Radiotherapy in cancer management at Mulago Hospital; Kampala; Uganda

Five hundred and seven cancer patients who received radiotherapy using the newly upgraded facilities at the Mulago Hospital over a 16 month period following the inception of the services are reviewed. previously available facilities had been limited to teletherapy using only a 300 KV orthovoltage X-ray machine which had proved inadequate to cope with the current needs at the department. The International Atomic Energy Agency (IAEA) in Vienna recently upgraded the available services through the provision of facilities for cobalt-60 teletherapy; brachytherapy and computerised treatment planning and dosimetry as well as providing training for all cadres of the radiotherapy department. We review the impact of this new service on the referral pattern and types of patients who received radiotherapy since inception. Over 60of all the patients were women who presented with carcinoma of the cervix and breast. Apart from the apparent increase in cases of cervical carcinoma; the current AIDS pandemic in Uganda did not appear to to reflect any increase in the incidence of other AIDS-related cancers such as Kaposi's sarcoma and non-Hodgkins lymphomas treated at the department. The need for more patients and earlier referrals to the department is stressed in order to maximise the use of the improved radiotherapy services

[Appearance on X-ray and computed tomography of femoral head necrosis in patients with sickle cell disease]. / Aspects radiographiques et tomodensitométriques de la nécrose de la tête fémorale chez le drépanocytaire.

The aim of this study was to describe X-ray and computed tomography signs and to estimate the severity of femoral head necrosis in patients with sickle cell disease. We studied two groups of patients with sickle cell disease (group A: 14 patients with no hip pain and group B: 34 patients with hip pain) over 17 months. Each patient underwent hip X-ray (lying face-down) and CT scan. None of the patients in group A presented hip lesions whereas we detected 42 necrotic femoral head lesions by standard X ray and 51 by CT scan. The lesions were frequently bilateral (82.14%) and were more frequent in young patients (from 11 to 30 years old). Their progression was faster in patients with the SS genotype. No significant difference was observed according to type of hemoglobin. All patients with sickle cell disease presenting with hip pain should undergo CT scan to check for femoral head necrosis.