Robert Lukande

Publications (15) View all

• Article: Destructive rib lesions in an HIV sero-negative male: an unusual presentation of tuberculosis in a high tuberculosis prevalence setting.

  Lydia Nakiyingi, John M Bwanika, Robert Lukande, Bruce Kirenga, Tom P Mwambu, William Worodria, Martin Okot-Nwang
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  ABSTRACT: Tuberculosis (TB) of the rib is a very rare form of skeletal TB and its diagnosis may be difficult because of a low index of suspicion by clinicians. The presentation often mimics malignant disease clinically and radiologically and diagnosis may only be confirmed by tissue biopsy. We present a 32-year-old HIV-negative man who presented with a three-month history of progressively worsening pleuritic chest pain, weight loss, fatigue, anorexia and low-grade fever with night sweats. A chest computerized tomography (CT) scan showed destructive lesions in the right fourth and seventh ribs with no pulmonary lesions. A diagnosis of TB of the rib was made after surgical resection and histopathology of the affected tissue. There was significant improvement when anti-TB therapy was initiated. This case report emphasizes the importance of a high index of suspicion of TB in patients presenting with destructive bone lesions in regions with high prevalence of TB.
  Tropical Doctor 11/2012; · 0.66 Impact Factor
• Article: The cause of endomyocardial fibrosis in Uganda.

  Daniel Henry Connor, Krishna Somers, Anne Marie Nelson, Paul G D'Arbela, Robert Lukande
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  ABSTRACT: The cause of endomyocardial fibrosis in Uganda remains unknown in spite of studies dating back to 1948. Herbal decoctions have been used by traditional healers for countless generations to treat many complaints, especially fever. We present evidence - ethnic, geographical, tribal, pathological and distribution by age - that the toxic herbal decoctions taken as medicines in Uganda can cause endomyocardial fibrosis.
  Tropical Doctor 08/2012; · 0.66 Impact Factor
• Article: A 'giant' intraluminal lipoma presenting with intussusception in an adult: a case report.

  Peter A Ongom, Henry Wabinga, Robert L Lukande
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  ABSTRACT: INTRODUCTION: Intussusception is an uncommon cause of intestinal obstruction in adults. It usually presents with typical features of intestinal obstruction, and is associated with the presence of a 'lead point' for the invaginated portion. This 'lead point' is rarely an intraluminal, submucosal lipoma. CASE PRESENTATION: We describe the case of a 64-year-old African-Ugandan woman of Bantu ethnicity who presented with features of intestinal obstruction secondary to intussusception. She was treated operatively. A left colocolonic invagination was found with the interssusceptum having a giant polyp. A left hemicolectomy was performed. A histopathological examination revealed a polypoid, submucosal lipoma. CONCLUSIONS: In resource-rich countries, most cases of colonic intraluminal polyps are detected through colonoscopy during routine medical check-ups. With limited resources in our region, many tumors present as intestinal obstructions secondary to intussusception. Even then, most are associated with adenomas and malignancies. Rarely are polypoid, submucosal lipomas found. In our patient's case a polyp of 9.5cm at its widest dimension is of particular interest. A lesson to learn is that the differential diagnosis for intussusceptions in resource-poor countries should be broadened to include submucosal lipomas.
  Journal of Medical Case Reports 10/2012; 6(1):370.
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  Available from: Robert Lukande

  Article: Autopsy acceptance rate and reasons for decline in Mulago Hospital, Kampala, Uganda

  Janneke A. Cox, Robert L. Lukande, Alice Kateregga, Harriet Mayanja-Kizza, Yukari C. Manabe, Robert Colebunders
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  ABSTRACT: Objective To determine the autopsy acceptance rate and reasons for decline at Mulago Hospital, Kampala, Uganda.Methods The next of kin of patients who died in a combined infectious diseases and gastro-enterology ward of Mulago Hospital were approached to answer a questionnaire concerning characteristics of their deceased relative. During the interview their consent was asked to perform a complete autopsy. If autopsy was declined, the next of kin were asked to provide their reason for the decline.Results Permission to perform an autopsy was requested in 158 (54%) of the 290 deaths that occurred during the study period. In 60 (38%) cases autopsy was accepted. Fifty-nine autopsies were performed. For 82% of refusals a reason was listed; mainly ‘not wanting to delay the burial’ (58%), ‘no use to know the cause of death’ (16%) and ‘being satisfied with the clinical cause of death’ (10%).Conclusion The autopsy rate achieved under study conditions was 38% compared to rates of 5% in Mulago Hospital over the past decade. Timely request and rapid performance of autopsies appear to be important determinants of autopsy acceptance. A motivated team of pathologists and clinicians is required to increase autopsy acceptance.Objectif: Déterminer le taux d’acceptation de l’autopsie et les raisons du refus à l’hôpital de Mulago, Kampala, Ouganda.Méthodes: Les proches de patients décédés dans un service combiné de maladies infectieuses et de gastro-entérologie de l’hôpital de Mulago ont été contactés pour répondre à un questionnaire concernant les caractéristiques de leur parent décédé. Au cours de l’entretien, leur consentement a été demandé afin d’effectuer une autopsie complète. Dans le cas d’un refus, les proches ont été invités à donner leur raison.Résultats: L’autorisation de procéder à une autopsie a été demandée pour 158 (54%) des 290 décès survenus pendant la période d’étude. Dans 60 (38%) des cas, l’autopsie a été acceptée. 59 autopsies ont été pratiquées. Pour 82% des cas de refus un motif a été répertoriée, principalement: «pour ne pas retarder l’enterrement” (58%), «inutilité de connaître la cause de décès» (16%) et «satisfait avec la cause médicale donnée pour le décès» (10%).Conclusion: Le taux d’autopsies réalisées dans les conditions de l’étude était de 38% par rapport au taux de 5% dans l’hôpital de Mulago au cours des dix dernières années. La demande en temps opportun et la réalisation rapide des autopsies semblent être des déterminants importants de l’acceptation de l’autopsie. Une équipe de pathologistes et de cliniciens motivés est nécessaire pour accroître l’acceptation de l’autopsie.
  Tropical Medicine & International Health 05/2011; 16(8):1015 - 1018. · 2.80 Impact Factor
• Article: Immunohistochemically confirmed HHV-8-related lymphoproliferative disorders in Uganda

  Lynnette Tumwine, Robert Lukande, Weiqiang Zhao, Leona Ayers
  Infectious Agents and Cancer. 01/2010;