Publications

Found 31 results

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2015
Ominde BS, Awori KO, Olabu BO, Ongen'o JA. "Anatomical Measurements of the Distal Clavicle in a Kenyan Population." Anatomy Journal of Africa. 2015;4(1):450-456.
Gichangi P, Mugania S, Olabu Beda. "Elastic Fibre System in the Shaft of Adult Human Penis." Anatomy Journal of Africa. 2015;4(1):466-475.
beryl Ominde S, Olabu B, Ongeng'o J. "Length of Coronary Sinus in a Black Kenyan Population: Correlation with Heart Length." Anatomy Journal of Africa. 2015;4(1):488-495.
Olabu BO, Loyal PK, Matiko BW, Nderitu JM, Misiani MK, Ogeng’o JA. "Variant Anatomy of the External Jugular Vein." Anatomy Journal of Africa. 2015;4(1):518-527.
2014
Ogeng'o J, Ongeti K, Obimbo M, Olabu B, Mwachaka P. "Features of atherosclerosis in the tunica adventitia of coronary and carotid arteries in a black kenyan population." Anat Res Int. 2014;2014:456741. Abstract

Introduction. Histologic changes which occur in the tunica adventitia during initiation, progression, and complications of atherosclerosis are seldom reported. This study aimed at describing the features of atherosclerosis in the tunica adventitia of two of the commonly afflicted arteries, namely, left anterior descending coronary and common carotid in black Kenyans. Materials and Methods. Specimens from 108 individuals [76 males and 32 females, mean age 34.6] were processed for paraffin embedding. Seven micron thick sections were stained with Mason's trichrome and Haematoxylin/Eosin and examined with a light microscope. Results. Features of atherosclerosis were present in the tunica adventitia of 14.8% of left anterior descending arteries and 11.1% of common carotid arteries. Increase in adventitial thickness was associated with increased density of vasa vasora in 8.3% of both arteries. In the left anterior descending and common carotid arteries, 6.5% and 3.7% of cases, respectively, the tunica adventitia thickened without intimal hyperplasia. Conclusion. Features of atherosclerosis occur in the tunica adventitia of coronary and carotid arteries in over 10% of the black Kenyans studied. These features often precede the intimo medial changes. Tunica adventitia should therefore be prioritized in evaluation for atherosclerosis, in individuals at risk. This may enhance early detection and intervention.

B O, P G, H S, J O’o. "Castration causes progressive reduction of length of the rabbit penis." Anatomy Journal of Africa. 2014;3(3):412-416.
2013
Olabu BO, Okoro DO, Thigiti JM, Oramisi VA. "Impact of socio-cultural practice of infant/young child gum lancing during teething." J Clin Pediatr Dent. 2013;37(4):355-9. Abstract

Fever and diarrhea are among the common morbidities that do occur during infancy and are sometimes wrongly associated with teething by the community. Some societies practice gum lancing, ordinarily referred to as gum cutting, as a remedy for the "teething diarrhoea". These myths have a potential of giving false security with the belief that these symptoms are part of the teething process, and so medical attention may not be sought when necessary. There are few studies focusing on the outcome of such practices despite their known potential dangers.

Ogeng'o JA, Gatonga PM, Olabu BO, Nyamweya DK, Ong'era D. "Pattern of congestive heart failure in a Kenyan paediatric population." Cardiovasc J Afr. 2013;24(4):117-20. Abstract

Heart failure in children is a common cause of morbidity and mortality, with high socio-economic burden. Its pattern varies between countries but reports from Africa are few. The data are important to inform management and prevention strategies.

Ogeng ’o JA, ONGETI K, Misiani M, Olabu B. "Maintaining excellence in Teaching of Human Anatomy: University of Nairobi Experience." Anatomy Journal of Africa. 2013;2(1):117-129. Abstract

Experience in maintaining excellence in teaching of human anatomy is important in informing strategies to mitigate worldwide decline in the level of knowledge of human anatomy among medical students and qualifying doctors. Factors responsible for the decline include reduction in teaching time, inadequate teachers and undermining of cadaver dissection. Measures to address these challenges have resulted in wide disparities in curriculum design, teaching methods, number and composition of instructors. Despite the challenges of rising student numbers and staff shortages, the Department of Human Anatomy of the University of Nairobi has maintained excellence in teaching for over 40yrs. This article describes the teaching of anatomy at the University with a view of elucidating the practices from which other departments can learn. Analysis reveals that human anatomy is allocated 630hrs per year of which 350hrs are assigned to gross anatomy with 270hrs devoted to dissection. Although dissection has remained the cornerstone of instruction, it is combined with problem based learning, use of prosections, diagnostic imaging, computer aided and small group teaching. Teaching of gross anatomy is integrated with microscopic, developmental and neuroanatomy. The department runs an intercalated Bachelor of Science degree program, which is a reliable source of members of staff. Over 70% of the staff are surgeons. They are assisted by demonstrators drawn from trainee surgeons and B.Sc. Anatomy graduates. Excellence in teaching anatomy can be maintained by reclaiming sufficient teaching time, combining dissection with other contemporary methods of instruction, integrating gross, microscopic, developmental anatomy, neuroanatomy, involvement of clinicians in teaching, commencing training anatomy early and engagement of demonstrators.

2012
Sinkeet SR, Ogeng'o JA, Elbusaidy H, Olabu BO, Irungu MW. "Variant origin of the lateral circumflex femoral artery in a black Kenyan population." Folia Morphol. (Warsz). 2012;71(1):15-8. Abstract

Variant origin of lateral circumflex femoral artery (FA) is important during harvesting of anterolateral thigh flaps, aortopopliteal by-pass, coronary artery grafting, and vascularised iliac transplant. The frequencies of variant origins display ethnic variations, but reports from black Africans are scarce. This study, therefore, aimed to describe the variant origins of lateral circumflex FA in a black Kenyan population. Eighty-four (42 right and 42 left) lateral femoral circumflex arteries from 42 cadavers (31 male and 11 female) were exposed by dissection of the femoral triangles at the Department of Human Anatomy, University of Nairobi. The arteries were then traced proximally to their parent trunks. Sites of origin were recorded and representative images of the variations taken using a high-resolution digital camera. Data were analysed using Statistical Program for Social Scientists version 16.0 for Windows and presented in tables and macrographs. The lateral circumflex artery was a branch of the profunda femoris in only 65.5% of cases. Variant origins included from a common trunk with medial circumflex artery (14.3%), with profunda femoris (10.7%), as a trifurcation with profunda femoris and medial circumflex FA (7.1%), and from FA (2.4%). Variant origin of the lateral circumflex FA occurred in nearly 35% of the Kenyan population studied, much lower than in oriental populations. The most frequent variant origin is as a common trunk with medial circumflex femoral and profunda femoris, with a very low prevalence of origin from FA. The unusual origins make the artery more vulnerable to iatrogenic injury during surgery and catheterisation. Preoperative angiographic evaluation of the femoral arterial system is recommended.

Ogeng ’o JA, Olabu BO, Obimbo MM, Sinkeet SR, Inyimili MI. "Variant termination of basilar artery in a black Kenyan population." Journal of Morphological Sciences. 2012;29(2):91-93. Abstract

Variant termination of basilar artery influences occurrence of atherosclerosis and aneurysms, and is also important during cerebrovascular surgery and interventional neuroradiology at the basilar bifurcation, interpeduncular fossa and clivus. There are, however, hardly any reports on these patterns. The purpose of this study was to describe the pattern of termination of the basilar artery in a black Kenyan population. One hundred and seventy three (99 male; 74 female) adult cadaveric and autopsy brains of black Kenyans (age range 20-79) were examined. The basilar artery was exposed in its entire length, terminal branches identified and termination pattern recorded. Representative patterns of variations were photographed with a high resolution digital camera. Data were analyzed for frequency and are represented in a pie chart and macrographs. Bifurcation occurred in 142 (82.1%) of cases. In some of these cases, the superior cerebellar and posterior cerebral arteries had a common trunk of origin. Variant terminations included trifurcation (18, 10.4%), quadrifurcation (10, 5.8%) and pentafircation (3, 1.7%). All the variants were related to duplication and/or point of origin of the superior cerebellar artery and occurrence of common trunk of origin for superior cerebellar and posterior cerebral artery. Variant termination of the basilar artery occurs in 17.9% of cases. These variations are related to the pattern of origin of superior cerebellar artery. Anticipation of these variations is important during neuroradiology, cerebrovascular surgery and interpretation of posterior circulatory stroke.

2011
Ogeng'o JA, Obimbo MM, Olabu BO, Gatonga PM, Ong'era D. "Pulmonary thromboembolism in an East African tertiary referral hospital." J. Thromb. Thrombolysis. 2011;32(3):386-391. Abstract

Pulmonary thromboembolism (PTE) is a frequent cause of mortality in Kenya, but its characteristics are hardly reported in Subsaharan Africa. To describe the pattern of PTE among black Africans, in a Kenyan referral hospital. Retrospective study at Kenyatta National Hospital (KNH), Nairobi, Kenya. Records of patients seen between January 2005 and December 2009 were examined for mode of diagnosis, comorbidities, age, gender, treatment and outcome. Data were analyzed using SPSS version 15.0 and are presented in tables and bar charts. One hundred and twenty-eight (60 male; 68 female) cases were analyzed. Diagnosis was made by clinical evaluation, a Well's score of >4.0, high D-dimer levels and ultrasound demonstration of a proximal deep venous thrombosis (DVT, 35.9%), lung spiral computer tomography (CT, 50%), multidetector CT (7.8%) and angiography (6.3%). Most frequent comorbidities included DVT (36%); hypertension (18.8%); pulmonary tuberculosis (PTB, 12.5%); HIV infection (10.9%), pueperium, diabetes mellitus and cigarette smoking (9.4% each). Mean age was 40.8 years (range 5-86 years) with a peak between 30 and 50 years. Over 46% of patients were aged 40 years and less. Male:female ratio was 1:1.13. All the patients were treated with anticoagulants and thrombolytics with only one having embolectomy. Ninety-two patients (71.9%) recovered, 18.8% of them with cor pulmonale, while 28.1% died. PTE is not uncommon in Kenya. It affects many individuals below 40 years without a gender bias, and carries high morbidity and mortality. Associated comorbidities include venous thrombosis, lifestyle conditions and communicable diseases. Control measures targeting both are recommended.

Ogeng'o JA, Otieno B. "Aneurysms in the arteries of the upper extremity in a Kenyan population." Cardiovasc. Pathol.. 2011;20(1):e53-e56. Abstract

Aneurysms in the arteries of the upper extremity are rare but important in predicting aortic aneurysms and their potential to thromboembolize and cause limb loss. Their localization, age, and gender distribution vary between countries depending on ethnic background and cause. These data are valuable in the management of aneurysms, but are largely lacking from the Kenyan population.

Ayugi J, OGENGO J, Macharia I, Olabu B. "Pattern of acquired neck masses in a Kenyan paediatric population." Int J Oral Maxillofac Surg. 2011;40(4):384-7. Abstract

Acquired paediatric neck masses constitute a diagnostic challenge. Their pattern is important in formulating management protocol. Reports from developing countries including Kenya are scarce. This study describes the causes, location, clinical features and gender distribution of these masses in a Kenyan paediatric population. This prospective cross-sectional study was carried out in a regional Eastern and Central African referral centre in Kenya. Children aged 16 years and below with neck masses, who presented to various clinics and wards in a 5 month period were examined. One hundred and eighty four of 235 masses (78%) were acquired. Inflammatory cases were the most common (64%), followed by malignant neoplasm (32%). The most common inflammatory cases were abscesses, reactive lymphadenopathy and tuberculous adenitis. They mainly involved upper cervical and submandibular lymph nodes and were more prevalent in those aged less than 4 years. Lymphomas were the most common malignant masses (42%). Malignant masses were widespread in location; non-tender, and most frequent in those aged 4-8 years. In conclusion, inflammatory conditions consistent with upper airway infection cause most acquired paediatric neck masses, but malignant neoplasms constitute a significant proportion. Prudent management of infection and early confirmation of diagnosis are recommended.

Ogeng'o JA, Gatonga P, Olabu BO. "Cardiovascular causes of death in an east African country: an autopsy study." Cardiol J. 2011;18(1):67-72. Abstract

The spectrum of cardiovascular diseases varies between countries. Data from east Africa is scarce, but important in formulating disease management strategies. The aim of this study was to describe the spectrum of cardiovascular causes of death in Kenya.

Ogeng'o JA, Gatonga P, Olabu BO, Ongera D. "Pattern of hypertensive kidney disease in a black Kenyan population." Cardiology. 2011;120(3):125-9. Abstract

Hypertensive kidney disease is a major cause of morbidity and mortality. Its pattern displays geographical and ethnic variations. Data on these patterns are important for informing management and prevention strategies, but on Kenyans such data are scarce.

Ogengo, J.A., Obimbo MM, Olabu BO, Sinkeet SR. "Pattern of aneurysms among young black Kenyans." Indian Journal of Thoracic and Cardiovascular Surgery. 2011;27(2):70-75. Abstract

Background: Reports on pattern of aneurysms among young people are scanty. These data are important for informing preventive and management strategies. This retrospective study at Kenyatta National Hospital, Nairobi. Kenya describes the pattern of aneurysms among young black Kenyans.
Patients and methods: Records of in-patients, aged up to 40 years, with a diagnosis of aneurysm between January 1998 and December 2007 were examined for localization, presentation, investigations, comorbidities, age and gender distribution. Data were analyzed by SPSS version 13.0 for Windows, and presented in tables and bar charts.
Results: One hundred and fifteen files were analyzed. Most frequent site was abdominal aorta (32.2%). Of these, majority (59.4%) were infrarenal. Other commonly affected arteries included thoracic aorta (11.3%), posterior communicating (7.8%), femoral (8.7%), brachial (8.7%), common carotid (6.1%) and internal thoracic (5.2%). They presented as pulsatile, often painful masses, and with pressure symptoms. Diagnosis was confirmed by ultrasound and angiography. Common comorbidities were hypertension,
smoking, Human Immunodeficiency Virus infection, alcohol, trauma, and connective tissue disorders. Mean age was 26.1 years and male: female ratio was 2.7:1.
Conclusion: Aneurysms are not uncommon in young Kenyans. They occur more commonly in males than females, and affect diverse vascular beds. Associated comorbidities comprise non communicable lifestyle factors, infection, inborn conditions and trauma. Lifestyle modification from early in life and control of infections are recommended.

Okoro D, Olabu B. "Spontaneous postpartum pneumomediastinum: A case report and review of literature." The Journal of Obstetrics and Gynecology of Eastern and Central Africa (JOGECA). 2011;23(2):64-66. Abstract

Spontaneous pneumomediastinum is a rare condition, more often seen among males with history of intravenous drug abuse. It may also complicate severe pneumonia in children; very few cases of this condition have been reported post partum. Management of this condition may result in numerous interventions including radiological investigations, dietary restriction and antibiotic administration with prolonged hospitalization. We report a case of a primiparous teenage girl with spontaneous pneumomediastinum following home delivery and successfully managed conservatively.

Ogeng’o JA, Mwachaka PM, Olabu BO. "Vasa Vasora in the Tunica Media of Goat Aorta." International Journal of Morphology. 2011;29(3):702-705. Abstract

This study aimed at describing the distribution of vasa vasora in the tunica media of various parts of goat aorta, since this influences the physico-mechanical properties and disease occurrence. Specimens were obtained from ascending, arch, each vertebral level of descending thoracic and various segments of abdominal aorta of sixteen healthy adult male domestic goats (Capra hircus). They were fixed in 10% formaldehyde solution, and routinely processed for paraffin embedding. Seven micron thick sections were stained with Mason’s Trichrome stain. Vasa vasora are present in the tunica media of all the aortic segments. In the proximal segments, they co-localize with muscle islands found in the adventitial half. Their density declines caudally, but they are still present in the tunica media even in the abdominal aorta where the thickness is less than 0.5mm and elastic lamellae less than 29. Vasa vasora in the goat aortic tunica
media penetrate into the luminal half and are present even in relatively thin segments. This extent, which may enhance vascular health, suggests that the goat aortic wall is very active, a feature probably related to auxillary pump function of the muscle islands in the aortic wall

2010
Ogeng'o JA, Olabu BO, Kilonzi JP. "Pattern of aortic aneurysms in an African country." J. Thorac. Cardiovasc. Surg.. 2010;140(4):797-800. Abstract

We sought to describe the regional, age, and sex distribution; diagnosis; treatment; and outcome of aortic aneurysms in a Kenyan population.

Ogeng'o JA, Olabu BO, Mburu AN, Sinkeet SR. "Pediatric stroke in an African country." J Pediatr Neurosci. 2010;5(1):22-4. Abstract

The pattern of pediatric stroke displays ethnic and geographical variations. There are few reports from black Sub-Saharan Africa, although relevant data are important in prevention, clinical diagnosis, treatment and prognostication.

Ogeng'o JA, Olabu BO. "Cortical stroke in Kenya." Int J Stroke. 2010;5(6):517-8.
Ogeng'o JA, Olabu BO, Ong'era D, Sinkeet SR. "Pattern of acute myocardial infarction in an African country." Acta Cardiol. 2010;65(6):613-618. Abstract

The objective of this study was to describe the pattern of acute myocardial infarction in an African country. These data are important for prevention strategies but are scarce from sub-Saharan African countries and altogether absent from Kenya.

Ogeng’o JA, Olabu BO, Gatonga PM, Munguti JK. "Branching pattern of aortic arch in a Kenyan population." Journal of Morphological Sciences. 2010;27(2):51-55. Abstract

Knowledge of the branching pattern of aortic arch is important during supraaortic angiography, aortic instrumentation, thoracic and neck surgery. Variant patterns are often associated with congenital cardiovascular malformations. The branching pattern shows population variation but there are no data for black Kenyans. The purpose of this study was to describe the pattern in a Kenyan population. One hundred and thirteen aortic arches of adult black Kenyans were exposed during cadaver dissection classes in the Department of Human Anatomy, University of Nairobi and their branches examined. All variations were recorded and photographed. The results are presented in macrographs and a table. Seventy six (67.3%) of the aortic arches showed classical 3 branch pattern of brachiocephalic, left common carotid and left subclavian arteries. Six variants were observed. The most common (25.7%) variation was that of two branches namely a common trunk for the brachiocephalic and left common carotid, and the left subclavian artery; followed by direct arch origin of the vertebral artery in 7 cases (6.2%). In 4 (3.5%) cases the arch had four branches. Over 30% of individuals in the Kenyan population may show variant branching pattern of the aortic arch. This should be taken into account during angiography, aortic instrumentation, supraaortic thoracic, head and neck surgery. Evaluation of cardiovascular malformations in the population is recommended.

Ogengo JA, Olabu BO. "Pattern of Extracranial Peripheral Aneurysm at a Referral Hospital in Kenya." Annals of African Surgery. 2010;5:3-8. Abstract

Peripheral aneurysms are important because of concurrence with aortic ones and potential to thromboembolise or rapture. Their distribution shows population variations yet reports from Africa are scarce and altogether absent from Kenya. Objective To describe the pattern of peripheral aneurysms in a Kenyan national referral hospital. Patients and methods Records of in-patients with a diagnosis of peripheral aneurysms at Kenyatta National Hospital between January 1998 and December 2007 were analyzed for presentation, diagnostic method, risk factors, site, age and gender distribution. Only records containing all these data were included. Data were analyzed using SPSS version 13.0 and presented using tables, and bar charts. Results Ninety six cases involved the femoral (24%), common carotid (15.6%); brachial (12.5%); brachiocephalic (11.5%) and popliteal (10.4%) arteries. They presented with pulsatile mass (37.5%), painful swelling (22.9%) and pressure on subjacent structures (13.5%). Diagnosis was confirmed by Doppler ultrasound (37.5%), conventional angiography (30.2%) and plain ultrasound (14.6%). Mean age was 45.6 years (range 13 – 79 years); with 50% of them occurring in individuals aged 40 years and younger. Common risk factors were trauma (39.6%), hypertension (13.5%) and atherosclerosis (9.4%). Male:female ratio was: 15:1 for femoropopliteal, 5:1 for brachial; 1:1 for common carotid and 1:2.6 for brachiocephalic trunk. Conclusion Characteristics of peripheral aneurysms in the Kenyan study population vary from those of Caucasians. They are more widespread, trauma related, and occur in younger individuals. Prudent management of risk factors is recommended.

Ogeng’o JA, Olabu BO. "Pattern of femoro-popliteal aneurysms in an African population." Journal of Vascular Brasileiro. 2010;9(2):1-4. Abstract

Objective: To describe the pattern of femoro-popliteal aneurysms in an African Kenyan population.
Patients and methods: Records of African in-patients with diagnosis of femoral or popliteal aneurysms admitted at the Kenyatta National Hospital, Nairobi, Kenya, from January 1998 to December 2007 were examined for presentation, diagnosis, risk/comorbid factors, site, age, and gender distribution. Data were analyzed using SPSS 13.0 and presented using tables.
Results: Femoro-popliteal aneurysms constitute 33 out of 96 of peripheral cases (34.4%). The most common presentations were pulsatile mass (48.5%) and pain and swelling (33.3%). Pain alone and bleeding occurred in 9.1% each. Diagnosis was performed through Doppler ultrasound (45.5%), angiography (30.3%) and ultrasonography (24.3%). Aneurysms were associated with trauma (51.5%), atherosclerosis (21.2%), smoking (9.1%) and hypertension (6.1%). Site distribution was common femoral (33.3%), superficial femoral (36.4%) and popliteal (30.3%). Mean age was 46 years (range 13-79 years); with 20 (60.6%) of them occurring in individuals aged 50 years and younger. Male:female ratio was 15:1.
Conclusion: In the present study, femoro-popliteal aneurysms constituted less than 40% of peripheral aneurysms, and superficial femoral artery was the most common site. They occurred predominantly in males aged 50 years and younger and were associated mainly with trauma and atherosclerosis. Prevalence, site and age distribution of these aneurysms in the Kenyan population differs from that described in studies of Caucasian populations.

Olabu BO, Ogeng'o JA. "Risk factors associated with Aortic aneurysms at Kenyatta National Hospital ." Afr J Hosp Sci med. 2010;25:29-32.
2009
Ogeng'o JA, Otieno BO, Kilonzi J, Sinkeet SR, Muthoka JM. "Intracranial aneurysms in an African country." Neurol India. 2009;57(5):613-616. Abstract

Characteristics of intracranial aneurysms display ethnic variations. Data on this disease from the African continent is scarce and often conflicting.

Ogeng’o JA, Malek AAK, Kiama SG, Olabu BO. "Muscle “islands” in the tunica media of the goat thoracic aorta." Journal of Morphological Sciences. 2009;26(3-4):171-175. Abstract

Muscle islands in tunica media of the aorta may influence its mechanical properties and disease distribution. This study aimed to elucidate their, hitherto undescribed, characteristics in the goat thoracic aorta. Twenty four healthy male domestic goats (capra hircus) aged 6 – 24 months were used in the study. The animals were euthanized with sodium pentabarbitone. Samples were taken from the ascending, arch and descending thoracic aorta. 7 μ paraffin embedded sections stained with Mason’s Trichrome and Weigert Resorcin Fuchsin/Van Gieson stains were examined by light microscopy for general organization of tunica media. Transmission electron microscopic examination of ultrathin sections stained with uranyl acetate and counterstained with lead citrate was done to study ultrastructure of the muscle islands. Fluorescent histochemical demonstration of adrenergic nerves was done by the sucrose-potassium phosphate-glyoxilic acid (SPG) method. Muscle “islands” were observed to interrupt elastic lamellae of the outer zone of tunica media in proximal aortic segments. These islands were preferentially vascularized and innervated. They comprised interconnected contractile smooth muscle cells linked to connective tissue fibres. These islands probably constitute an auxillary pump which supplements the windkessel function of the elastic lamellae, regulate blood flow and also strengthen the aortic wall.

2008
Olabu B, Ogeng’o JA, Kirsteen A, Saidi H. "Variations in the Formation of Supraclavicular Brachial Plexus in Kenyans." Annals of African Surgery. 2008;2:9-14. Abstract

Objective: To describe the pattern and prevalence of variations that occur in the supraclavicular part of the brachial plexus in a
Kenyan population.
Study design: Descriptive cross-sectional study.
Materials and methods: Ninety-four brachial plexuses from forty-seven formalin fixed cadavers were displayed by gross
dissection.
Results: The presence of at least one variation from the classical anatomy was observed in 73 (77.7%) of the 94 plexuses. The roots and trunks were involved in 32 (34%) of the plexuses . Preand postfixed roots were present in 23 (24.7%) and 3 (3.2%), respectively. The presence of four
trunks, and trunks passing between the scalene medius and posterior were also noted. The long thoracic nerve was variant in 51 (54.3%) of the plexuses. Unusual relations of the phrenic nerve to scalene muscles and the subclavian vein were
encountered.
Conclusion: The presence of four trunks and an accessory phrenic nerve passing through the subclavian vein are probably described and reported for the first time. However, most of the
variations of the BP among Kenyans are similar to those reported in the other populations.

2007
Olabu B, Saidi HS, Hassanali J, Ogeng’o JA. "Prevalence and Distribution of the Third Coronary Artery in Kenyans." International Journal of Morphology. 2007;25(4):851-854. Abstract

A third coronary artery (TCA) has been defined as a direct branch from the right aortic sinus (RAS) that contributes to the vascularization of the infundibulum of the right ventricle (RV). The distribution of this artery may be important in surgical procedures and in understanding the extent and progression of acute myocardial infarction. Its reported prevalence however shows ethnic disparity. The aim of the study was describe the prevalence and distribution of the third coronary artery in a Kenyan population. 148 cadaveric and postmortem human adult hearts obtained from the Department of Human Anatomy, University of Nairobi, and the Chiromo and Nairobi city mortuaries were used after an ethical approval. The hearts were studied by gross dissection for the prevalence and topographical anatomy of the TCA. Data was coded and analyzed using SPSS. The TCA is present in 35.1% of the heart specimens. It was variably distributed to the conducting system (23%), anterior wall of the RV (100%), interventricular septum (IVS) (51.9%) and the apex of the heart (5.8%). The TCA, with substantial contribution to cardiac vascularization, may be present in about a third of the Kenyans. It may constitute a significant collateral circulation to apical and septal perfusion. Interpretation of signs and symptoms of coronary occlusion should therefore consider possible contribution of this vascular channel.

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