Journal of General Practice

Since the worldwide COVID-19 pandemic, various sources have indicated the long-term symptoms after recovery that is now known as Long COVID (LC). Knowing the damage acute CoV-2 has caused worldwide, it is predicted that LC will have a massive impact on Primary Health Care (PHC). It remains unknown how PHC should cope with such an upcoming burden. The aim is to review studies exploring the most common symptoms as predictors of LC and potential syndrome management challenges in the PHC context. The study undertook a systematic review using Cochrane methodology and PRISMA guidelines. It is known that LC can have numerous nonspecific manifestations; however the main widespread symptoms were chronic fatigue (up to 68.0%), shortness of breath (up to 59.5%), dry cough, chest, and musculoskeletal pain. Most patients reported neurological symptoms, including headache (up to 68.0%), anosmia, partial olfactory dysfunction, and vertigo. LCS usually manifests in psychiatric disorders, such as depression, anxiety, insomnia, and mood changes. Not many clinical trials determined possible risk factors, however, hospitalization in Intensive Care Unit (ICU), intubation, smoking, obesity, and comorbidities such as diabetes and hypertension are some of few confirmed. There is very limited data on LC management specifics regarding PHC context. Although LC remains to be defined, it is necessary to understand its impact and clinical manifestations promptly, so that Family Physicians (FP) would be able to manage the syndrome. There are no predictors which would let a FP predict LC course, severity and recovery. Hence, new strategies and management guidelines of LC need to be established and elaborated for PHC to function thoroughly.

It was implemented the most restrictive lockdowns ever since 1 April 2022 to control the omicron outbreak, seriously impacting the patients visit their GPs. We aim to present interim data on how the GP clinical management approach has been adapted during the first two weeks of this critical complete lockdown. The GP Department, Tongren Hospital, covering a population of ~700,000 in the Changning District, Shanghai, has been the only place able to provide consultations and prescribe medicines from the Tongren Pharmacy to these chronic illness patients via a limited number of volunteers exempt from lockdown. Consultations/interactions were increased by >4-fold since the beginning of the complete lockdown. In the event any emergency, the hotlines can be called for transporting to ER, but only to designated COVID-19 hospitals. We have managed our regular patients in a very satisfactory way under current severe lockdown circumstances. Our interim data may offer some useful information for GPs to handle similar situations in future as the pandemic continues to evolve.

Introduction: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal system. Histopathological and immunochemistry examination takes an important part in confirming the types of GISTs, to choose appropriate therapeutics for patients. Patients demographics, anatomic sites, histopathology and immunochemistry characteristics of GISTs are unknown in St Francis Hospital Nsambya (SFHN) and Uganda Cancer Institute (UCI).

Objectives: This study aimed to explore the demographics, anatomic sites, histopathological and immunochemical characteristics of GISTs in St Francis Nsambya Hospital and Uganda Cancer institute.

Methodology: A cross sectional study was conducted. The study population included patients with a histological diagnosis of GISTs who presented between 2018 to 2021 in both facilities. Clinical, pathological and immunochemistry data was collected and analyzed.

Results: A total of 146 records/blocks of patients were reviewed and out of these only Histology and immunochemistry was done on 81 blocks/ patients. Majority of the patients were aged 40 to 59years, (42%) and had a median age of 57 years with IQR (45-65). There was a male predominance of 51.9%. The commonest tumor site was the stomach, (81.5%). The commonest histological type was spindle cell (79%) followed by mixed (11.1%) then epithelioid 8 (9.9%). Most of cases in our study were benign (80.1%) and mitotic count ≤ 5/50 HPF in 71.6% cases. All cases with low mitotic rate were mostly benign with a p value of <0.0001.

Conclusion: We found GISTs were more common in male gender, stomach being the commonest site and 19% of GISTs were below 40 years. Spindle cell was the commonest histologic type and most of them were CKIT positive. Malignancy was correlated with non-spindle cell type and high mitotic rate.

Background: Whereas Colorectal Diseases (CRD) is common throughout the world, their incidence and prevalence vary with different geographic locations worldwide. This study was aimed at determining the indications and findings at colonoscopy performed at St. Francis Hospital Nsambya Endoscopy Unit from January 2013 to December 2018.

Methods: This was a 6-year descriptive cross-sectional study based on registry of patients screened for colorectal diseases. The study population included all patients referred for colonoscopy at the Endoscopy Unit of St Francis Hospital Nsambya for suspected colorectal diseases. Continuous variables were presented as mean and standard deviation (SD) while categorical variables presented as proportions. Independent sample t-tests were employed for comparisons of continuous, normally distributed variables. Two-sided tests with a 0.05 significance level were used. Statistical analyses were performed using STATA 14 (Stata Corp LP, Texas).

Results: A total of 806 patients underwent colonoscopy at the endoscopy unit between January 2013 and December 2018. Their average age was 53.37 ± 18.44 years. Males accounted for 62.5% of the cases. The most common indications for colonoscopy in descending order were Rectal Bleeding (60.6%), abdominal pain (49.1%), constipation (30.4%) anemia-unknown etiology (28.9%) and weight loss of unknown etiology (15.4%). The commonest endoscopic findings were internal haemorrhoids (35.2%), followed by colitis (27.2%), tumors (18.20%), diverticulosis (17%) and polyps (11.3%). Non-specific colitis and internal haemorrhoids increased significantly from 5% to 34% during the study period. The colonoscopy findings were normal in 18.9%.

Conclusion: Our study findings indicate that there is a high prevalence of colorectal diseases in our population. The most common indication for colonoscopy was Rectal bleeding while the most common endoscopic finding was internal hemorrhoids, colitis and colonic tumors.