Background Wilms’ tumor (nephroblastoma) is mostly unilateral; however, bilateral Wilms’ tumors are seen in about 5–8% of patients. This can be synchronous or metachronous. It is uncommon to get liver metastasis from bilateral Wilms’ tumor. Case presentation An 8-year-old male Ugandan presented with a history of abdominal swelling and flank pains for 1 year. There was no history of hematuria. Both ultrasound and computed tomography of the abdomen demonstrated multiple solid lesions in both kidneys and a huge solid mass in segments V, VI, VII and VIII of the liver. Histological examination of renal biopsy specimen was favorable for chemotherapeutic regimens. However, following a multidisciplinary tumor board consensus, a nephron-sparing surgery was deemed unsuitable, and he was managed conservatively with chemotherapy (adriamycin and vincristine) with a palliative intent. Conclusions Metastatic bilateral Wilms’ tumor has a particularly poor prognosis. There are no clear evidence-based guidelines for the management of this rare presentation. This patient benefited from early palliative care and symptom management.

Background: In developing countries like Uganda, the burden of stroke is growing and causing significant morbidity and disability with high mortality rates. Neuroimaging is required to differentiate ischemic stroke from an intracerebral hemorrhage, as well as to diagnose entities other than stroke. Therefore, understanding the clinico-demographic features and brain Computed Tomography (CT) findings of stroke as well as their correlation is of utmost value in stroke management. Hence, this study sought to determine the clinical and brain CT scan findings of stroke patients attending selected centers in Kampala. Mention ASPECTS briefly Methods: This was a cross-sectional study of clinically suspected stroke patients at three selected hospitals in Kampala, Uganda. All brain CT scans of patients with suspected stroke were evaluated and The Alberta stroke programme early CT score (ASPECTS) a 10-point quantitative topographic CT scan score used for middle cerebral artery (MCA) stroke patients. Data on the clinical-demographic and cranial CT findings were collected, and entered into REDCap software. Univariate analysis was used to describe the clinico-demographic and cranial CT features of stroke and summarized them as percentages. Further analysis was done at bivariate and multivariate levels to determine the adjusted odds ratios as a measure of association with a 95% confidence interval. Results: Of the 270 study participants,141(52.2%) were male. 162(60%) had CT findings of stroke, and 90(33.3%) had normal cranial CT findings. While 18(6.7%) had other CT findings like a tumor, dural hemorrhage, epidermoid cyst, and others. The ischemic stroke, hemorrhagic stroke, and subarachnoid hemorrhage accounted for 124(45.9%), 34(12.6%), and 4(1.5%) respectively. Limb weakness (55.2%), headache (41.1%), and loss of consciousness (39.3%) were associated with stroke findings on CT. Among the acute ischemic strokes, 30(73.2%) had a worse (0-7) ASPECT score. Those aged ≥65 years were associated with a worse ASPECTS [AOR: 22.01, (95%CI:1.58-306.09) p-value =0.021]. Conclusion: Currently, non-contrasted brain CT is the first line imaging modality for diagnosis, differentiation of the stroke types, patient management, treatment, and timely referral to a stroke center. The clinical diagnosis of stroke is inadequate to exclude other stroke mimics. Hypertension and advanced age are the most prevailing risk factors attributed to both ischemic and hemorrhagic stroke and patients over 65 years were associated with a worse ASPECT score.

Background Tamoxifen therapy is an effective and mainstay adjuvant treatment for estrogen-positive breast cancer patients. However, it has partial estrogen receptor agonist activity that causes hypercoagulation of blood and consequently venous thrombus formation. Patients who are being treated with tamoxifen require monitoring, because of the increased risk for developing deep venous thrombosis (DVT) and pulmonary embolism that could increase morbidity and mortality if left undiagnosed. This study sought to determine the prevalence and associated factors of lower limb DVT among breast cancer patients on tamoxifen, in Uganda. Methods This was a cross-sectional study done among patients receiving tamoxifen therapy who attended the breast clinic at the Uganda Cancer Institute. Clinical evaluation, mean platelet volume (MPV) and bilateral lower limb compression and Doppler ultrasound scans were done to screen for DVT. Univariate analysis was used to summarize continuous variables as mean and corresponding standard deviations, and categorical variables as proportions. Results Of the 180 participants, 170 (94.4%) were females, 141 (78.3%) were below 60 years. More than 95% were neither diabetic nor smokers and 163 (90.6%) of them had a BMI of < 35Kg/m2. The prevalence of DVT was 0.6%. The statistical significance of the associated factors could not be elucidated at bivariate or multivariate analysis due to the very low prevalence of DVT. Conclusion The prevalence of DVT among breast cancer patients on tamoxifen at the Uganda cancer institute was very low (0.6%). The patients with normal MPV findings are unlikely to have DVT despite the intermediate risk on clinical assessment, therefore a routine sonographic examination for younger Ugandan patients on tamoxifen may not be necessary.

Background and Aims: In developing countries, the burden of stroke is growing and causing significant morbidity and disability with high mortality rates. Neuroimaging plays a crucial role in differentiating ischemic stroke from an intracerebral hemorrhage, as well as entities other than stroke. This study sought to determine the correlation between the clinical and brain CT scan findings of stroke patients attending three hospitals in Kampala, Uganda.Methods: This was a cross-sectional study of clinically suspected stroke patients who were sent for brain CT scan at three selected hospitals in Kampala, Uganda. All brain CT scans of patients with suspected stroke were evaluated and the Alberta stroke program early CT score (ASPECTS) was used for middle cerebral artery (MCA) strokes. Univariate analysis was used to describe the clinico-demographic and brain CT features of stroke and summarized them as percentages. Bivariate and multivariate analysis were used to determine the adjusted odds ratios as a measure of association with a 95% confidence interval (CI).Results: Of the 270 study participants, 141 (52.2%) were male. 162 (60%) had CT findings of stroke, and 90 (33.3%) had normal brain CT findings. Eighteen (6.7%) had other CT findings like tumor, dural hemorrhage, epidermoid cyst, and others.Ischemic stroke, hemorrhagic stroke, and subarachnoid hemorrhage accounted for 124 (45.9%), 34 (12.6%), and 4 (1.5%) respectively. Limb weakness (55.2%), headache (41.1%), and loss of consciousness (39.3%) were associated with stroke findings on CT. Among the acute ischemic strokes, 30 (73.2%) had a worse (0-7) ASPECT score. Those aged ≥65 years were associated with a worse ASPECTS [AOR: 22.01, (95% CI: 1.58-306.09) p = 0.021]. Conclusion: More than a third of patients with a clinical diagnosis of stroke had either no CT features of stroke or had other findings. The most commonly affected vascular territory was left MCA. Old age was strongly associated with having the worst ASPECTS score.

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Myositis ossificans circumscripta (MOC) is a benign and self-limiting heterotopic ossification in the subcutaneous fat, tendons, muscles, and nerves. It is commonly due to trauma and is frequently encountered in the arm, shoulder, thigh, and hand which are prone to trauma. Non-traumatic MOC arising from the abdominal muscles is extremely rare. We report a case of 7-year-old male child with a three-year history of progressive painless abdominal swelling in the left hypochondria region with no history of associated trauma. CT scan of the abdomen showed a well-defined hyperdense mass in the left external oblique muscle. Histological diagnosis confirmed myositis ossificans of the external oblique muscle. The mass was removed surgically with no immediate or late complications. K E Y W O R D Sabdomen, computed tomography scan, myositis ossificans circumscripta How to cite this article: Isse HM, Sereke SG, Vincent M, Zeridah M. Non-traumatic myositis ossificans circumscripta in the anterior abdominal wall of a seven-year-old Ugandan child: A case report.

Myositis ossificans circumscripta (MOC) is a benign, self-limiting heterotopic ossification in the subcutaneous fat, tendons, muscles, and nerves. It is commonly due to trauma and is frequently encountered in the arm, shoulder, thigh, and hand which are prone to trauma. Non-traumatic MOC arising from the abdominal muscles is extremely rare