1-year-old patient at Muhimbili National Hospital: a case report and literature review.

Diaphragmatic ruptures rarely occur in isolation, a pathology in paediatric that is difficult to diagnose and can lead to serious complications if left untreated. We present a rare case of isolated right diaphragmatic rupture with liver herniation that was successfully repaired, along with a literature review. A 1-year-old female child was admitted at Emergency Department after being involved in a motor traffic crash as a passenger.

Development of the PIP score: A metric for predicting Intensive Care Unit admission among patients undergoing emergency laparotomy.

Background: Emergency laparotomy cases account for a significant proportion of the surgical caseload requiring postoperative intensive care. However, access to Intensive Care Unit (ICU) services has been limited by the scarcity of resources, lack of guidelines, and paucity of triaging tools.

Objective: This study aimed at developing a feasible ost-emergency laparotomy CU admission redictive (PIP) scoring tool.

Diagnostic challenges and management of choledochal cyst in an 11-year-old child: a delayed diagnosis (a case report).

Choledochal cyst are rare congenital disease of the biliary tree. It presenting as cystic dilatations of the biliary tree can involve the extrahepatic biliary radicles, the intrahepatic biliary radicles or both. They are typically a surgical problem of infancy and childhood, but less than a quarter of the patients the diagnosis is delayed until adulthood as it presenting with vague and nonspecific signs and symptoms.