BackgroundFlexible bronchoscopy enables visualization of the respiratory airway mucosa from the oropharynx to third generation branching of the tracheobronchial tree. Bronchoscopic diagnoses vary from one locality to the other in accordance to the locality specific risk factors for lung diseases. This study aimed at describing diagnoses of all specimen of patients who underwent flexible bronchoscopy at Muhimbili National Hospital from January 2013 to November 2017.MethodsA retrospective hospital-based cross sectional study was conducted among 451 patients. Data was collected from archives and included both demographic and clinical variables. Descriptive statistics were used to summarize the study findings.ResultsThere was a 3 fold increase in the number of patients who underwent flexible bronchoscopy from 57 cases in 2013 to 180 cases in 2017. About 39% (174/451) of patients underwent lung biopsies while 64.5% (291/451) underwent bronchioalveolar lavage, bronchial washings or brush cytology, alone or in combination with biopsy. Generally, 64.4% (112/174) of all lung biopsies were malignant. Adenocarcinoma was the most common diagnosis seen in 33.9% (59/174). Of 76 cytological samples which were sent for bacterial culture and sensitivity, 11/76 (11.8%) were culture positive. A total of 6 (10.7%) out of 56 samples which were sent for GeneXpert MTB/RIF tested positive for M.tuberculosis.ConclusionAdenocarcinoma was the most common diagnosis. Bacterial and mycobacterial infections were among the most reported findings in cytological samples. Suspicious tuberculosis lesions during bronchoscopy made it possible to diagnose tuberculosis which was hard to diagnose before patients were sent for bronchoscopy.

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Background:A flexible bronchoscopy is an essential tool that is globally used for the diagnosis and treatment of Broncho-pulmonary diseases. However the indication and outcome of flexible bronchoscopy has not been widely documented in majority of low resource settings. Objective:To determine the indications and outcome of flexible bronchoscopy (FB) at Muhimbili National Hospital (MNH). Methodology: A cross sectional analytical study was conducted for a period of 12months. Details involving indications and outcome of flexible bronchoscopy includes; bronchoscopy findings, therapeutic value, diagnostic yield, and early procedural related complications together with their demographic data were documented after each procedure followed by analysis using SPSS version 25. Results:Among 151 patients underwent flexible bronchoscopy 76(50.3%) were male and 75(49.7%) were female. The median age of 58 years with IQR (43, 65). Among the indications of flexible bronchoscopy, Cough and hemoptysis were the leading by 82.1% and 25.2% respectively. On the other hand hyperemic mucosa (31.1%) and endobronchial mass (21.2%) constituted the majority of the bronchoscopy findings. The overall diagnostic yield was 34.3% and procedural related complications was 18.54%. Among the indications for flexible bronchoscopy, the hemoptysis was associated with procedure related complications by 31.6% (p-value<0.020, OR 2.779). Among sampling technique of flexible bronchoscopy, the endobronchial biopsy and BAL sampling technique were associated with procedure related complications by 39.5 %( p-value<0.001, OR 4.393) and 14.7 %( p-value<0.005, OR 1.870) respectively Conclusion: We have demonstrated that flexible bronchoscopy is a safe and reliable procedure in diagnosis of respiratory maladies including MTB at Muhimbili National Hospital.

Objective The profile, success and progression of patients undergoing coronary artery bypass graft at the institute has not adequately been reviewed. Coronary artery bypass graft though a widely performed procedure in developed countries, it is uncommon procedure in a few centers found in developing countries. The procedure is skill and expertise demanding. The study aimed to evaluate patients’ characteristics, number and disposition of patients after coronary artery bypass graft surgery. Methods This was a retrospective study that enrolled all patients who underwent coronary revascularization at the centre from May 2016 through November 2022. Patients’ demographic was entered into a structured data sheet, excluded were those whom their surgical and clinical details could not be retrieved. Preoperative clinical details, intraoperative and postoperative patients’ profile were recorded and entered into a data sheet in SPSS version 20 program and analyzed; Chi square (χ2) was used to compare categorical variables. Results There was a total of 220 patients who underwent coronary artery bypass graft from May 2016 through November 2022. Male patients were 172 (78.2%) and female patients were 48(21.8%). Male patients outnumbered female patients by 3.6 folds. The minimum age was 42 years and maximum were 89 years with a mean year age of 63.7 ± 8years. The majority of patients were overweight and obese in 73%. The mean duration of presentation was 13.5 ± 8.6 months and the overall early mortality rate was 10.5%. Conclusion The key to a successful of a well-established cardiac centre in sub-Saharan countries of Africa and to any newly established cardiac center requires government commitment to invest in human resource; that in turn forms a local core cardiac team that should work focused to archive its goals. Investing into a well-planned structure that fits the requirement of a cardiac Centre. There should be a system that ensures availability and constant supply of consumables. The success and progress of open heart surgery demonstrated by Jakaya Kikwete Cardiac Institute from simple open heart procedures to complex surgical procedures required a well-planned short and long term plan with good coordination and focus, backed by unwavering government commitment.

Background The assessment of outcomes of interventions based on the patient’s perspective using patient-reported outcome measures (PROMs) has been increasingly highlighted in clinical practice. However, health related quality of life (HRQoL), one of the common constructs measured by PROMs remain unknown among patients after heart valve replacement (HVR) in Tanzania. Objectives To assess the HRQoL amongst patients operated on for rheumatic mitral stenosis at Jakaya Kikwete Cardiac Institute (JKCI). Methods A prospective study of patients operated on due to rheumatic mitral stenosis at JKCI from January 2020 to April 2021 was undertaken. The HRQoL was assessed by using the MacNew questionnaire, addressing three domains (physical, emotional, and social function); the score ranges from 0 to 7. We categorized HRQoL as low (mean score ≤ 4.9), moderate (5–6) and high (> 6). We analysed several sociodemographic and clinical variables for HRQoL. Results Out of 54 patients, there were 34 females and 20 males. Their mean (± SD) age was 37.98 (± 12.58) years. The reliability of translated Kiswahili version of MacNew was good. The mean (± SD) global scores were 3.47 ± 0.59, 4.88 ± 0.71 and 6.14 ± 0.50 preoperatively, at 3 months and 6 months respectively (p-values < 0.001 preoperatively vs. 3 months, preoperatively vs. 6 months and at 3 months vs. 6 months). The median of individual mean difference HRQoL score pre-operatively and at 6 months was 2.67. The preoperative and 6 months mean difference HRQoL scores were higher among patients with vs. without atrial fibrillation (2.95 ± 0.59 vs. 2.45 ± 0.53, p = 0.003) and those on anticoagulants (preoperatively) vs. not on anticoagulants (3.14 ± 0.58 vs. 2.57 ± 0.57, 0.009). The mean difference HRQoL scores were similar for sociodemographic and other clinical parameters, including those with stroke vs. without stroke. Conclusion Six months after HVR the overall MacNew HRQoL scores improved markedly. This improvement in HRQoL was regardless of the presence of comorbidities (e.g. stroke and atrial fibrillation) which underscores the importance of considering valvular surgery if they fit the criteria. Clinicians and researchers in low-resource settings should collaborate to promote the utilization of PROMs in the routine care of patients.