Medicine and Health Sciences Commons^™

Pathological Sub-Types, Risk Factors And Outcome Of Stroke At The Nairobi Hospital, Kenya, James Jowi, Peter Mativo

Internal Medicine, East Africa

Background: Stroke is one of the most common causes of morbidity and mortality the world over. Established risk factors such as arterial hypertension, diabetes mellitus, cigarette smoking, hyper-lipidaemia, micro-vascular rupture, male gender, age and observed co-morbities such as sickle cell disease, HIV/AIDS infection and cerebral malaria are increasingly being encountered in the tropics.

Objectives: To determine pathological sub-types, risk factors, in-hospital period prevalence and in-hospital outcome of stroke.

Design: Hospital-based retrospective study.

Setting: The Nairobi Hospital, Nairobi, Kenya.

Subjects: Patients with recorded diagnosis of stroke/cerebral vascular accident; as per WHO criteria for diagnosis of stroke, …

Hiv-Associated Pulmonary Hypertension: Case Report, Jay Shavadia, S. Das, Gerald Yonga

Internal Medicine, East Africa

With the advent of highly active antiretroviral therapy, there has been a significant change in the epidemiology of pulmonary disease in HIV/AIDS. The relative prevalence of non-infectious manifestations is likely to rise. HIV associated pulmonary hypertension (HIV-PH), albeit low prevalence, is associated with significant morbidity and mortality. Presently, despite having scanty evidence on the management modalities of HIV-PH, evidence extrapolated from idiopathic pulmonary hypertension is being utilised to effectively manage some of these patients. Efforts should therefore be made to screen, diagnose and treat these patients. A case of a thirty year old female with HIV disease and severe pulmonary …

Images In Cardiovascular Medicine. Cardiac Tuberculoma., Jeilan Mohamed, Matthias Schmitt, Gerry Mccann, Joan Davies, Joseph Leverment, Derek Chin

Internal Medicine, East Africa

A 43-year–old man with a 6-month history of cough, dyspnea, nocturnal sweats, and weight loss was reviewed in the clinic. Clinical examination revealed cervical lymphadenopathy and indicated constrictive physiology. Initial tests, including chest radiography, sputum examination, QuantiFERON-TB Gold test, and lymph node biopsy, were unyielding. HIV serology was nonreactive.

A Review Of Electroencephalograms Done At The Kenyatta National Hospital, Nairobi, J. O. Jowi, Z. P Kidiga, M. G. Gitau

Internal Medicine, East Africa

Background: Electroencephalogram based studies done elsewhere suggest that epileptiform activity originates predominantly from the left cortical hemisphere. There is evidence that partial epilepsies (focal spike and wave epileptiform discharges on tracings) connotes focal;secondary structural cortical dysfunction.Studies seeking similar findings have not been done locally.

Objective: To review electroencephalograms (BEGs) done at Kenyatta National Hospital (KNH); looking for various types of epileptiform discharges and their cerebral cortex of origin.

Design: Retrospective observational study.

Setting: Kenyatta National Hospital, Nairobi, Kenya- from January 1986 to June 2004

Results: A total10431EEG records were reviewed. Ninety Eight percent of referrals for EEG evaluation was for …

Hiv, Hepatitis B And Hepatitis C Coinfection In Kenya, Reena Shah, Jane Karuru, Mark Nelson, Justin Stebbing

Internal Medicine, East Africa

There are few data regarding hepatitis and HIV coinfection in Africa. In 378 HIV seropositive individuals in Nairobi, 23 (6%) were hepatitis B virus (HBV) and HIV coinfected, four (1%) were hepatitis C virus (HCV) and HIV coinfected and one patient was infected with all three viruses. Coinfected individuals were more likely to be men and older; a lack of HBV vaccination was a risk factor for HIV/HBV coinfection (PU0.001) and tenofovir containing regimens appeared most effective at reducing HBV viral load.