Background The Surgical Apgar Score (SAS) describes a feasible and objective tool for predicting surgical outcomes. However, the accuracy and applicability of the score has not been widely tested in majority of low resource settings. Objective To determine the accuracy of Surgical Apgar Score in predicting post-operative complications among patients undergoing emergency laparotomy at Muhimbili National Hospital. Methods A prospective cohort study was conducted for a period of 12 months; SAS and CCI outcomes were recorded and analyzed according to the risk level and degree of severity. Spearman correlation and simple linear regression were employed to establish the relationship between SAS and CCI, the Accuracy of SAS was evaluated by determining its discriminatory capacity on ROC, data normality was tested by Shapiro-Wilk statistic 0.929 (p < 0.001) .Analysis was done using IBM –SPSS. Results Among 111 patients who underwent emergency laparotomy, 71 (64%) were male, the mean age was 49 (± 17). The mean SAS was 4.86 (± 1.29) and mean CCI 44.46 (± 25.77), patients in high-risk group SAS (0–4) were more likely to develop severe and life threatening complications with mean CCI 53.3 (47. 2- 63.4, 95% CI) than the low risk group SAS (7–10) mean CCI of 21.0 (5.3–36.2, 95% CI). There was a negative correlation between SAS and CCI, spearman r -0.575 (p < 0.001) and regression coefficient b − 11.5 (p < 0.001). SAS revealed a good accuracy for prediction of post-operative complication on ROC, Area under Curve 0.712 (0.523–0.902, 95% CI, p < 0.001). Conclusion We have demonstrated that SAS can accurately predict the occurrence of complications following emergency laparotomy at Muhimbili National Hospital.

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.

Gastrointestinal malignancies constitute the most common neoplasms with increasing prevalence worldwide, which portend a dismal morbidity and higher mortality rate. Epigenetic phenotypes and field cancerization impute a cutting edge for precursor of several gastrointestinal malignancies; this genetic aberration has been implicated in tumorigenesis and recurrence of gastrointestinal malignancies. This systematic review aims at assessing the effect of epigenetics and field cancerization on carcinogenesis and recurrence of gastrointestinal malignancies. This systematic review and meta-analysis will administer the provisions of Preferred Reporting Items for Systematic Review and Meta-analysis 2020 guideline, and the review protocol has been registered at PROSPERO. The literature search will be executed through several electronic databases including EMBASE, PubMed, Scopus, Web of Science, Cochrane, Global Index Medicus, Semantic Scholar and Google Scholar. All original research articles reporting on the effect of epigenetic signatures, epigenetics and field cancerization on the carcinogenesis and recurrence of gastrointestinal cancers in adults will be included. Only articles with Newcastle–Ottawa Scale score above 4 and low risk of bias based on D1–D5 for randomized controlled trials will be included for a meta-analysis. There is no involvement of human subject participation in this review, thus giving no effect to ethical clearance approval. The evidence report of this review will be disseminated on scientific conferences and will be published to a reputable journal of gastroenterology oncology. This review has been registered at PROSPERO registry ID CRD 42023391339.

Background Gastrointestinal malignancies constitute the most common neoplasms with increasing prevalence worldwide, which portend a dismal morbidity and higher mortality rate. Epigenetic phenotypes and field cancerization impute a cutting edge for precursor of several gastrointestinal malignancies, this genetic aberration have been critically implicated in tumorigenesis and recurrence of gastrointestinal malignancies. There has been a paucity of knowledge about the interface effect between epigenetic signatures, epigenetic phenotype and field cancerization for carcinogenesis and recurrence of disease, a comprehensive analysis on the interplay of these biomarkers would streamline the strategy for epigenetic screening and chemoprevention therapy of gastrointestinal malignancy. This systematic review aims at assessing the effect of epigenetics and field cancerization on carcinogenesis and recurrence of gastrointestinal malignancies. Methods and Analysis This Systematic review and Meta-analysis will administer the provisions of Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) 2020 guideline and the review protocol will be submitted to PROSPERO review registry for registration. The literature search will be executed through several electronic databases including EMBASE, PubMed, Scopus, Web of Science, Cochraine , Global index medicus , semantic scholar and google scholar . All original research articles reporting on the effect of epigenetic signatures, epigenetics and field cancerization on the carcinogenesis and recurrence of gastrointestinal cancers in adults will be included. Only articles with NOS score above 4 and Low ROB based on D1-D5 for RCTs will be included for a Meta-analysis. Ethical Consideration and Dissemination There is no involvement of human subject participation in this review thus giving no effect to ethical implication .The evidence report of this review will be disseminated on scientific conferences and will be published to a reputable journal of gastroenterology oncology. This review has been registered at PROSPERO registry ID CRD 42023391339

Background: Appendectomy is a surgical procedure performed on a patient with acute appendicitis and is often performed by surgery and performed in an emergency. The authors have carried out this study, which aims to describe the surgical characteristics of appendectomies. Methods: This retrospective, descriptive, and documentary cross-sectional study was conducted from October 2021 to October 2022. Within this time ~591 acute abdominal surgical procedures were performed, including 196 appendectomies performed in the general surgery department. Results: This study focused on 196 appendectomies performed out of a total of 591 surgeries performed, with an incidence of 34.2%. 51 cases (26%) for the age group between 15 and 20 years, 129 cases (65.8%) of women participated in the appendectomy. 133 (67.8%) acute appendicitis, 48 (24.5%) appendicular abscess and 15 (7.7%) appendicular peritonitis were indications for appendectomies. For the American Society of Anesthesiologists (ASA) score: for the ASA I, 112 (57.1%) of the patients had no conditions other than those requiring surgery (appendectomy). For the Altemeier classification, the authors recorded 133 (67.9%) own surgeries. 56 (28.6%) surgical site infections followed by 39 (19.8%) inflammation (swelling and redness), 37 (18.8%) pain, 24 (12.4%) purulent peritonitis, 21 (10, 7%) postoperative hemorrhage and 19 (9.7%) paralytic ileus and 157 (80.1%) patients benefited from medical treatment. Conclusion: The low incidence of complications related to laparotomy appendectomy has been reduced to a minimum thanks to the respect of sanitary measures and the quality of the technique.