Medicine and Health Sciences Commons^™

Understanding Adolescent Perinatal Wellbeing In Rural Parts Of Kenya: A Qualitative Study, Evaline Chepchirchir Langat, Marleen Temmerman, Margrette Hanselmann, Kethakie Lamahewa, Violet Naanyu, Mellan Lilumbi, Tatiana Taylor Salisbury

Centre of Excellence in Women and Child Health

Introduction: Despite global efforts to reduce adolescent birth rates, the problem persists in low- and middleincome countries. Sub-Saharan Africa has the highest rates (97.9 births per 1000 women). In Kenya, more than 15 % of adolescent girls become pregnant. Forty-three percent of these develop depression. This study investigated adolescent pregnancy in rural Kenya to understand the challenges and context-specific factors that can help adolescents maintain good mental health during pregnancy and the motherhood.

Methods: An exploratory qualitative study was conducted in Kilifi County between October and November 2021. A total of 73 participants consented to participate in the …

Community Perspectives On Maternal Dietary Diversity In Rural Kenya, Mozambique And The Gambia: A Precise Network Qualitative Study, Mai-Lei Woo Kinshella, Shilla Dama, Onesmus Wanje, Rosa Pires, Helena Boene, Papa Jagne, Hawanatu Jah, Angela Koech, Grace Mwashigadi, Violet Naanyu

Centre of Excellence in Women and Child Health

Pregnant and lactating women in sub-Saharan Africa are vulnerable to micronutrient inadequacies, with risk of adverse pregnancy outcomes. Adequate intakes of diverse foods are associated with better micronutrient status and recommended by the World Health Organization as part of healthy eating counselling during antenatal care. However, our understanding of community knowledge of dietary diversity within the context of maternal diets is limited. We used a descriptive qualitative approach to explore community perceptions of dietary diversity during pregnancy and lactation, as well as influencing factors in sub-Saharan Africa. A total of 47 in-depth interviews were conducted between May and October 2022 …

Standardization And Quality Control Of The Introduction Of A Noninvasive Cardiac Output Monitor For Pregnancy Measurements In A Low- And Middle-Income Country, Helen Perry

Centre of Excellence in Women and Child Health

Introduction :There is increasing awareness of the role of the maternal cardiovascular system in complicated pregnancies. Despite the high disease burden, noninvasive cardiac output monitors have not been used extensively in low- and middle-income countries. The aim of this study was to evaluate the quality control of the use of the ultrasonic cardiac output monitor (USCOM) 1A® in a LMIC.

Material and Methods This was a quality assessment study of the introduction of the USCOM 1A® to measure maternal hemodynamic indices. Inter-observer agreement was assessed across all four study sites by intraclass correlation coefficient. Quality control was assessed using pre-defined …

Strengthening The Paediatric Clinical Trial Ecosystem To Better Inform Policy And Programmes, James A. Berkley, Judd L. Walson, Glenda Gray, Fiona Russell, Zulfiqar Ahmed Bhutta, Per Ashorn, Shane A. Norris, Ebunoluwa A. Adejuyigbe, Rebecca Grais, Bernhards Ogutu

Institute for Global Health and Development

The first WHO Global Clinical Trials Forum was convened in November, 2023 to develop a shared vision of an effective global clinical trial infrastructure. The Paediatric Clinical Trials Working Group was formed to provide perspectives, identify challenges, and propose solutions to strengthen the paediatric clinical trials ecosystem. Participants represented paediatric disciplines, including infectious diseases, nutrition, neonatology, pharmacology, oncology, neurodevelopment, public health, and policy. Childhood diseases have profound lifelong effects on health, livelihoods, and societies. Investment in early childhood results in highly cost-effective changes to lifelong health, productivity, and human capital returns. Yet, there remain substantial gaps in knowledge on the …

Estimation Of Therapeutic Threshold For Tuberculosis Using Adapted Nominal Group Technique And Clinical Vignettes In Clinical And Community Settings In Southern Africa, Alfred Kipyegon Keter, Alastair Van Heerden, Tom Decroo, Tom Boyles, Shannon Bosman, Thandanani Madonsela, Lindani Innocent Msimango, Lenika Naiken, Carlos Kiyan, Mashaete Kamele

Population Health, East Africa

Background: When confronted with diagnostic uncertainty and a decision on whether to start treatment or not, clinicians consider the potential harm and benefit of offering versus withholding treatment. Treatment can be offered if the probability of tuberculosis (TB) in the patient is above the “therapeutic threshold” (ThT): the probability of disease at which the expected utility of treating and not treating is the same. We estimated ThT for TB in clinical and community settings in Southern Africa using two methods: an adapted nominal group technique (aNGT), and decisions made based on clinical vignettes (CVs).

Methods: We enrolled health …

Emergence Of Transferable Daptomycin Resistance In Gram-Positive Bacteria, Tessa Marciniak, Lukas Kirchner, Silver A. Wolf, Birgit Walther, Thorsten Bischler, Justin Nyasinga, R Gunturu, Torsten Semmler, Tom Gräfenhan, Andrew Whitelaw

Pathology, East Africa

Daptomycin (DAP) is a last-resort antibiotic to treat infections by multiresistant Gram-positive pathogens, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci. DAP resistance and clinical treatment failure has been associated with adaptive chromosomal mutations, but so far not with transmissible resistance traits. Here we report for the first time an acquired DAP-R determinant (named drc) that we detected in a livestock-associated Mammaliicoccus sciuri isolate. drc consists of a two-gene operon (drcAB) that is controlled by an adjacent two-component system (drcRS). The DrcAB proteins, which mediate DAP inactivation, are similar to BceAB-like antimicrobial peptide transporters of Gram-positives, but are distinct from …

Rising Incidence Of Acute Hepatitis A Among Adults And Clinical Characteristics In A Tertiary Care Center Of Pakistan, Yumna Shahid, Amna Subhan Butt, Iqra Jamali, Faisal Wasim Ismail

Section of Gastroenterology

Background: For decades, hepatitis A virus (HAV) has been a leading cause of acute hepatitis among children and was less prevalent among adults. However, recently a paradigm shift has been observed in the epidemiology of HAV, as evident by cases of acute hepatitis due to HAV among adults.
Aim: To estimate frequency of HAV in acute viral hepatitis and compare characteristics in HAV and hepatitis E virus (HEV) infection.
Methods: This was a trend analysis conducted at Aga Khan University Hospital Karachi (Sindh, Pakistan) from February 2024 to May 2024. Individuals aged 18 years and older diagnosed with acute viral …

From Past To Present: Tracing Africa’S Path To Universal Health Coverage, Evaline Chepchirchir Langat, Paul Russell Ward, Hailay Abrha Gesesew, Lillian Mwanri

Centre of Excellence in Women and Child Health

At the 58th World Health Assembly in 2005, the international community charted a course for universal health coverage (UHC), aiming to ensure access to health care for all in need, of sufficient quality, and without causing financial hardship. At the time, barriers to accessing health care were overwhelming, particularly in low-and middle-income countries like Africa. Currently, 50 of Africa’s 54 countries are in various phases of UHC implementation. Some are developing national UHC agendas, while others have made significant progress but still face gaps in meeting UHC targets. This mini review comprehensively examines the literature to understand the temporal and …

Evaluating The Effect Of Consumption Of Fermented Foods On Glycemic Control And Markers Of Cardiometabolic Risk Amongst Pre-Diabetic And Type 2 Diabetes Mellitus Adult Patients: A Systematic Review And Meta-Analysis, Alex Makau Muia

Master of Medicine in Family Medicine

Introduction 

Type 2 diabetes mellitus (T2DM) remains a major global health challenge, particularly in resource limited countries where conventional treatments are often inaccessible or unaffordable. While lifestyle interventions can reduce diabetes risk, their efficacy is moderate, highlighting the need for alternative strategies. Fermented foods (FFs), which are widely available and affordable, have been shown to improve glucose metabolism and may offer a promising adjunct in the prevention and management of T2DM and prediabetes.

Methods 

A systematic review and meta-analysis were conducted to assess the effects of fermented food consumption on glycemic control and cardiometabolic risk markers in adults with prediabetes …

African Guidelines For Diagnosis And Management Of Polyarticular Juvenile Idiopathic Arthritis: Paflar Initiative, Mohammed Hassan Abu-Zaid, Angela Migowa, Hanna Lishan Kassa, Wassila Messadi, Yassmine Taha, Yaninga Halwani Fuseini, Madeleine Ngandeu, Yasser El Miedany, Michael Hofer, Wafa Hamdi

Paediatrics and Child Health, East Africa

Background Juvenile idiopathic arthritis (JIA) is the most common rheumatologic disease of childhood. The Existing guidelines for polyarticular JIA are typically based on data from non-African populations and may not fully address the unique challenges faced in African settings. We aimed to produce updated African guidelines for the diagnosis and treatment of children and adolescents with polyarticular juvenile idiopathic arthritis (poly-JIA).

Methods This study was conducted with the aim of reaching a consensus among African experts on the diagnosis and treatment of poly-JIA using the Delphi technique. The frst scientifc committee identifed a total of 15 key clinical questions according …

Neurocognitive Gains Among Ugandan Children With Sickle Cell Anemia On Hydroxyurea: 18-Month Trial Interim Results, Shubaya Kasule Naggayi, Dennis Kalibbala, Vincent Mboizi, John M. Ssenkusu, Zhezhen Jin, Caterina Rosano, Deogratias Munube, Bill Wambaka, Ruth Namazzi, Robert Opoka

Paediatrics and Child Health, East Africa

Children with sickle cell anemia (SCA) frequently develop progressive neurocognitive impairment. We aimed to determine effects of hydroxyurea therapy on neurocognitive function in Ugandan children with SCA by comparing levels at enrollment to a planned 18-month interim assessment. Ugandan children (N=264) ages 3-9 years were enrolled from a SCA clinic and treated in a 30-month singlearm open-label trial with escalation to maximum tolerated dose (MTD). Primary outcome was the effects of hydroxyurea on cognition, attention and executive function, along with transcranial doppler ultrasound (TCD) blood flow velocity. Sibling controls (N=110) without SCA underwent neurocognitive testing in parallel to establish age-normalized …

Risk Factors And Public Health Interventions Associated With Adolescent Pregnancy Prevention Among Females Aged 10–19 Years In Kenya: A Scoping Review Protocol, Kimbley Asaso Omwodo, Abdu Mohiddin, Danielle Denwood, Augustine N. Gitonga

Centre of Excellence in Women and Child Health

Background ; Adolescent pregnancy is associated with multifaceted challenges that impact countries’ health, education and economic stability. Despite ongoing interventions, in developing countries such as Kenya, adolescent pregnancy rates continue to be high. There is a need for more synthesised evidence on regional-specific risk factors to support tailored prevention strategies.

Objective; This scoping review aims to explore what is known about the risk factors and intervention strategies focused on adolescent pregnancy prevention in Kenya.

Methods and analysis; Using the Arksey and O’Malley framework combined with a three-step search strategy as recommended by the Joanna Briggs Institute, relevant articles will be …

Violence Against Healthcare Workers In Kenya: A Cross-Sectional Sub-Analysis Of The Global Vishwas Study, Reena Shah, Jasmit Shah, Rakhtan K. Qasba, Ruman K. Qasba, Annastacia Mbithi, Eric Njenga, Akshat Banga, Rahul Kashyap, Salim Surani

Institute for Educational Development, East Africa

Background: Global concern exists for workplace violence against healthcare workers (HCWs), especially in low and middle-income nations. This violence includes physical, verbal, or sexual abuse and has a significant impact despite initiatives like Occupational Safety and Health Administration (OSHA) guidelines. We conducted a study in Kenya to address this issue.

Methods: We did a cross-sectional survey that collected responses during June 6th to August 9th, 2022, focused on healthcare professionals in Kenya within the global ViSHWaS study. Violence against healthcare professionals in multiple Kenyan counties was analysed, The study reached participants through social media, emails, and other channels using a …

Current Management Of Skin Conditions In Kenya: Exploring Teledermatology Preferences And Perspectives Among Providers, Jennifer Fernandez, Hashim Kaderbhai, Jennifer Adams, Mary B. Adam, Rodney Adam

Internal Medicine, East Africa

Background: Teledermatology programs may help expand access to care for skin conditions in areas that are underserved by dermatologists such as sub-Saharan Africa, but their success requires input from participating providers.

Objective: This study assesses teledermatology preferences among healthcare providers in Kenya.

Methods: An anonymous cross-sectional survey of nondermatology providers was conducted in Kenya from January to March 2024 at Aga Khan University Hospital-Nairobi and Kijabe Hospital.

Results: Among the 38 providers, 81.6% were physicians. Patient population was primarily Fitzpatrick skin types V and VI. Almost all (97.4%) regularly encountered patients with skin disorders, yet only …

Global Burden Of Major Chronic Liver Diseases In 2021, Gong Feng, Yusuf Yilmaz, Luca Valenti, Wai Kay Seto, Calvin Q. Pan, Nahum Méndez Sánchez, Feng Ye, Silvia Sookoian, Giovanni Targher, Christopher Opio

Internal Medicine, East Africa

Background: This study utilised the Global Burden of Disease data (2010–2021) to analyse the rates and trends in point preva-lence, annual incidence and years lived with disability (YLDs) for major chronic liver diseases, such as hepatitis B, hepatitis C,metabolic dysfunction-associated liver disease, cirrhosis and other chronic liver diseases.

Methods: Age-standardised rates per 100,000 population for prevalence, annual incidence and YLDs were compared acrossregions and countries, as well as the socio-demographic index (SDI). Trends were expressed as percentage changes (PC) andestimates were reported with uncertainty intervals (UI).

Results: Globally, in 2021, the age-standardised rates per 100,000 population for the …

Management Of Pulmonary Arterial Hypertension: Current Strategies And Future Prospects, Munish Sharma, Vivek Paudyal, Saifullah Khalid Syed, Rubi Thapa, Nadeem Kassam, Salim Surani

Internal Medicine, East Africa

Primary pulmonary hypertension (PPH), now known as pulmonary arterial hypertension (PAH), has induced significant treatment breakthroughs in the past decade. Treatment has focused on improving patient survival and quality of life, and delaying disease progression. Current therapies are categorized based on targeting different pathways known to contribute to PAH, including endothelin receptor antagonists (ERAs), phosphodiesterase-5 inhibitors (PDE-5 inhibitors), prostacyclin analogs, soluble guanylate cyclase stimulators, and activin signaling inhibitors such as Sotatercept. The latest addition to treatment options is soluble guanylate cyclase stimulators, such as Riociguat, which directly stimulates the nitric oxide pathway, facilitating vasodilation. Looking to the future, advancements in …

The Swahili Version Of The Cd-Risc 10 Resilience Scale: Psychometric Properties And Factors Associated With Resilience Among Healthcare Workers In Tanzania, Kevinson Mwangi, Sabina Odero, Gideon Mbithi, Rachel Odhiambo, Rosemary Stephen, Tumbwene Mwansisya, Eunice Pallangyo, Eunice Ndirangu, Amina Abubakar

Institute for Human Development, East Africa

Background: Despite the central role of resilience in promoting mental well-being, little is known about the resilience process among healthcare workers in East Africa, partly due to the lack of adequately standardised and psychometrically sound assessment tools for our context. This study provides the first psychometric evaluation of the Swahili version of the Connor-Davidson Resilience Scale 10 (CD-RISC 10) among nurses/midwives and community health volunteers (CHVs) in Tanzania, potentially informing the accuracy of measuring resilience in this setting. Additionally, we examine factors associated with self-reported resilience as measured by the CD-RISC 10 scale.

Methods We used cross-sectional data on nurses/midwives …

The Feasibility Of Pharmacokinetic-Based Dosing Of Hydroxyurea For Children With Sickle Cell Anaemia In Uganda : Baseline Results Of The Alternative Dosing And Prevention Of Transfusions Trial, Alexandra Power Hays, Ruth Namazzi, Min Dong, Caroline Kazinga, Charles Kato, Sadat Aliwuya, Kathryn Mcelhinney, Andrea L. Conroy, Adam Lane, Robert Opoka

Paediatrics and Child Health, East Africa

Pharmacokinetic (PK)-guided dosing of hydroxyurea for children with sickle cell anaemia (SCA) could optimize dosing and improve outcomes, but its feasibility has not been demonstrated in low-resource settings where the majority of affected children live. Alternative Dosing And Prevention of Transfusions (ADAPT) is a prospective trial evaluating blood transfusions and the feasibility of determining PK-guided, hydroxyurea maximum tolerated doses (MTD) for children with SCA in Uganda, using portable high-performance liquid chromatography (HPLC) and a novel PK software programme (HdxSim). ADAPT enrolled 106 participants, and 100% completed PK testing. PK-guided doses were generated for 78%, of which 38% were within the …

Self-Inflicted Chronic Laparoscopic Wounds In Endometriosis - Unveiling Major Depressive Disorder- A Case Report., Mwangi Maryanne, Charles Muteshi

Obstetrics and Gynaecology, East Africa

Background: There is no case in literature reporting an adolescent with endometriosis with major depressive disorder manifesting as chronic laparoscopic wounds. Major depressive disorder in patients with endometriosis is a common occurrence, but self-directed violence is rare.

Case presentation: We present the case of an adolescent female with chronic pelvic pain and who was treated with medical management that proved ineffective. She then underwent laparoscopic excision of endometriosis. Post-surgery she continued to experience oozing of a brown colored discharge from the primary umbilical port site, and it became a chronic non-healing wound with associated pelvic pain. Four months later she …

Putting The Substance In Substantial Evidence: An Evidence-Based Approach To Flexible Drug Regulation, Emanuel Krebs, Tania M. Bubela, Melanie Mcphail, Christopher Mccabe, Dean A. Regier

Office of the Provost

For new drugs or indications, substantial evidence of clinical effectiveness is required for market authorization. In most jurisdictions, substantial evidence is not explicitly defined. Health regulators exercise discretion and are increasingly tolerant of earlier or less mature evidence. To align with flexible evidentiary standards, we argue for the adoption of a principle and, context-based approach to the evidence threshold. Our approach aims to balance the potential benefits and harms of accelerated authorization, low therapeutic value, and safety, based on a value of information (VoI) framework. In our VoI framework, substantial evidence exists when the expected net health value of further …

Knowledge Of Human Papillomavirus Vaccine As A Determinant Of Uptake Among Guardians Of Adolescent Girls: A Single Hospital Experience In Nairobi, Kenya, Irene Nzisa, Rose Kamenwa, James Orwa, Pauline Samia

Paediatrics and Child Health, East Africa

Abstract : Cervical cancer is one of the most common preventable cancers, causing significant morbidity and mortality in women, especially in Sub-Saharan Africa. Despite the availability of free HPV vaccination, the proportion of adolescent girls vaccinated against HPV remains low.

Methods: Our aim was to identify knowledge and factors influencing HPV vaccine uptake among parents of adolescent girls and to determine the proportion of adolescent girls vaccinated within three months after the provision of additional information on cervical cancer and HPV vaccine. We undertook a mixed methods study design, with an initial cross-sectional part followed by a prospective cohort study …

Evaluating Performance Of The Pre-Eclampsia Integrated Estimate Of Risk-Machine Learning (Piers-Ml) Model In A Kenya Cohort Of Women With Pre-Eclampsia, Felix Mogire Nyagaka

Master of Medicine in Obstetrics and Gynecology

Introduction 

Pre-eclampsia is a leading cause of significant maternal morbidity and mortality and complicates approximately 2%-4% of all pregnancies. Delivery is the only known definitive treatment. Pre-eclampsia can have unpredictable progression with sudden deterioration leading to severe adverse outcomes.

Currently, no adverse maternal risk prediction model is validated for use in sub-Saharan Africa. The new Pre-Eclampsia Integrated Estimate of Risk Machine Learning (PIERS-ML) model identifies women with pre-eclampsia who are at the lowest and greatest risk of severe adverse maternal outcomes within 48 hours of initial assessment and informs their care. Whereas, it has been validated for use in high …

Correlation Between Fetal Abdominal Wall Adiposity And Neonatal Outcomes, Elaine Murugi Nyaga

Master of Medicine in Obstetrics and Gynecology

BACKGROUND 

Fetal growth is a result of complex interactions between genetic, nutritional, environmental, uteroplacental, and fetal factors which impact on delivery and subsequent neonatal outcomes. Fetal abdominal adiposity serves as an important indicator of fetal growth and body composition. While gestational diabetes mellitus (GDM) can influence fetal fat deposition, understanding how adiposity correlates with birth weight and neonatal outcomes in both GDM and non-GDM pregnancies provides insight into the broader significance of fetal adiposity as a marker of fetal health.

Methodology 

A cross-sectional study was conducted on 269 pregnant women to examine fetal abdominal adiposity, measured as fetal abdominal subcutaneous …

The Clinical Phenotype Of Motor Neurone Disease In A Kenyan Hospital – Based Population, Effie Nailah Kamadi

Master of Medicine in Internal Medicine

Introduction: Motor Neurone Disease (MND) is a rare, disabling and incurable illness marked by relentless degeneration of motor neurons with loss of voluntary motor function and eventual death. In the West, patient demographics and clinical characteristics are well documented. Available African research is mostly for North, West and South Africa with a knowledge gap existing on the East African illness. This study characterized MND phenotype in a Kenyan population.

Objectives: To describe the clinical phenotype and outcomes of MND in a Kenyan hospital-based population.

Methods: The medical charts of all adult MND patients assessed at AKUHN between …

Detection Rate And Patterns Of Biochemical Recurrence Of Prostate Cancer Using 18f-Psma-1007 Pet/Ct At A Tertiary Teaching Hospital In Sub-Saharan Africa., Lynet Wairimu Barasa

Master of Medicine in Imaging and Diagnostic Radiology

Background: Rising PSA levels following local therapy with curative intent are seen in about one third of men previously treated for prostate cancer, indicative of disease recurrence. This is usually not detectable through imaging modalities like computed tomography (CT) or magnetic resonance imaging (MRI). Several studies show high detection rates of recurrence with 18F-PSMA-1007 PET/CT, one of the novel PET imaging modalities for prostate cancer. No studies, however, have been done to show the patterns of recurrence in the Sub-Saharan African population in whom prostate cancer is known to occur earlier and be more aggressive. Biochemical recurrence almost always …

Comparison Of Positivity Rate Of Dual Phase Sestamibi Versus Dual Tracer Pertechnetate/Sestamibi In Identification Of Parathyroid Adenomas., Naomi Chirindo Chikuro

Master of Medicine in Imaging and Diagnostic Radiology

Background 

Parathyroid adenomas are the commonest cause of primary hyperparathyroidism. The primary mode of treatment is surgical excision which can only be achieved with pre surgical localization of adenomas. Ultrasound, CT and MRI can be used but the most sensitive and specific imaging modality is parathyroid scintigraphy with use of Sestamibi labelled with technetium 99 metastable radionuclide. A few studies have been done comparing dual phase, dual tracer and combined dual phase/tracer protocols with an apparent lack of consensus on which is superior.

Objectives

This study aimed to compare the positivity rates of the mentioned parathyroid scintigraphy protocols and identify …

The Prevalence And The Predictors Of Diabetes Distress In Patients With Type 2 Diabetes Attending Diabetes Clinics At A Tertiary Private Hospital In Nairobi, Kenya., Soulthy Azamkhan Mohamed

Master of Medicine in Family Medicine

Background Diabetes distress encompasses a spectrum of emotional and psychological challenges faced by individuals managing diabetes, including anxiety, stress, depression, frustration, and feelings of helplessness. This distress arises from the constant demands of monitoring blood sugar levels, managing medications, adhering to dietary restrictions, engaging in regular physical activity, and navigating potential complications. Social and emotional factors such as stigma, discrimination, and concerns about future health further contribute to this burden. Factors like fear of hypoglycemia, financial strain, fluctuating blood sugar levels, anxiety about complications, and impacts on personal relationships exacerbate diabetes distress. Left unaddressed, diabetes distress can lead to poor …

Comparison Of The Use Of Therapeutic Plasma Exchange To Intravenous Immunoglobulin For Autoimmune Neurological Conditions At A Tertiary Hospital In Kenya., Swafiya Salim Busaidy

Master of Medicine in Internal Medicine

Background 

Plasma exchange (Barth et al.) and Intravenous Immunoglobulin (Barth et al.) have emerged as favored therapeutic options for autoimmune neurological conditions. Neurological conditions cause high morbidity and mortality in the sub-Saharan region. The utilization of these treatment options in Sub-Saharan Africa remains relatively unknown. We can determine the most efficient treatments with minimal cost implications by comparing the two treatment modalities in our setup.

Methods 

This retrospective descriptive chart review took place at Aga Khan University Hospital. It encompassed all patients admitted between 1st January 2011 and 31st December 2023 who had a neurological condition that necessitated treatment with …

Diagnostic Accuracy Of 18f-Fdg Pet-Ct Compared To Ultrasound In Identification Of Metastatic Axillary Lymph Nodes In Newly Diagnosed Breast Cancer Patients., Sarah Muthii Kibe

Master of Medicine in Imaging and Diagnostic Radiology

Background: Determination of axillary lymph node metastasis is a crucial part of breast cancer staging as it is the most important marker of overall recurrence and survival. Although axillary ultrasound (AUS) is the imaging reference standard, it has a wide range of sensitivity necessitating evaluation of other imaging modalities that may be used as adjuncts.18F-FDG PET-CT is recommended for use in metastatic and recurrent breast cancer with infrequent use in early disease due to its low spatial resolution for small axillary lymph nodes. The aim of this it study is to evaluate the diagnostic accuracy of axillary ultrasound compared …

Dementia In A Resource-Constrained Sub-Saharan African Setting: A Comprehensive Retrospective Analysis Of Prevalence, Risk Factors, And Management At The Only Neuropsychiatric Facility In Northeastern Nigeria, Ibrahim Abdu Wakawa, Umar Baba Musami, Suleiman Hamidu Kwairanga, Placidus Nwankuba Ogualili, Mohammed Yusuf Mahmood, Muhammad Abba Fugu, Mohammed Mala Gimba, Muktar Mohammed Allamin, Zaharadeen Umar Abbas, Chinedu Momoh

Brain and Mind Institute

INTRODUCTION: Dementia prevalence is increasing in sub-Saharan Africa, poten-tially due to population growth and aging. Resource-constrained settings such asNortheastern Nigeria face challenges in dementia management.

METHODS: We assessed dementia burden and management at the Federal Neuropsy-chiatric Hospital Maiduguri, the only neuropsychiatric facility in Northeastern Nigeria.This retrospective analysis included patient records from 1999 to 2023 for individuals60 year of age and older with a dementia diagnosis.

RESULTS: Of the 1216 cases reported, Alzheimer’s disease (60.5%) was the mostcommon subtype, followed by vascular dementia (24.5%). Hypertension (41.6%) wasthe most frequent comorbidity. Memory loss was present in all cases, whereasbehavioral …