D. Nwaneri, A. Sadoh, Bc Ogboghodo, O. Famuyiwa, C. Eregie, O. Oviawe
Background : Mortality from pneumonia can be prevented by prompt recognition of symptoms of pneumonia by caregivers at home and appropriate seeking for medical care in a health facility. Active participation in pneumonia control by caregivers is dependent on the extent to which the members of the community are aware of features of pneumonia and recognising that the child needs medical attention. Objective : To document the knowledge of community members about pneumonia using traders (market women and men in a popular market in Benin City, Nigeria). Design : A descriptive cross-sectional study. Setting : Edaiken market, Benin City, Nigeria. Subjects : All traders, women and men in Edaiken market Benin City Nigeria. Results : Of the 1374 respondents, 1220(88.8%) about pneumonia. Of these 1220, 57.9% correctly identified that pneumonia affects the lungs and exposure to breeze was the risk factor of pneumonia (86.7% of respondents). Knowledge score for pneumonia was generally low with most respondents 1140(93.5%) scoring < 10 (Poor); and 79(6.5%) had scores 10 – 14 (Fair). Only one person (0.1%) had a score ≥ 15 (Good knowledge). Married individuals were five times more likely to have fair knowledge of pneumonia when compared to the unmarried individuals (OR = 5.0, p = 0.01). Also statistical significant proportion of respondents with presence of an under-five year old in the household had fair knowledge of childhood pneumonia when compared with household with no child younger than five years (p = 0.00). Conclusion : General knowledge of the traders in Benin City about childhood pneumonia was poor. There is need for improved public awareness on childhood pneumonia in this community.
{"title":"Awareness of childhood pneumonia in Benin City, Nigeria","authors":"D. Nwaneri, A. Sadoh, Bc Ogboghodo, O. Famuyiwa, C. Eregie, O. Oviawe","doi":"10.4314/EAMJ.V93I5","DOIUrl":"https://doi.org/10.4314/EAMJ.V93I5","url":null,"abstract":"Background : Mortality from pneumonia can be prevented by prompt recognition of symptoms of pneumonia by caregivers at home and appropriate seeking for medical care in a health facility. Active participation in pneumonia control by caregivers is dependent on the extent to which the members of the community are aware of features of pneumonia and recognising that the child needs medical attention. Objective : To document the knowledge of community members about pneumonia using traders (market women and men in a popular market in Benin City, Nigeria). Design : A descriptive cross-sectional study. Setting : Edaiken market, Benin City, Nigeria. Subjects : All traders, women and men in Edaiken market Benin City Nigeria. Results : Of the 1374 respondents, 1220(88.8%) about pneumonia. Of these 1220, 57.9% correctly identified that pneumonia affects the lungs and exposure to breeze was the risk factor of pneumonia (86.7% of respondents). Knowledge score for pneumonia was generally low with most respondents 1140(93.5%) scoring < 10 (Poor); and 79(6.5%) had scores 10 – 14 (Fair). Only one person (0.1%) had a score ≥ 15 (Good knowledge). Married individuals were five times more likely to have fair knowledge of pneumonia when compared to the unmarried individuals (OR = 5.0, p = 0.01). Also statistical significant proportion of respondents with presence of an under-five year old in the household had fair knowledge of childhood pneumonia when compared with household with no child younger than five years (p = 0.00). Conclusion : General knowledge of the traders in Benin City about childhood pneumonia was poor. There is need for improved public awareness on childhood pneumonia in this community.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4314/EAMJ.V93I5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70522927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jethro J. C. Wambugu, N. Matu, T. Mulli, L. Gathece
Objectives: To determine the occurrence of Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans in patients with periodontal disease using polymerase Chain Reaction. Design: A descriptive cross-sectional study. Setting: The University of Nairobi Dental Hospital. Subjects: Patients presenting at the Oral Diagnosis and Periodontology clinics during the period of the study. The patients had periodontal examination done followed by subgingival plaque collection from selected teeth. DNA extraction from the plaque samples was then done followed by PCR based on Taqman probes using commercially available kits. Results: A total of 92 participants were recruited in the study. Aggregatibacter actinomycetemcomitans ( A.a ) was found in 14 (15.20%) while Porphyromonas gingivalis ( P.g ) was present in 16 (17.40%) of the study participants. Based on independent sample t-test, statistically significant positive associations were found between detection frequency of Porphyromonas gingivalis and plaque score (t= 2.47, p= 0.015), gingival index (t= 3.24, p= 0.022), but not with clinical attachment loss (t= 1.90, p= 0.061). Chi square test revealed a positive association between detection rate of P.g and periodontal disease severity (X 2 = 6.34, p= 0.042). Similar association was also found between detection rate of Aggregatibacter actinomycetemcomitans and increasing age (t=2.19, p= 0.031), clinical attachment loss (t= 4.61, p<0.001) and periodontal disease severity (X 2 =11.23, p= 0.004). Conclusion: The multiplex polymerase chain reaction technique utilised in this study enabled detection of target bacteria in the same reaction mixture as opposed to other periodontal microbiological techniques that require each bacteria to be investigated individually therefore PCR should be considered as an alternative to other methods of periodontal microbiology investigation. The association between periopathogenic microorganisms, A.a and P.g with occurrence and severity of periodontal disease were also confirmed in this study.
{"title":"OCCURENCE OF PORPHYROMONAS GINGIVALIS AND AGGREGATIBACTER ACTINOMYCETEMCOMITANS IN SUBGINGIVAL PLAQUE AMONG PATIENTS WITH PERIODONTAL DISEASE AT THE UNIVERSITY OF NAIROBI DENTAL HOSPITAL","authors":"Jethro J. C. Wambugu, N. Matu, T. Mulli, L. Gathece","doi":"10.4314/EAMJ.V93I4","DOIUrl":"https://doi.org/10.4314/EAMJ.V93I4","url":null,"abstract":"Objectives: To determine the occurrence of Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans in patients with periodontal disease using polymerase Chain Reaction. Design: A descriptive cross-sectional study. Setting: The University of Nairobi Dental Hospital. Subjects: Patients presenting at the Oral Diagnosis and Periodontology clinics during the period of the study. The patients had periodontal examination done followed by subgingival plaque collection from selected teeth. DNA extraction from the plaque samples was then done followed by PCR based on Taqman probes using commercially available kits. Results: A total of 92 participants were recruited in the study. Aggregatibacter actinomycetemcomitans ( A.a ) was found in 14 (15.20%) while Porphyromonas gingivalis ( P.g ) was present in 16 (17.40%) of the study participants. Based on independent sample t-test, statistically significant positive associations were found between detection frequency of Porphyromonas gingivalis and plaque score (t= 2.47, p= 0.015), gingival index (t= 3.24, p= 0.022), but not with clinical attachment loss (t= 1.90, p= 0.061). Chi square test revealed a positive association between detection rate of P.g and periodontal disease severity (X 2 = 6.34, p= 0.042). Similar association was also found between detection rate of Aggregatibacter actinomycetemcomitans and increasing age (t=2.19, p= 0.031), clinical attachment loss (t= 4.61, p<0.001) and periodontal disease severity (X 2 =11.23, p= 0.004). Conclusion: The multiplex polymerase chain reaction technique utilised in this study enabled detection of target bacteria in the same reaction mixture as opposed to other periodontal microbiological techniques that require each bacteria to be investigated individually therefore PCR should be considered as an alternative to other methods of periodontal microbiology investigation. The association between periopathogenic microorganisms, A.a and P.g with occurrence and severity of periodontal disease were also confirmed in this study.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70522912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Madzimbamuto, E. Chikumba, H. Lonnée, L. Kashiri, NS Dube, S. Shumbairerwa
Background: Post-partum haemorrhage is the leading cause of mortality for labouring women in Zimbabwe. Current literature supports the use of low dose oxytocin to prevent bleeding during Caesarean section. Internationally, clinical practice has been slow to change and the use of potentially harmful, higher than recommended dose is common. Objective: To describe the current clinical practice in Zimbabwe. Design: A self-administered questionnaire survey. Descriptive statistics were used to report the study results. Setting: In 2013 a national survey was conducted on the use of oxytocin by different types of clinicians, who provide either anaesthesia or surgery for Caesarean section. Results: Of a total of 221 (61%) questionnaires returned, 170 (80%) were completed fully. Only 23% of respondents would give an intravenous dose of 5.0 IU or less of oxytocin for elective Caesarean section. The majority of clinicians (77%) would administer more than 5.0 IU of oxytocin at elective. A significant number of nurse anaesthetists 16/59 (27%), and a non-negligible number of specialist anaesthetists 3/48 (6%) would even give 20 IU of oxytocin in elective cases rising to 30% and 13% respectively for emergency cases. In case of persistent bleeding due to uterine atony, oxytocin was more likely to be repeated (45%), rather than using misoprostol (25%) or ergometrine (19%). Conclusion: Most clinicians in Zimbabwe use oxytocin doses well above current internationally recommended. This illustrates the urgent need for updated national guidelines for the prevention of post-partum haemorrhage during Caesarean section.
{"title":"A national survey of oxytocin use during caesarean section in Zimbabwe","authors":"F. Madzimbamuto, E. Chikumba, H. Lonnée, L. Kashiri, NS Dube, S. Shumbairerwa","doi":"10.4314/EAMJ.V93I1","DOIUrl":"https://doi.org/10.4314/EAMJ.V93I1","url":null,"abstract":"Background: Post-partum haemorrhage is the leading cause of mortality for labouring women in Zimbabwe. Current literature supports the use of low dose oxytocin to prevent bleeding during Caesarean section. Internationally, clinical practice has been slow to change and the use of potentially harmful, higher than recommended dose is common. Objective: To describe the current clinical practice in Zimbabwe. Design: A self-administered questionnaire survey. Descriptive statistics were used to report the study results. Setting: In 2013 a national survey was conducted on the use of oxytocin by different types of clinicians, who provide either anaesthesia or surgery for Caesarean section. Results: Of a total of 221 (61%) questionnaires returned, 170 (80%) were completed fully. Only 23% of respondents would give an intravenous dose of 5.0 IU or less of oxytocin for elective Caesarean section. The majority of clinicians (77%) would administer more than 5.0 IU of oxytocin at elective. A significant number of nurse anaesthetists 16/59 (27%), and a non-negligible number of specialist anaesthetists 3/48 (6%) would even give 20 IU of oxytocin in elective cases rising to 30% and 13% respectively for emergency cases. In case of persistent bleeding due to uterine atony, oxytocin was more likely to be repeated (45%), rather than using misoprostol (25%) or ergometrine (19%). Conclusion: Most clinicians in Zimbabwe use oxytocin doses well above current internationally recommended. This illustrates the urgent need for updated national guidelines for the prevention of post-partum haemorrhage during Caesarean section.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70522607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Omondi-Ogutu Omondi-Ogutu, J. Adwok, N. Nganga, E. Rogena, P. Olang
Objective: To provide data on nutritional status and risk factors affecting the population aged 45 years and above for health policy development and program planning.Design: A cross sectional studySetting: Dagoretti sub-County of Nairobi County.Subjects: Two hundred and eighty nine (289) purposefully selected households (29.8%males and 70.2%females) aged 45 years and above.Main outcome measures: Quantitative household data were collected using a semistructured questionnaire. In-depth interviews and focus group discussions were used to collect qualitative data. Information on selected demographic and socio-economic household characteristics, health and food security was documented. Nutritional status was assessed using body mass index (BMI) and mid-upper arm circumference (MUAC).Results: The study established that majority of this population faced many nutrition risks including lack of access to finances 161(58.5%), ill health 70(25.5%), rejection by community and relatives 26(9.5%) and taking care of grandchildren 10(3.6%) abandoned or orphaned by HIV/AIDS. Malnutrition using MUAC was 18.8% while by BMI was 11.4%. Of the population assessed, 46.4% had normal nutritional status while 40.9% were overweight, and 12.7% underweight, with more females (48.0%) than males (25.9%) being overweight.Conclusion: Under nutrition and obesity are problems facing this population group aged 45 years and above in Nairobi. There is need for policy makers and programme managers to develop interventions aimed at minimising the effects of risks faced by this population in order to improve their well being.
{"title":"Ogilvie’s syndrome: case report of spontaneous rupture of the ceacum following caesarean section","authors":"Omondi-Ogutu Omondi-Ogutu, J. Adwok, N. Nganga, E. Rogena, P. Olang","doi":"10.4314/EAMJ.V93I12","DOIUrl":"https://doi.org/10.4314/EAMJ.V93I12","url":null,"abstract":"Objective: To provide data on nutritional status and risk factors affecting the population aged 45 years and above for health policy development and program planning.Design: A cross sectional studySetting: Dagoretti sub-County of Nairobi County.Subjects: Two hundred and eighty nine (289) purposefully selected households (29.8%males and 70.2%females) aged 45 years and above.Main outcome measures: Quantitative household data were collected using a semistructured questionnaire. In-depth interviews and focus group discussions were used to collect qualitative data. Information on selected demographic and socio-economic household characteristics, health and food security was documented. Nutritional status was assessed using body mass index (BMI) and mid-upper arm circumference (MUAC).Results: The study established that majority of this population faced many nutrition risks including lack of access to finances 161(58.5%), ill health 70(25.5%), rejection by community and relatives 26(9.5%) and taking care of grandchildren 10(3.6%) abandoned or orphaned by HIV/AIDS. Malnutrition using MUAC was 18.8% while by BMI was 11.4%. Of the population assessed, 46.4% had normal nutritional status while 40.9% were overweight, and 12.7% underweight, with more females (48.0%) than males (25.9%) being overweight.Conclusion: Under nutrition and obesity are problems facing this population group aged 45 years and above in Nairobi. There is need for policy makers and programme managers to develop interventions aimed at minimising the effects of risks faced by this population in order to improve their well being.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70522778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Adoka, G. Dida, D. Anyona, A. Matano, D. Othero, C. Kanangire
Background : Infections with mosquito-borne parasites are common in human populations inhabiting tropical regions of the world. Malaria is endemic along Kenyan Lake Victoria basin and its vectors are fresh water breeders. However, much less is known about the current spatial distribution and habitat characterisation of mosquitoes including vectors of malaria in the lake waters and adjacent terrestrial aquatic habitats. Objectives : To characterise mosquito larval habitats and to determine the spatial distribution of mosquito species in lake and land habitats, measure aquatic habitats’ (water) physic-chemical parameters, enumerate the number of phytoplankton, zooplankton and fish species and determine their effects on the abundance of mosquitoes. This could allow larval control to be more effectively targeted at specific sites which in its turn could reduce malaria transmission in the area. Design : Cross-sectional study. Setting : The Kenyan Lake Victoria Basin. Results : Anopheles and Culex species of mosquitoes were absent in different locations in the lake, but abundant in different aquatic habitats in different locations on land. There was heterogeneity in the relative abundance of Anopheles and Culex species in the aquatic habitats in different locations on land, p 0.05 (Pearsons correlation coefficiency). Also, there was no significant correlation between abundance of Anopheles mosquitoes and phytoplanktons, (P>0.05). Significant correlation was however, observed with Dinoflagellates on land, P=0.014. Clarias gariepinus were more insectivorous compared to Oreochromis niloticus , which mostly fed on zooplankton and food remains. The most abundant mosquitoes in the lake were Mansonia followed by Aedes species of mosquitoes. Conclusion : Anopheles species of mosquitoes do not breed in deep permanent lake waters even if it is heavily infested by water hyacinth and other aquatic weeds. However, they breed in temporary or seasonal aquatic land habitats such as pools and swamps, more so when infested by aquatic and other vegetations. We recommend that, focus of malaria vector control should concentrate on land sites. Health education and awareness programs should be scaled up to inform the local communities on mosquito species ecology in relation to transmission of malaria and other mosquito- borne diseases. There is need to introduce certain fish species ( Clarias gariepinus ) for biological control of mosquitoes breeding in the aquatic habitats near human habitats.
{"title":"Spatial distribution and habitat characterisation of mosquito species in the lake and land habitats of western Kenya","authors":"S. Adoka, G. Dida, D. Anyona, A. Matano, D. Othero, C. Kanangire","doi":"10.4314/EAMJ.V93I3","DOIUrl":"https://doi.org/10.4314/EAMJ.V93I3","url":null,"abstract":"Background : Infections with mosquito-borne parasites are common in human populations inhabiting tropical regions of the world. Malaria is endemic along Kenyan Lake Victoria basin and its vectors are fresh water breeders. However, much less is known about the current spatial distribution and habitat characterisation of mosquitoes including vectors of malaria in the lake waters and adjacent terrestrial aquatic habitats. Objectives : To characterise mosquito larval habitats and to determine the spatial distribution of mosquito species in lake and land habitats, measure aquatic habitats’ (water) physic-chemical parameters, enumerate the number of phytoplankton, zooplankton and fish species and determine their effects on the abundance of mosquitoes. This could allow larval control to be more effectively targeted at specific sites which in its turn could reduce malaria transmission in the area. Design : Cross-sectional study. Setting : The Kenyan Lake Victoria Basin. Results : Anopheles and Culex species of mosquitoes were absent in different locations in the lake, but abundant in different aquatic habitats in different locations on land. There was heterogeneity in the relative abundance of Anopheles and Culex species in the aquatic habitats in different locations on land, p 0.05 (Pearsons correlation coefficiency). Also, there was no significant correlation between abundance of Anopheles mosquitoes and phytoplanktons, (P>0.05). Significant correlation was however, observed with Dinoflagellates on land, P=0.014. Clarias gariepinus were more insectivorous compared to Oreochromis niloticus , which mostly fed on zooplankton and food remains. The most abundant mosquitoes in the lake were Mansonia followed by Aedes species of mosquitoes. Conclusion : Anopheles species of mosquitoes do not breed in deep permanent lake waters even if it is heavily infested by water hyacinth and other aquatic weeds. However, they breed in temporary or seasonal aquatic land habitats such as pools and swamps, more so when infested by aquatic and other vegetations. We recommend that, focus of malaria vector control should concentrate on land sites. Health education and awareness programs should be scaled up to inform the local communities on mosquito species ecology in relation to transmission of malaria and other mosquito- borne diseases. There is need to introduce certain fish species ( Clarias gariepinus ) for biological control of mosquitoes breeding in the aquatic habitats near human habitats.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70522860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Wanyoike-Gichuhi, R. Parkar, B. Kihara, D. Ondieki
Premature ovarian failure (POF)is a serious life-changing condition that affects young women, remains an enigma and the researchers’ challenge. POF, premature ovarian insufficiency (POI), premature menopause, premature dysfunction (POD), or hypergonadotropic hypogonadism is one of the most perplexing disorders with aheterogeneous origin. Infertility, social and psychological stress are common consequences of this entity. This paper presents a rare condition where both twins had presented with POF.
{"title":"Premature ovarian failure in twins: case report","authors":"J. Wanyoike-Gichuhi, R. Parkar, B. Kihara, D. Ondieki","doi":"10.4314/EAMJ.V93I6","DOIUrl":"https://doi.org/10.4314/EAMJ.V93I6","url":null,"abstract":"Premature ovarian failure (POF)is a serious life-changing condition that affects young women, remains an enigma and the researchers’ challenge. POF, premature ovarian insufficiency (POI), premature menopause, premature dysfunction (POD), or hypergonadotropic hypogonadism is one of the most perplexing disorders with aheterogeneous origin. Infertility, social and psychological stress are common consequences of this entity. This paper presents a rare condition where both twins had presented with POF.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70523057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Endometriosis, defined as the presence of endometrial tissue outside the uterine cavity, is itself an enigmatic and multifaceted pathology, a puzzle whose manifold piece remain largely disconnected despite some decades of investigation. Its medical history and clinical presentation is heterogeneous. Endometriosis affects approximately 10% of women of reproductive age, given its high prevalence and that women with endometriosis may have severe pelvic pain and infertility, endometriosis poses a significant health problem. Evaluating and understanding the pathogenesis, clinical presentation, diagnosis of the endometriosis is critical in the management of this debilitating disease. A rare case of endometriosis in a patient with congenital anomaly-Unicornuate uterus with one unconnected rudimentary horn is presented.
{"title":"Endometriosis in unicornuate uterus with non-communicating rudimentary horn","authors":"J. Gichuhi, R. Parkar, D. Ondieki","doi":"10.4314/EAMJ.V92I10","DOIUrl":"https://doi.org/10.4314/EAMJ.V92I10","url":null,"abstract":"Endometriosis, defined as the presence of endometrial tissue outside the uterine cavity, is itself an enigmatic and multifaceted pathology, a puzzle whose manifold piece remain largely disconnected despite some decades of investigation. Its medical history and clinical presentation is heterogeneous. Endometriosis affects approximately 10% of women of reproductive age, given its high prevalence and that women with endometriosis may have severe pelvic pain and infertility, endometriosis poses a significant health problem. Evaluating and understanding the pathogenesis, clinical presentation, diagnosis of the endometriosis is critical in the management of this debilitating disease. A rare case of endometriosis in a patient with congenital anomaly-Unicornuate uterus with one unconnected rudimentary horn is presented.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70521799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Non-communicable diseases (NCD) are emerging as the leading cause of morbidity & mortality globally, with the greatest rise in incidence of cardiovascular disease cases observed in Sub-Saharan Africa. This is in addition to the heavy burden of infectious diseases already present in this setting. Describing the cross-cutting epidemiology of NCDs and infectious diseases with focus on the interaction between tuberculosis and diabetes mellitus, HIV and cardiovascular disease, HIV and cervical cancer as well as assessing the disparities in funding and service delivery systems between NCDs and infectious diseases; we review this rising double burden of infectious and non-infectious diseases and propose four lessons that can be learnt from the HIV response and adapted to inform the scale up of NCD control in Kenya which are also applicable in other African countries.
{"title":"SCALING UP NON-COMMUNICABLE DISEASE CONTROL: LESSONS TO BE LEARNT FROM THE INFECTIOUS DISEASE PARADIGM IN KENYA.","authors":"A Njoroge, K E Munene","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Non-communicable diseases (NCD) are emerging as the leading cause of morbidity & mortality globally, with the greatest rise in incidence of cardiovascular disease cases observed in Sub-Saharan Africa. This is in addition to the heavy burden of infectious diseases already present in this setting. Describing the cross-cutting epidemiology of NCDs and infectious diseases with focus on the interaction between tuberculosis and diabetes mellitus, HIV and cardiovascular disease, HIV and cervical cancer as well as assessing the disparities in funding and service delivery systems between NCDs and infectious diseases; we review this rising double burden of infectious and non-infectious diseases and propose four lessons that can be learnt from the HIV response and adapted to inform the scale up of NCD control in Kenya which are also applicable in other African countries.</p>","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5554602/pdf/nihms882228.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35273109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mullerian anomalies are rare and are often associated with infertility, chronic pelvic pain and pregnancy wastage. This is a case report of a primigravida at 27 weeks gestation, who presented in shock. Intra- operatively, a mullerian anomaly with a ruptured left horn was found and excised. She made remarkable recovery and was discharged home. Uterine anomalies should be ruled out in the evaluation of pregnancy wastage. When present, management should be individualized based on the clinical history, presentation, anatomical aberration and the patient’s future fertility desire.
{"title":"Uterine Rupture in a Primigravida with Mullerian Anomaly at 27 Weeks Gestation","authors":"K. Kunuthia, A. Kihara, RJ Kosgei, AN Bosire","doi":"10.4314/EAMJ.V92I5","DOIUrl":"https://doi.org/10.4314/EAMJ.V92I5","url":null,"abstract":"Mullerian anomalies are rare and are often associated with infertility, chronic pelvic pain and pregnancy wastage. This is a case report of a primigravida at 27 weeks gestation, who presented in shock. Intra- operatively, a mullerian anomaly with a ruptured left horn was found and excised. She made remarkable recovery and was discharged home. Uterine anomalies should be ruled out in the evaluation of pregnancy wastage. When present, management should be individualized based on the clinical history, presentation, anatomical aberration and the patient’s future fertility desire.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70522030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
HI Magale, I. Kassim, S. Odera, MJ Omolo, W. Jaoko, P. E. Jolly
Background : Post-pneumonectomy bronchopleural fistulae is associated with high mortality and morbidity. The omental flap has been widely used to manage this condition either through laparoscopic or open surgery with varied degrees of success. We present a modification of the omental flap by using two flaps of the omentum in obliterating the bronchopleural fistulae. Objective : To evaluate the effectiveness of dual omental flap in obliteration of postpneumonectomy bronchopleural fistulae D esign: A prospective clinical study. Setting : The cardiothoracic unit at the Kenyatta National Hospital between January 2010 and December 2013 . Subjects : Five patients with post-pneumonectomy bronchopleural fistulae managed in a period of four years. Results : Pneumonectomy were due to cancer of the lungs in two patients and tuberculosis in three patients. All the patients had previously attempted repair with a pleural patch without success. Dual omental flap was utilised to repair the fistulae. All patients had successful repair of the fistula and no recurrence was noted at one year of follow up. Conclusion : Dual omental flap offers an alternative technique in obliterating postpneumonectomy fistula. The two flap technique allows for one flap to completely seal the fistula while the second flap provides an additional airtight closure over the first flap and hence prevents any leakages. This ensures higher success rate with few recurrences.
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