Medical Specialties Commons^™

Pregnancy Care Integrating Translational Science, Everywhere (Precise): A Prospective Cohort Study Of African Pregnant And Non-Pregnant Women To Investigate Placental Disorders – Cohort Profile, Rachel Craik, Joseph Akuze, Marie-Laure Volvert, Hannah Blencowe, Moses Mukhanya, Angela Koech, Grace Mwashigadi, Marleen Temmerman, Marvin Ochieng, Emily Mwadime

Centre of Excellence in Women and Child Health

Purpose: The Pregnancies' Care Integrating translational Science, Everywhere Network was established to investigate specific placental disorders (pregnancy hypertension, preterm birth, fetal growth restriction and stillbirth) in sub-Saharan Africa. We created a repository of clinical and social data with associated biological samples from pregnant and non-pregnant women. Alongside this, local infrastructure and expertise in the field of maternal and child health research were enhanced.

Participants: Pregnant women were recruited in participating health facilities in The Gambia, Kenya and Mozambique at their first antenatal visit or at the time a placental disorder was diagnosed (Kenya and The Gambia only). Follow-up study …

Editorial: Promoting Patient-Centered Care For Pediatric Rheumatology Across Africa, Wafa Hamdi, Angela Migowa

Paediatrics and Child Health, East Africa

Pediatric rheumatology remains an evolving field in Africa, where challenges such as limited specialist availability, diagnostic delays, and inadequate public awareness hinder optimal patient care (1). Similarly, research in this field remains scarce, with a significant lack of data needed to define the spectrum and clinical expression of these diseases. Capturing real-world experiences and field reports is invaluable, as it provides critical insights to identify key areas for action and develop strategies to advance research in Africa. This collection of six manuscripts offers valuable perspectives on various aspects of pediatric rheumatic diseases, including caregiver experiences, diagnostic challenges, therapeutic patient education, …

A Survey On The Use Of Continuous Positive Airway Pressure In Newborn Care In Kenya In 2017–2018, Jemma L. Wright, Emma Haddon, Helen Nabwera, Fiona M. Dickinson, Mary Jo Hoare, Pamela Godia, Judith Maua, Mercy K. Sammy, Bridget C. Naimoi, Onesmus Muchemi

Centre of Excellence in Women and Child Health

Background

Globally, complications of preterm birth are the leading cause of under-5-mortality. Respiratory distress syndrome (RDS) is a common and life-threatening complication among preterm infants. Continuous positive airway pressure (CPAP) is a relatively simple and effective intervention that is recommended for RDS treatment. However, appropriate infrastructure and processes are required to ensure that it is used safely, effectively and sustainably. This study describes how CPAP was used in newborn care in Kenya between 2017–2018. Our aim was to identify enablers, barriers and gaps in CPAP use.

Methods

A cross-sectional survey was carried out across all newborn baby units in Kenya …

Uterus Didelphys Bicollis Bicolpos —A Case Report, Felix Oindi, Felix Nyagaka

Obstetrics and Gynaecology, East Africa

Uterus didelphys refers to a congenital uterine anomaly that occurs due to failed fusion of the paired Müllerian ducts. It is characterized by two separate noncommunicating uterine horns each with its cervix and fallopian tube. Duplication may be limited to the uterus, cervix or also involve the vagina. Here, we present a case of a 27-year-old primigravida incidentally diagnosed during pregnancy, followed up with cervical cerclage at 13 weeks due to a short cervix and had preterm delivery via cesarean section at 35 weeks. She had a successful pregnancy outcome and an uneventful postnatal course. Uterus didelphys is associated with …

The Effect Of A M-Health Application Compared To Standard Of Care On Adherence To Preoperative Fasting Instructions Among Adult Patients Undergoing Elective Surgery: A Randomized Controlled Study, Ivy Njeri Wanyoike

Master of Medicine in Anaesthesiology

Background: Preoperative fasting has been a pillar of the practice of anaesthesiology with the main aim of enhancing patient safety by reducing the risk of aspiration. Current clinical guidelines on preoperative fasting guidelines encourage shorter durations of fasting in keeping with current evidence that shows better patient outcomes while maintaining patient safety. Despite this, adherence to preoperative fasting instructions remains universally poor, with patients enduring long fasting periods. Advances in mobile technology, improving internet access and the widespread availability of smartphones have made mobile health a useful tool in patient care. mHealth applications are being increasingly used in perioperative …

Experiences And Attitudes Of Caregivers During Mealtimes In Children With Autism Spectrum Disorder At A Tertiary Facility In Kenya., Lynnette Muthoni Mwangi

Master of Medicine in Paediatrics and Child Health

Introduction: - ASD is a neurodevelopmental disorder characterized by deficits in social interactions and communication along with restrictive and repetitive behaviours affecting 1 in 100 children globally, with a higher prevalence in males. Despite the rising global statistics, there is limited information regarding the prevalence of ASD in Sub-Saharan Africa. Children with ASD often experience feeding challenges, which have been broadly categorized as food selectivity, food refusal, and disruptive mealtime behaviour, which poses challenges for caregivers during mealtime. While medical management of ASD receives considerable attention, less focus has been placed on the impact of ASD on caregivers and …

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 …

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 …

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 …

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 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 …

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 …

Substance Use Among Healthcare Professionals: A Cross-Sectional Study In Kenya, Jasmit Shah, Cynthia Smith, Cyprian Mostert, Linda Khakali, Zul Merali, Sayed Karar

Brain and Mind Institute

Substance use among healthcare professionals, including alcohol, tobacco, marijuana, benzodiazepines etc., is a rising concern. The immensity of substance use is not yet clear, though recently, studies conducted on medical students and physician trainees show that 10% to 15% of all healthcare professionals misuse drugs at some point in their career, and that 6% to 8% of physicians have a substance use disorder. Substance use has a direct impact on relationships, physical health, and job performance, and is associated with depression, burnout, and decreased career satisfaction. The aim of this study was to shed light on the prevalence of substance …

Case Series On Prosthetic Valve Thromboses Treated With Intravenous Thrombolysis At A Tertiary Teaching Hospital In Nairobi – Kenya, John Odhiambo, Salim Abdallah, Mzee Ngunga

Internal Medicine, East Africa

Valvular heart disease is a significant global health issue, particularly in developing countries where Rheumatic Heart Disease (RHD) is the leading cause. Valve replacement surgeries have increased, with mechanical prostheses favored for their durability. However, thromboembolism remains a critical complication post-surgery, with prosthetic valve thrombosis rates of 0.03% for bioprosthetic valves and between 0.5% to 8% for mechanical valves in the aortic and mitral position. This report details two cases of heart failure following valve replacement due to rheumatic heart disease. The first case involves a 42-year-old female who developed prosthetic valve thrombosis after discontinuing warfarin for menorrhagia postmechanical mitral …