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ItemPrevalence, radiographic patterns, and pathologies associated with impacted third molars among patients 20-39 years old attending selected hospitals in Kampala, Uganda.(Makerere University, 2025-07-12)Background: The most commonly impacted teeth in the oral cavity are the third molars. Different third molar patterns and prevalence are seen in various populations and geographic places. For Uganda, there is little information available.Objective: This study aimed to determine the prevalence, radiographic patterns, and associated pathologies of impacted third molars in selected hospitals in Kampala, Uganda, from January 2019 to May 2024.Materials and methods: A retrospective study was conducted in the dental departments of three selected hospitals: Mulago National Referral Hospital, Makerere University Dental School and Hospital, and the Mengo Hospital Dental Department, all located in Kampala. A total of about 1130 valid radiographic records (orthopantomograms) of patients who attended the selected dental facilities from January 2019 to May 2024 were assessed. The radiographs were assessed by the principal investigator and 2 research assistants placed at each Hospital, who were Dental surgeons using standardised criteria. Data were collected using a checklist that included items to determine demographic variables, patterns of impaction, and associated pathologies. Data were entered and analysed using SPSS software and summarised using descriptive statistics. Chi-square tests were conducted to check for relationships between categorical variables. P values less than 0.05 were considered statistically significant.Results: 350 (31.0%) of the 1130 OPGS showed at least one impacted third molar, with no significant difference between males (m=561; 49.6%) and females (F=570; 50.4%) (P 0.284). Impacted third molars were 3.5 times more likely to occur in the mandible than in the maxilla. The most common angulation of impaction in the mandible was the mesioangular (50.6%), while the most common angulation in the maxilla was the vertical (47.4%). Level A impaction was the most common in the mandible (61.5%) and level B in the maxilla (62.6%). Conclusion: The study reveals a moderately high prevalence of impacted third molars and associated pathologies like caries and periodontal diseases in Kampala. This could influence clinical recommendations and preventive dental care. Targeted oral education and treatment measures are needed to address root causes and improve oral health outcomes. To manage complications, dental facilities should have well-trained professionals, appropriate interventions, and panoramic radiographic services. Supporting accessible and affordable dental services, particularly in rural areas, is crucial to addressing this issue. Keywords: Radiographic patterns, impacted third molars, associated pathologies, panoramic
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ItemA dissertation submitted to the Directorate of Research and Graduate Training in partial fulfilment of the requirements for the award of the Degree of Master of Dentistry in Oral & Maxillofacial Surgery(Makerere University., 2025-07-27)Background: The most commonly impacted teeth in the oral cavity are the third molars. Different third molar patterns and prevalence are seen in various populations and geographic places. For Uganda, there is little information available.Objective: This study aimed to determine the prevalence, radiographic patterns, and associated pathologies of impacted third molars in selected hospitals in Kampala, Uganda, from January 2019 to May 2024. Materials and methods: A retrospective study was conducted in the dental departments of three selected hospitals: Mulago National Referral Hospital, Makerere University Dental School and Hospital, and the Mengo Hospital Dental Department, all located in Kampala. A total of about 1130 valid radiographic records (orthopantomograms) of patients who attended the selected dental facilities from January 2019 to May 2024 were assessed. The radiographs were assessed by the principal investigator and 2 research assistants placed at each Hospital, who were Dental surgeons using standardised criteria. Data were collected using a checklist that included items to determine demographic variables, patterns of impaction, and associated pathologies. Data were entered and analysed using SPSS software and summarised using descriptive statistics. Chi-square tests were conducted to check for relationships between categorical variables. P values less than 0.05 were considered statistically significant.Results: 350 (31.0%) of the 1130 OPGS showed at least one impacted third molar, with no significant difference between males (m=561; 49.6%) and females (F=570; 50.4%) (P 0.284). Impacted third molars were 3.5 times more likely to occur in the mandible than in the maxilla. The most common angulation of impaction in the mandible was the mesioangular (50.6%), while the most common angulation in the maxilla was the vertical (47.4%). Level A impaction was the most common in the mandible (61.5%) and level B in the maxilla (62.6%). Conclusion: The study reveals a moderately high prevalence of impacted third molars and associated pathologies like caries and periodontal diseases in Kampala. This could influence clinical recommendations and preventive dental care. Targeted oral education and treatment measures are needed to address root causes and improve oral health outcomes. To manage complications, dental facilities should have well-trained professionals, appropriate interventions, and panoramic radiographic services. Supporting accessible and affordable dental services, particularly in rural areas, is crucial to addressing this issue. Keywords: Radiographic patterns, impacted third molars, associated pathologies, panoramic
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ItemPrevalence and factors associated with HIV-related stigma among pregnant women living with HIV attending selected public health facilities in Kaliro District(Makerere University, 2025)Introduction: Despite significant efforts to combat HIV-related stigma through public health campaigns, community sensitization programs, and the widespread availability of antiretroviral therapy, stigma remains a persistent challenge among women living with HIV. Objectives: This study determined the prevalence of HIV-related stigma as well as the associated socioeconomic, HIV-related, and health system factors among pregnant women living with HIV attending selected public health facilities in Kaliro District, Uganda. Methods: This study was cross-sectional, conducted among 214 randomly selected pregnant women living with HIV at selected public health facilities (Namugongo, Nawaikoke, and Bumanya Health Centres). Data was collected between April 2025 and May 2025, through the researcher-administered questionnaire method, while analysis was done through descriptive and inferential statistical techniques. Results: The study found the prevalence of HIV-related stigma among pregnant women living with HIV attending selected public health facilities in Kaliro District, Uganda, to be 15.9% (95% CI = 12.8% -19.0%). The significant factors included socioeconomic factors such as low educational level [PR: 1.094(95% CI: 1.049-2.044); P-value: 0.001] and peri-urban residence [PR: 1.034(95% CI: 1.014 - 1.054); P-value: <0.002], and health system factors, namely lack of privacy at health facilities [PR = 1.960(95% CI: 1.258-4.893); p = 0.048]. Conclusion: The study found a relatively high prevalence of HIV-related stigma among pregnant women living with HIV attending selected public health facilities in Kaliro District, and this was due partly to some socio-economic factors as well as health system-related factors Recommendation: The district should strengthen stigma-reduction interventions by focusing on improving privacy in health facilities and supporting women at higher risk of HIV-related stigma, to enhance ANC attendance and PMTCT service uptake.
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ItemThe role of oxidative stress response in modulating fluconazole resistance in cryptococcus clinical isolates.(Makerere University, 2025)Introduction: Fluconazole-resistant Cryptococcus neoformans has emerged as a significant public health concern, complicating the management and treatment of cryptococcal infections. Resistance to fluconazole is associated with increased rates of treatment failure, relapse, and mortality. Resistant strains have been reported globally, with varying prevalence rates. Objectives: This study aimed to assess the role of oxidative stress resistance in modulating fluconazole resistance using cryptococcal isolates. Methods: A laboratory-based experimental study was conducted at the Makerere University Microbiology Laboratory. Twenty Cryptococcus species isolates were analysed for tolerance to hydrogen peroxide (H2O2) and fluconazole resistance. Minimum inhibitory concentrations (MICs) were determined before and after oxidative stress exposure. Data were analyzed using STATA to calculate the proportion of H2O2- and fluconazole-resistant isolates. Results At lower H2O2 concentrations, most isolates-maintained growth, though responses varied at higher doses. C. gattii showed increased MICs under oxidative stress compared to non-stressed conditions. C. neoformans exhibited a heterogeneous response to fluconazole following H2O2 exposure. Oxidative stress sensitized some isolates to fluconazole, although several remained resistant. Conclusion Resistance patterns in Cryptococcus isolates are influenced by oxidative stress and are highly heterogeneous. These findings highlight the complexity of antifungal resistance and the need for individualized resistance profiling. Recommendations Routine resistance profiling should be incorporated into clinical management of cryptococcal infections. Combination antifungal therapy using agents with diverse mechanisms of action should be considered for resistant cases. Further research is needed to understand the molecular basis of oxidative stress-induced sensitivity and resistance. • At lower H2O2 concentrations, most isolates-maintained growth, though responses varied at higher doses. • C. gattii showed increased MICs under oxidative stress compared to non-stressed conditions. • C. neoformans exhibited a heterogeneous response to fluconazole following H2O2 exposure. • Oxidative stress sensitized some isolates to fluconazole, although several remained resistant. Conclusion Resistance patterns in Cryptococcus isolates are influenced by oxidative stress and are highly heterogeneous. These findings highlight the complexity of antifungal resistance and the need for individualized resistance profiling. Recommendaions • Routine resistance profiling should be incorporated into clinical management of cryptococcal infections. • Combination antifungal therapy using agents with diverse mechanisms of action should be considered for patients with resistant species. Further research is needed to understand the molecular basis of oxidative stress-induced sensitivity and resistance. Fluconazole resistant Cryptococcus neoformans has emerged as a significant public health concern, posing challenges in the management and treatment of Cryptococcal infections. This abstract provides a comprehensive overview of the epidemiology, mechanism of resistance, clinical implications and therapeutic strategies associated with fluconazole resistant Cryptococcus neoformans. fluconazole resistant Cryptococcus neoformans strains have been reported worldwide, with varying prevalence rates. The clinical implications of fluconazole resistance include increased rates of treatment failure, relapse and mortality. To address the challenges due to fluconazole resistance, alternative treatment approaches have been explored. combination therapy, employing multiple antifungal agents with different mechanisms of action. This study determined the resistance pattern of Cryptococcus isolates with and without external oxidative stress. In a laboratory-based experiment study, we analysed 20 Cryptococcus species isolates at the Makerere University Microbiology laboratory. We determined their tolerance levels to hydrogen peroxide and assessed for their resistance partners before and after exposure to hydrogen peroxide. Data was analysed to determine the proportion of H2O2 and fluconazole resistant isolates were calculated using STATA. At lower doses of H2O2, most isolates-maintained growth although there was a heterogeneity response at higher concentrations. The MIC values for C. gattii were higher in stressed compared with non-stressed conditions. While in C. neoformans, there was a heterogenous response to Fluconazole post-oxidative stress exposure. We observed that oxidative stress sensitizes cryptococcus isolates to fluconazole though there were a number of isolates that remined resistant after exposure. This study demonstrates that the resistance patterns of Cryptococcus isolates are oxidative stress dependant and heterogenous in nature. The results highlight the heterogenous resistance nature of Cryptococcus isolates underpinning the need for cases to case analysis of resistance profiles.
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ItemPrevalence and determinants of herbal medicine utilization and phytochemical analysis of selected used plants among hypertensive patients at Mulago National Referral Hospital, Uganda(Makerere University, 2025)Background: Hypertension remains a major public health challenge in Uganda, with many patients using herbal medicine alongside conventional treatments. However, data on prevalence, associated factors, commonly used plants, and their phytochemical properties remain limited. This study aimed to determine the prevalence and factors influencing herbal medicine use among hypertensive patients at Mulago National Referral Hospital and analyze the phytochemical composition of two frequently used medicinal plants. Methods: A cross-sectional study was conducted among 384 hypertensive patients attending Mulago Hospital’s outpatient clinic. Data were collected using a structured questionnaire. Two commonly reported plants (Spathodea campanulata and Solanum anguivii) were selected for phytochemical screening using decoction, cold maceration, and Soxhlet extraction methods. Standard tests identified alkaloids, flavonoids, glycosides, saponins, and other bioactive compounds. Modified Poisson regression analyzed factors associated with herbal medicine use. Results: The prevalence of herbal medicine use was 76.8%, with 20.8% concurrently using herbal and conventional medicines. Key factors associated with herbal medicine use included marital status (married patients: aPR=1.59, p=0.002), lower education (primary level: aPR=0.83, p=0.032), and prior hypertension diagnosis (aPR=2.10, p=0.003). Patients receiving information from traditional healers were 11% more likely to use herbal medicine (p=0.049). Garlic (41.1%) and ginger (25.8%) were the most cited plants, followed by Solanum anguivii (12.2%) and Spathodea campanulata (11.2%). Phytochemical analysis of S. anguivii and S. campanulata revealed flavonoids, alkaloids, terpenoids, and glycosides in both plants, supporting their potential antihypertensive effects . Only 15% of participants reported being asked by doctors about herbal medicine use, with 45% experiencing side effects (e.g., nausea, allergic reactions). Conclusion: Herbal medicine is widely used among hypertensive patients in Uganda, driven by accessibility, cultural beliefs, and perceived efficacy. The presence of bioactive compounds in S. campanulata and S. anguivii validates their traditional use but underscores the need for safety and efficacy studies. The low disclosure rate to healthcare providers highlights risks of herb-drug interactions, necessitating policy integration, patient education, and clinician awareness to optimize hypertension management. Future research should expand phytochemical analyses and clinical trials for commonly used plants. Keywords: Hypertension, herbal medicine, phytochemical screening, Spathodea campanulata, Solanum anguivii, prevalence