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Publications


Submitted

Onyambu, CK.  Submitted.  The pattern of chest radiographic findings in immunocompromised patients at the Kenyatta national hospital. Abstract

The pattern of chest radiograph findings were studied in 280 HIV positive individuals.
These were compared to 40 HIV negative patients who acted as controls. The
commonest disease seen was pneumonia 94 (33.9%), followed by pulmonary
tuberculosis 89 (3l.7%). Mixed infections were seen in 34 (12.2%) cases while PCP
occurred in 16(5.6%) cases. The pneumonia seen was more of bronchopneumonia than
lobar pneumonia in-patients with HIV (33.9) than HIV negative patients (23%).
The cases of pulmonary tuberculosis seen showed less upper lobe distribution than in
HIV negative patients. Most of the cases showed mid and lower zone distribution.
There are less cavitations than HIV negative patients. Also more cases with hilar and
mediastinal nodes were seen. There were 34 (12.2%) cases of mixed infection, which
constituted of 3 (1.1 %) cases of non-Hodgkin's lymphoma. These mainly presented
with hilar and mediastinal nodes. The clinical differentiating features were KS skin
nodules in-patients with pulmonary K.S.

2017

D. Mang’oka, Mathenge IM, Onyambu C.  2017.  The spectrum of radiographic and sonographic findings in patients with shoulder pain at the department of diagnostic imaging and radiation medicine, University of Nairobi. East African Orthopaedic Journal. 11(1) AbstractWebsite

Background: Shoulder pain is a common complaint. Prevalence estimates vary from 6.9% to 26% in the general population. The most frequent cause of shoulder pain is rotator cuff disease. Shoulder radiography is the primary imaging modality in shoulder pain but is limited in the evaluation of the soft tissues. MRI is the chief modality used in the evaluation of shoulder soft tissues both locally and elsewhere but is limited by cost and availability. Shoulder ultrasonography is a cost effective modality for evaluating the soft tissues but is underutilized locally. No data is available in our local population regarding spectrum of findings in shoulder radiographs and ultrasound.
Objective: This study was designed to determine the spectrum of shoulder radiographic and sonographic findings in patients with shoulder pain.
Setting: Department of Diagnostic Imaging and Radiation Medicine, University of Nairobi. It is located within the old wing of Kenyatta National Hospital.
Design: This was a cross sectional descriptive study.
Subjects: A total of 72 patients with shoulder pain who were referred for shoulder radiographs.
Method: The study was conducted over a period of four months between the months of January 2016 to April 2016. Seventy two consecutive patients with shoulder pain referred for shoulder radiographs had a complementary shoulder ultrasound scan done and findings of both examinations recorded in the data collection form. Statistical analysis of the findings was then done using SPSS version 20 IBM. No surgery findings were available to correlate with the imaging findings.
Results:. Radiographs identified abnormalities in 36 (50%) patients’ majority of which were degenerative changes. Ultrasound identified abnormalities in 57 (79%) patients with the bulk of lesions seen within the rotator cuff. There was statistically significant association between presence of greater tuberosity degenerative changes and rotator cuff tears (p<0.001).
Conclusion: The combination of shoulder radiography and ultrasound significantly increased the diagnostic yield by evaluating both osseous and soft tissue components. These findings aim to increase the awareness and utility of shoulder ultrasound locally.

2016

Kimani, NM, Muia JM, Amakabane DM, Onyambu CK.  2016.  Spontaneous infected biloma: case report. Abstract

Biloma is defined as any collection of bile outside the biliary tree. It mainly results from surgical complications and abdominal trauma. Spontaneous biloma is extremely rare and is occasionally associated with choledocholithiasis. This report describes a case of spontaneous biloma diagnosed radiologically and confirmed at laparotomy. An intraperitonial biloma and a large common bile duct calculus were observed. The biloma was drained and the patient progressed well and was discharged in good condition

2015

Otieno, W, ODHIAMBO A, Onyambu CK.  2015.  Upper Abdominal Ultra-Sonography Findings in HIV Patients at Kenyatta National Hospital and the Defense Forces Memorial Hospital. East African Medical Journal. 92(4) AbstractWebsite

Background: Easy availability, accessibility and affordability make ultra-sonography an invaluable diagnostic tool in clinical investigation of infectious and non-infectious complications of human immunodeficiency virus (HIV).
Objective: To determine the pattern of upper abdominal abnormalities in HIV infected patients at ultra-sonography and correlate with clinical presentations.
Design: A descriptive cross-sectional study.
Setting: Kenyatta National Hospital and the Defence Forces Memorial Hospital, Nairobi, Kenya.
Subjects: HIV infected patients referred for upper abdominal sonography within the study duration of eight months.
Results: Two hundred and seventy three (273) patients were included in the study. Overall, upper abdominal pain accounted for 31.9%, pyrexia of unknown origin 30.40% and general abdominal pains 27.68% of clinical indications for sonography. The main clinical indication for liver sonography was hepatitis (45.80%) and the kidney was renal failure (66.67%). The most common liver pathology was diffuse fat infiltration at 35.71%. The most common renal pathology was renal parenchymal disease (93%). Para-aortic lymphadenopathy was present in 42.90% and ascites 25.60% of patients. Conclusion: Renal parenchymal changes (type I and II), fatty liver, intra-abdominal lymphadenopathy and gallbladder sludge are common findings in HIV infected individuals despite paucity of clinical suspicion.

2014

Muthami, KM, Onyambu CK, Odhiambo AO, Muriithi IM, Byakika TK.  2014.   Correlation of magnetic resonance imaging findings with arthroscopy in the evaluation of rotator cuff pathology.. East African Orthopaedic Journal. 8(2):52-59.
Rodriguez, JC, Onyambu CK, Aywak AA.  2014.  JC, R, CK O, AA A. 2014. A Rare Case of Crossed Renal Ectopia without Fusion. East and Central African Journal of Surgery. 19(3):112-115.AJO. East and Central African Journal of Surgery. 19(3):112-115.
Ndii, MK, Kimani NM, Onyambu CK.  2014.  Utility of routine chest radiography in Kenya. East African Medical Journal. 91(7):216-218.
Onyambu, CK, Mugambi LM.  2014.  The pattern of MRI findings in patients with shoulder pain at three Imaging Centres in Nairobi . East African Orthopaedic Journal. 8(1):10-15.

2013

Onyambu, CK, Amayo EO, Ktonyi JM.  2013.  Clinical features and patterns of imaging findings in patients with cerebral Venous sinus thrombosis. East African Medical Journal. 90(10):181-188.

2012

Dr Onyambu C.K, DWMN.  2012.  PATTERN OF INTERSTITIAL LUNG DISEASE AS SEEN BY HIGH RESOLUTION. East African Medical Journal. 89(9):285-293.
Dr Onyambu C.K, Dr Mzumara S.S, DKNM.  2012.  EVALUATING CHAMBERLAIN’S, McGREGOR’S, AND McRAE’S SKULL-BASE. East African Medical Journal. 89(8):272-277.

2011

2010

ONYAMBU, DRKWAMBOKACALLEN, MATHENGE DRMURIITHIIAN.  2010.  Onyambu CK, Muriithi IM, Ngare SM. Cerebral Venous Sinus Thrombosis: A Report of Two Cases. EAMJ.2010;87:220-224.. EAST AFRICAN MEDICAL JOURNAL. 87(5):220-224.: EAMJ AbstractWebsite

Cerebral venous sinus thrombosis is an uncommon yet potentially life threatening condition which is often under-diagnosed or misdiagnosed because of the variability of the clinical signs and symptoms. The imaging findings are often subtle thus the need for a high index of suspicion. The superior sagittal and transverse sinuses are the most frequently involved. The correct diagnosis of cerebral venous thrombosis relies on neuroimaging studies. The two cases reported highlight the fact that the radiologist may be the first clinician to suspect and diagnose this condition. This ultimately affects prognosis as early diagnosis and treatment reduces morbidity and mortality.

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