It is a tertiary care and teaching hospital for the Catholic University of Health and Allied Sciences-Bugando (CUHAS-Bugando) and other paramedics and has a bed capacity of 1000. BMC is one of the four largest referral
hospitals in the country and serves as a referral centre for tertiary specialist care for a catchment population of approximately 13 million people. Study population All patients selleck screening library who were operated for intestinal obstruction at BMC during the period of study and in whom the operative and histopathological findings were suggestive of tuberculosis were consecutively enrolled into the study. Patients who failed to give proper history and those without next of kin to consent for the study were excluded from the study. Patients who failed to consent for HIV infection testing were
also excluded from the study. Preoperatively, all the patients recruited into the study had intravenous fluids to correct fluid and electrolyte deficits; nasogastric suction; urethral catheterization and broad-spectrum antibiotic coverage. Relevant preoperative investigations included packed cell volume, serum electrolytes, urea and creatinine, check details blood grouping and cross-matching and erythrocyte sedimentation rate (ESR). Patients were also MK-0457 clinical trial screened for HIV testing using Tanzania HIV Rapid Test Algorithm  and CD 4+ count using FACS or FACSCALIBUR from BD Biosciences USA. A
determination of CD 4 count was only performed in HIV positive patients. Radiological investigations including X-ray abdomen erect and supine, X-ray chest PA-view were done in all patients. Abdominal ultrasound was also performed in some patients suspected to have associated abdominal collections. Dolutegravir supplier Patients presenting in a critical condition were treated with vital system support by: administration of Oxygen, ionotropic support when found hypotensive and oliguric despite adequate fluid replacement. After resuscitation, all patients, under general anesthesia were subjected to exploratory laparotomy through midline incision. They had pre-operative anesthetic assessment using the American Society of Anesthetists (ASA) classification  as shown in Table 1. To minimize variability in our study, the assignation of ASA class was performed by one consultant anesthetist adhering strictly to criteria above. Adequate hydration was indicated by an hourly urine output of 30 ml/hour. The operations were performed either by a consultant surgeon or a senior resident under the direct supervision of a consultant surgeon.