ABSTRACT
Background: Venous thromboembolism (VTE) is the leading cause of morbidity and mortality worldwide among patients undergoing surgical procedures. This study aimed to determine the incidence, predictors, and outcome of VTE among patients undergoing major surgical procedures at Bugando Medical Centre (BMC). Methods: A descriptive longitudinal study involving 381 participants was conducted from February 2020 to July 2020 at BMC. Patients with a high modified Caprini and modified Wells score underwent doppler ultrasound and computed tomography pulmonary angiogram to confirm presence of VTE. Post mortem was performed on participants who succumbed to death prior to these investigations. Categorical variables significance calculated using Chi-square and Fisher’s exact tests. Cox regression analysis was used determine the predictors. Kaplan-Meier survival curve used to depict the occurrence of VTE. Results: The cumulative incidence of VTE was 11.8%. Age ≥45 years, body mass index ≥25, hypertension and prolonged immobilization were significant predictors of VTE. Around 43.0% (n=164) were postoperatively classified as having a high risk of developing VTE. Of these, 27.7% (n=45) developed VTE (p<0.001) of which 14 patients died resulting in a mortality rate of 31.1%, and the mortality was significantly associated with males (p=0.013). Only 17.7% (n=29) of high-risk patients received VTE prophylaxis, however, prophylaxis was protective against development of VTE (p=0.023). Conclusion: Venous thromboembolism is not uncommon among postoperative patients and is associated with high mortality rate. Appropriate VTE screening and prophylaxis is of paramount importance in order to lower VTE morbidity and mortality.

ABSTRACT
Decompression illness (DCI) has been deemed a rare clinical entity in different diver populations. The incidence of DCI varies from 0.010% to 0.095% per dive. The DCI is a collective term including two disorders. The first one is caused by evolution of bubbles from dissolved inert gas; the second one is caused by introduction of air to the systemic circulation by pulmonary barotrauma. The gold standard treatment for DCI is recompression in a hyperbaric chamber with administration of hyperbaric oxygen during the treatment. We report a case of a 46-year-old technical diver complained decrease motor and sensory function of lower limbs 50 minutes after diving mission had been completed. He had received first aid 100% oxygen and sought medical attention right after the accident. After hyperbaric chamber treatment, the lower limb muscle power recovered from 2/5 to 3/5. He was discharged from hospital after rehabilitation for 3 months when he could walk by himself. After follow up for 12 years, his lower limb muscle power had no improvement while he complained increase of walking instability. The MRI scan discover thoracic spinal cord atrophy. The side effect of spinal cord atrophy induced by DCI has not been reported before.

ABSTRACT
Aim: To determine proportion of patients for eye surgery who are HIV and HBsAg seropositive. Method: This observational hospital based study was performed in a tertiary care centre between August 2019 to February 2020. Voluntary counselling and testing for HIV and HBsAg was done to determine viral status of the patients. They were screened by immune-assay based rapid diagnostic card tests for viral infection. Positive cases were confirmed with ELISA test. Result was interpreted as reactive or non reactive. Result: Total 560 patients were screened. The distribution of the indications for selection were- cataract(73.8%), glaucoma(6%), and pterygium(20.2%). Seven patients were found to be HIV seropositive while twelve were HBsAg positive. Conclusion: Awareness of prevalence along with knowledge of rate of accidental exposure and risk of transmission would help to understand cost effectiveness of universal preoperative screening before surgery.