East African medical journal最新文献

{"title":"Injection safety knowledge and practices among clinical health care workers in Garissa provincial general hospital","authors":"F. M. Mwangangi, J. Mweu, Theresa Odero, A. Kirui, J. Kinuthia, S. Bett, C. Musee","doi":"10.4314/EAMJ.V92I1","DOIUrl":"https://doi.org/10.4314/EAMJ.V92I1","url":null,"abstract":"Marfan’s syndrome is a rare genetic disease, autosomal dominant. The most affected organs are eyes (myopia, subluxation of the lens); skeleton (hyperlaxity, arachnodactyly, scoliosis, dolichostenomelia) and cardiovascular system (aortic pathology). The severity of this disease is related to its cardiovascular damage. We proposed to carry out a review of the literature from the first case reported in the ophthalmology department of the University Hospital of Brazzaville.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":"41 1","pages":"43-46"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70521751","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}

{"title":"Truncus Arteriosus in a 43 year old Male: Case Report","authors":"TK Ng’eno, M. Koech, R. Yanoh, M. C. Foster, E. Velazquez, G. Bloomfield","doi":"10.4314/EAMJ.V92I12","DOIUrl":"https://doi.org/10.4314/EAMJ.V92I12","url":null,"abstract":"In truncus arteriosus, the embryologic truncus fails to properly divide in-utero resulting in the pulmonary, aortic and coronary arteries arising from a single ascending portion of this trunk. This condition is usually fatal within the first year of life without correction. Over the past two decades, there has been a dramatic expansion in access to diagnostic echo cardiography in Kenya and greater ability to diagnose congenital heart diseases. We present the case of a 43 year old male from western Kenya, newly diagnosed with heart failure due to truncus arteriosus. This case highlights the value of echo-cardiography in Kenya, and supports the need for surgical and interventional cardiac services to grow in tandem with these diagnostic capabilities.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":"92 1","pages":"612-615"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70521948","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}

{"title":"OBSTACLES TO FAMILY PLANNING USE AMONG RURAL WOMEN IN ATIAK HEALTH CENTER IV, AMURU DISTRICT, NORTHERN UGANDA.","authors":"S Ouma,&nbsp;M Turyasima,&nbsp;H Acca,&nbsp;F Nabbale,&nbsp;K O Obita,&nbsp;M Rama,&nbsp;C C Adong,&nbsp;A Openy,&nbsp;M O Beatrice,&nbsp;E I Odongo-Aginya,&nbsp;S Awor","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Uganda's rapid population growth (3.2%) since 1948 has placed more demands on health sector and lowered living standard of Ugandans resulting into 49% of people living in acute poverty especially in post conflict Northern Uganda. The population rise was due to low use of contraceptive methods (21% in rural areas and 43% in urban areas) and coupled with high unmet need for family planning (41%). This indicated poor access to reproductive health services. Effective use of family planning could reduce the rapid population growth.</p><p><strong>Objective: </strong>To determine obstacles to family planning use among rural women in Northern Uganda.</p><p><strong>Design: </strong>A descriptive cross-sectional analytical study.</p><p><strong>Setting: </strong>Atiak Health Centre IV, Amuru District, rural Northern Uganda.</p><p><strong>Subjects: </strong>Four hundred and twenty four females of reproductive ages were selected from both Inpatient and Outpatient Departments of Atiak Health Centre IV.</p><p><strong>Results: </strong>There was high level of awareness 418 (98.6%), positive attitude 333 (78.6%) and fair level of utilisation 230 (54.2%) of family planning. However, significant obstacles to family planning usage included; long distance to Health facility, unavailability of preferred contraceptive methods, absenteeism of family planning providers, high cost of managing side effects, desire for big family size, children dying less than five years old, husbands forbidding women from using family planning and lack of community leaders' involvement in family planning programme.</p><p><strong>Conclusions: </strong>In spites of the high level of awareness, positive attitude, and free family planning services, there were obstacles that hindered family planning usage among these rural women. However, taking services close to people, reducing number of children dying before their fifth birthday, educating men about family planning, making sure family planning providers and methods are available, reducing cost of managing side effects and involving community leaders will improve utilisation of family planning and thus reduce the rapid population growth and poverty.</p>","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":"92 8","pages":"394-400"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4834556/pdf/nihms747635.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34421111","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}

{"title":"Incidence of Ventilator-associated pneumonia in the critical care unit at Kenyatta National Hospital, a public tertiary care hospital","authors":"F.A.A. Sattar, D. S. Quadros, P. Olang, T. Chokwe","doi":"10.4314/EAMJ.V95I6","DOIUrl":"https://doi.org/10.4314/EAMJ.V95I6","url":null,"abstract":"Background: Human Immunodeficiency virus infected children are highly susceptible to opportunistic infections of the respiratory system which are the most common cause of morbidity and mortality. The chest radiograph is the most frequently requested examination for the evaluation of respiratory disease. Its applications include screening, diagnosis and monitoring response to medication of respiratory illnesses.Objective: To determine the prevalence of abnormal chest radiograph findings among HIV infected children. Design: Prospective cross-sectional descriptive study Setting: Kenyatta National Hospital and Mbagathi Level 5 Nairobi County hospital Subjects: The chest radiographs and clinical history of 123 HIV infected children below 15 years were studied between November 2014 and February 2015. Results: The age range of the children was 1-15 years with a median age of 24 months. The male: female ratio was 1:1.02. Normal chest radiographs were found in 54/123 (44%) while 69/123 (56%) had abnormal chest radiographic findings. Pulmonary opacities were identified in the majority of patients with abnormal chest radiographs (67%) while almost 51% showed lymphadenopathy. In the pulmonary opacities, “other infiltrate’’ (61%) was found to be more common than consolidation (39%). Pleural effusions were not common while cavitary lesions and pneumothorax were not identified. There was no significant association between the radiographic findings and the children’s age and sex. The findings of this study correlated well with similar studies in Africa. Conclusion: HIV infected children especially those below the age of 5 years, are highly susceptible to chest infections. This was seen in the high prevalence of cough and severe respiratory distress as well as the significant number of abnormal chest radiograph findings. The high prevalence of ‘other infiltrate’ in this study may indicate that the causative pathogen may not respond to standard antibiotic regimes; and further clinical studies to confirm this are required.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":"95 1","pages":"1680-1686"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70523632","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}

{"title":"The role of endoscopic ultrasound elastography in diagnosis of pancreatic lesions","authors":"M. Mutua, J. Wanyoike, N. Kihara, JB Oyieke","doi":"10.4314/eamj.v92i2","DOIUrl":"https://doi.org/10.4314/eamj.v92i2","url":null,"abstract":"Objective : To evaluate the accuracy of elastography in differentiating benign from malignant pancreatic masses for patients. Design : A prospective, consecutive, study Setting : Kasr Alini hospital department of internal Medicine , university of Cairo, Egypt. Subjects : Thirty patients had a solid-appearing pancreatic mass at conventional ultrasound, EUS and CT abdomen were included in the study. Results : A total of 30 patients were included in the study. The age of the Patients ranged between 38 and 70 years with a mean value of 54± 8.6 Years. The study included 22 (73.3%) males and eight (26.7%) females. The mean size of pancreatic masses was 35.6 ± 11.8 mm. The final diagnosis were pancreatic adenocarcinoma (n =25) papillary adenocarcinoma (n =1), papillary adenoma (n =2) and chronic pancreatitis ( n =2). The strain ratio was significantly higher among patient with pancreatic malignant tumour compare with those with inflammatory masses. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy for elastograpgy to Differentiate malignant from benign pancreatic masses were: 88%, 80%, 95.6%, 57.14% and 86% respectively (area under receiver operating curve 0 .974). Conclusion : EUS elastography is a useful tool for differentiating malignant from benign pancreatic masses through objective evaluation of tissue stiffness.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":"92 1","pages":"53-59"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70521647","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}

{"title":"Necrotising haemorrhagic pancreatitis with intra-abdominal hypertension: Case report","authors":"C. Kwobah, F. Some, F. Ndiangui, J. Abuya","doi":"10.4314/eamj.v92i8","DOIUrl":"https://doi.org/10.4314/eamj.v92i8","url":null,"abstract":"Severe necrotising haemorrhagic pancreatitis is a challenging clinical condition that carries a high mortality especially in resource-limited settings. The management requires a multidisciplinary approach in a well-equipped critical care unit. The decision for operative versus conservative management is a close call and one that continues to challenge clinicians. In this case report, we present a 36 years old HIV-infected African male who presented at a tertiary care teaching and referral hospital in Kenya with worsening intra-abdominal bleeding. We highlight the management challenges faced by clinicians and review the literature on this subject.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":"92 1","pages":"426-430"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70522356","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}

{"title":"Kidney function predictors and associated serum electrolytes changes in HIV out patients attending Jaramogi Oginga Odinga teaching and referral hospital, Kisumu county, Kenya","authors":"W. Opiyo, A. Ng’wena, A. Ofulla","doi":"10.4314/eamj.v92i11","DOIUrl":"https://doi.org/10.4314/eamj.v92i11","url":null,"abstract":"Background: Kidney disease has been recognised as one of the health challenges complicating HIV infection, prognosis and management. Early recognition, diagnosis and treatment are therefore key to ameliorating the deleterious impacts of kidney disease in HIV infected patients. Objectives: To assess serum kidney function markers in order to highlight the state of kidney health and the impact of its functional impairment on other serum electrolytes and body fluids parameters Design: A case-control study. Setting: At Jaramogi Oginga Odinga Teaching and Referral Hospital’s Patient support centre. Subjects: Eight Hundred HIV positive and 406 HIV negative participants above 18 years of age. Results: Mean serum creatinine and urea levels was significantly elevated in HIV – infected individuals than the healthy control group (95.2μmol/l v/s 86.2μmol/l, p<0.0001 and 4.6mmol/l v/s 4.1mmol/l, p<0.0001 respectively). The prevalence of pathological levels of serum creatinine, urea and sodium was higher in HIV-infected patients than HIV-negative participants (26.1% v/s 11.8%, p<0.0001; 4.4% v/s 0.5%, P<0.0001and 26.1% v/s 10.6%, p=0.001 respectively). Females experienced more serum creatinine disorders than their male counterparts (31.8% v/s 18.1%, p<0.0001). Age and antiretroviral treatment were not predictors of aberrations in levels of kidney function markers in HIV infected patients. AIDS defining CD4 depletion was associated with enhanced deterioration of kidney function. However, kidney function anomalies were not sufficient explanation for co-existing electrolyte anomalies as clinically altered creatinine states only correlated and co-varied with urea states (r =0.715) while sodium states co-varied with chloride levels (r = 0.296). Conclusion: Kidney function disorders are not infrequent in HIV infected individuals. Serum sodium aberration is observed more frequently in seropositive than in seronegative individuals. Routine review of kidney health status in local HIV infected individuals ought to be adopted for comprehensive management of HIV patients, more so among the female gender.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":"92 1","pages":"550-561"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70521914","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}

{"title":"Perception of Labour Pain among Rural Women Presenting to A Tertiary Hospital in Kenya","authors":"W. Waweru-Siika","doi":"10.4314/EAMJ.V92I3","DOIUrl":"https://doi.org/10.4314/EAMJ.V92I3","url":null,"abstract":"Background : Childbirth results in severe pain for many women. In many hospitals in Resource-Limited Countries (RLCs), women endure the pain of labour with little or no pain relief. There have not been any studies done within 36 hours of a recent delivery to determine how rural Kenyan women perceive the pain of labour, and whether they have embraced the concept of labour analgesia. Objectives : To find out how rural women who had recently given birth at the Moi Teaching and Referral Hospital (MTRH) rate the severity of their pain, and whether the expectations of these women with regards to pain relief for labour were met. Design : A retrospective cohort study. Setting : The Moi Teaching and Referral Hospital (MTRH) post-natal wards. Subjects : Women who had had a normal vaginal delivery in the preceding 36 hours. Intervention s: A structured questionnaire was administered. Results : Three hundred and eighy nine women who fulfilled the eligibility criteria were interviewed. Two hundred and eighty seven (73.8%) of 389 women rated their pain as severe to unbearable. Only 43 (11.0%) received any labour analgesia. This was in the form of an anti-spasmodic injection (Buscopan®). Thirty four (79%) of the 43 women who received an anti-spasmodic rated the pain relief obtained as good to very good. The level of knowledge of possible labour analgesia options was very low. Three hundred and thirty four (86%) of 389 women indicated that they would want to be given analgesia for future deliveries. Conclusion : The majority of rural women who give birth at the MTRH do so without any labour analgesia. Although the level of knowledge is low regarding possible labour analgesia options, the majority of these women would welcome medical intervention that would reduce their discomfort. There is need to  establish a formal labour analgesia service at MTRH and to educate rural Kenyan women on the various labour analgesia options, to enable them make informed choices regarding their use.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":"92 1","pages":"120-125"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70521758","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}

{"title":"Prevalence and intensity of intestinal parasitic infections and factors associated with transmission among school going children","authors":"Ek Kamande, Zipporah Ng’ang’a, LN Muthami, JH Ouma","doi":"10.4314/EAMJ.V92I6","DOIUrl":"https://doi.org/10.4314/EAMJ.V92I6","url":null,"abstract":"Objective : To determine the prevalence and intensity of intestinal parasitic infections and factors associated with transmission among primary school going children. Design : Cross-sectional descriptive study. Setting : Muthithi Location situated in Murang’a County, Kenya. Subjects : Multi-stage sampling was used to select 418 children. Stool specimens were examined using Kato-katz technique to determine the number of helminthes eggs per gram of stool and formol ether concentration technique to detect the different protozoan cysts. Data were analysed using Statistical Package format (SPSS version 20.0). Pearson’s Chi-square test was used to establish the association between categorical variables. Multivariate analysis was used to determine the factors associated with the infections. Results : The study established that 53.8% (225 out of 418) were infected with one or more of intestinal parasite. Five species of helminthes were identifiedwith prevalence of 11.5%; the predominant helminth parasite identified was Ascaris lumbricoides 9.1% (38 cases). Intestinal protozoan identified in this population was Entamoeba histolytica with prevalence of 42.3% (177 cases). The factors established to be independently associated with presence of intestinal parasitic infection were: age 11-15 years P<0.001, use of plain water for hand washing P<0.05, eating food without spoon P<0.05, consuming raw vegetables P<0.001, untrimmed finger nails P<0.001 and source of drinking water [river P<0.001 and mixed sources (river, well and tap) P<0.05]. Conclusion : This study revealed that intestinal parasites still pose a public health problem to school going children. Despite lack of school based deworming programme in this area, treatment combined with health education and other interventions in school age children is recommended as a way of controlling transmission.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":"92 1","pages":"264-269"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70522167","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}

{"title":"Eruptive syringoma mimicking keloid scars: Case report","authors":"E. Bayonne, PC Essouli, A. Gathsé","doi":"10.4314/EAMJ.V92I9","DOIUrl":"https://doi.org/10.4314/EAMJ.V92I9","url":null,"abstract":"The eruptive syringoma represent a rare variant of syringomas. It is a benign tumour derived from eccrine ductal elements. The disease is manifested by papules that arise on the front side of body, usually in young subjects. The eruptive syringoma is asymptomatic, but it may sometimes be pruritic. We report a 25-year-old woman presented with eruptive syringoma resembling keloids scars.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":"92 1","pages":"463-464"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70522446","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}