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O PROFWASUNNAAGGREY. "Kinoti SN, Maggwa AB, Turkish J, Wasunna A. Management of acute childhood diarrhoea with oral rehydration therapy at Kenyatta National Hospital, Nairobi, Kenya. East Afr Med J. 1985 Jan;62(1):5-11.". In: East Afr Med J. 1985 Jan;62(1):5-11. John Benjamins Publishing Company; 1985. Abstract
PIP: A study of 125 children aged 0-6 months who were seen at Kenyatta National Hospital for acute diarrhea was conducted between 1982-1983 to determine the benefits of oral rehydration therapy (ORT) in treatment of diarrheal illness. At admission, specimens of stool, blood and urine were collected and examine for bacterial, parasitic, and viral agents (including malaria), serum electrolytes, urea, white cell counts and hematocrit. Children were started on oral rehydration solution (ORS) unless severly dehydrated, in which case intravenous therapy was initiated. 84% of the children were successfully treated with ORS alone regardless of etiological agent found; 15% required IV therapy initially, then were placed on ORS. Average hospital stay was 56.2 hours. Cost of treatment by ORT is less than 20% the cost of IV therapy. When investigators surveyed other health institutions, they found that ORT was used alone in less than 10% of all children seen with diarrhea. A side benefit of ORT is the utilization of mothers in preparation and administration of solution, reducing the demand on hospital staff. Since 20% of all pediatric admissions at Kenyatta are due to acute diarrheal disease, use of ORT would reduce costs tremendously. Initiation of ORT at home may prevent development of dehydration altogether.
O PROFWASUNNAAGGREY. "Kinoti SN, Wasunna A, Turkish J, Gateere R, Desai M, Agwanda R, Juma R. A comparison of the efficacy of maize-based ORS and standard W.H.O. ORS in the treatment of acute childhood diarrhoea at Kenyatta National Hospital, Nairobi, Kenya: results of a pilot.". In: East Afr Med J. 1986 Mar;63(3):168-74. John Benjamins Publishing Company; 1986. Abstract
Two major etiological agents, hepatitis B virus and aflatoxin B1, are considered to be involved in the induction of liver cancer in Africa. In order to elucidate any synergistic effect of these two agents we conducted a study in various parts of Kenya with different liver cancer incidence in order to establish the rate of exposure to aflatoxin and the prevalence of hepatitis infections. Of all tested individuals 12.6% were positive for aflatoxin exposure as indicated by the urinary excretion of aflatoxin B1-guanine. Assuming no annual and seasonal variation, a regional variation in the exposure was observed. The highest rate of aflatoxin exposure was found in the Western Highlands and Central Province. The incidence of hepatitis infection nationwide as measured by the presence of the surface antigens was 10.6%, but a wide regional variation was observed. A multiplicative and additive regression analysis to investigate if hepatitis and aflatoxin exposure had a synergetic effect in the induction of liver cancer was negative. However, a moderate degree of correlation between the exposure to aflatoxin and liver cancer was observed when the study was limited to certain ethnic groups. The study gives additional support to the hypothesis that aflatoxin is a human liver carcinogen.

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