William Buwembo | Makerere University Kampala (original) (raw)

Papers by William Buwembo

Introduction: Periodontitis is a common complication of diabetes mellitus associated with poor gl... more Introduction: Periodontitis is a common complication of diabetes mellitus associated with poor glycemic control. The relationship between periodontal disease and glycemic control in patients with diabetes mellitus remains unclear. This study set out to determine the outcomes of periodontal treatment in diabetic patients in Uganda. Methods: Using a cohort study design, 41 adult diabetic patients with periodontal disease were enrolled and followed up for 3 months. Fasting blood sugar, glycated hemoglobin levels, pocketprobing depth, bleeding and clinical attachment loss at baseline and 3 months after periodontal treatment were determined. Gingival crevicular fluid was assessed to detect presence of Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Bacteroides forsythus and Fusobacterium nucleatum. Data were analyzed using R version 4.10. Mean differences were calculated to determine effect of treatment and multiple logistic regressions was used to determine association ...

BMC Research Notes

Introduction Evidence suggests that majority of patients with diabetes mellitus in Uganda have po... more Introduction Evidence suggests that majority of patients with diabetes mellitus in Uganda have poor glycaemic control as well as periodontal disease. This study set out to determine the association between periodontitis and insulin resistance in adult patients with diabetes mellitus in Uganda using the triglyceride glucose index. Methods Two hundred and twenty-three adult study participants with confirmed diabetes mellitus were enrolled in a cross-sectional study. Oral examination was carried with the aid of a periodontal probe to determine the periodontal status and findings recorded using the WHO Oral Health Assessment Tool for Adults, 2013. We recorded clinical details for body mass index (BMI in kg/m2) and laboratory parameters including fasting blood sugar (mmol/L), glycated hemoglobin levels (HbA1c, %) and serum triglycerides (mmol/L) using a study questionnaire. Data were analyzed using R version 4.10. The glucose triglyceride index was used as a measure of insulin resistance...

Anatomy journal of Africa, 1970

Spina bifida is one of the commonest neural tube defects. Though food fortification with folic ac... more Spina bifida is one of the commonest neural tube defects. Though food fortification with folic acid has been reported to reduce spina bifida, the incidence of spina bifida and the benefits of taking folic acid have not been documented in many developing countries including Uganda. This study set out to determine the incidence of spina bifida and related skeletal neural tube defects in the skeletons currently housed in the Galloway skeletal collection at Makererere University College of Health Sciences, Anatomy department with the aim of using the data to extrapolate on the usefulness of food fortification with folic acid. This was a descriptive cross sectional study on 226 skeletons in the Galloway osteological collection examined by an experienced anatomist for features of neural tube defects that ranged from non-fusion of the spinal arches to total absence of vertebral structures. Of the skeletons examined 43/226 (19%) had spina bifida. Of these 38/43 (88%) were male, suggesting a higher incidence of spina bifida in males than in the females. Overall 55.2% of the skeletons were within the age range of 20-55 years. This historical study highlights possible differences in the maternal micro nutrient status in the early months of pregnancy for various African populations as shown by the differences in the prevalence rates of minor spina bifida defects in the Galloway osteological collection. There is need for baseline studies on folic acid levels during pregnancy and the various local dietary sources of folic acid for Africans.

Academia Anatomica International

Background: Morphometric characteristics of typical cervical vertebrae have been studied across d... more Background: Morphometric characteristics of typical cervical vertebrae have been studied across different populations and racial differences have been documented. Morphometry of typical cervical vertebrae are useful reference data for spine surgeons and radiologists in the safe management of patients with cervical spine disorders. Objective: The objective of this study was to determine the morphometric characteristics of typical cervical vertebrae (C3-C6). Methods: This was a cross sectional study of 404 typical cervical vertebrae retrieved from the Galloway osteological collection atMakerere University. Linear dimensions were measured using digital Vernier calipers. Data was summarized using descriptive statistics. Inferential statistics were performed using the independent sample t-test to determine differences between males and females. The level of significance was set at 0.05. Results: There was progressive increase in the transverse diameter of the vertebral bodies fromC3-C6. The mean transverse diameter of C3 was (22.1±1.5mm), C4 (22.7±1.65mm), C5 (23.6 ±1.5mm) and, C6 (24.7±1.75mm). There was progressive increase in the length of the laminae from C3-C6. Conversely, the pedicle width progressively reduced from C3-C6. The other linear dimensions measured did not show any logical trend. The transverse diameters of the vertebral body, pedicle width, and lamina dimensions were significantly greater in males than in females (P= 0.028, P= 0.001and P= 0.001 respectively). Conclusion: There is progressive increase in the morphometric dimensions of most parameters of the vertebrae from C3 to C6. Conversely the pedicle width progressively reduces from C3-C6. There are significant differences between males and females.

Fertility and Sterility, 2008

TABLE 1. Clinical results 5% CO2, 5%O2 6% CO2, 5%O2 Number of cycles 177 231 Age(MAESD)(years) 33... more TABLE 1. Clinical results 5% CO2, 5%O2 6% CO2, 5%O2 Number of cycles 177 231 Age(MAESD)(years) 33.4AE3.3 33.2AE3.6 Duration of infertilityAESD) (years) 4.8AE3.0 4.8AE3.0 No. of oocytes/cycle(MAESD) 14.2AE7.8 14.6AE8.2 No. of embryos/cycle(MAESD) 10.2AE5.9 10.5AE6.1 No. of good embryos 321/673(47.7) a 553/866(63.9) b No. of transferred embryos/ cycle(MAESD) 3.8AE0.9 3.7AE0.7 No. of preg (%) 95/177(53.7) 112/231(48.5) a,b <0.05. CONCLUSIONS: Our results with day 3 embryo transfer have shown no significant differences in clinical pregnancy rate. But in vitro culture of human embryo under 6% CO 2 , 5%O 2 resulted in significantly better quality embryos than 5%CO 2 , 5%O 2 conditions. It seems that for early embryonic development, 6% CO 2 , 5% O 2 is good gas phase system.

The Pan African medical journal, 2022

The Pan African medical journal, 2014

Clinical Oral Investigations, Jan 7, 2010

Open Journal of Stomatology, 2011

Aim : To determine the variations in the root and canal morphology of the maxillary first premola... more Aim : To determine the variations in the root and canal morphology of the maxillary first premolar teeth in a Ugandan population. Methodology : Extracted maxillary first premolar teeth (n = 202) were evaluated in this study. The specimens had their pulp chambers de-roofed. They were decalcified in nitric acid and made transparent with methyl salicylate. Indian ink was injected into the root canals to display their configuration. Results : One hundred and forty eight (73.3%) of the specimens had two roots, of which 16.9% (n = 25) had fused roots. About 26.7% (n = 54) of the specimens were single rooted. Eleven (20.4%) of the single rooted specimens had one canal of either Vertucci type I, III, V or VII configuration while 79.6% (n = 43) of the specimens had two canals of either Vertucci type II, IV or VI configuration. The two-rooted specimens exhibited Vertucci type IV and VIII canal configuration: 96.6% and 3.4%, respectively. The single rooted teeth had a higher prevalence of lateral canals, canal intercommunications and multiple apical foramina as compared to the two-rooted specimens. Conclusion : The maxillary first premolar teeth in this Ugandan population showed a higher prevalence of two-root morphology with majority of the roots having Vertucci type IV canal configuration. There was no three-root anomaly recorded in the present material.

Academia Anatomica International, Jun 24, 2020

Introduction: Placenta morphometry varies with increased heavy metal concentrations among other f... more Introduction: Placenta morphometry varies with increased heavy metal concentrations among other factors. There is limited knowledge on the effect of perceived heavy metal exposure due to mining activities on placenta morphometry specific to the Tanzanian population. The study thus aimed to determine the morphometric characteristics of the human placenta and the association between placental weight with maternal factors in mining and non-mining areas in Northwestern Tanzania. Subjects and Methods: This was a comparative crosssectional study conducted in Mwanza and Geita regions of Northwestern Tanzania representing the mining and non-mining areas, respectively. Included in the study were placentas from 490 mothers, residing in the respective areas throughout pregnancy. Comparison of the placenta morphometric variables between the two groups was made using the independent sample t-test, and association between the maternal factors and placenta weight was done using multi-level linear analysis. Results: The mean placenta weight in the non-mining and mining areas was 465.9±101.2 g and 443.6±82.7g, and the mean thickness was 1.52±0.32cm and 1.61±0.38cm respectively. The mean diameter in the non-mining and mining areas was 19.0±1.9cm, the mean cotyledon number was 20±5 and 19±4, and the mean cord length was 49.0±12.7cm and 50.1 ±10.4cm respectively. With the exception of cord length, the differences in the morphometric parameters in the non-mining and mining areas were significant p<0.5. Increase in maternal weight on booking and maternal age were associated with corresponding increase in placenta weight. Conclusion: The findings of this study seem to suggest that heavy metal exposure due to mining activities does affect placenta growth.

BMC Oral Health, Jul 23, 2012

Background: Accurate prediction of the space forms an important part of an orthodontic assessment... more Background: Accurate prediction of the space forms an important part of an orthodontic assessment in the mixed dentition. However the most commonly used methods of space analysis are based on data developed on Caucasian populations. In order to provide more accurate local data we set out to develop a formula for predicting the widths of un-erupted canines and premolars for a Ugandan population and to compare the predicted widths of the teeth from this formula with those obtained from Moyers' tables, and Tanaka and Johnston's equations. Methods: Dental casts were prepared using mandibular and maxillary arch impressions of 220 children (85 boys/ 135 girls) aged 12-17 years recruited from schools in Kampala, Uganda. The mesio-distal width of the mandibular incisors, mandibular and maxillary canines and premolars were measured with a pair of digital calipers. Based on regression analysis, predictive equations were derived and the findings were compared with those presented in Moyers' probability tables, and Tanaka and Johnston's equations. Results: There were no statistically significant differences between the tooth widths predicted by our equations and those from Moyers' probability tables at the 65 th and 75 th percentile probabilities for the girls and at 75 th level in boys in the mandibular arch. While in the maxillary arch no statistically significant differences at the 75 th and 95 th levels were noted in girls. There were statistically significant differences between predicted tooth sizes using equations from the present study and those predicted from the Tanaka and Johnston regression equations. Conclusions: In this Ugandan population, Moyers' probability tables could be used to predict tooth widths at specific percentile probabilities, but generally, Tanaka and Johnston technique tends to overestimate the tooth widths.

African Journal of Oral Health Sciences, 2004

BMC Medical Education, May 24, 2013

Introduction: Of more than the 2,323 recognized and operating medical schools in 177 countries (w... more Introduction: Of more than the 2,323 recognized and operating medical schools in 177 countries (world wide) not all are subjected to external evaluation and accreditation procedures. Quality Assurance in medical education is part of a medical school's ethical responsibility and social accountability. Pushing this agenda in the midst of resource limitation, numerous competing interests and an already overwhelmed workforce were some of the challenges faced but it is a critical element of our medical profession's social contract. This analysis paper highlights the process of standard defining for Medical Education in a typically low resourced sub Saharan medial school environment. Methods: The World Federation for Medical Education template was used as an operating point to define standards. A wide range of stakeholders participated and meaningfully contributed in several consensus meetings. Effective participatory techniques were used for the information gathering process and analysis. Results: Standards with a clear intent to enhance education were set through consensus. A cyclic process of continually measuring, judging and improving all standards was agreed and defined. Examples of the domains tackled are stated. Conclusion: Our efforts are good for our patients, our communities and for the future of health care in Uganda and the East African region.

Open Access Rheumatology: Research and Reviews

Background: Rheumatoid arthritis (RA) is a chronic, debilitating disease that leads to joint dest... more Background: Rheumatoid arthritis (RA) is a chronic, debilitating disease that leads to joint destruction and disability if left untreated. Few studies on RA have been conducted in Uganda, and there is limited information on disease severity and associated factors. This study sought to characterize the clinical presentation and to determine disease severity and the factors associated with disease severity among participants with RA in Uganda. Methods: Between August 2018 and February 2019, patients presenting to the rheumatology outpatient clinic in Mulago National Referral Hospital were enrolled into the study using a cross-sectional design. Participants' demographics and clinical characteristics were collected using a study questionnaire, and laboratory results were extracted from their charts. The patients' functionality was assessed using the Modified Health Assessment Questionnaire and their disease severity was assessed using the RA Disease Activity Score based on 28-joint count (DAS28). Results: A total of 170 participants were enrolled, of whom 81.2% were female. Nearly two-thirds (111/170) were classified as having severe disease. Having a functional status score of >0.5 (adjusted odds ratio 1.7, 95% confidence interval 1.4-2.2, p<0.001) was significantly associated with severe disease. Conclusion: In this population, the majority of the patients seen at the rheumatology outpatient clinic had severe disease, suggesting that patients may be presenting late, with limited early detection of the disease. Impaired functional status was associated with increased disease severity and may be used by clinicians to highlight disease severity when it is not possible to assess the RA DAS28.

Open Access Rheumatology : Research and Reviews, May 1, 2022

Vaccine, Aug 28, 2016

GMZ2 is a recombinant protein malaria vaccine, comprising two blood-stage antigens of Plasmodium ... more GMZ2 is a recombinant protein malaria vaccine, comprising two blood-stage antigens of Plasmodium falciparum, glutamate-rich protein and merozoite surface protein 3. We assessed efficacy of GMZ2 in children in Burkina Faso, Gabon, Ghana and Uganda. Children 12-60months old were randomized to receive three injections of either 100μg GMZ2 adjuvanted with aluminum hydroxide or a control vaccine (rabies) four weeks apart and were followed up for six months to measure the incidence of malaria defined as fever or history of fever and a parasite density ⩾5000/μL. A cohort of 1849 children were randomized, 1735 received three doses of vaccine (868 GMZ2, 867 control-vaccine). There were 641 malaria episodes in the GMZ2/Alum group and 720 in the control group. In the ATP analysis, vaccine efficacy (VE), adjusted for age and site was 14% (95% confidence interval [CI]: 3.6%, 23%, p-value=0.009). In the ITT analysis, age-adjusted VE was 11.3% (95% CI 2.5%, 19%, p-value=0.013). VE was higher in ol...

Root and canal morphology of maxillary first premolar teeth in a Ugandan population