Browsing by Author "Pebalo, Pebolo Francis"

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    Chronicles of an uncommon term abdominal pregnancy with successful outcome: a case report
    (BioMed Central, 2024-01-24) Magezi, Joad; Wacha, Joshua; Pebalo, Pebolo Francis
    Abstract Background Intra-abdominal pregnancies, while rare, present with unique diagnostic and management challenges. We present a case of a 25-year-old para 2+1, black African woman, who was referred from a peripheral Health Centre level IV in the Northern part of Uganda to a Regional Referral Hospital due to an abnormal presentation with easily palpable fetal parts. This case emphasizes the signifcance of prompt diagnosis, interdisciplinary collaboration, surgical planning, and managing the placenta in advanced intra-abdominal pregnancies. Case presentation A 25 year African black female, para 2+1 upon arrival at Regional Referral Hospital, a University Teaching Hospital during a weekend, an ultrasound was sourced from a nearby private clinic revealing an extra-uterine intra-abdominal pregnancy at 38 weeks of gestation and she was promptly sent back to the University Teaching Hospital. Following this diagnosis, the patient, who hailed from a remote village over 30 km away, returned to her family for discussions. After three days, she was readmitted. Emergency laparotomy unveiled an omental gestation sac with extensive placental attachment. A live female infant was delivered successfully, placenta was left in situ. The post-operative course was uneventful, with initial concerns about inadequate breast milk fow which resolved after placental removal during the second exploratory laparotomy. Conclusion This case highlights the uncommon occurrence of an advanced intra-abdominal pregnancies and emphasizes the importance of multi-disciplinary teamwork and placental management. The favorable outcome in the management was based on thorough assessment of the placental location, attachments and blood supply during surgery. It demonstrates the possibility of reduced risk of massive bleeding if there is a delayed removal of placenta with favorable attachment. This is particularly important for milk letdown as well as reducing the needs of blood transfusion in resource limited settings.
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    Safety and efficacy of herbal medicines for the management of sickle cell disease in Africa: a systematic review and meta-analysis
    (PAMJ One Health, 2024-12-16) Awor, Silvia; Bongomin, Felix; Kaggwa, Mark Mohan; Pebalo, Pebolo Francis; Kivumbi, Ronald Muganga; Malinga, Geoffrey Maxwell; Ongwech, Acaye; Nnamuyomba, Proscovia; Oryema, Christine; Abola, Benard; Epila, Jackie; Musoke, David
    This systematic review and meta-analysis evaluated the safety and efficacy of herbal remedies used to manage sickle cell disease (SCD) in Africa. Before the advent of western medicine, people depended on herbal medicines for treating different illnesses. Using herbal medicines to sickle cell disease (SCD) is still common in Africa. However, data on the safety and efficacy of any of these remedies are limited. We searched PubMed, Embase, Google Scholar and Web of Science from inception to 11thJanuary 2024 using the keywords "herbal medicine" and "sickle cell" and the name of each of the countries in Africa without language restrictions. We included cross-sectional studies that reported the safety or efficacy of herbal medicine for managing sickle cell disease. Two reviewers assessed all included studies for suitability for inclusion in this review. All included articles were assessed using ROBINS-1, a tool for assessing the risk of bias in non-randomized studies of interventions. We used the randomeffect model to pool the efficacy and safety profiles of the herbal medicines using RStudio version 4.2.2. Overall, we included five studies involving 1,489 individuals with SCD. Of these, 789 (53.0%) used herbal remedies like Aloe barbadensis (Aloe vera), Zingiber officinale (ginger), Cymbopogon citratus (lemongrass), Forever Living products, Golden Neo-Life Diamite International (GNLD) diet supplements and ginseng products. About 22.9% (181 out of 789) of the participants who used herbal remedies reported side effects, while 38.5% (304 out of 789) reported improving their symptoms. There was a high risk of publication bias in the articles included in this review. The pooled adverse effects of the herbal medicines for SCD treatment were 48% lower (Odds ratio: 0.52, 95% confidence interval (CI): 0.26 - 1.05, I²= 82%, p<0.01) while the pooled efficacy of herbal remedies for treating SCD was nearly 100% higher (odds ratio= 2.07, 95% confidence interval 0.99 - 4.32, I²= 78%, p<0.01) among the users than controls. However, these findings were not statistically significant. Our findings indicate no significant difference in the safety and efficacy of herbal medicines among people with SCD who used or did not use herbal remedies. However, the sample sizes of the primary studies were small. Thus, more extensive controlled studies with better-defined endpoints are required to inform the use of herbal medicines in managing SCD in Africa.