Bio

Publications


2006

2005

OLONDE, PROFAMAYOERASTUS, OTIENO PROFOGUTUELLY.  2005.  Lwai-Lume L, Ogutu EO, Amayo EO, Kariuki S.Drug susceptibility pattern of Helicobacter pylori in patients with dyspepsia at the Kenyatta National Hospital, Nairobi.East Afr Med J. 2005 Dec;82(12):603-8. East Afr Med J. 2005 Dec;82(12):603-8. : Journal of British Ceramic Transactions, 99 [5], 206-211. Abstract
OBJECTIVE: To determine drug susceptibility pattern of Helicobacter pylori to metronidazole, clarithromycin, amoxicillin and tetracycline in patients presenting with dyspepsia at the Kenyatta National Hospital. DESIGN: Cross-sectional descriptive study. SETTING: Kenyatta National Hospital, Nairobi. SUBJECTS: Two hundred and sixty-seven patients aged 15 to 85 years, presenting with dyspepsia and referred for upper gastro-intestinal endoscopy were recruited into the study. RESULTS: Between October 2003 and April 2004, 138 male and 129 female patients aged 15-85 years, with a mean age of 45.4 years were studied. Gastritis was the most common endoscopic finding, occurring in 55%, followed by normal-looking mucosa in 27% and peptic ulcer disease in 16% of the patients. The rapid urease test was positive in 184 patients (69%). The culture yield was 62% of these CLO (Campylobacter like organisms) positive biopsies. The MIC90 (minimum inhibitory concentration) was 256 mg/l for metronidazole, 1.5 mg/l for clarithromycin, 1.5 mg/l for tetracycline and 0.75 mg/l for amoxicillin. The MIC values for amoxicillin were significantly higher in the female patients (p = 0.02) but showed no significant variation for age. The MIC values for metronidazole, tetracycline and clarithromycin showed no significant difference for age or gender. MIC values for tetracycline were significantly higher for patients with duodenitis and duodenal ulcer p = 0.009 and 0.02, respectively. CONCLUSION: All isolated H. pylori organisms were resistant to metronidazole. The susceptibility of the H. pylori isolates was 93.6% for clarithromycin, 95.4% for amoxicillin and 98.1% for tetracycline. The MIC90 for amoxicillin and clarithromycin were found to be close to the upper limit of the susceptibility range. There was a rising MIC90 for tetracycline and metronidazole compared to that found in a previous study in 1991.

2004

OTIENO, PROFOGUTUELLY.  2004.  Atina. J.O..Ogutu E. O The prevalence of Hepatitis A,B & C and HIV seroprevalence among patients with acute icteric hepatitis at the Kenyatta National Hospital East African medical journal april 2004 issue. East Afr Med J. 2004 Apr;81(4):183-7.. : Journal of British Ceramic Transactions, 99 [5], 206-211. Abstract
Department of Medicine, College of Health Sciences, University of Nairobi, P.O. Box 19676, Nairobi, Kenya. OBJECTIVE: To determine the prevalence of hepatitis A, B, C and HIV seropositivity among patients with acute icteric hepatitis. DESIGN: Cross-sectional descriptive survey. SETTING: Kenyatta National Hospital, Nairobi. SUBJECTS: Eighty four patients aged above six months with a history of jaundice not exceeding six months were recruited. There were 47 males and 17 females with an age range of eight months to 67 years and a median age of 25 years. METHODS: History was obtained physical examination done and blood taken for determination of bilirubin, ALT, AST and ALP levels. Sera that had disproportionately greater transaminase than ALP elevation were assayed for IgM anti-HAV, IgM anti-HBc, HbsAg, anti-HCV and anti-HIV antibodies. RESULTS: Evidence of hepatitis A, B, and C was round in 41.7%, 26.2%, and 7.1% of the patients respectively, 13.1% of the patients were HBsAg carriers while 30.1% of all patients were HIV positive. Thirty two patients did not have evidence of hepatitis A, B, or C infection and this group was significantly associated with HIV infection (p = 0.003). CONCLUSION: Hepatitis A was the commonest overall type of acute icteric hepatitis seen at the KNH, and among patients aged 15 years and below. Hepatitis B was the leading identified cause of acute hepatitis among those aged over 15 years. Hepatitis C accounted for 7.1% of acute icteric hepatitis 30.1% of all patients and 50% of those admitted with acute hepatitis were also HIV positive.

1999

N, PROFOGOLAELIJAHS, OTIENO PROFOGUTUELLY.  1999.  Oyoo GO, Ogola EN.Clinical and socio demographic aspects of congestive heart failure patients at Kenyatta National Hospital, Nairobi.East Afr Med J. 1999 Jan;76(1):23-7.. East Afr Med J. 1999 Jan;76(1):23-7.. : Journal of British Ceramic Transactions, 99 [5], 206-211. Abstract
socio-demographic determinants in patients admitted to Kenyatta National Hospital, Nairobi in congestive heart failure. DESIGN: Cross sectional descriptive study. SUBJECT: All patients aged thirteen years and above of either sex consecutively admitted with clinical diagnosis of congestive heart failure. SETTING: Kenyatta National Hospital (KNH), a national referral hospital. PATIENT EVALUATION: Detailed history including socio-demographic characteristics and physical examination was done. Patients underwent haematological and biochemistry tests followed by a chest x-ray, ECG and 2D Echo-doppler examination. Blood culture sensitivity was done when clinically indicated. RESULTS: Ninety one patients were studied, 44 males and 47 females. Almost 32% had rheumatic heart disease, 25.2% had cardiomyopathy, 17.6% hypertensive heart disease, 13.2% had pericardial disease while 2.2% had ischaemic heart disease. Three quarters of patients with hypertensive heart disease were above the age of 50 years, while 79% of patients with rheumatic heart disease were below the age of 30 years. Factors associated with patient deterioration leading to admission with congestive heart failure (CHF) included inadequate therapy (27.4%), arrhythmia (20.9%), respiratory infections (17.6%), anaemia (13.2%) and infective endocardiatis. Sixty two per cent of patients investigated were in New York Heart Association (NYHA) functional classification class IV, 31.9% in class III and 5.5% in class II. CONCLUSION: Congestive heart failure constitutes 3.3% of all medical admissions at KNH. Rheumatic heart disease is the commonest cause of congestive heart failure in our set-up while inadequate therapy, arrhythmias and respiratory infections are the three major causes of decompensation in our patients with cardiac disease.

1998

OTIENO, PROFOGUTUELLY.  1998.  Ogutu EO, Kang'ethe SK, Nyabola L, Nyong'o A.Endoscopic findings and prevalence of Helicobacter pylori in Kenyan patients with dyspepsia.East Afr Med J. 1998 Feb;75(2):85-9.. East Afr Med J. 1998 Feb;75(2):85-9.. : Journal of British Ceramic Transactions, 99 [5], 206-211. Abstract
One hundred and twenty consecutive patients above 12 years of age with dyspepsia were studied from June 1993 to September 1994. They underwent upper gastrointestinal endoscopy to find the mucosal lesions which were associated with their dyspeptic symptoms. At endoscopy gastric mucosal biopsies were taken in order to identify Helicobacter pylori (H. pylori) using three different techniques: culture, histology and the rapid urease test. Normal looking mucosa was the commonest single endoscopic finding, accounting for 34.2%, followed by gastritis 31.7% and duodenal ulcer 29.2%. However, when duodenal ulcers and gastric ulcers were put together, then peptic ulcer was the most prevalent finding accounting for 38.4%. Peptic ulcer was the most prevalent pathological finding in both young (less than 50 years) and older patients (50 years and above). Duodenal ulcer was more prevalent than gastric ulcer in the younger age group with a ratio of 5.8:1, however, the ratio in the older age group was 1:1. Gastric cancer was only found in patients aged 50 years and above, accounting for 17.4% of dyspeptic symptoms in this age group. Females were found to have more normal endoscopic findings than males (59.6%, versus 17.8% respectively). The difference being statistically significant (p < 0.001). All our cases of peptic ulcer disease had evidence of H. pylori infection while dyspeptic patients with normal endoscopic mucosal findings had H. pylori in 80.5% of cases. The difference in prevalence of H. pylori in the two groups was statistically significant (p < 0.001). Surprisingly, evidence of H. pylori in gastric cancer cases was very low in this study, being found in only 25% of patients.
OTIENO, PROFOGUTUELLY.  1998.  Omonge E., Ogutu E.O., Aluoch J.R. Clinical and laboratory predictors of Cholelithiasis in patients with sickle cell anaemia. EAMJ 75: 347, 1998.. East Afr Med J. 1998 Jun;75(6):347-50.. : Journal of British Ceramic Transactions, 99 [5], 206-211. Abstract
Kiambu District Hospital, Nairobi, Kenya. Cholelithiasis is a common clinical condition in patients with sickle cell disease and there are conflicting reports on laboratory indices useful in predicting those patients who are likely to have gallstones. There is however lack of similar studies from Kenya. We therefore studied the role of clinical (Body Mass Index), haematological (reticulocyte count, haemoglobin level), and biochemical (serum bilirubin: direct and indirect, serum alkaline phosphatase, serum transaminase) indices in predicting sickle cell anaemia patients likely to develop gallstones. A cross sectional descriptive study was conducted from October 1993 to December 1994 on consecutive male and female patients of all ages with homozygous sickle cell disease (HbSS) confirmed by cellulose acetate paper electrophoresis. A total of 64 patients aged between three and 37 years were recruited into the study. They were classified into two groups: stone formers and non-formers. The difference in the two groups with respect to clinical, haematological and biochemical indices were determined by Chi-square contingency test. Body mass index (BMI), reticulocyte count and alkaline phosphatase were found to have a significant positive association with increased likelihood of gallstone formation at p values of 0.004, 0.007 and 0.007, respectively. The rest of the study indices had no association. The cut-off points were reticulocyte counts above ten per cent and alkaline phosphatase levels above 13 K.A. units. Though sickle cell anaemia patients with BMI > 20 had significant increased likelihood of cholelithiasis, we could not determine its cut-off value.
OTIENO, PROFOGUTUELLY.  1998.  Ogutu E.O., Kanja C., Kimanzi, Kangethe S.K., Nyongo A. Prevalence of intestinal parasites in Kenyans with dyspepsia. EAMJ 75: 16, 1998.. East Afr Med J. 1998 Jan;75(1):16-8.. : Journal of British Ceramic Transactions, 99 [5], 206-211. Abstract
Department of Medicine, University of Nairobi, Kenya. Dyspepsia and intestinal worm infestation are both common clinical conditions in a developing country like Kenya and thus this study was designed to look at the correlation between the two in a referral gastroenterology clinic at Kenyatta National Hospital. One hundred and twenty five patients with dyspepsia had their stool, duodenal aspirate and duodenal biopsy analysed for evidence of intestinal parasites. Seven (5.6%) were found to have various types of intestinal parasites with giardia lamblia comprising 42.8% of worms isolated. 71.4% of patients with dyspepsia and worm infestation had their symptoms improved after deworming, but the low prevalence of intestinal parasite in dyspeptic patients makes routine deworming not cost effective. Stool examination had the best yield for intestinal parasites.
OTIENO, PROFOGUTUELLY.  1998.  Maende JA, Ogutu EO, Nyong'o A, Aluoch JR.Upper gastrointestinal mucosal lesions in dyspeptic patients with homozygous sickle cell disease in Kenya.East Afr Med J. 1998 Mar;75(3):148-50.. East Afr Med J. 1998 Mar;75(3):148-50.. : Journal of British Ceramic Transactions, 99 [5], 206-211. Abstract
A case controlled study comprising 51 patients with homozygous sickle cell (HbSS) disease who complained of dyspepsia and 41 age and sex matched non-HbSS control dyspeptic patients was carried out, to look at upper gastrointestinal mucosal lesions associated with dyspepsia. Upper gastrointestinal tract (UGIT) endoscopy was performed with gastric control biopsy taken for histology. Thirty two (62.3%) of the HbSS or sickle cell anaemia (SCA) patients had upper gastrointestinal pathology at endoscopy as compared to 17 (41.5%) of controls. The difference was significant at p = 0.042. Bile reflux (47%) was the predominant abnormal morphological finding in SCA patients while duodenal ulcer was the most common morphological finding in dyspeptic controls. The prevalence of duodenal ulcer in controls (22%) though higher than in SCA patients (9.8%), was not statistically significant p = 0.18. Gastric ulcer was not found in SCA patients. Duodenal ulcer was commoner in males than females in both cases and controls with a ratio of 4:1 and 3.5:1 respectively. Only four (7.8%) SCA patients and one (2.4%) of controls had normal mucosa at histology, the rest had evidence of histological gastritis. We could not draw any correlation between non-steroidal anti-inflammatory drugs (NSAIDS) use and UGIT findings. Since the proportion of SCA cases with UGIT abnormalities was significantly high, we recommend that dyspeptic SCA patients undergo UGIT investigations including endoscopy to maximise their clinical care.
OTIENO, PROFOGUTUELLY.  1998.  Ogutu E.O., Okoth F.A., Lule G.N. Colonoscopic Findings in Kenyan African Patients EAMJ Vol 75 pp 540 . East Afr Med J. 1998 Sep;75(9):540-3.. : Journal of British Ceramic Transactions, 99 [5], 206-211. Abstract

Kenyatta National Hospital, Nairobi, Kenya. OBJECTIVE: To determine the types and prevalence of colonic diseases in Kenyan African patients referred for colonoscopy with lower gastrointestinal tract symptoms. DESIGN: A cross sectional survey conducted over a two year period. SETTING: Major private hospitals in Nairobi. PATIENTS: Two hundred forty seven consecutive patients of both sexes and all ages referred for colonoscopy between January 1996 and December 1997. Only Kenyans of African origin were included. Patients were referred from all over the country though the majority of cases were from Nairobi and its surrounding districts. RESULTS: The major indications for colonoscopy were lower abdominal pain (35.6%), non-bloody diarrhoea (22.3%), constipation (21.4%) and rectal bleeding (19.8%). Nearly 53% of patients colonoscoped had abnormal mucosal findings, with the main abnormalities being: proctocolitis (20.2%), colorectal cancers (12.1%), haemorrhoids (7.3%), colorectal polyps (6.5%) and diverticulosis (5.3%). The main histological diagnosis among patients whose colonic biopsy were done included normal colonic mucosa (29%), non-specific colitis (28.5%), adenocarcinoma (18.2%), benign colonic polyp (9.7%) and ulcerative colitis (7.3%). There was one case of Crohn's colitis and five cases (3%) of infective colitis. CONCLUSION: The study shows that the African colon has a number of pathological lesions contrary to previous reported literature.

1995

N, PROFOGOLAELIJAHS, OTIENO PROFOGUTUELLY.  1995.  Ogola ES.Use of aspirin in preeclampsia.East Afr Med J. 1995 Nov;72(11):689.. East Afr Med J. 1995 Nov;72(11):689.. : Journal of British Ceramic Transactions, 99 [5], 206-211. Abstract
One hundred and twenty consecutive patients above 12 years of age with dyspepsia were studied from June 1993 to September 1994. They underwent upper gastrointestinal endoscopy to find the mucosal lesions which were associated with their dyspeptic symptoms. At endoscopy gastric mucosal biopsies were taken in order to identify Helicobacter pylori (H. pylori) using three different techniques: culture, histology and the rapid urease test. Normal looking mucosa was the commonest single endoscopic finding, accounting for 34.2%, followed by gastritis 31.7% and duodenal ulcer 29.2%. However, when duodenal ulcers and gastric ulcers were put together, then peptic ulcer was the most prevalent finding accounting for 38.4%. Peptic ulcer was the most prevalent pathological finding in both young (less than 50 years) and older patients (50 years and above). Duodenal ulcer was more prevalent than gastric ulcer in the younger age group with a ratio of 5.8:1, however, the ratio in the older age group was 1:1. Gastric cancer was only found in patients aged 50 years and above, accounting for 17.4% of dyspeptic symptoms in this age group. Females were found to have more normal endoscopic findings than males (59.6%, versus 17.8% respectively). The difference being statistically significant (p < 0.001). All our cases of peptic ulcer disease had evidence of H. pylori infection while dyspeptic patients with normal endoscopic mucosal findings had H. pylori in 80.5% of cases. The difference in prevalence of H. pylori in the two groups was statistically significant (p < 0.001). Surprisingly, evidence of H. pylori in gastric cancer cases was very low in this study, being found in only 25% of patients.

1994

N, PROFLULEGODFREY, OTIENO PROFOGUTUELLY.  1994.  Lule GN, Obiero ET, Ogutu EO.Factors that influence the short term outcome of upper gastrointestinal bleeding at Kenyatta National Hospital. East Afr Med J. 1994 Apr;71(4):240-5.. East Afr Med J. 1994 Jan;71(1):44-8.. : Journal of British Ceramic Transactions, 99 [5], 206-211. Abstract
Between April 1990 to January 1991, a prospective study of 97 consecutive patients admitted to the medical wards of Kenyatta National Hospital with upper gastrointestinal haemorrhage was done. All the patients studied under went upper gastrointestinal endoscopy within 24 hours of presentation and a positive endoscopic diagnosis was possible in 90 (93%) of the patients studied. The leading causes of bleeding were oesophageal varices in 34 (35%) patients, duodenal ulceration in 17 (17.5%) patients, and superficial inflammatory lesions in 17 (17.5%) patients. 17 (17.5%) patients had multiple lesions with superficial inflammation and oesophageal varices as the commonest combination. In 86 (88%) patients, bleeding settled on simple conservative measures which included intravenous fluids, blood transfusion and antacids. Further haemorrhage was observed in 11 (11.3%) patients. Tachycardia (> 100/minute), hypotension (systolic BP < 100mm Hg) and low haemoglobin (< 8 g/dl) at admission were all correlated with a poor outcome. Variceal bleeding had the worst prognosis and the overall mortality rate was 5%.
N, PROFLULEGODFREY, OTIENO PROFOGUTUELLY.  1994.  Okoth FA, Lule GN, Ogutu EO, Pilczer S, Dubois C. Famotidine in the management of gastro-oesophageal reflux. East Afr Med J. 1994 Jan;71(1):44-8.. East Afr Med J. 1994 Jan;71(1):44-8.. : Journal of British Ceramic Transactions, 99 [5], 206-211. Abstract
Famotidine has been used for the treatment of peptic ulcers and Zollinger Ellison syndrome and is also useful in reflux and erosive oesophagitis. To evaluate the effects of Famotidine 20 mg given twice daily in the symptomatic relief of gastro-oesophageal reflux disease with normal oesophagus or mild endoscopic oesophagitis, patients were followed over a period of six weeks. 70% of the patients had complete day-time heartburn relief during the study and 75% had complete night-time heartburn relief during the study. Famotidine was found to be safe and there were no serious clinical or laboratory adverse experiences.

1993

N, PROFOGOLAELIJAHS, OTIENO PROFOGUTUELLY.  1993.  Ogola EN, Yonga GO.Comparative study of the efficacy and tolerability of hydroflumethiazide versus propranolol in Africans with mild to moderate hypertension.East Afr Med J. 1993 May;70(5):277-9.. East Afr Med J. 1993 May;70(5):277-9.. : Journal of British Ceramic Transactions, 99 [5], 206-211. Abstract

Sixty patients with Diastolic Blood Pressure (DBP) of 100-110mmHg matched for age, sex and Bp levels were randomly assigned to propranolol 80mg daily or Hydroflumethiazide (HFM) 50mg daily. HFM causes a significant reduction in systolic blood pressure (SBP) and DBP within 4 weeks compared both with baseline and propranolol (SBP 143.7 +/- 12.3 vs 158.1 +/- 10.9mmHg, P < 0.05; DBP 92.0 +/- 4.5 vs 102.4 +/- 5.1mmHg, P < 0.05), (SBP 143.7 +/- 12.2 vs 152 +/- 11.0mmHg P < 0.05; DBP 92.0 +/- 4.5 vs 101.1 +/- 6.1mmHg, P < 0.05), respectively. Propranolol produced no significant difference from the baseline at 4 weeks (SBP 152.0 +/- H.0 vs 154.1 +/- 11.5mmHg NS; DBP 101.1 +/- 6.1 vs 102.2 +/- 5.6mmHg, NS). Reduction in BP by HFM was maintained after 8 and 12 weeks with further reduction but which did not achieve statistical significance. Increased dose of propranolol (160mg daily) after 4 weeks caused significant reduction in BP by 8 week (SBP 146.8 +/- 11.8 vs 152.0 +/- 11.0mmHg, P < 0.05; DBP 95.9 +/- 4.4 vs 101.1 +/- 6.1mmHg P < 0.05), which was maintained upto 12 weeks. The values however remained higher than in the HFM group. More patients in the HFM group achieved target BP (< 140/90), SBP 53.8% vs 29.6% P < 0.05, DBP 69.2% vs 14.8% P < 0.01. Incidence of side effects was similar and will be discussed. Thiazides are superior to B'blockers as initial monotherapy in black hypertensives.

N, PROFOGOLAELIJAHS, OTIENO PROFOGUTUELLY.  1993.  Yonga GO, Ogola EN, Orinda DA.Metabolic effects of propranolol and hydroflumethiazide treatment in Kenyans with mild to moderate essential hypertension.East Afr Med J. 1993 Nov;70(11):696-700.. East Afr Med J. 1993 Nov;70(11):696-700.. : Journal of British Ceramic Transactions, 99 [5], 206-211. Abstract
In a prospective single-blind comparative trial, sixty newly diagnosed mild to moderate hypertensives were randomly assigned to either propranolol or hydroflumethiazide monotherapy. Baseline fasting serum glucose lipid profiles, serum uric acid and potassium levels, were determined at the beginning of the trial. Repeat levels were determined at completion of twelve weeks of treatment. Propranolol treatment significantly reduced HDL-cholesterol (p < 0.02) and increased both VLDL and total serum triglycerides (p < 0.01). Hydroflumethiazide significantly increased total and LDL-chole-sterol, fasting serum glucose and uric acid levels (p < 0.01); potassium levels were significantly lowered (p < 0.01). Treatment with either propranolol or hydroflumethiazide is associated with significant metabolic side-effects which require regular monitoring and intervention as appropriate.

1992

OTIENO, PROFOGUTUELLY.  1992.  Mourad F.H., O. East Afr Med J. 1993 May;70(5):277-9.. : Journal of British Ceramic Transactions, 99 [5], 206-211. Abstract

Sixty patients with Diastolic Blood Pressure (DBP) of 100-110mmHg matched for age, sex and Bp levels were randomly assigned to propranolol 80mg daily or Hydroflumethiazide (HFM) 50mg daily. HFM causes a significant reduction in systolic blood pressure (SBP) and DBP within 4 weeks compared both with baseline and propranolol (SBP 143.7 +/- 12.3 vs 158.1 +/- 10.9mmHg, P < 0.05; DBP 92.0 +/- 4.5 vs 102.4 +/- 5.1mmHg, P < 0.05), (SBP 143.7 +/- 12.2 vs 152 +/- 11.0mmHg P < 0.05; DBP 92.0 +/- 4.5 vs 101.1 +/- 6.1mmHg, P < 0.05), respectively. Propranolol produced no significant difference from the baseline at 4 weeks (SBP 152.0 +/- H.0 vs 154.1 +/- 11.5mmHg NS; DBP 101.1 +/- 6.1 vs 102.2 +/- 5.6mmHg, NS). Reduction in BP by HFM was maintained after 8 and 12 weeks with further reduction but which did not achieve statistical significance. Increased dose of propranolol (160mg daily) after 4 weeks caused significant reduction in BP by 8 week (SBP 146.8 +/- 11.8 vs 152.0 +/- 11.0mmHg, P < 0.05; DBP 95.9 +/- 4.4 vs 101.1 +/- 6.1mmHg P < 0.05), which was maintained upto 12 weeks. The values however remained higher than in the HFM group. More patients in the HFM group achieved target BP (< 140/90), SBP 53.8% vs 29.6% P < 0.05, DBP 69.2% vs 14.8% P < 0.01. Incidence of side effects was similar and will be discussed. Thiazides are superior to B'blockers as initial monotherapy in black hypertensives.

N, PROFOGOLAELIJAHS, OTIENO PROFOGUTUELLY.  1992.  Lore W, Muita AK, Ogola ES.The efficacy and tolerability of enalapril–hydrochlorothiazide combination as a first line therapy in black patients with mild to moderate arterial hypertension: a clinical study in Kenya.East Afr Med J. 1992 Jan;69(1):18-21.. East Afr Med J. 1992 Jan;69(1):18-21.. : Journal of British Ceramic Transactions, 99 [5], 206-211. Abstract
The study aimed at evaluating tolerability and efficacy of the combination enalapril 20 mg with hydrochlorothiazide 12.5 mg (co-renitec) as first line therapy in black patients with mild to moderate primary hypertension. Fifty patients completed a twelve weeks of open clinical study preceded by two weeks of washout period. They were evaluated every four weeks and haematological, biochemical urine microscopy and electrocardiographic tests were undertaken before the start and after the completion of study. Pre-treatment values of mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 172.16 mm hg (+/- 20.41) and 104.38 mm hg (+/- 7.339) respectively. The usual daily dosage was one tablet which was increased to two after eight weeks in case the DBP was not normalized, i.e. less than or equal to 95 mm hg. In 44 (88%) patients, the DBP was normalised at the end of the study period; three patients (6%) were resistant to treatment and another three (6%) exhibited labile response to the treatment. Clinical tolerance was considered to be very good with only five episodes of headache, backache and anxiety, probably not related to the test drug. Biological tolerance was excellent: there was no change in the haematologic parameters; there was a decrease of 5% in mean blood urea, of 9% in the mean serum creatinine and of 4% in the mean serum uric acid and a 5% increase in plasma potassium from 3.99 to 4.28 mmol/l.(ABSTRACT TRUNCATED AT 250 WORDS)

1991

OTIENO, PROFOGUTUELLY.  1991.  Ogutu EO, McLigeyo SO. Adult polycystic liver disease.East Afr Med J. 1991 May;68(5):352-8.. East Afr Med J. 1991 May;68(5):352-8.. : Journal of British Ceramic Transactions, 99 [5], 206-211. Abstract
Characteristics of 14 patients above 12 years of age with congenital polycystic liver disease attending liver clinic at KNH were analysed. The diagnosis was mainly based on ultrasonographic findings. The disease was found predominantly among the Kikuyu ethnic group with a female/male ratio of 6:1 and the peak age at presentation was in the 5th decade. The liver function tests were essentially normal in all cases with no complication directly relating to liver disease. Hypertension was found in 78.6% of cases and chronic renal failure in 35.7% of cases. There was an associated polycystic disease in at least one other abdominal organ in all cases.
OTIENO, PROFOGUTUELLY.  1991.  Ogutu EO, Lule GN, Okoth F, Musewe AO.Gastric carcinoma in the Kenyan African population.East Afr Med J. 1991 May;68(5):334-9.. East Afr Med J. 1991 May;68(5):334-9.. : Journal of British Ceramic Transactions, 99 [5], 206-211. Abstract

Fifty three consecutive patients with histological evidence of gastric carcinoma were studied between June 1987 and June 1989 at Kenyatta National Hospital (KNH). The male to female ration was 3.4:1 and the peak age of occurrence was in the 7th decade with 62.3% of gastric carcinoma being at the gastric antrum. Poorly differentiated adenocarcinoma was found in 68.2% of patients while well differentiated adenocarcinoma in 4.5% of cases. Intestinal metaplasia was a rare finding. If Lauren's classification of gastric carcinoma is considered then diffuse type of gastric cancer is by far the commoner type in our environment.

OTIENO, PROFOGUTUELLY.  1991.  Sang F.C., Lule G.N., Ogutu E.O. Evaluation of culture media and antimicrobial susceptibility of Helicobacter Pylori. EAMJ 68: 865, 1991.. East Afr Med J. 2005 Dec;82(12):603-8.. : Journal of British Ceramic Transactions, 99 [5], 206-211. Abstract
Departmnent of Medicine, College of Health Sciences, University of Nairobi, P.O. Box 19676, Nairobi, Kenya. OBJECTIVE: To determine drug susceptibility pattern of Helicobacter pylori to metronidazole, clarithromycin, amoxicillin and tetracycline in patients presenting with dyspepsia at the Kenyatta National Hospital. DESIGN: Cross-sectional descriptive study. SETTING: Kenyatta National Hospital, Nairobi. SUBJECTS: Two hundred and sixty-seven patients aged 15 to 85 years, presenting with dyspepsia and referred for upper gastro-intestinal endoscopy were recruited into the study. RESULTS: Between October 2003 and April 2004, 138 male and 129 female patients aged 15-85 years, with a mean age of 45.4 years were studied. Gastritis was the most common endoscopic finding, occurring in 55%, followed by normal-looking mucosa in 27% and peptic ulcer disease in 16% of the patients. The rapid urease test was positive in 184 patients (69%). The culture yield was 62% of these CLO (Campylobacter like organisms) positive biopsies. The MIC90 (minimum inhibitory concentration) was 256 mg/l for metronidazole, 1.5 mg/l for clarithromycin, 1.5 mg/l for tetracycline and 0.75 mg/l for amoxicillin. The MIC values for amoxicillin were significantly higher in the female patients (p = 0.02) but showed no significant variation for age. The MIC values for metronidazole, tetracycline and clarithromycin showed no significant difference for age or gender. MIC values for tetracycline were significantly higher for patients with duodenitis and duodenal ulcer p = 0.009 and 0.02, respectively. CONCLUSION: All isolated H. pylori organisms were resistant to metronidazole. The susceptibility of the H. pylori isolates was 93.6% for clarithromycin, 95.4% for amoxicillin and 98.1% for tetracycline. The MIC90 for amoxicillin and clarithromycin were found to be close to the upper limit of the susceptibility range. There was a rising MIC90 for tetracycline and metronidazole compared to that found in a previous study in 1991.
OTIENO, PROFOGUTUELLY.  1991.  Lule G.N., Sang F., Ogutu E.O. Helicobacter Pylori in peptic ulcer disease. E. Afr. Med. J. 68: 324, 1991.. East Afr Med J. 1991 May;68(5):324-7.. : Journal of British Ceramic Transactions, 99 [5], 206-211. Abstract
Department of Medicine, University of Nairobi. Sixty six patients with dyspeptic symptoms underwent upper gastrointestinal endoscopy and biopsies for Helicobacter pylori culture. The number of H. pylori isolated increased with age reaching a peak at 51 to 60 years of age. Antral gastritis closely followed by duodenitis accounted for the highest number of H. pylori isolated, (87.5% and 85.7% respectively). In patients with duodenal ulceration only, 57% had H. pylori isolated from their antral biopsies, a result that was just slightly higher than that where no endoscopic diagnosis was made (50%).

1990

N, PROFLULEGODFREY, OTIENO PROFOGUTUELLY, OLONDE PROFAMAYOERASTUS.  1990.  Ogutu EO, Amayo EO, Okoth F, Lule GN. The prevalence of hepatitis B surface antigen (HBsAg), anti-hepatitis B surface (anti-HBs) and anti-hepatitis B core (anti-HBc) in patients with acquired immuno-deficiency syndrome (AIDS). East Afr Med J. 1990 May;67(. East Afr Med J. 1990 May;67(5):355-8.. : Journal of British Ceramic Transactions, 99 [5], 206-211. Abstract
Forty one consecutive patients (24 males and 17 females) with AIDS had their blood assayed for HBsAg, anti-HBs and anti-HBc by Reversed Passive Haemagglutination (RPHA), Passive Haemagglutination (PHA) and Enzyme Linked Immunosorbent Assay (ELISA) techniques respectively. 5 (12.2%) were found positive for HBsAg. 10 (24.4%) for anti-HBs and 31 (75.6%) for anti-HBc. 32 (78%) out of 41 patients with AIDS had serological evidence of exposure to hepatitis B virus (HBV). The prevalence of HBsAg found in this study is not different from what has been found in the Kenyan community without AIDS, while that of anti-HBs is much lower than what has been reported in the general community.

1989

OTIENO, PROFOGUTUELLY.  1989.  Ogutu E.O. Aetiology of Pancreatic Pseudocyst at Kenyatta National Hospital, Nairobi Journal of Medicine, 13:24, 1987.. East Afr Med J. 1989 Dec;66(12):830-3.. : Journal of British Ceramic Transactions, 99 [5], 206-211. Abstract

The mean fasting insulin level in 30 apparently normal Kenyan Africans was determined by Radio-Immuno Assay (RIA) technique based on coat A-count. The mean value was found as 16.33 microIu/ml with a standard deviation (s.d) of 10.51 microIu/ml. The mean at 95% confidence interval (CI) for the population studied was 16.33 +/- 1.92. The findings are similar to what have been reported among the caucasians. This paper also reports on a case of insulinoma in a young female patient at Kenyatta National Hospital (KNH).

OTIENO, PROFOGUTUELLY.  1989.  Ogutu EO, Orinda DA.Fasting insulin levels in normal Kenyan Africans and a case report on insulinoma.East Afr Med J. 1989 Dec;66(12):830-3.. East Afr Med J. 1989 Dec;66(12):830-3.. : Journal of British Ceramic Transactions, 99 [5], 206-211. Abstract
The mean fasting insulin level in 30 apparently normal Kenyan Africans was determined by Radio-Immuno Assay (RIA) technique based on coat A-count. The mean value was found as 16.33 microIu/ml with a standard deviation (s.d) of 10.51 microIu/ml. The mean at 95% confidence interval (CI) for the population studied was 16.33 +/- 1.92. The findings are similar to what have been reported among the caucasians. This paper also reports on a case of insulinoma in a young female patient at Kenyatta National Hospital (KNH).
OTIENO, PROFOGUTUELLY.  1989.  Ogutu EO.The pattern of pancreatic carcinoma at Kenyatta National Hospital. East Afr Med J. 1989 Feb;66(2):105-8.. East Afr Med J. 1989 Jan;66(1):10-4.. : Journal of British Ceramic Transactions, 99 [5], 206-211. Abstract
A 10-year (1976-1986) retrospective study was done on 30 cases with histological diagnosis of pancreatic carcinoma. The male to female ratio was 1.3:1 and the peak incidence was in the 6th and 7th decades. The head of the pancreas was involved in 96% of cases while solid adenocarcinoma of duct cell origin accounted for 73.3% of cases, followed by anaplastic carcinoma (23.3%). The commonest complications were distinct metastasis (86.6%), obstructive jaundice (73.3%) and upper gastrointestinal bleed (13.6%).
OTIENO, PROFOGUTUELLY.  1989.  Lule GN, Okoth F, Ogutu EO, Mwai SJ.HBV markers (HBsAg, HBSAb, HBCAb in 160 medical students at Kenyatta National Hospital. East Afr Med J. 1989 May;66(5):315-8.. East Afr Med J. 1989 Jan;66(1):10-4.. : Journal of British Ceramic Transactions, 99 [5], 206-211. Abstract
In an exercise to study the immunogenicity and reactogenicity of the Engerix B vaccine, 160 medical students were screened for Hepatitis B Markers (HBsAg, HBsAb and HBcAb) with a view to vaccinating those that were negative. 18% were HBsAg + ve, 33% were HBsAb + ve and 38% were positive for the HBcAb. These figures were extremely high and obviated the need to vaccinate the students as they begin their clinical years.
OTIENO, PROFOGUTUELLY.  1989.  Okoth FA, Ogutu EO, Lule GN, Wambugu MN.Some aspects of obstructive jaundice at Kenyatta National Hospital. East Afr Med J. 1989 Sep;66(9):594-7.. East Afr Med J. 1989 Jan;66(1):10-4.. : Journal of British Ceramic Transactions, 99 [5], 206-211. Abstract
A prospective study was carried out at Kenyatta National Hospital (KNH) between June 1987 and September 1988 to look at some aspects of obstructive jaundice in patients above 12 years of age. Screening for cases was done by use of abdominal ultrasonography. A total of 20 cases (11 females, 9 males) were diagnosed. Carcinoma of the head of pancreas accounted for 55% of cases of the obstruction, followed by gallstones (10%), hepatocellular carcinoma (10%) and gall bladder tumour (10%).
N, PROFLULEGODFREY, OTIENO PROFOGUTUELLY.  1989.  Ogutu EO, Lule GN, Okoth FN, Were BO. The pattern of chronic gastric ulcer at Kenyatta National Hospital (K.N.H.). East Afr Med J. 1989 Jan;66(1):10-4.. East Afr Med J. 1989 Jan;66(1):10-4.. : Journal of British Ceramic Transactions, 99 [5], 206-211. Abstract
Thirty consecutive patients with gastric ulcer diagnosed during upper gastrointestinal fibreoptic panendoscopy at both Kenya Medical Research Institute and Kenyatta National Hospital endoscopy rooms were studied. The male/female ratio was 5:1 with a peak prevalence in the 6th decade. 76.6% of the patients were from the Kikuyu ethnic group. Smoking habit was found in only 50% of patients with gastric ulcers. There were a total of 32 gastric ulcers in 30 patients. 84.4% of these were at the incisura angularis. All the incisural ulcers were benign. Two (6.25%) of the 32 ulcers were malignant (one at the cardia and the other at the antrum). Gastric ulcers whose diameter were greater than 30 mm had a higher tendency of being malignant. Five patients (16.7%) had both gastric (4 benign and 1 malignant) and duodenal ulcers while 4 (13.3%) patients had both gastric and pyloric ring ulcers. Apparent healing of a gastric ulcer while on an H2-antagonist does not totally exclude malignancy. Upper gastrointestinal bleed which was present in 53.3% of cases was the most frequent complication.
N, PROFLULEGODFREY, OTIENO PROFOGUTUELLY.  1989.  Ogutu EO, Lule GN, Okoth F, Mwai SJ. The clinical pattern of duodenogastric bile reflux in the Kenyan Africans. East Afr Med J. 1989 Jan;66(1):35-9.. East Afr Med J. 1989 Jan;66(1):35-9.. : Journal of British Ceramic Transactions, 99 [5], 206-211. Abstract
Forty consecutive African patients found to have duodenogastric bile reflux at endoscopy were studied. Bile reflux was found more commonly among males than females, giving a male/female ratio of 2.3:1, with a peak age at 41-60 years. ABO blood groups had no significant influence on duodenogastric bile reflux. Flatulence and borborygmi were the most consistent symptoms other than the classical dyspeptic pain pattern. Bilious vomiting was a rare finding. Duodenogastric bile reflux was more commonly associated with endoscopic gastritis (67.5%), gastric ulcer (35%) and oesophagitis (30%) than with duodenal ulcer (22.5%), deformed pyloric ring (5%) or distorted duodenal bulb (2.5%). The dysfunction in the pyloric sphincter in people with duodenogastric bile reflux appears to be more of a physiological defect than structural.

1988

OTIENO, PROFOGUTUELLY.  1988.  Ogutu EO.The pattern of acute pancreatitis at Kenyatta National Hospital (KNH): retrospective study. East Afr Med J. 1988 Feb;65(2):86-91. No abstract available.. East Afr Med J. 1989 Dec;66(12):830-3.. : Journal of British Ceramic Transactions, 99 [5], 206-211. Abstract
The mean fasting insulin level in 30 apparently normal Kenyan Africans was determined by Radio-Immuno Assay (RIA) technique based on coat A-count. The mean value was found as 16.33 microIu/ml with a standard deviation (s.d) of 10.51 microIu/ml. The mean at 95% confidence interval (CI) for the population studied was 16.33 +/- 1.92. The findings are similar to what have been reported among the caucasians. This paper also reports on a case of insulinoma in a young female patient at Kenyatta National Hospital (KNH).
OTIENO, PROFOGUTUELLY.  1988.  Ogutu EO, Lore W.The aetiology and presentation of chronic calcific pancreatitis in patients seen at Kenyatta National Hospital. East Afr Med J. 1988 Mar;65(3):155-9. No abstract available.. East Afr Med J. 1989 Dec;66(12):830-3.. : Journal of British Ceramic Transactions, 99 [5], 206-211. Abstract
The mean fasting insulin level in 30 apparently normal Kenyan Africans was determined by Radio-Immuno Assay (RIA) technique based on coat A-count. The mean value was found as 16.33 microIu/ml with a standard deviation (s.d) of 10.51 microIu/ml. The mean at 95% confidence interval (CI) for the population studied was 16.33 +/- 1.92. The findings are similar to what have been reported among the caucasians. This paper also reports on a case of insulinoma in a young female patient at Kenyatta National Hospital (KNH).
OTIENO, PROFOGUTUELLY.  1988.  Lule GN, Ogutu EO, Okoth F, Were JB, Wambugu M.Sclerotherapy in the treatment of bleeding oesophageal varices: preliminary report. East Afr Med J. 1988 Jun;65(6):416-20. Review. No abstract available.. East Afr Med J. 1989 Dec;66(12):830-3.. : Journal of British Ceramic Transactions, 99 [5], 206-211. Abstract
The mean fasting insulin level in 30 apparently normal Kenyan Africans was determined by Radio-Immuno Assay (RIA) technique based on coat A-count. The mean value was found as 16.33 microIu/ml with a standard deviation (s.d) of 10.51 microIu/ml. The mean at 95% confidence interval (CI) for the population studied was 16.33 +/- 1.92. The findings are similar to what have been reported among the caucasians. This paper also reports on a case of insulinoma in a young female patient at Kenyatta National Hospital (KNH).
OTIENO, PROFOGUTUELLY.  1988.  Ogutu E.O., Wankya B.M., Shah M.V., Ndinya Achola J.O. The prevalence of Spontaneous Bacterial Peritonitis at Kenyatta National Hospital. E. Afr. Med. J. 65: 547, 1988. East Afr Med J. 1989 Dec;66(12):830-3.. : Journal of British Ceramic Transactions, 99 [5], 206-211. Abstract
The mean fasting insulin level in 30 apparently normal Kenyan Africans was determined by Radio-Immuno Assay (RIA) technique based on coat A-count. The mean value was found as 16.33 microIu/ml with a standard deviation (s.d) of 10.51 microIu/ml. The mean at 95% confidence interval (CI) for the population studied was 16.33 +/- 1.92. The findings are similar to what have been reported among the caucasians. This paper also reports on a case of insulinoma in a young female patient at Kenyatta National Hospital (KNH).

1987

Okoth, F, Ogutu EO, LULE GN, Were JBO, Gatei D, Kinoti SN.  1987.  Upper Gastrointestinal Tract Endoscopic findings in 709 Africans Patients Endoscoped at KEMRI – May 198.

1985

Lule, GN;, Okoth F;, Ogutu EO;, Mwai SJ.  1985.  HBV markers (HBsAg, HBSAb, HBCAb in 160 medical students at Kenyatta National Hospital. Abstract

In an exercise to study the immunogenicity and reactogenicity of the Engerix B vaccine, 160 medical students were screened for Hepatitis B Markers (HBsAg, HBsAb and HBcAb) with a view to vaccinating those that were negative. 18% were HBsAg + ve, 33% were HBsAb + ve and 38% were positive for the HBcAb. These figures were extremely high and obviated the need to vaccinate the students as they begin their clinical years

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