Background The Novel Coronavirus was declared as a pandemic by the WHO at the end of 2019. Proper hand hygiene was identified as one of the simplest most cost-effective Covid-19 control and prevention measures. It is therefore very important to identify gaps in the knowledge, attitude, and practices, and barriers regarding hand hygiene in the community. Methods A descriptive cross-sectional study was conducted using a simple random sampling technique. An interviewer-guided questionnaire with questions on knowledge, attitude, practice, and barriers to hand hygiene was used in data collection. Collected data were analyzed using Microsoft office excel 2016 and STATA 15 software. A 95% confidence interval was used and statistical significance was P<0.05. Results Only 88 (24.5%) of the participants had adequate knowledge of hand hygiene. 32.8% of the university students had adequate knowledge compared to 6.3% of the Katanga residents. The majority of 336 (93.6%) participants had a good attitude towards hand hygiene. University students had a significantly better knowledge of hand hygiene while Katanga slum residents had a slightly better attitude towards hand hygiene. Only 19.6% accomplished all the seven steps of handwashing. 38.4% of the participants were still greeting by handshaking. Of the participants, 60.1% noted lack of soap as a barrier to hand hygiene and 62.9% reported having more than three barriers to hand hygiene. Participants who had been taught handwashing were more likely to have better hand hygiene knowledge and practice. Conclusion There was an overall high proportion of participants with a low level of hand hygiene knowledge. There is a need for optimizing hand-hygiene practices through addressing the barriers and promoting public health education.

Patient autonomy and participation have a significant impact on patient satisfaction and compliance with treatment. We aimed to establish and describe the level of shared decision-making (SDM) among the patients in a developing country. Uganda is a low resource country with a 2019 GDP of 35.17 billion US dollars. In some regions, over 60% of Ugandans live below the national poverty line and most of them depend on the underfunded health care system. Methods: A cross-sectional, quantitative study was carried out among the outpatients attending Kisenyi Health center IV, Kampala, Uganda. An interviewer-administered questionnaire with a 5-point Likert scale was used to assess patients' SDM. All statistical analysis was performed using STATA 15 software. Results: A total of 326 patients participated in this study. Majority of the participants were females (n=241, 73.9%) and aged 18-35 years (n=218, 66.9%). Only 22 (7%) of the participants knew the name of their consulting doctor. Most of the participants, 84% were given enough time to narrate their symptoms. Overall, only 11.3% (n=37) of the participants had adequately participated in SDM. The overall mean score of participation in SDM was 2.7 (SD:0.8). Participants who knew the name of their consulting doctor were approximately 11 times more likely to participate in SDM (OR: 10.7, 95% CI: 4.2-27.0, P<0.0001). Conclusion:The majority of patients attending Kisenyi Health Center IV did not adequately participate in SDM. Continued medical education should be organized for healthcare professionals to promote SDM.

COVID-19 is an emerging and highly infectious disease that is becoming a global health challenge affecting all sectors. To prevent COVID-19 transmission, all education institutions were closed and advised to turn to online learning. The present study sought to determine the factors affecting the acceptance and use of electronic learning among Ugandan University students in three universities. The study relied on two data collection instruments: a questionnaire and a semi-structured interview. An online cross-sectional survey was conducted on a population of students in three pre-selected universities: Kyambogo (KYU), Makerere (MAK), and Kampala International University (KIU). Of the 614 questionnaires returned, 578 were valid; 65.4% of the respondents were males; 60.7% were from MAK and the majority being in their third year of study (49%). Overall, 69.2% had good knowledge, 22.5% had positive attitudes toward e-learning. The semi-structured interviews revealed connectivity and skills challenges as the main barriers to the implementation of e-learning. For better implementation of e-learning by Universities, effective planning needs to be done with active students’ involvement to avert negative attitudes. We recommend more studies be done on the Universities’ preparedness for the implementation of e-learning. Universities should collaborate with telecommunication companies to provide subsidized prices for internet costs and information and communications technology (ICT) equipment to students.

Background China reported the Novel Coronavirus at the end of the year 2019 which was, later on, declared a Pandemic by the WHO. Proper hand hygiene was identified as one of the simplest most cost effective Covid-19 control and prevention measures. It is therefore very important to understand the compliance of the community to hand hygiene. Method A descriptive cross-sectional study was conducted among the undergraduate students of Makerere University and residents of Katanga slum from 17th to 22nd of March, 2020. An interviewer guided questionnaire with questions on knowledge, attitude, practice, and barriers to hand hygiene was used in data collection. The collected data was analyzed using Microsoft office excel 2016 and STATA 15 software. A 95% confidence interval was used and statistical significance was P<0.05. Results Only 8.4% of the participants had good knowledge of hand hygiene. 11.7% of the university students had good knowledge compared to 0.9% of the Katanga residents. 29.0% of the participants had a good attitude while 50.1% had a moderate attitude to hand hygiene. University students were 6.3 times (OR: 6.3, 95%C1: (2.1 18.5), P=0.001) more likely to have good knowledge while Katanga residents were 3.6 times (OR: 3.6, 95%C1: (1.5 8.4), P=0.003) more likely to have good attitude to hand hygiene. Only 19.6% accomplished all the seven steps of handwashing. 38.4% of the participants still greeted by handshaking and 60.1% noted lack of soap as a barrier to hand hygiene and 62.9% reported having more than three barriers to hand hygiene. Participants that had been taught handwashing were more likely to have better hand hygiene knowledge and practice. Conclusion Despite a fair attitude, deficiency of knowledge coupled with many barriers such as Lack of soap hindered the Practice of proper hand hygiene. Public health involvement to promote hand hygiene must be promoted.

Fetal macrosomia can present with numerous complications. We report a case of a term baby girl with a birthweight of 5.31 kg admitted with respiratory distress and suffered several complications of macrosomia. There is a need to closely monitor neonates for early diagnosis and management of complications of macrosomia.

Introduction and importance: Liver cysts are a common liver disease, classified into simple and complex cysts. Simple liver cysts present the commonest benign liver disease while echinococcal liver cysts are part of the complex cysts found among pastoral communities. Liver cysts usually become symptomatic when they increase to sizes > 5 cm that require percutaneous drainage, open or laparoscopic surgical intervention. Laparoscopic liver cyst deroofing with or without omentoplasty is not routinely practiced in resource-limited settings. Case presentation: Case 1; a 22-year-old female with a recurrent echinococcal liver cyst diagnosed by contrasted abdominal computed tomography scan, and case 2; a 71-year-old female with a recurrent simple liver cyst. Both patients had undergone prior ultrasound-guided cyst drainage. For case 1, PAIR (puncture, aspiration, injection, and reaspiration) was done by injecting 20% hypertonic saline to inactivate the scolocides before cyst deroofing. Omentoplasty was not done in both patients but the remnant cyst cavities in each case were cauterized to minimize recurrence. Both patients were discharged on the sixth and second postoperative days, respectively, without complications. Clinical discussion: Laparoscopic and open deroofing, enucleation, excision, and rarely hepatectomy have less recurrence rates for liver cysts than percutaneous drainage. These 2 reported cases had undergone ultrasound-guided drainage but had cyst recurrence. Laparoscopic liver cyst deroofing with cyst cavity cauterization with or without omentoplasty has good outcomes. Conclusion: We therefore, report successful laparoscopic liver cyst deroofing of recurrent giant echinococcal and simple liver cysts in Uganda and encourage this relatively new technique in our setting.

<b>This paper aimed at determining the factors affecting acceptance and use of electronic learning among Ugandan University students. The study relied on two data collection tools: Questionnaire and semi-structured interview.</b>

Cytoreductive surgery is removal of tumor as much as possible when complete resection is impossible because of advanced disease. It is a management option for giant intra-abdominal tumors with pressure symptoms. We present three patients who underwent cytoreductive surgery for giant intra-abdominal tumors between May 2019 and November 2021. Patient 1 had a gastrointestinal stromal tumor (GIST) involving stomach, spleen and transverse colon. En bloc resection of the GIST with the involved viscera was done. Patient 2 had a liposarcoma measuring 25.8 × 19.6 × 15.3 cm infiltrating the stomach, spleen and the left hemidiaphragm. Involved viscera and liposarcoma were resected en bloc. Patient 3 had a liposarcoma measuring 40 × 35 × 12 cm and encasing the left ureter. Mass was excised together with part of the left ureter and left ureter reconstructed. Giant intra-abdominal tumors are rare. Involvement of adjacent structures may necessitate multivisceral resections with or without organ reconstruction.