Titus Mutwiri, J. Magambo, E. Zeyhle, G. Mkoji, C. N. Wamae, E. Mulinge, H. Wassermann, P. Kern, T. Romig
Objective : To determine the impact of Clinical Officer (C.O) Anaesthetist Training programme at Kenya Medical Training College (KMTC) Nakuru, on Trainee satisfaction, quality of practice and cadre shortfall alleviation. Design : Cross-sectional descriptive study Setting : Kenya Medical Training College, Nakuru. Subjects : All thirty one Clinical Officer Anaesthetist graduates from KMTC Nakuru, since the training programme started 8 years ago. Results : Twenty nine of the 31 C.O Anaesthetist graduates responded. Twenty six of the 29 respondents (89.7%) passed in the final qualifying examination in the first sitting. Twenty one (72.4%) are working in Public health facilities. All graduates are distributed in 16 out of the 47 counties in Kenya. Twenty six (89.7%) are satisfied with the training. Their average working week is 54 hours, with a median of 45 working hours a week. They recommend an improvement in peripheral nerve blocks and epidural training in the 2005 curriculum. Conclusion : C.O Anaesthetist training in KMTC Nakuru over the last eight years has produced self reported satisfied, adequately trained graduates and has had an impact in alleviating shortage of this cadre in Kenya. Improvement in peripheral nerve blocks and epidural training is needed.
{"title":"IMPACT OF CLINICAL OFFICER ANAESTHETIST TRAINING PROGRAMME AT THE KENYA MEDICAL TRAINING COLLEGE, NAKURU, ON TRAINEE SATISFACTION, QUALITY OF PRACTICE, AND CADRE SHORTFALL ALLEVIATION.","authors":"Titus Mutwiri, J. Magambo, E. Zeyhle, G. Mkoji, C. N. Wamae, E. Mulinge, H. Wassermann, P. Kern, T. Romig","doi":"10.4314/EAMJ.V90I7","DOIUrl":"https://doi.org/10.4314/EAMJ.V90I7","url":null,"abstract":"Objective : To determine the impact of Clinical Officer (C.O) Anaesthetist Training programme at Kenya Medical Training College (KMTC) Nakuru, on Trainee satisfaction, quality of practice and cadre shortfall alleviation. Design : Cross-sectional descriptive study Setting : Kenya Medical Training College, Nakuru. Subjects : All thirty one Clinical Officer Anaesthetist graduates from KMTC Nakuru, since the training programme started 8 years ago. Results : Twenty nine of the 31 C.O Anaesthetist graduates responded. Twenty six of the 29 respondents (89.7%) passed in the final qualifying examination in the first sitting. Twenty one (72.4%) are working in Public health facilities. All graduates are distributed in 16 out of the 47 counties in Kenya. Twenty six (89.7%) are satisfied with the training. Their average working week is 54 hours, with a median of 45 working hours a week. They recommend an improvement in peripheral nerve blocks and epidural training in the 2005 curriculum. Conclusion : C.O Anaesthetist training in KMTC Nakuru over the last eight years has produced self reported satisfied, adequately trained graduates and has had an impact in alleviating shortage of this cadre in Kenya. Improvement in peripheral nerve blocks and epidural training is needed.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70520645","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}
Pub Date : 2013-06-20DOI: 10.4172/2167-1095.1000117
Jaya R Mallidi, S. Penumetsa, A. Lotfi
Hypertension is a common problem encountered in everyday clinical practice. Patients with poorly controlled hypertension may present to the emergency room with “hypertensive emergency” - severely elevated blood pressure (>180/120 mmHg) associated with end organ damage, involving neurological, cardiovascular or renal systems. There is a paucity of literature regarding the preferred rate of decline of blood pressure, while treating these patients, as well as the appropriate medications to be used. Based on expert opinion and anecdotal data, it is recommended that the initial management should focus on promptly identifying impending or established end organ damage and decreasing the blood pressure by about 25% in the first 2 hours, except in aortic dissection where rapid lowering of blood pressure is recommended. This review provides a focused approach to the management of hypertensive emergencies.
{"title":"Management of hypertensive emergencies.","authors":"Jaya R Mallidi, S. Penumetsa, A. Lotfi","doi":"10.4172/2167-1095.1000117","DOIUrl":"https://doi.org/10.4172/2167-1095.1000117","url":null,"abstract":"Hypertension is a common problem encountered in everyday clinical practice. Patients with poorly controlled hypertension may present to the emergency room with “hypertensive emergency” - severely elevated blood pressure (>180/120 mmHg) associated with end organ damage, involving neurological, cardiovascular or renal systems. There is a paucity of literature regarding the preferred rate of decline of blood pressure, while treating these patients, as well as the appropriate medications to be used. Based on expert opinion and anecdotal data, it is recommended that the initial management should focus on promptly identifying impending or established end organ damage and decreasing the blood pressure by about 25% in the first 2 hours, except in aortic dissection where rapid lowering of blood pressure is recommended. This review provides a focused approach to the management of hypertensive emergencies.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-1095.1000117","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70816942","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}
E. Ndahimana, A. Gothot, C. Gérard, F. Senyana, S. R'Zik, O. Mukabayire, L. Mutesa
BACKGROUND Screening of alloantibodies in patients is not yet done in district hospitals of Rwanda. The practice is to transfuse ABO/D compatible blood following an immediate spin crossmatch (IS-XM) or indirect antiglobulin test crossmatch (IAT-XM). OBJECTIVES To assess the risk of red blood cell (RBC) alloimmunisation associated with the use of IS-XM compared to the IAT-XM in patients receiving blood transfusions in district hospitals in Rwanda. DESIGN A cross-sectional comparative descriptive study. SETTING Four Rwandan district hospitals. Kirehe and Nyanza hospitals used IS-XM while Muhima and Ruhengeri hospitals used IAT-XM. SUBJECTS Blood samples were obtained from 187 patients (101 with IS-XM and 86 with IAT-XM) transfused in January, February, October, and November of 2012. RESULTS The median age of blood recipients was 31 years (7 - 80) and 36% of them were male. Sixteen specific antibodies were identified in 12 patients: anti-RH1/D (2),anti-RH2/C (2), anti-RH3/E (2), anti-RH4/c (1), anti-RH5/e (2),anti-LE1/Lea (2),anti-JK1/Jka (1), anti-JK2/Jkb (1), anti-KEL1/K (1), anti-MNS1/M (1), and autoantibody (1).The global prevalence of redblood cell (RBC) alloimmunisationwas 6.4% (12/187). Thatprevalence was significantly higher in the IS-XM group (10.4%) than in the IAT-XM group (2.3%) with an odds ratio of 4.8; [95% CI=1.2-19.8]; and a p-value of 0.031. CONCLUSION The prevalence of red blood cell (RBC) alloimmunisation in 187 patients receiving blood transfusions was 6.4% and was higher in recipients from hospitals using IS-XM, with Rhesus (RH) system antibodies widely predominant (56.2%).We recommend that IAT-XM be used in all district hospitals in Rwanda to minimise this risk.
{"title":"RISK OF RED BLOOD CELL ALLOIMMUNISATION IN RWANDA: ASSESSMENT OF PRETRANSFUSION CROSSMATCH TECHNIQUES USED IN DISTRICT HOSPITALS.","authors":"E. Ndahimana, A. Gothot, C. Gérard, F. Senyana, S. R'Zik, O. Mukabayire, L. Mutesa","doi":"10.4314/EAMJ.V90I4","DOIUrl":"https://doi.org/10.4314/EAMJ.V90I4","url":null,"abstract":"BACKGROUND\u0000Screening of alloantibodies in patients is not yet done in district hospitals of Rwanda. The practice is to transfuse ABO/D compatible blood following an immediate spin crossmatch (IS-XM) or indirect antiglobulin test crossmatch (IAT-XM).\u0000\u0000\u0000OBJECTIVES\u0000To assess the risk of red blood cell (RBC) alloimmunisation associated with the use of IS-XM compared to the IAT-XM in patients receiving blood transfusions in district hospitals in Rwanda.\u0000\u0000\u0000DESIGN\u0000A cross-sectional comparative descriptive study.\u0000\u0000\u0000SETTING\u0000Four Rwandan district hospitals. Kirehe and Nyanza hospitals used IS-XM while Muhima and Ruhengeri hospitals used IAT-XM.\u0000\u0000\u0000SUBJECTS\u0000Blood samples were obtained from 187 patients (101 with IS-XM and 86 with IAT-XM) transfused in January, February, October, and November of 2012.\u0000\u0000\u0000RESULTS\u0000The median age of blood recipients was 31 years (7 - 80) and 36% of them were male. Sixteen specific antibodies were identified in 12 patients: anti-RH1/D (2),anti-RH2/C (2), anti-RH3/E (2), anti-RH4/c (1), anti-RH5/e (2),anti-LE1/Lea (2),anti-JK1/Jka (1), anti-JK2/Jkb (1), anti-KEL1/K (1), anti-MNS1/M (1), and autoantibody (1).The global prevalence of redblood cell (RBC) alloimmunisationwas 6.4% (12/187). Thatprevalence was significantly higher in the IS-XM group (10.4%) than in the IAT-XM group (2.3%) with an odds ratio of 4.8; [95% CI=1.2-19.8]; and a p-value of 0.031.\u0000\u0000\u0000CONCLUSION\u0000The prevalence of red blood cell (RBC) alloimmunisation in 187 patients receiving blood transfusions was 6.4% and was higher in recipients from hospitals using IS-XM, with Rhesus (RH) system antibodies widely predominant (56.2%).We recommend that IAT-XM be used in all district hospitals in Rwanda to minimise this risk.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70520865","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}
K. Tijani, R. Ojewola, GL Yahya, A. Oluwole, B. Odusanya
Background : Nigeria with a growth rate of 28%, accounts for over two thirds of the West African population. It also has one of the highest maternal mortality rates in the world with contraceptive prevalence among married couples less than 10%. Despite its safety and efficacy vasectomy appears to be unpopular in our environment. Objective : To assess the perception and acceptance of married men and women towards vasectomy and the influence of the spouse on the man’s decision to accept or reject vasectomy. Design : A cross sectional questionnaire based study. Setting : With an estimated population of 20 million, Lagos is the most cosmopolitan and urbanised city in Nigeria and accounts for 65% of all commercial activities in the country. Virtually all the tribes in Nigeria are represented in the city. Subjects : Literate pregnant women recruited from the antenatal clinics and literate new fathers. All subjects were recruited from three health facilities in the Lagos metropolis. Results : Twenty seven point five and twenty one percent of the men and women respectively had a good Knowledge of vasectomy while 49.1% and 19% of all men and women respectively with good knowledge would accept vasectomy (or agree for their spouses to have the procedure). Overall acceptance rates for men and women were 26 and 13.5% respectively while 92% of men who can opt for vasectomy will only do so if their spouses agree. Knowledge about vasectomy was the strongest single factor influencing the acceptance of vasectomy (p= 0.013) with stronger correlation among men than women (p=0.005 vrs p=.0.023). Conclusion : Knowledge and acceptance of vasectomy is significantly better in males than female Nigerians living in Lagos.
背景:尼日利亚人口增长率为28%，占西非人口的三分之二以上。它也是世界上孕产妇死亡率最高的国家之一，已婚夫妇的避孕普及率不到10%。尽管输精管结扎术安全有效，但在我们的环境中却不受欢迎。目的:评估已婚男女对输精管结扎术的认知和接受程度，以及配偶对男性接受或拒绝输精管结扎决定的影响。设计:基于横断面问卷的研究。环境:拉各斯人口约2000万，是尼日利亚最国际化和城市化的城市，占该国所有商业活动的65%。几乎尼日利亚所有的部落都在这个城市有代表。研究对象:从产前诊所招募的识字孕妇和识字的新父亲。所有受试者都是从拉各斯大都会的三个卫生机构招募的。结果:27.5%的男性和21%的女性对输精管结扎术有良好的了解，49.1%的男性和19%的女性对输精管结扎术有良好的了解。男性和女性的总体接受率分别为26%和13.5%，而92%的男性只有在配偶同意的情况下才会选择输精管结扎术。输精管结扎知识是影响输精管结扎接受度的最强单因素(p= 0.013)，男性比女性相关性更强(p=0.005 vs p= 0.023)。结论:拉各斯地区尼日利亚男性对输精管结扎术的认识和接受程度明显高于女性。
{"title":"Attitudes and acceptance of Nigerians towards vasectomy--A comparison of married men and women in Lagos.","authors":"K. Tijani, R. Ojewola, GL Yahya, A. Oluwole, B. Odusanya","doi":"10.4314/EAMJ.V90I3","DOIUrl":"https://doi.org/10.4314/EAMJ.V90I3","url":null,"abstract":"Background : Nigeria with a growth rate of 28%, accounts for over two thirds of the West African population. It also has one of the highest maternal mortality rates in the world with contraceptive prevalence among married couples less than 10%. Despite its safety and efficacy vasectomy appears to be unpopular in our environment. Objective : To assess the perception and acceptance of married men and women towards vasectomy and the influence of the spouse on the man’s decision to accept or reject vasectomy. Design : A cross sectional questionnaire based study. Setting : With an estimated population of 20 million, Lagos is the most cosmopolitan and urbanised city in Nigeria and accounts for 65% of all commercial activities in the country. Virtually all the tribes in Nigeria are represented in the city. Subjects : Literate pregnant women recruited from the antenatal clinics and literate new fathers. All subjects were recruited from three health facilities in the Lagos metropolis. Results : Twenty seven point five and twenty one percent of the men and women respectively had a good Knowledge of vasectomy while 49.1% and 19% of all men and women respectively with good knowledge would accept vasectomy (or agree for their spouses to have the procedure). Overall acceptance rates for men and women were 26 and 13.5% respectively while 92% of men who can opt for vasectomy will only do so if their spouses agree. Knowledge about vasectomy was the strongest single factor influencing the acceptance of vasectomy (p= 0.013) with stronger correlation among men than women (p=0.005 vrs p=.0.023). Conclusion : Knowledge and acceptance of vasectomy is significantly better in males than female Nigerians living in Lagos.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70520771","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}
T. Aliyazicioglu, N. Z. Cantürk, T. Simsek, F. Kolaylı, M. Çekmen
BACKGROUND AND AIMS Protein calorie malnutrition for cancer patients is related with altered cellular and humoral immunity. Standard TPN and glutamine and lipid emulsion with omega 3 fatty acids were given to colorectal cancer patients and the effects of these to neutrophil functions and IL-8 levels are compared. METHODS Consecutive 36 patients with colorectal cancer diagnosed with endoscopic biopsy and with malnutrition determined by subjective global assessment were enrolled to study. The patients are randomly divided into four groups. Standard TPN to control group, TPN with glutamine solution to S-D group, TPN with omega 3 fatty acid solution to S-O group and TPN with omega 3 fatty acids solution and glutamine to S-D-O group were given for seven days after the operation. At the preoperative, postoperative first day and 7th day, neutrophil phagocytosis index, neutrophil adhesivity index and IL-8 levels were determined. RESULTS In all groups compared to control group neutrophil phagocytosis index were increased significantly (p<0.05). The most increasing was in group 3. There wasn't significant difference between groups about postoperative first day neutrophil adhesiveness index (p>0.05). At the 7th day the neutrophil adhesivity index for study groups were increased compared with control group, but there was no significant differences between groups. There was no significant difference between groups for IL-8 levels. CONCLUSIONS As a result of the study, altered cellular immunity in colorectal cancer patients with malnutrition can be corrected with omega 3 fatty acid emulsions and glutamine added to TPN so the ratio of morbidity and mortality can be decreased.
{"title":"EFFECTS OF STANDARD AND/OR GLUTAMINE DIPEPTIDE AND/OR OMEGA-3 FATTY ASCID-SUPPLEMENTED PARENTERAL NUTRITION ON NEUTROPHIL FUNCTIONS, INTERLEUKIN-8 LEVEL AND LENGTH OF STAY--A DOUBLE BLIND,CONTROLLED, RANDOMISED STUDY.","authors":"T. Aliyazicioglu, N. Z. Cantürk, T. Simsek, F. Kolaylı, M. Çekmen","doi":"10.4314/EAMJ.V90I2","DOIUrl":"https://doi.org/10.4314/EAMJ.V90I2","url":null,"abstract":"BACKGROUND AND AIMS\u0000Protein calorie malnutrition for cancer patients is related with altered cellular and humoral immunity. Standard TPN and glutamine and lipid emulsion with omega 3 fatty acids were given to colorectal cancer patients and the effects of these to neutrophil functions and IL-8 levels are compared.\u0000\u0000\u0000METHODS\u0000Consecutive 36 patients with colorectal cancer diagnosed with endoscopic biopsy and with malnutrition determined by subjective global assessment were enrolled to study. The patients are randomly divided into four groups. Standard TPN to control group, TPN with glutamine solution to S-D group, TPN with omega 3 fatty acid solution to S-O group and TPN with omega 3 fatty acids solution and glutamine to S-D-O group were given for seven days after the operation. At the preoperative, postoperative first day and 7th day, neutrophil phagocytosis index, neutrophil adhesivity index and IL-8 levels were determined.\u0000\u0000\u0000RESULTS\u0000In all groups compared to control group neutrophil phagocytosis index were increased significantly (p<0.05). The most increasing was in group 3. There wasn't significant difference between groups about postoperative first day neutrophil adhesiveness index (p>0.05). At the 7th day the neutrophil adhesivity index for study groups were increased compared with control group, but there was no significant differences between groups. There was no significant difference between groups for IL-8 levels.\u0000\u0000\u0000CONCLUSIONS\u0000As a result of the study, altered cellular immunity in colorectal cancer patients with malnutrition can be corrected with omega 3 fatty acid emulsions and glutamine added to TPN so the ratio of morbidity and mortality can be decreased.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70520625","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}
OBJECTIVE To analyse implementation of the pilot study of the per capita system of healthcare financing in Ghana in 2012 for a determination of the likelihood of realising the inherent theoretical benefits when the system is rolled out nationally. DESIGN AND SETTING First, publicly available information on how the pilot unfolded is presented, followed by the reaction of the health authorities to these developments. We then analysed accrued evidence on costs and developments vis-à-vis the theoretical benefits. RESULTS It would appear that preparation for the pilot exercise could have been handled better. Concerns include i) the low level of both education and awareness of the capitation system among healthcare subscribers and primary care providers; ii) confusion about service provider to whom subscribers had been assigned for the capitation period; and iii) service providers not understanding differences between capitation financing and financing under the Ghana diagnostic Related Grouping; and iv) some indication of cost savings. CONCLUSION Cost savings may be available nationally. This is important because cost containment is the driving force behind the introduction of the capitation system.
{"title":"CAPITATION IN HEALTHCARE FINANCING IN GHANA.","authors":"A. Aboagye","doi":"10.4314/EAMJ.V90I5","DOIUrl":"https://doi.org/10.4314/EAMJ.V90I5","url":null,"abstract":"OBJECTIVE To analyse implementation of the pilot study of the per capita system of healthcare financing in Ghana in 2012 for a determination of the likelihood of realising the inherent theoretical benefits when the system is rolled out nationally. DESIGN AND SETTING First, publicly available information on how the pilot unfolded is presented, followed by the reaction of the health authorities to these developments. We then analysed accrued evidence on costs and developments vis-à-vis the theoretical benefits. RESULTS It would appear that preparation for the pilot exercise could have been handled better. Concerns include i) the low level of both education and awareness of the capitation system among healthcare subscribers and primary care providers; ii) confusion about service provider to whom subscribers had been assigned for the capitation period; and iii) service providers not understanding differences between capitation financing and financing under the Ghana diagnostic Related Grouping; and iv) some indication of cost savings. CONCLUSION Cost savings may be available nationally. This is important because cost containment is the driving force behind the introduction of the capitation system.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70520910","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}
OBJECTIVE To isolate and identify Cryptococcus from domestic Chicken dropping. DESIGN cross sectional study. SETTING Kabigeriet village, Olenguorone Division, Nakuru county, approximately 282 km from Nairobi, Kenya. SUBJECTS Sixty four domestic chicken droppings were sampled in thirty two homesteads after obtaining the farmers consent. RESULTS Two species of Cryptococcus were isolated. CONCLUSION Domestic chicken (Gallus gallus) harbor Pathogenic Cryptococcus in their dropping and their close proximity to human habitation poses a risk of AIDS to immunocompromised persons.
{"title":"PRESENCE OF CRYPTOCOCCUS SPECIES IN DOMESTIC CHICKEN (GALLUS GALLUS) DROPPINGS AND THE POSSIBLE RISK IT POSED TO HUMANS IN KABIGERIET VILLAGE, NAKURU COUNTY, KENYA.","authors":"E. K. Kemoi, P. Okemo, Christine C Bii","doi":"10.4314/EAMJ.V90I6","DOIUrl":"https://doi.org/10.4314/EAMJ.V90I6","url":null,"abstract":"OBJECTIVE To isolate and identify Cryptococcus from domestic Chicken dropping. DESIGN cross sectional study. SETTING Kabigeriet village, Olenguorone Division, Nakuru county, approximately 282 km from Nairobi, Kenya. SUBJECTS Sixty four domestic chicken droppings were sampled in thirty two homesteads after obtaining the farmers consent. RESULTS Two species of Cryptococcus were isolated. CONCLUSION Domestic chicken (Gallus gallus) harbor Pathogenic Cryptococcus in their dropping and their close proximity to human habitation poses a risk of AIDS to immunocompromised persons.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70520919","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}
OBJECTIVE To determine the prevalence of RHD among primary school pupils in Egor Local Government Area (LGA) of Edo State of Nigeria. DESIGN A cross sectional study SETTING The study was carried out among selected primary pupils in three public and six private schools in Egor LGA, (the smallest governmental unit) in mid-Western Nigeria. SUBJECTS Using a multistage sampling technique, pupils were selected from public and private primary schools in Egor LGA. They were clinically screened for evidence of RHD by auscultating for significant murmurs. The pupils with significant murmurs then had echocardiographic evaluation to confirm the presence of RHD. MAIN OUTCOMES Pupils with significant murmurs and pupils with echocardiographically confirmed RHD. RESULTS Of the 1764 pupils recruited, 900 (51.02%) were females while 864 (48.98%) were males. The mean age of the pupils was 8.86 ± 2.14 years. 1065 (60.37%) and 699 (39.63%) respectively were recruited from public and private schools. Of the 1764 pupils, six (0.34%) had significant murmur. Only one of the six had RHD, giving a prevalence of 0.57/1000 pupils. The pupil with RHD was a male, from public school and in the low socioeconomic class. CONCLUSION The prevalence of RHD in this study is low compared to similar studies conducted outside the country. The true prevalence may be underestimated since higher prevalence is obtained from echocardiographic based screening compared to clinical screening.
{"title":"PREVALENCE OF RHEUMATIC HEART DISEASE AMONG PRIMARY SCHOOL PUPILS IN MID-WESTERN NIGERIA.","authors":"W. Sadoh, V. Omuemu, Yt Israel-Aina","doi":"10.4314/EAMJ.V90I1","DOIUrl":"https://doi.org/10.4314/EAMJ.V90I1","url":null,"abstract":"OBJECTIVE To determine the prevalence of RHD among primary school pupils in Egor Local Government Area (LGA) of Edo State of Nigeria. DESIGN A cross sectional study SETTING The study was carried out among selected primary pupils in three public and six private schools in Egor LGA, (the smallest governmental unit) in mid-Western Nigeria. SUBJECTS Using a multistage sampling technique, pupils were selected from public and private primary schools in Egor LGA. They were clinically screened for evidence of RHD by auscultating for significant murmurs. The pupils with significant murmurs then had echocardiographic evaluation to confirm the presence of RHD. MAIN OUTCOMES Pupils with significant murmurs and pupils with echocardiographically confirmed RHD. RESULTS Of the 1764 pupils recruited, 900 (51.02%) were females while 864 (48.98%) were males. The mean age of the pupils was 8.86 ± 2.14 years. 1065 (60.37%) and 699 (39.63%) respectively were recruited from public and private schools. Of the 1764 pupils, six (0.34%) had significant murmur. Only one of the six had RHD, giving a prevalence of 0.57/1000 pupils. The pupil with RHD was a male, from public school and in the low socioeconomic class. CONCLUSION The prevalence of RHD in this study is low compared to similar studies conducted outside the country. The true prevalence may be underestimated since higher prevalence is obtained from echocardiographic based screening compared to clinical screening.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70519964","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}
Background : Cryptococcus meningitis is the most lethal meningitis in patients with HIV/AIDS. It is invariably fatal if not treated appropriately and promptly. In sub-Saharan Africa with the highest prevalence of HIV/AIDS, response to treatment of cryptococcal meningitis has seldom been assessed. Objective : To describe the clinical features, laboratory findings, CD4+ cell counts and clinical outcome after a two-week treatment course of patients having cryptococcal meningitis. Design : Longitudinal, prospective, consecutive entry study. Setting : Kisumu District Hospital, Nairobi Rheumatology Clinic and Mater hospital between July 2001 and May 2007. Subjects : One hundred and forty one patients with cryptococcus meningitis. Main outcome measures :CD4+cellcount,cerebrospinalfluid(CSF) biochemistry/microbiology, morbidity and mortality. Results : One hundred and forty one patients (80 males and 61 females) with cryptococcus meningitis were included. Mean age and CD4+ cell counts was 36.12 ± 9.1 years (15-75) and 66.9 ± 102.8 cells/µl (1-1058) respectively. One hundred and forty one (83%) patients had CD4 + cell counts 350 cells/µl and 22 (15.6%) patients had CD4+ cell counts between 100-350 cells/µl. Ten (six males and four females) died within one week (four amphotericin B, three fluconazole, three no treatment). Eighty one patients were simultaneously initiated on HAART. Conclusion : Cryptococcal meningitis has a good clinical outcome when promptly and appropriately managed despite the low CD4+ cell count. Measures to avail amphotericin B and fluconazole at the mid level healthcare facilities must be enhanced.
{"title":"Cryptococcus Meningitis in a Cohort of HIV Positive Kenyan Patients: Outcome after Two Weeks of Therapy","authors":"A. Otedo, C. Otieno, J. Jowi, G. Oyoo, E. Omonge","doi":"10.4314/EAMJ.V90I12","DOIUrl":"https://doi.org/10.4314/EAMJ.V90I12","url":null,"abstract":"Background : Cryptococcus meningitis is the most lethal meningitis in patients with HIV/AIDS. It is invariably fatal if not treated appropriately and promptly. In sub-Saharan Africa with the highest prevalence of HIV/AIDS, response to treatment of cryptococcal meningitis has seldom been assessed. Objective : To describe the clinical features, laboratory findings, CD4+ cell counts and clinical outcome after a two-week treatment course of patients having cryptococcal meningitis. Design : Longitudinal, prospective, consecutive entry study. Setting : Kisumu District Hospital, Nairobi Rheumatology Clinic and Mater hospital between July 2001 and May 2007. Subjects : One hundred and forty one patients with cryptococcus meningitis. Main outcome measures :CD4+cellcount,cerebrospinalfluid(CSF) biochemistry/microbiology, morbidity and mortality. Results : One hundred and forty one patients (80 males and 61 females) with cryptococcus meningitis were included. Mean age and CD4+ cell counts was 36.12 ± 9.1 years (15-75) and 66.9 ± 102.8 cells/µl (1-1058) respectively. One hundred and forty one (83%) patients had CD4 + cell counts 350 cells/µl and 22 (15.6%) patients had CD4+ cell counts between 100-350 cells/µl. Ten (six males and four females) died within one week (four amphotericin B, three fluconazole, three no treatment). Eighty one patients were simultaneously initiated on HAART. Conclusion : Cryptococcal meningitis has a good clinical outcome when promptly and appropriately managed despite the low CD4+ cell count. Measures to avail amphotericin B and fluconazole at the mid level healthcare facilities must be enhanced.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70520205","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}
Objective: Orbital exenteration results in devastating functional, aesthetic and psychological losses. We studied the psycho-social challenges of patients following orbital exenteration. Design : Retrospective descriptive study Setting: Korle-Bu Teaching Hospital, eye clinic, Accra Subjects: Ten surviving patients, at least six months post orbital exenteration. Results: Though all the patients were satisfied with the medical results of the surgery, 50% felt strongly uncomfortable or dissatisfied with the cosmetic effect of the surgery. Sixty percent of the patients suffered unwelcome comments and 50% uncomfortable stare from close friends and relations. Sixty percent were not uncomfortable in the company of friends and close relations. Conclusion : Our findings call for a counseling plan for our patients while it is also necessary to find ways of improving their cosmesis.
{"title":"PSYCHO-SOCIAL CHALLENGES OF PATIENTS FOLLOWING ORBITAL EXENTERATION.","authors":"Ackuaku-Dogbe Em, Biritwum Rb, Briamah Zi","doi":"10.4314/EAMJ.V89I12","DOIUrl":"https://doi.org/10.4314/EAMJ.V89I12","url":null,"abstract":"Objective: Orbital exenteration results in devastating functional, aesthetic and psychological losses. We studied the psycho-social challenges of patients following orbital exenteration. Design : Retrospective descriptive study Setting: Korle-Bu Teaching Hospital, eye clinic, Accra Subjects: Ten surviving patients, at least six months post orbital exenteration. Results: Though all the patients were satisfied with the medical results of the surgery, 50% felt strongly uncomfortable or dissatisfied with the cosmetic effect of the surgery. Sixty percent of the patients suffered unwelcome comments and 50% uncomfortable stare from close friends and relations. Sixty percent were not uncomfortable in the company of friends and close relations. Conclusion : Our findings call for a counseling plan for our patients while it is also necessary to find ways of improving their cosmesis.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4314/EAMJ.V89I12","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70519991","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}
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