Medicine and Health Sciences Commons^™

Spontaneous Regression Of A Primary Squamous Cell Lung Cancer Following Biopsy: A Case Report, Nathan Esplin, Khadija Fergiani, Timothy B. Legare, John W. Stelzer, Hammad Bhatti, Sayed Karar

Internal Medicine, East Africa

Background: Spontaneous regression has been defined as occurring when the malignant tumor mass partially or completely disappears without any treatment or as a result of a therapy considered inadequate to influence systemic neoplastic disease. Recently, studies have implicated immunological responses as likely being involved. We report a case of a patient with squamous cell carcinoma of the lung who experienced spontaneous regression following biopsy without other intervention.

Case Presentation: A 57-year-old white man was referred to our pulmonary clinic after an incidental finding of a nodule in the lower lobe of his left lung. Thoracic computed tomography revealed a 2.0 …

Mammographic Breast Density And Breast Cancer Molecular Subtypes: The Kenyan-African Aspect, Asim Jamal, Maeve Mullooly, Shahin Sayed, Rose Ndumia, Innocent Abayo, James Orwa, Ronald Wasike, Zahir Moloo, Gretchen L. Gierach

Internal Medicine, East Africa

Introduction: Data examiningmammographic breast density (MBD) among patients in Sub-Saharan Africa are sparse.We evaluated how MBD relates to breast cancer characteristics in Kenyan women undergoing diagnostic mammography.

Methods: This crosssectional study included women with pathologically confirmed breast cancers (𝑛 = 123). Pretreatment mammograms of the unaffectedbreast were assessed to estimate absolute dense area (cm2), nondense area (cm2), and percent density (PD). Relationships between density measurements and clinical characteristics were evaluated using analysis of covariance.

Results: Median PD and dense area were 24.9% and 85.3 cm2. Higher PD and dense area were observed in younger women (𝑃 < 0.01). Higher dense and nondense areas were observed in obese women (𝑃-trend < 0.01). Estrogen receptor (ER) positive patients (73%) had higher PD and dense area than ER-negative patients (𝑃 ≤ 0.02). Triple negative breast cancer (TNBC) patients (17%) had lower PD and dense area (𝑃 ≤ 0.01) compared with non-TNBCs. No associations were observed between MBD and tumor size and grade.

Conclusions: Our findings show …

The Association Between Asymptomatic And Mild Neurocognitive Impairment And Adherence To Antiretroviral Therapy Among People Living With Human Immunodeficiency Virus, Violet Awori, Peter Mativo, Gerald Yonga, Reena Shah

Internal Medicine, East Africa

Background: Asymptomatic cognitive impairment in human immunodeficiency virus (HIV)-infected patients has recently been recognised as part of HIV-associated neurocognitive disorders. This has been implicated as one of the causes of poor adherence to antiretroviral therapy (ART).

Objective: To assess the association between neurocognitive impairment (asymptomatic and mild forms) and adherence to ART.

Methods: This was a cross-sectional survey involving 218 participants consecutively sampled from those attending the HIV treatment clinic at Aga Khan University Hospital in Nairobi. Data collected included quantitative primary data on pre-defined baseline characteristics, neurocognitive assessment by Montreal Cognitive Assessment (MoCA) tool (Appendix 1), instrumental …

Prevalence Of Hla-B*5701 In A Kenyan Population With Hiv Infection, Reena Shah, H. Nabiswa, Nancy Okinda, Gunturu Revathi, Mark Hawken, Nelson M.

Internal Medicine, East Africa

We read with interest the article published in your Journal entitled “Real-world persistence with antiretroviral therapy for HIV in the United Kingdom: a multicentre retrospective cohort study”1 which concluded that treatment discontinuation attributable to toxicity profile is not an uncommon event. They also acknowledged lack of data collection on HLA-B*5701 status, which would heavily influence initial ART regimen and the choice to discontinue medication. Of the 25.6 million living with Human Immunodeficiency Virus (HIV) in Africa, an estimated 1.6 million people live in Kenya.2 With an HIV prevalence of 5.6%, Kenya has upscaled HIV treatment and care in the past …

Evaluation Of Alcohol Screening And Community-Based Brief Interventions In Rural Western Kenya: A Quasi-Experimental Study, Risa Takahashi, Calistus Wilunda, Karani Magutah, Wanja Mwaura-Tenambergen, Lukoye Atwoli, Usaneya Perngparn

Internal Medicine, East Africa

Aims:To assess the effectiveness of community-based alcohol brief interventions (ABI) implemented by community-health workers with and without motivational talks (MT) by former drinkers, in reducing harmful and hazardous alcohol consumption. Methods:We conducted a three-arm quasi-experimental study (one control and two intervention groups) between May and December 2015 in Kakamega County, Kenya. Participants were hazardous or harmful alcohol drinkers with an Alcohol Use Disorders Identification Test (AUDIT) score of 8–19 at baseline. One intervention group received only ABI while the other received ABI + MT. The interventions’ effects on AUDIT scores were analysed using linear mixed models. Logistic regression …