Other Medical Specialties Commons^™

The Influence Of Antiretroviral Therapy On The Qtc Interval In An African Cohort, J. Shavadia, Reena Shah, Gerald Yonga, R. Patel, J. Stebbing, M. Nelson

Internal Medicine, East Africa

Cardiovascular disease in human immunodeficiency virus (HIV) infection encompasses a wide range of pathologic entities, including myocardial, pericardial, and endocardial disease, atherosclerosis, arrhythmias, and vasculitis. The most common manifestations of HIV-associated heart disease in sub- Saharan Africa are pericarditis, cardiomyopathy, and pulmonary hypertension [1]. Coronary artery disease, lipodystrophy, and metabolic syndrome, although common in developed countries, are traditionally thought to be less clinically significant problems in the African subcontinent [2]. It is well known that prolongation of the QTC interval can predispose patients to potentially fatal ventricular tachyarrhythmias, particularly torsades de pointes, and thus is an independent predictor of cardiovascular …

Outbreak Of Beriberi Among African Union Troops In Mogadishu, Somalia, John T. Watson, Hassan El Bushra, Emmaculate J. Lebo, Godfrey Bwire, James Kiyengo, Gideon Emukule, Victor Omballa, John Tole, Muvunyi Zuberi, Robert F. Breiman, Mark A. Katz

Internal Medicine, East Africa

Context and Objectives: In July 2009, WHO and partners were notified of a large outbreak of unknown illness, including deaths, among African Union (AU) soldiers in Mogadishu. Illnesses were characterized by peripheral edema, dyspnea, palpitations, and fever. Our objectives were to determine the cause of the outbreak, and to design and recommend control strategies.

Design, Setting, and Participants: The illness was defined as acute onset of lower limb edema, with dyspnea, chest pain, palpitations, nausea, vomiting, abdominal pain, or headache. Investigations in Nairobi and Mogadishu included clinical, epidemiologic, environmental, and laboratory studies. A case-control study was performed to identify risk …

Cytological Diagnosis Of Typical Carcinoid On Bronchoscopic Brush Smears In An Hiv-Positive Patient, Neeta Kumar, Shahin Sayed, Swati Das

Internal Medicine, East Africa

We report a case of typical carcinoid of the lung in a 60-year-old human immunodeficiency virus (HIV)-positive man diagnosed on brush cytology smears. Bronchial carcinoids are rare tumors, accounting for 1% to 2% of all lung tumors. Although the exact incidence in HIV-infected individuals is not known, the paucity of their documentation in the literature indicates that they may be equally rare. Cytological diagnosis on brush smears is rarely documented as the tumor is covered with mucosa and cellular yield is often not good. In this case, bronchial brushings showed distinctive cytological features of typical carcinoid. The awareness of its …

Familial Clustering Of Cancer In Two Tertiary Care Hospitals In Nairobi, Kenya, G. W. Kiarie, N. O. Abinya, M. D. Joshi, G. N. Lule, G. Z. Mutuma

Internal Medicine, East Africa

Objective: To describe the occurrence of cancers in families of individuals diagnosed cancer.

Design: Cross-sectional descriptive study.

Setting: Outpatient cancer clinics at Kenyatta National Hospital (KNH) and Radiotherapy Clinic at Nairobi Hospital.

Subjects: Patients with a tissue histological or cytological diagnosis of cancer.

Main outcome measures: A reported family history of cancer.

Results: A total number of 485 cancer patients were recruited, 382, from KNH and 103 from Nairobi Hospital. These index cases had 45 different types of cancer, with the most common being breast and uterine-cervical malignancies. Prevalence of family history of cancer was found to be 18.8% and …

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.

Nephropathy In Patients With Recently Diagnosed Type 2 Diabetes Mellitus Black Africans, F. W. Wanjohi, F. C. F. Otieno, E. N. Ogola, E. O. Amayo

Internal Medicine, East Africa

Background: Albuminuria is long recognised as a sign of renal disease in diabetes. In type 1 diabetes, renal disease occurs after a longer duration of diabetic state. In type 2 diabetes, it is more variable.

Objective: To determine the prevalence and any risk factors of albuminuria in short­ term (≤2 yrs) type 2 diabetes.

Design: Cross sectional, descriptive study. Microalbuminuria was assessed using micro II strips.

Setting: Outpatient diabetic clinic at Kenyatta National Hospital, Nairobi.

Subjects: Patients who were newly diagnosed or had had type 2 diabetes for two years or less.

Main outcome measures: Microalbuminuria, lipids, glycated haemoglobin, fasting …