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2011

Chunge, CN, Chunge RN, Masinde MS, Atinga JN.  2011.  An Outbreak of Acute Schistosomiasis Following a Church Retreat to Mwanza, Tanzania, 2008. Journal of Travel Medicine Volume . 18(6):408–410. Abstract

Clinical and laboratory findings are described from 77 persons from Nairobi, Kenya, of whom 66 were diagnosed with acute Schistosoma mansoni infection following a trip to Mwanza, Tanzania. Unusual ocular symptoms were observed as a rare manifestation of acute schistosomiasis. The outbreak highlights the risk of swimming in Lake Victoria.

2010

Ojuka, D, Ating’a J, Ojuka D.  2010.  Redisplacement Rates after Reduction and Cast Immobilization of Isolated Distal Radial Fractures. Annals of African Surgery. 5 AbstractWebsite

Background The maintenance of satisfactory alignment in distal radial fractures following closed reduction and casting of the forearm is challenging. Redisplacement rates of between 2 and 91% have been described, mostly for Western populations and for fractures involving both the forearm bones. The local scenario is unexplored. Objective This study sought to determine the rate of redisplacement in isolated closed distal radial fractures in children aged 6-15 years and the factors contributing to the redisplacement. Setting The Kenyatta National Hospital, a teaching and referral hospital in Kenya. Patients and Methods This was a prospective study carried out between June 2005 and February2006. Patients were recruited from casualty, where the fracture was reduced and casted. Immediate check x-rays were taken to ascertain satisfactory alignment. At follow up the fractures were evaluated for redisplacement in the fracture clinic in the second and fourth weeks with further check x-rays. Redisplacement was regarded as the presence of dorsal or volar- angulation of greater than 200. The data was collected and entered into statistical package for social sciences (SPSS) 12.0 version. Comparison of the binomial outcomes of the factors determining the redisplacement of the distal radial fractures was carried out using Fischer’s exact test. P value <0.05 was taken to be significant. Results Ninety-two patients were evaluated. Overall redisplacement rate was 15.7%. Factors significantly associated with redisplacement included initial displacement, completeness of fracture and non-satisfactory initial reduction. Conclusion
The rate of redisplacement of 15.7% reported here is within the range that is considered acceptable. The success of re-manipulation at the KNH is unsatisfactory. Percutaneous K-wiring should be considered for those with complete fractures with displacement that do not achieve perfect reduction at initial check radiographic film

Kireti, VM, Atinga JE.  2010.  Osgood Schlatter disease: An Audit Profile of 35 Adolescents. The Annals of African Surgery, . 6 Abstract

Background
Osgood-Schlatter disease is a common cause of anterior knee pain in the adolescent. Treatment is usually conservative with surgery reserved for those who do not respond to this treatment. There is little published work regarding the experience with the disease in our local set up. This series documents the experience with 35 adolescents treated for the disease.

Design
Case series

Subjects
Thirty five adolescents with clinical and radiological diagnoses of Osgood-Schlatter disease at Nairobi and Kenyatta National Hospitals, between 2001and 2007.

Method
Patients were evaluated for demographics, knee involvement, activities associated with pain and treatment outcome

Results
There were 28 males and 7 females, aged 10 to 16 years (mean 12.8 years). Thirteen had bilateral knee involvement. Twenty two were involved in active sports while the rest had constant pain and unable to sit or kneel. A family history of the disease was documented in one case. Thirty adolescents responded well to the conservative treatment. In the five adolescents who underwent surgery, the patella tendon was edematous with thickening of the tendon sheath and neovascularisation. All the operated adolescents returned to active sports with 6 weeks after the surgery.

Conclusion
Osgood-Schlatter disease is a self-limiting condition in majority of adolescents. Surgery when indicated has an excellent outcome.

Atinga, JEO, Otsyeno FMT.  2010.  Unusual Bones Articulating With the Pelvic Girdle. The Annals of African Surgery, . 6 Abstract

We report a case of a 44 year old man who presented with right gluteal pain following trivial trauma, associated with unusual bones, with all the characteristics of clavicles articulating with the pelvic girdle. The pain on that side was completely relieved by excision of the bone.

2007

Oburu, E, Ating'a JEO.  2007.  Non-Metabolic Causes Of Pathological Fractures in Kenyatta National Hospital in Kenya: A Descriptive Prospective Study. . East and Central African Journal of Surgery. 12(1):19-23. Abstract

Background: Pathological fractures pose a major challenge to surgeon since he has to treat both the fracture and the pathology associated with it. This study was aimed at determining the pattern of non-metabolic causes of pathological fractures in Kenyatta National Hospital.
Methods: Thirty-eight patients with 53 non-metabolic pathological fractures admitted to the orthopaedic wards were recruited into the study during the period of April 2002 and January 2003. Patient’s demographic and clinical data was collected by the lead investigator. Data was collected by the use of a questionnaire designed for the study. The data was analysed using Microsoft excel software.
Results: The age range was between 1 to 74 years with a peak age in the sixth decade; the male to female ratio was 1:1. The most common causes of these fractures were malignancy, which constituted 47% of all fractures, followed by infection (31%). Osteomyelitis was the cause of all the paediatric pathological fractures. The lower limb was the most common site of pathological fractures regardless of age (47%) and the spine was second (43%). While patients with spinal fractures presented with the complaints of back pain and difficulty in walking, trivial trauma was the most common complaint of patients with appendicular skeleton fractures.
Conclusion: The most common cause of non metabolic pathological fractures in adults was malignancy and osteomyelitis was the most common cause of pathological fracture in children. While there are some differences in the aetiology of these fractures in Kenya from what is documented in literature, the sites and mode of presentation concur although a significant percentage of patients present late

Awori, KO, Ating’a JEO.  2007.  Early outcome of vascular lower limb amputations at a National Referral Hospital in Kenya. Annals of African Surgery. 1 Abstract

BACKGROUND: Majority of lower limb amputations performed in the African setting have been reported to be mainly due to trauma and neoplasms. These affect mainly young
and therefore, fit individuals with lower risks of complications. Recent local studies show an increase in the incidence of cardiovascular diseases including peripheral vascular diseases.
These are associated with higher rates of both systemic and amputation stump-related complications. There is however little published data in Africa on the outcomes of vascular lower
limb amputations.
OBJECTIVE: To determine the early outcome of vascular lower limb amputations.
DESIGN: Descriptive prospective study, conducted between July 2003 and June 2004.
SETTING: The Kenyatta National Hospital, the largest referral and teaching hospital in Kenya.
SUBJECTS: All patients with gangrene of the lower limb due to occlusive peripheral vascular disease not caused by trauma or inappropriate limb splintage who were amputated at Kenyatta
National Hospital during the study period were included.
OUTCOME MEASURES: These included the wound healing time, number of stump revisions, number of conversions to a higher
amputation level, the thirty-day post-operative mortality and the hospitalization period.
CONCLUSION: While the findings of this study compare with other series, the prolonged hospital stay is of concern considering the younger average age of the patients.

Ating’a, JEO, KO A.  2007.  Lower limb amputations at the Kenyatta National Hospital, Nairobi. East Afr Med J. 2007 Mar;84(3):121-6.. Occasional Publication Number 3 2003. pp 21-32. : E Afr Med J Abstract

OBJECTIVE: To determine the causes and pattern of lower limb amputations at the Kenyatta National Hospital. DESIGN: Descriptive prospective study. SETTING: The Kenyatta National Hospital between July 2003 and June 2004. RESULTS: A total of 77 lower limb amputations (LLA) were performed on 74 patients. The age ranged from seven months to 96 years (mean 44.8 +/- 22.5). Forty six patients (62.1%) were male. Majority of the patients (89.1%) had primary or no formal education, forty one (55.4%) were unemployed, with 39% self employed in the informal sector. Peripheral vascular diseases were the main indication for LLA (55.3%), 13 patients (17.5%) due to diabetes-related gangrene. Eighteen patients (24.3%) had tumours, mainly osteogenic sarcoma (16.2%), while trauma accounted for 18.9%. Forty two (55%) of the amputations were above-the-knee, 24 (31%) below-the-knee, four (5%) hip disarticulations and seven (9%) were foot amputations. CONCLUSION: This study found peripheral vascular diseases unrelated to diabetes to be the main indication for lower limb amputations at Kenyatta National Hospital contrary to previous institutional and loco-regional studies which report trauma as the leading cause. Further investigation into vascular causes is therefore recommended.

2005

OLUOCH, PROFATINGAJOHNERNEST.  2005.  Hassan S, Macharia WM, Atinga J.Self reported alcohol use in an urban traffic trauma population in Kenya. East Afr Med J. 2005 Mar;82(3):144-7.. Occasional Publication Number 3 2003. pp 21-32. : E Afr Med J Abstract
BACKGROUND: Kenya has a soaring rate of road traffic fatalities. Available evidence suggests significant alcohol-relatedness to trauma. We know little about the prevalence of alcohol-related injuries in Nairobi. OBJECTIVE: To determine the extent and pattern of alcohol use in subjects admitted following road traffic accident. DESIGN: A descriptive hospital based survey. SETTING: Kenyatta National Hospital (KNH)- a university affiliated hospital in Nairobi, Kenya. RESULTS: The overall incidence of alcohol use was 26.3%. This was higher in males (29.6%) than females (9.1%). Use was 24.4%, 31.0%, 28.6% and 13.6% in the 16-25, 26-35, 36-45 and 46-55 age groups respectively. The mean ages, pre-hospital times and ISS were similar for the AUG and NAUG. The incidence of males, weekend injuries, night collisions, and pedestrian involvement was 94.4%, 69.4%, 41.7%, 77.8% in the AUG and 83.2%, 35.6%, 19.8% and 61.4% in the NAUG respectively. The incidence of head and extremity injuries in AUG was 27.8% and 50% respectively compared to 11.9% and 66.3% in the NAUG. Treatment costs were higher for the NAUG. CONCLUSIONS: The results suggest a high incidence and potential alcohol-relatedness to road trauma in Nairobi. The study calls for objective evaluation of the extent, interactions and effects of this modifiable trauma factor.

1995

OLUOCH, PROFATINGAJOHNERNEST, DR. MUTISO VINCENTMUOKI.  1995.  The Conservative Management of Back Pain by Corset. African Journal of Medical Practice, 2: 196 - 197. : E Afr Med J Abstract
n/a
OLUOCH, PROFATINGAJOHNERNEST.  1995.  Lateral Condylar Mass Fracture of the Elbow in Children. African Journal of Medical Practice, Vol. 2: 160 - 162. : E Afr Med J Abstract
n/a

1984

OLUOCH, PROFATINGAJOHNERNEST.  1984.  Conservative management of supracondylar fractures of the humerus in Eastern Provincial General Hospital, Machakos.. East Afr Med J. 1984 Jul;61(7):557-60.. : E Afr Med J Abstract
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1980

Oluoch, AJ.  1980.  A Comparative Study Of Needle Aspiration Biopsy With Histology In The Diagnosis Of Enlarged Prostate. Abstract

Forty one patients with enlarged prostate were studied
as regards their acid phospatase estimation, clinical findings
on rectal examination and needle aspiration biopsy. The results
of this study were compared with histological diagnosis after
surgery. It was found that combined needle aspiration biopsy,
rectal examination plus acid phosphatase estimation gave a
reliable diagnosis of pathological state of prostate gland in
terms of malignancy in 82 per cent of the cases.
Since the disease in consideration is early cancer, the
combined diagnostic approach as above can be quite useful in
contemplating early surgery to eradicate early cancer with hope of
cure. On the other hand, those who believe in hormonal therapy
and want to avoid operation can start the hormonal treatment quite
early.

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