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MACHARIA PROFNGANGAPETER. "Ng'ang'a PM, Ogaard B. Dental caries and fluorides in relation to fixed orthodontic treatment: a review.East Afr Med J. 1993 Feb;70(2):75-7.". In: East Afr Med J. 1993 Feb;70(2):75-7. Elsevier; 1993. Abstract
Dental School, College of Health Sciences, University of Nairobi. This paper reviews the cariological aspects of fixed orthodontic treatment and discusses the role played by topical fluorides. During fixed orthodontic treatment, carious lesions may occur in the form of white spots. These may constitute an aesthetic problem. The clinical management of white spot lesions remains unresolved. In order to prevent development of these lesions, the use of topical fluorides is advocated. The need for patient co-operation in the use of self-administered topical fluorides is critical. To reduce this critical need, the use of fluoride-releasing orthodontic cements is recommended. The literature suggests that calcium fluoride, which is the major reaction product on enamel during topical fluoride application, plays an important role in the cariostatic mechanism.
Macharia G, Kungu A LA. "Spectrum of endoscopic findings at Kenyatta National Hospital. .". In: Kenya Pediatrics Association Annual Scientific Conference, Mombasa 2012.; 2012.
Macharia-Mutie CW, Moreno-Londono AM, den Wiel VAM, Mwangi AM, Brouwer ID. "Sensory Acceptability and Factors Predicting the Consumption of Grain Amaranth in Kenya." Ecology of Food & Nutrition . 2011;50(5):375-392.
Macharia-Mutie CW, Moretti D, den Briel VN, Omusundi AM, Mwangi AM, Kok FJ, Zimmerman MB, Brouwer ID. "Maize porridge enriched with a micronutrient powder containing low-dose iron as NaFeEDTA but not amaranth grain flour reduces anemia and iron deficiency in Kenyan pre-school children." Journal of Nutrition . 2012;142:1756-1763.
Macharia-Mutie CW, Brouwer ID, Mwangi AM, Kok FJ. "Complementary Feeding Practices and Dietary Intake among Children 12-23 months in Mwingi District Kenya." Int. J. Food Safety, Nutrition and Public Health . 2010;3(1):45-56.
Macharia. J, Thenya T. "Conservation and Management Assessment of Ondiri Swamp, a Shared Natural Resource." Report Prepared fro Royal Netherlands Embassy; 2007. Abstract
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Macharia. J, Thenya T. "Conservation and Management Assessment of Ondiri Swamp, a Shared Natural Resource." Report Prepared fro Royal Netherlands Embassy; 2006. Abstract
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Macharia. J, Thenya T. "Proceedings of Ondiri Swamp stakeholders' workshop." held on 18th Oct 2006 at Wida highway hotel; 2007. Abstract
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Machasio RM, Nyabanda R MTM. "Proportion of Variant Anatomy of the Circle of Willis and Association with Vascular Anomalies on Cerebral CT Angiography." Radiology Research and Practice. 2019;2019(1):Article ID 6380801, 7 pages.
MACHATHA PROFGITUPETER. "Synthesis of Carboxamide Protected Asparagine and Glutamine Derivatives.". In: Inter. J. Biochem. Phy., 4, 3, 22. International Journal of BiochemiPhysics; 1994. Abstract
The Rose-Bengal plate test (RBPT) was performed on 488 patients with flu-like symptoms from Narok district. There was poor agreement between RBPT results from four health facilities in Narok and from the central veterinary laboratory (CVL). Agreement was poorer for the three rural dispensaries than for the District Hospital. On the other hand, for tests conducted at the CVL, there was good agreement between RBPT, serum agglutination test (SAT) and complement fixation test (CFT) results, indicating that all these tests were probably performing well. Better training and quality control and the use of white rather than a clear background surface for judging agglutination results are recommended to improve the performance of test results in Narok District health facilities.
MACHATHA PROFGITUPETER. "The use of allyl (All) and allyloxycarbonyl (Alloc) protecting groups in the preparation of cyclic glucagon analogues.". In: presented at the 16th American Peptide Society Symposium, June 26-July 1, Minneapolis, Minnesota. International Journal of BiochemiPhysics; 1999. Abstract
The Rose-Bengal plate test (RBPT) was performed on 488 patients with flu-like symptoms from Narok district. There was poor agreement between RBPT results from four health facilities in Narok and from the central veterinary laboratory (CVL). Agreement was poorer for the three rural dispensaries than for the District Hospital. On the other hand, for tests conducted at the CVL, there was good agreement between RBPT, serum agglutination test (SAT) and complement fixation test (CFT) results, indicating that all these tests were probably performing well. Better training and quality control and the use of white rather than a clear background surface for judging agglutination results are recommended to improve the performance of test results in Narok District health facilities.
MACHATHA PROFGITUPETER. "PolymericAntioxidant from vernonia oil.". In: Mycromolecular Chemistry and Physics, 2001, 202(13), 2790-2796. International Journal of BiochemiPhysics; 2001. Abstract
The Rose-Bengal plate test (RBPT) was performed on 488 patients with flu-like symptoms from Narok district. There was poor agreement between RBPT results from four health facilities in Narok and from the central veterinary laboratory (CVL). Agreement was poorer for the three rural dispensaries than for the District Hospital. On the other hand, for tests conducted at the CVL, there was good agreement between RBPT, serum agglutination test (SAT) and complement fixation test (CFT) results, indicating that all these tests were probably performing well. Better training and quality control and the use of white rather than a clear background surface for judging agglutination results are recommended to improve the performance of test results in Narok District health facilities.
MACHATHA PROFGITUPETER, BHALENDU PROFBHATT. "Synthesis of 12,13-dihydroxyoctadec-9-enoic, octanedioic and nonanedioic acids from Vernonia galamensis Seed oil.". In: Kenya Chemical Society Inaugural Conference Proceedings. B.M. Bhatt and P.M. Gitu; 1993. Abstract
We surveyed the phytoseid mites in four different geographical zones of Kenya: Zone I, upper highland and tropical alpine (2400-4400m): Zone II, lower highland (1800-2400m); zone III, midland (800-1800m); Zone IV, tropical, hot and humid( 0-800m ). A total of 107 species was found. In the sub family, amblyseeinae there were 14 species in the genus Neoseilus , one in Aspereroseius Chant, one in Paraphytoseius Swirski &Schechter, five in typhlodromips De Leon, five in Transeius Chant & McMurty, one in Graminaseius Chant &McMurty, 11 in Amblyseius Berlese, one in Arrenoseius Wanstein, two in Typhlodromalus muma, seven in Ueckemannseius Chant &McMurty, one in Ambylodromalus Chant &Mcmurty,, 20 in Euseius Wanstein, one in Iphiseius Berlese, one in Phytoseilus Evans and one in Gynaseius Ehara & Imano. In the subfamily Phytoseiinae Berlese there were four species in the genus Phytoseiius Ribaga. In the subfamily Typhlodrominae Wanstein, there were four species in the genus Kuzinellus Wainstein and 27 in Typhlodromus Scheuten
MACHATHA PROFGITUPETER. "Protection of the amide side-chain of asparagine with 1-tetralynil group in the sollidphase peptide synthesis of lysine-vasopressin.". In: South Africa Journal of Chemistry, 2002, 55, 87-96. International Journal of BiochemiPhysics; 2002. Abstract
The Rose-Bengal plate test (RBPT) was performed on 488 patients with flu-like symptoms from Narok district. There was poor agreement between RBPT results from four health facilities in Narok and from the central veterinary laboratory (CVL). Agreement was poorer for the three rural dispensaries than for the District Hospital. On the other hand, for tests conducted at the CVL, there was good agreement between RBPT, serum agglutination test (SAT) and complement fixation test (CFT) results, indicating that all these tests were probably performing well. Better training and quality control and the use of white rather than a clear background surface for judging agglutination results are recommended to improve the performance of test results in Narok District health facilities.
MACHATHA PROFGITUPETER. "I-Tetralinyl group for asparagine side-chainprotection and application for Boc-solid phase peptide synthesis of mesotocin.". In: Journal of Kenya Chemical Society, 2004, 2(1), 14-18. International Journal of BiochemiPhysics; 2004. Abstract
The Rose-Bengal plate test (RBPT) was performed on 488 patients with flu-like symptoms from Narok district. There was poor agreement between RBPT results from four health facilities in Narok and from the central veterinary laboratory (CVL). Agreement was poorer for the three rural dispensaries than for the District Hospital. On the other hand, for tests conducted at the CVL, there was good agreement between RBPT, serum agglutination test (SAT) and complement fixation test (CFT) results, indicating that all these tests were probably performing well. Better training and quality control and the use of white rather than a clear background surface for judging agglutination results are recommended to improve the performance of test results in Narok District health facilities.
MACHATHA PROFGITUPETER. "Solid Phase Synthesis of (2-Isoluecine-4-Leucine)oxytocin and (2-phenylalanine-4-Leucine)oxytocin and Some of Their Pharmacological Properties.". In: Journal of Medicinal Chemistry. International Journal of BiochemiPhysics; 1973. Abstract
18) , P.M. Muturi, S. Dirlikov and P.M. Gitu. .
MACHATHA PROFGITUPETER. "HF Cleavage of Carboxamide Protected Asparagine and Glutamine Derivatives.". In: Inter. J. Biochem. Phy. 3, 20. International Journal of BiochemiPhysics; 1994. Abstract
The Rose-Bengal plate test (RBPT) was performed on 488 patients with flu-like symptoms from Narok district. There was poor agreement between RBPT results from four health facilities in Narok and from the central veterinary laboratory (CVL). Agreement was poorer for the three rural dispensaries than for the District Hospital. On the other hand, for tests conducted at the CVL, there was good agreement between RBPT, serum agglutination test (SAT) and complement fixation test (CFT) results, indicating that all these tests were probably performing well. Better training and quality control and the use of white rather than a clear background surface for judging agglutination results are recommended to improve the performance of test results in Narok District health facilities.
MACHATHA PROFGITUPETER. "Design and Synthesis of truncated and conformationally constricted glucagon analogues.". In: presented at the 16thAmerican Peptide Symposium, June 26-July 1, Minneapolis, Minnesota. International Journal of BiochemiPhysics; 1999. Abstract
The Rose-Bengal plate test (RBPT) was performed on 488 patients with flu-like symptoms from Narok district. There was poor agreement between RBPT results from four health facilities in Narok and from the central veterinary laboratory (CVL). Agreement was poorer for the three rural dispensaries than for the District Hospital. On the other hand, for tests conducted at the CVL, there was good agreement between RBPT, serum agglutination test (SAT) and complement fixation test (CFT) results, indicating that all these tests were probably performing well. Better training and quality control and the use of white rather than a clear background surface for judging agglutination results are recommended to improve the performance of test results in Narok District health facilities.
MACHATHA PROFGITUPETER. "A new Approach to Search for the Bioactive Conformation of Glucagon Position Cyclization Scanning.". In: Journal of Medicinal Chemistry, 2001, 44, 3109 - 3116. International Journal of BiochemiPhysics; 2001. Abstract
The Rose-Bengal plate test (RBPT) was performed on 488 patients with flu-like symptoms from Narok district. There was poor agreement between RBPT results from four health facilities in Narok and from the central veterinary laboratory (CVL). Agreement was poorer for the three rural dispensaries than for the District Hospital. On the other hand, for tests conducted at the CVL, there was good agreement between RBPT, serum agglutination test (SAT) and complement fixation test (CFT) results, indicating that all these tests were probably performing well. Better training and quality control and the use of white rather than a clear background surface for judging agglutination results are recommended to improve the performance of test results in Narok District health facilities.
MACHATHA PROFGITUPETER. "Isdolation and in Vitro antiplasmodial Activities of Alkaloid from Teclea trichocarpa: In Vivo antimalaria activity and X-ray crystal structure of normelicopicine.". In: J. Nat. Prod. 2002, 65, 956-959. International Journal of BiochemiPhysics; 2002. Abstract
The Rose-Bengal plate test (RBPT) was performed on 488 patients with flu-like symptoms from Narok district. There was poor agreement between RBPT results from four health facilities in Narok and from the central veterinary laboratory (CVL). Agreement was poorer for the three rural dispensaries than for the District Hospital. On the other hand, for tests conducted at the CVL, there was good agreement between RBPT, serum agglutination test (SAT) and complement fixation test (CFT) results, indicating that all these tests were probably performing well. Better training and quality control and the use of white rather than a clear background surface for judging agglutination results are recommended to improve the performance of test results in Narok District health facilities.
MACHATHA PROFGITUPETER. "Synthesis of Side Chain Conformationally Restricted alpha-Amino Acids.". In: Methods of Organic Chemistry, Volume E 22c, 5-51. International Journal of BiochemiPhysics; 2003. Abstract
The Rose-Bengal plate test (RBPT) was performed on 488 patients with flu-like symptoms from Narok district. There was poor agreement between RBPT results from four health facilities in Narok and from the central veterinary laboratory (CVL). Agreement was poorer for the three rural dispensaries than for the District Hospital. On the other hand, for tests conducted at the CVL, there was good agreement between RBPT, serum agglutination test (SAT) and complement fixation test (CFT) results, indicating that all these tests were probably performing well. Better training and quality control and the use of white rather than a clear background surface for judging agglutination results are recommended to improve the performance of test results in Narok District health facilities.
MACHATHA PROFGITUPETER. "The Preparation and use of Carboxamide Protected Asparagine and Glucagon Derivatives; Chemistry and Biology of Peptides.". In: Journal of Medicinal Chemistry. International Journal of BiochemiPhysics; 1972. Abstract
1) , V. J. Hruby, F. A. Muscio, W. Brown, and P. M. Gitu, 1972, 331.
MACHATHA PROFGITUPETER. "Vernonia and Epoxidized Linseed and Soybean Oils; as Low Reactive Diluents in Alkyd Coatings.". In: Pigments & Resin Technology,3(23), 3-7. International Journal of BiochemiPhysics; 1994. Abstract
18) , P.M. Muturi, S. Dirlikov and P.M. Gitu. .
MACHATHA PROFGITUPETER. "Gynadropsis gynandra essential oil and its constituents as tick (Rhippicephalus appendiculatus) repellents.". In: Phytochemistry, 50, 401 - 405. International Journal of BiochemiPhysics; 1999. Abstract
The Rose-Bengal plate test (RBPT) was performed on 488 patients with flu-like symptoms from Narok district. There was poor agreement between RBPT results from four health facilities in Narok and from the central veterinary laboratory (CVL). Agreement was poorer for the three rural dispensaries than for the District Hospital. On the other hand, for tests conducted at the CVL, there was good agreement between RBPT, serum agglutination test (SAT) and complement fixation test (CFT) results, indicating that all these tests were probably performing well. Better training and quality control and the use of white rather than a clear background surface for judging agglutination results are recommended to improve the performance of test results in Narok District health facilities.
MACHATHA PROFGITUPETER. "Potential Antitermite Compouds from Juniperus procera extracts.". In: Chemosphere, 2000, 41, 1071-1074. International Journal of BiochemiPhysics; 2000. Abstract
The Rose-Bengal plate test (RBPT) was performed on 488 patients with flu-like symptoms from Narok district. There was poor agreement between RBPT results from four health facilities in Narok and from the central veterinary laboratory (CVL). Agreement was poorer for the three rural dispensaries than for the District Hospital. On the other hand, for tests conducted at the CVL, there was good agreement between RBPT, serum agglutination test (SAT) and complement fixation test (CFT) results, indicating that all these tests were probably performing well. Better training and quality control and the use of white rather than a clear background surface for judging agglutination results are recommended to improve the performance of test results in Narok District health facilities.
MACHATHA PROFGITUPETER. "Preparation of "side-chain to side-chain" cyclic peptides by Allyl and Alloc strategy: potential for library synthesis.". In: Journal of Peptide Research, 2001, 57, 250-256. International Journal of BiochemiPhysics; 2001. Abstract
The Rose-Bengal plate test (RBPT) was performed on 488 patients with flu-like symptoms from Narok district. There was poor agreement between RBPT results from four health facilities in Narok and from the central veterinary laboratory (CVL). Agreement was poorer for the three rural dispensaries than for the District Hospital. On the other hand, for tests conducted at the CVL, there was good agreement between RBPT, serum agglutination test (SAT) and complement fixation test (CFT) results, indicating that all these tests were probably performing well. Better training and quality control and the use of white rather than a clear background surface for judging agglutination results are recommended to improve the performance of test results in Narok District health facilities.
MACHATHA PROFGITUPETER. "Odor composition of preferred (buffalo and ox) and nonpreferred (warebuck) host of some savanna tsetse.". In: Journal of Chemical Ecology, 2002, 28(5). International Journal of BiochemiPhysics; 2002. Abstract
The Rose-Bengal plate test (RBPT) was performed on 488 patients with flu-like symptoms from Narok district. There was poor agreement between RBPT results from four health facilities in Narok and from the central veterinary laboratory (CVL). Agreement was poorer for the three rural dispensaries than for the District Hospital. On the other hand, for tests conducted at the CVL, there was good agreement between RBPT, serum agglutination test (SAT) and complement fixation test (CFT) results, indicating that all these tests were probably performing well. Better training and quality control and the use of white rather than a clear background surface for judging agglutination results are recommended to improve the performance of test results in Narok District health facilities.
MACHATHA PROFGITUPETER, BHALENDU PROFBHATT. "Synthesis of 12,13-dihydroxyoctadec-9-enoic, octanedioic and nonanedioic acids from Vernonia galamensis Seed oil.". In: Kenya Chemical Society Inaugural Conference Proceedings. International Journal of BiochemiPhysics; 1993. Abstract
18) , P.M. Muturi, S. Dirlikov and P.M. Gitu. .
Machera M, ed) SA(. Opening a Can of Worms: A Debate on Female Sexuality in the Lecture Theatre. Uppsala: Nordic Africa Institute; 2004.
Macheyeki AS, Chapola LS, Manhiça V, Chisambi J, Feitio P, Ayele A, Barongo J, Ferdinand RW, Ghebrebrhan O, Goitom B, Hlatywayo JD, Kianji GK, Marohbe I, Mulowezi A, Mutamina D, Mwano JM, Shumba B, andTumwikiri. "Active Fault Mapping in Karonga-Malawi after the December 19, 2009 Ms 6.2 Seismic Event.". 2014.
Machio P. "The Effect of Chronic Illness on Labor Market Outcomes in Kenya.". In: Center for the Study of Africa Economies. Oxford, UK; 2012.
Machio P. Demand for Maternal Health Care Services in Kenya. University of Nairobi; 2008.
Machio PM. "Determinants of Neonatal and Under-five Mortality in Kenya: Do Antenatal and Skilled Delivery Care Services Matter?" Journal of African Development, African Finance and Economic Association. 2018;20(1):59-67.
Machua SK, Mukuria JC, Mukuria JC, Ngure RM, Gitu PM. "Modulation of partially purified rat liver mitochondrial carbamoyl phosphate synthetase I using two glutamic acid analogues." Unique Research Journal . 2014;1(1):001-010. Abstract Unique Research Journal

Description
Mitochondrial carbamoyl phosphate synthetase I (CPS I) is the first enzyme involved in urea biosynthesis in ureotelic mammals and has an absolute requirement for N-acetyl-L-glutamate (NAG) or N-carbamyl-L-glutamate (NCLG) in absence of NAG as its allosteric modulator. To investigate effect of diet on CPS I activation, three male albino rats were maintained under normal laboratory diet (control) and another three on high protein egg white diet for 10 days. The percentage mean weight gain for the normal diet was 6.4% while the percentage mean weight loss for the high protein diet group 18.6%. The rats were sacrificed and CPS I isolated from the liver mitochondria through differential centrifugation and partially purified by ammonium sulphate precipitation, gel filtration on Sephadex G-200 and native polyacrylamide gel electrophoresis (PAGE). Lactate dehydrogenase-pyruvate kinase (LDH-PK) coupled assay system was devised to determine the effect of NAG and its structural analogue NCLG in the activation of CPS I from rats fed on the two diets. CPS I activity of 268.16 nmol/min/mg in the control group doubled to 553.86 nmol/min/mg in rats fed on high protein. An initial velocity of CPS I of 3.07 nmol/min/mg was observed when activated by 0.57 mM NAG and a lowered activity of 2.2 nmol/min/mg when replaced with 0.57 mM NCLG. Both NAG and NCLG activated CPS I at all concentrations tested in the assay system devised with improved activity seen when CPS I activity was measured in presence of NAG.

Machuka JS;, Waithaka K;, Gopalan HNB. "Discovery and Innovation, 5(1): 75-80."; 1993.
Machuki VN, K’Obonyo, P.O. "Organizational Strategic Behaviour and Performance of Publicly Quoted Companies in Kenya." Business Administration and Management Journal. 2011;1(7):219-232.
Machuki VN. "Strategy Implementation: Practices and Challenges in a Multidivisional Company (The Case of Cooper Motors Corporation, Kenya)." LAP Lambert Academic Publishing AG & KG. ISBN: 978-3-8443-1275-1; 2011. Abstract
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Machuki, V. N. AE, K. LN. "Firm-Level Institutions and Performance of Publicly Quoted Companies in Kenya." International Journal of Humanities and Social Science, Vol. 2(21) pp. 289-312; 2012. Abstract
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Machuki VN, Aosa E. "The influence of the external environment on the performance of publicly quoted companies in Kenya." Prime Journal of Business Administration and Management . 2011;1(7):pp. 205-218. Abstract

This study investigated the effect of the external environment on corporate performance. Based on a survey of 23 companies listed on the Nairobi Stock Exchange, three environmental dimensions of complexity, dynamism and munificence were used to describe Kenya’s business environment. Performance implications of these environmental dimensions were then examined. The study reports that for the surveyed companies, varying degrees of external environmental complexity, dynamism, and munificence exist which tend to be mostly manifested in economic factors, competitive rivalry, market factors, technological factors, regulatory factors as well as threat of new entrants. Consequently, these factors appeared to have great influence in the companies’ strategic decision making. However, the overall results for the effect of external environment on corporate performance were statistically not significant. Based on the findings, implications of the study and suggestions for further study are presented.

Key Words: External environment, corporate performance, publicly quoted companies, Kenya

Machumi F, Yenesew A, Midiwo JO, Heydenreich M, Kleinpeter E, Khan S, Tekwani BL, Walker LA, Muhammad I. "Antiparasitic and anticancer carvotacetone derivatives from Sphaeranthus bullatus.". 2012.Website
Machumi F, Midiwo JO, Jacob MR, Khan SI, Tekwani BL, Walker LA, Muhammad I. "Phytochemical, Antiparasitic and Antimicrobial Investigations of Terminalia brownii.". 2013. AbstractPhytochemical, Antiparasitic and Antimicrobial Investigations of Terminalia brownii

Terminalia brownii is an African medicinal plant used to treat parasitic and microbial infections [1]. Chromatographic separations on the stem bark extract aimed at identifying the active components led to isolation of a new oleanane-type triterpenoid, along with seven known oleanane-type triterpenoids and seven ellagic acid derivatives. The new compound was identified using spectroscopic methods as 3β,24-O-ethylidenyl-2α,19α-dihydroxyolean-12-en-28-oic acid (1). The compounds were evaluated for their antiplasmodial, antileishmanial and antimicrobial activities giving the most potent antiplasmodial activity with IC50 values of 2.76 µg/mL for 23-galloylarjunolic acid (2) against P. falciparum W2 strain and the most potent antimicrobial activity with IC50 values of 0.32 µg/mL for diellagic lactone (3) against C. glabrata.

Maciel S;, Mwai OA;, Amimo JO;, Moyo S;, Scholtz M;, Neser F;, Martins M. "Environmental descriptors influencing performance of the Nguni ecotypes."; 2009.
Maciel S, Okeyo AM, Amimo J, Scholtz MM, Neser FWC, Martins M. "The effect of geographical region of birth on the reproductive performance of the Nguni in southern Mozambique." South African Journal Of Animal Science. 2013;43(5 (1)):59-62.
Maciel S;, Mwai OA;, Amimo JO;, Moyo S;, Scholtz M;, Neser F;, Martins M. "Environmental descriptors influencing performance of the Nguni ecotypes."; 2009.
Maciel S, Amimo J, Martins M, Okeyo AM, Scholtz MM, Neser FWC. "Feedlot performance of the Nguni ecotypes in southern Mozambique." Livestock Research for Rural Development. 2013;25(6):article 111.
Macigo FG, James RM, Ogunbodede E, Gathece LW. "Sugar consumption and dental caries experience in Kenya." International Dental Journal. 2016;66:158-162. Abstract
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Macigo FG, James RM, Ogunbodede E, Gathece LW. "Sugar consumption and dental caries experience in Kenya." International dental journal. 2016;66:158-162. Abstract
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Macigo FG, Guthua SW. The State of Oral Health in Kenya.. Nairobi: English Press Ltd; 2007.
Macigo FG, Gathece LW, Guthua SW, Wagaiyu EG, Mulli TK. "Oral Hygiene Practices and Risk of Oral Leukoplakia." East African Medical Journal, 83 (4), 74-79, 2006.. 2006;83(4):74-79. AbstractWebsite

Department of Periodontology/ Community and Preventive Dentistry, School of Dental Sciences, University of Nairobi, P.O. Box 19676 - 00202, Nairobi, Kenya. OBJECTIVE: To determine the influence of oral hygiene habits and practices on the risk of developing oral leukoplakia. DESIGN: Case control study. SETTING: Githongo sublocation in Meru District. SUBJECTS: Eighty five cases and 141 controls identified in a house-to-house screening. RESULTS: The relative risk (RR) of oral leukoplakia increased gradually across the various brushing frequencies from the reference RR of 1.0 in those who brushed three times a day, to 7.6 in the "don't brush" group. The trend of increase was statistically significant (X2 for Trend : p = 0.001). The use of chewing stick as compared to conventional tooth brush had no significant influence on RR of oral leukoplakia. Non-users of toothpastes had a significantly higher risk of oral leukoplakia than users (RR = 1.8; 95% confidence levels (CI) = 1.4-2.5). Among tobacco smokers, the RR increased from 4.6 in those who brushed to 7.3 in those who did not brush. Among non-smokers, the RR of oral leukoplakia in those who did not brush (1.8) compared to those who brushed was also statistically significant (95% CL = 1.6-3.8). CONCLUSION: Failure to brush teeth and none use of toothpastes are significantly associated with the development of oral leukoplakia, while the choice of brushing tools between conventional toothbrush and chewing stick is not. In addition, failure to brush teeth appeared to potentiate the effect of smoking tobacco in the development of oral leukoplakia. Recommendations: Oral health education, instruction and motivation for the improvement of oral hygiene habits and practices; and therefore oral hygiene status, should be among the strategies used in oral leukoplakia preventive and control programmes.

Mackatiani, C.I. MGJNDK. "Quality Primary Education in Kenya: Implications of Teachers’ Characteristics." Journal of Education Studies (EJES). 2017;3(8).
Mackatiani C, Imbovah M, Imbova N. "PEACE AND DEVELOPMENT IN AFRICA: PROSPECTS AND CHALLENGES." Journal of International affairs and global strategy Journal of International affairs and global strategy Journal of International affairs and global strat . 2014;21(1):2224-8951. Abstractpeace_and_development_in_africa-1.doc

This paper provides a critical appraisal of continental peace and development in Africa. Since the formation of Organization of African Unity (O.A.U) in early 1960s, African states agreed to strengthen their relalationship at continental and regional levels. The primary aim was a drive for liberty. With most of African countries attaining independence, there was a shift to regional economic cooperation, trade and conflict issues. Organizations such as the African Union (AU), the Economic Community of West African States (ECOWAS), the Intergovernmental Authority on Development (IGAD), and the Southern African Development Community (SADC) emerged in order to address security issues and economic development. This is as a result of the cooperation of countries in specific regions. With growing leadership crises, conflicts have developed in various regions leading to political unrest in most countries. This has led to security issues being focal points of concern. As a result, peace agreements were signed and developmental activities being initiated. The paper examines Global and African peace and security architecture. The paper further assesses prospects that have arisen because of peace. It also analyzes challenges that arise due to peace initiatives and how they affect development in Africa. Particular attention is given to the crises in the Central African Republic, Rwanda, DRC Congo, Ivory Coast, Egypt, Chad Angola, Sudan, Kenya, Zimbabwe, Nigeria, South Sudan, Uganda, and Somalia.

Mackatiani C. "Fallacy of institutionalized Schooling in Kenya." Journal of Education Management Society of Kenya. 2012.
Mackatiani C. "Evolution of Technical Education Policy in Kenya ." Journal of Education Management Society of Kenya. 2012.
Mackatiani C. "Evolution of modern slavery." AFRICE Journal. 2013.
Mackatiani, Caleb Imbova NMKGDJ &. "Learning Achievement: Illusions of Teacher-Centered Approaches in Primary Schools in Kenya." The International Institute for Science, Technology and Education. 2018;9(18):46-54.
Mackelprang RD, Bosire R, Guthrie BL, Choi RY, Liu A, Gatuguta A, Rositch AF, Kiarie JN, Farquhar C. "High rates of relationship dissolution among heterosexual HIV-serodiscordant couples in Kenya." AIDS Behav. 2014;18(1):189-93. Abstract

HIV-1 serodiscordant couples may experience increased risks of relationship dissolution; however, longitudinal stability of these relationships is poorly understood. We determined rates and correlates of separation among 469 serodiscordant couples in Nairobi and found that 113 (24 %) separated during 2 years of follow-up. Couples with a female HIV-1 infected partner (F+M-) and no income were more likely to separate than M+F- couples without income (HR = 5.0; 95 % CI 1.1-25.0), and F+M- and M+F- couples with income (HR = 2.4; 95 % CI 1.3-4.5 and HR = 2.3; 95 % CI 1.2-4.8, respectively). High separation rates may be important for couple support services and for conducting discordant couple studies.

Mackelprang RD, Carrington M, G J-S, Lohman-Payne B, Richardson BA, Wamalwa D, Farquhar C, Gao X, Majiwa M, Mbori-Ngacha D, C. F. "Maternal human leukocyte antigen A*2301 is associated with increased mother-to-child HIV-1 transmission. ." J Infect Dis. 2010 Oct 15;202(8):1273-7. doi: 10.1086/656318. 10. . 2010. Abstract

Abstract
We examined associations between maternal human leukocyte antigen (HLA) and vertical human immunodeficiency virus type 1 (HIV-1) transmission in a perinatal cohort of 277 HIV-infected women in Nairobi. HLA class I genes were amplified by using sequence-specific oligonucleotide probes, and analyses were performed using logistic regression. Maternal HLA-A*2301 was associated with increased transmission risk before and after adjusting for maternal viral load (unadjusted: odds ratio [OR], 3.21; 95% confidence interval [CI], 1.42-7.27; P = .005; Pcorr = 0.04; adjusted: OR, 3.07; 95% CI, 1.26-7.51; P =.01; Pcorr is not significant). That maternal HLA-A*2301 was associated with transmission independent of plasma HIV-1 RNA levels suggests that HLA may alter infectivity through mechanisms other than influencing HIV-1 load.

MacLeod DT, Choi NM, Briney B, Garces F, Ver LS, Landais E, Murrell B, Wrin T, Kilembe W, Liang C-H, Ramos A, Bian CB, Wickramasinghe L, Kong L, Eren K, Wu C-Y, Wong C-H, Kosakovsky Pond SL, Wilson IA, Burton DR, Poignard P. "Early Antibody Lineage Diversification and Independent Limb Maturation Lead to Broad HIV-1 Neutralization Targeting the Env High-Mannose Patch." Immunity. 2016;44(5):1215-26. Abstract

The high-mannose patch on HIV Env is a preferred target for broadly neutralizing antibodies (bnAbs), but to date, no vaccination regimen has elicited bnAbs against this region. Here, we present the development of a bnAb lineage targeting the high-mannose patch in an HIV-1 subtype-C-infected donor from sub-Saharan Africa. The Abs first acquired autologous neutralization, then gradually matured to achieve breadth. One Ab neutralized >47% of HIV-1 strains with only ∼11% somatic hypermutation and no insertions or deletions. By sequencing autologous env, we determined key residues that triggered the lineage and participated in Ab-Env coevolution. Next-generation sequencing of the Ab repertoire showed an early expansive diversification of the lineage followed by independent maturation of individual limbs, several of them developing notable breadth and potency. Overall, the findings are encouraging from a vaccine standpoint and suggest immunization strategies mimicking the evolution of the entire high-mannose patch and promoting maturation of multiple diverse Ab pathways.

Maclure R;, Gakuru O;, Sotelo M. "Social policies and marginalized urban youth: centrist prescriptions and divergent practices .". 2001. AbstractWebsite

Although conditions of risk confronting urban youth are most visible in the immediate contexts of family and community, the degree to which specific social policies affect the status of adolescence is less understood. Between 1999 and 2002, with support from the International Development Research Centre, a team of researchers in Canada, Kenya and Nicaragua undertook a comparative inquiry into policy changes designed to influence social services impinging on the welfare of marginalized urban youth. Qualitative case studies focused on three stages of policy: a) the politics and macro-level forces underlying the formulation of social policies that affect urban youth; b) the institutional dynamics of policy implementation within selected urban sites and corresponding relations between units of local government and civil society organizations; and c) the actions and perspectives of groups of individuals who have been engaged in, and affected by, these policy processes. Despite the diversity of contexts and policies examined, case study findings revealed how the formulation of youth-oriented policies are shaped by dominant discourses that rarely accommodate the perspectives of youth themselves. Likewise, the implementation of such policies constitutes a complex set of practices that are subject to negotiation and different forms of appropriation, and therefore often exacerbate the marginalization of urban youth. In keeping with the qualitative and collaborative design of the project, the research helped to generate inter organizational dialogue within the communities that were the sites of inquiry. It also fostered insights regarding the role of collaborative international research as a catalyst for cross-national dialogue and a knowledge base for grassroots rights-oriented social change.

MacNeil MA, Heussy JK, Dacheux RF, Raviola E, Masland RH. "The population of bipolar cells in the rabbit retina." The Journal of comparative neurology. 2004;472:73-86. Abstract

The population of bipolar cells in the rabbit retina was studied using Golgi impregnation and photocatalyzed filling of single cells with dihydrorhodamine, a quantitative sampling technique. The Golgi method revealed the morphology and stratification of cells in detail. The photofilling method allowed us to estimate the frequency of the cell types. From a sample of 243 Golgi-impregnated bipolar cells and 107 photofilled cells, we identified 1 type of rod bipolar cell and 12 types of cone bipolar cells. An analysis based on retinal coverage indicates that this number of types could be contained within the number of bipolar cells known to exist. The dendrites of most cone bipolars contacted all the cones within the individual cone bipolar cell's dendritic field. Types of bipolar cell were encountered at roughly similar frequency, without any one type predominating. The rabbit retina thus contains about a dozen parallel and roughly equipotent through-pathways.

MacNeil MA, Heussy JK, Dacheux RF, Raviola E, Masland RH. "The population of bipolar cells in the rabbit retina." The Journal of Comparative Neurology. 2004;472:73-86. AbstractWebsite

The population of bipolar cells in the rabbit retina was studied using Golgi impregnation and photocatalyzed filling of single cells with dihydrorhodamine, a quantitative sampling technique. The Golgi method revealed the morphology and stratification of cells in detail. The photofilling method allowed us to estimate the frequency of the cell types. From a sample of 243 Golgi-impregnated bipolar cells and 107 photofilled cells, we identified 1 type of rod bipolar cell and 12 types of cone bipolar cells. An analysis based on retinal coverage indicates that this number of types could be contained within the number of bipolar cells known to exist. The dendrites of most cone bipolars contacted all the cones within the individual cone bipolar cell's dendritic field. Types of bipolar cell were encountered at roughly similar frequency, without any one type predominating. The rabbit retina thus contains about a dozen parallel and roughly equipotent through-pathways. J. Comp. Neurol. 472:73–86, 2004. © 2004 Wiley-Liss, Inc.

Macoco DK. Construction of a Gravity Map, .; 1973. Abstract

To display more clearly the gravity anomalies caused by geologic bodies in the upper parts of the crust, a new colored isostatic residual gravity map of the conterminous United States has been prepared using the gravity data set compiled for the Gravity Anomaly Map of the United States (Society of Exploration Geophysicists, 1982). The new isostatic residual gravity map is based on an Airy-Heiskanen model of local compensation, in which the surface load requiring compensation is defined by 5-min topographic and bathymetric data sets. A colored first-vertical-derivative map of isostatic residual gravity further enhances the short-wavelength anomalies produced by bodies at or near the surface and emphasizes the regional fabrics and trends in the gravity field. For the purpose of displaying gravity anomalies caused by shallow bodies of geologic significance, the nature of the isostatic model and the values of its parameters are of lesser importance than the application of an isostatic correction of some sort. Most isostatic models result in residual gravity maps that appear nearly identical in their main patterns and features. Anomalies on isostatic residual gravity maps should not be casually interpreted in terms of “undercompensation” or “overcompensation” because large-amplitude anomalies can be produced by crustal bodies in complete local isostatic equilibrium. Many isostatic residual gravity anomalies less than several hundred kilometers wide can be related to known geologic bodies. We present here a classification scheme that attempts to categorize such anomalies on the basis of tectonic environment. In general, highs correlate with intruded or accreted mafic material or with upthrusted crustal sections, whereas lows occur over low-density sedimentary or volcanic sections, felsic intrusive bodies, or down-warped crustal sections. Although some longer-wavelength anomalies, such as the broad gravity high centered over Montana, could be manifestations of density contrasts deep in the mantle, many such anomalies can also be modeled by geologically reasonable density contrasts that are isostatically compensated and confined to depths of less than several hundred kilometers, so that their source bodies need not be deep. The fact that certain of these broader anomalies have well-defined boundaries which correlate with near-surface geologic features increases the likelihood that their sources lie entirely within the lithosphere. If so, then the density contrasts required to explain the gravity data imply fundamental anomalies in chemical composition or thermal state for the crustal and upper mantle columns under these regions. We have investigated spectral analysis as a method to quantitatively characterize regional anomaly patterns. Contoured plots of normalized amplitude spectra were prepared for various areas of the isostatic residual gravity field of the United States. These Fourier domain representations show characteristic patterns that can be interpreted in terms of the trends and wavelengths of anomalies and may help to more objectively distinguish geologic basements with different origins or tectonic histories.

Macpherson CNL, Wachira TM, Zeyhle E, Romig T, Machpherson C. "Hydatid disease-research and control in Turkana." Transactions of the Royal Society of Tropical Medicine and Hygiene. 1996;80:196-200.
Madadi VO, Wandiga SO, Jumba IO. Mineralization Versus Degradation of 2,4-D in Tropical Soil. Arusha - Tanzania: The African Network for Chemical Analysis of Pesticides (ANCAP); 2004.
Madadi VO, Wandiga SO, Jumba IO. The status of persistent Organic pollutants in Lake Victoria catchments. Nairobi, Kenya: ILEC; 2005. Abstract

The paper shows that in the analysis of a queuing system with fixed-size batch arrivals, there emerges a set of polynomials which are a generalization of Chebyshev polynomialsof the second kind. The paper uses these polynomials in assessing the transient behaviour of the overflow (equivalently call blocking) probability in the system. A key figure to noteis the proportion of the overflow (or blocking) probability resident in the transient component,which is shown in the results to be more significant at the beginning of the transient and naturally decays to zero in the limit of large t. The results also show that the significanceof transients is more pronounced in cases of lighter loads, but lasts longer for heavier loads.

Madadi VO, Wandiga SO, Ndunda EN, Mavuti KM. "Analysis of Organochlorine Pesticides in Lake Naivasha Catchment." IJSRSET. 2017;3(5):139-149.
Madadi VO, Ngotho MW, Masese FA. "Drinking Water Quality Challenges in Nakuru County, Kenya." IJSRSET. 2017;3(6):5-11.
Madara O. "Improving the acoustics in a historic building using axiomatic design and TRIZ.". In: Proceedings of the TRIZ Conference, Department of Mechanical and Nuclear Engineering, State University, Pennsylvania.; 2005. Abstract

This article investigates the use of TRIZ and Axiomatic Design to solve the problem of poor acoustics in
the historic Schwab Auditorium on the Penn State University Park campus. The problem is dissected to its
functional requirements and the design parameters which govern the requirements. TRIZ and Axiomatic
Design are then used to create an uncoupled design which solves all the functional requirements with one
design parameter each. Finally there is a suggestion on how to combine all of the solutions to solve the
poor acoustic problem in Schwab Auditorium.

Keywords: Axiomatic Design, Acoustics, Physical Contradictions

Madigo L, Otieno SPV. Benji. Imbusi P, ed. Talent Empire Kenya; 2012.
Maecker HT, Rinfret A, D'Souza P, Darden J, Roig E, Landry C, Hayes P, Birungi J, Anzala O, Garcia M, Harari A, Frank I, Baydo R, Baker M, Holbrook J, Ottinger J, Lamoreaux L, Epling LC, Sinclair E, Suni MA, Punt K, Calarota S, El-Bahi S. "Standardization of cytokine flow cytometry assays.". 2006. Abstract

Cytokine flow cytometry (CFC) or intracellular cytokine staining (ICS) can quantitate antigen-specific T cell responses in settings such as experimental vaccination. Standardization of ICS among laboratories performing vaccine studies would provide a common platform by which to compare the immunogenicity of different vaccine candidates across multiple international organizations conducting clinical trials. As such, a study was carried out among several laboratories involved in HIV clinical trials, to define the inter-lab precision of ICS using various sample types, and using a common protocol for each experiment (see additional files online). Results: Three sample types (activated, fixed, and frozen whole blood; fresh whole blood; and cryopreserved PBMC) were shipped to various sites, where ICS assays using cytomegalovirus (CMV) pp65 peptide mix or control antigens were performed in parallel in 96-well plates. For one experiment, antigens and antibody cocktails were lyophilised into 96-well plates to simplify and standardize the assay setup. Results (CD4+cytokine+ cells and CD8+cytokine+ cells) were determined by each site. Raw data were also sent to a central site for batch analysis with a dynamic gating template. Mean inter-laboratory coefficient of variation (C.V.) ranged from 17–44% depending upon the sample type and analysis method. Cryopreserved peripheral blood mononuclear cells (PBMC) yielded lower inter-lab C.V.'s than whole blood. Centralized analysis (using a dynamic gating template) reduced the inter-lab C.V. by 5–20%, depending upon the experiment. The inter-lab C.V. was lowest (18–24%) for samples with a mean of >0.5% IFNγ + T cells, and highest (57–82%) for samples with a mean of <0.1% IFNγ + cells. Conclusion: ICS assays can be performed by multiple laboratories using a common protocol with good inter-laboratory precision, which improves as the frequency of responding cells increases. Cryopreserved PBMC may yield slightly more consistent results than shipped whole blood. Analysis, particularly gating, is a significant source of variability, and can be reduced by centralized analysis and/or use of a standardized dynamic gating template. Use of pre-aliquoted lyophilized reagents for stimulation and staining can provide further standardization to these assays.

magabe PC. "Large aneurysm in renal angiomyolipoma causing life-threatening retroperitoneal hemorrhage." African Journal of Urology . 2014; Vol 20, (No 4 (2014) ).
magabe PC. "Endovascular Overlapping Stenting for Chronic Left Common Iliac Vein Occlusion in May Turner Syndrome: A Case report." East and Central African Journal of Surgery . 2014; Vol 19, No 2 (2014(no2,2014).
magabe PC. "Endovascular Overlapping Stenting for Chronic Left Common Iliac Vein Occlusion in May Turner Syndrome: A Case report." East and Central African Journal of Surgery . 2014; Vol 19, No 2 (2014(no2,2014).
magabe PC, Bloom A. "Sudden Death from Carcinoid Crisis during Image-Guided Biopsy of a Lung Mass." Journal of Vascular and Interventional Radiology ), . 2014;25 (3:484-487.
Magadi M, Agwanda A. "HIV and Fertility Link in Kenya.". In: The 6th African Population Conference. Ougadougou , Burkina Faso; 2011.
Magadi M, Taffa N, Onyango F, Otieno A. "Comparing maternal health indicators between teenagers and older women in sub- Saharan Africa: Evidence from Demographic and Health Surveys.". In: Population of Association of America Annual Meeting . Boston USA : E Afr Med J; 2004. Abstract

African Population Studies 19 (2): 42-62

Magadi M, Agwanda ALO, Obare F. "Size of newborn and Caesarean section deliveries among teenagers in sub-Saharan Africa: Evidence from DHS"." Journal of Biosocial Science . 2007;39(2):175-187.
Magadi M, Agwanda A. "Investigating the association between HIV/AIDS and Recent Fertility Patterns in Kenya." Social Science and Medicine . 2010;71:335-344.
Magadi M, Otieno AAT, Obare F, Taffa N. "A comparative analysis of the use of maternal Health services between teenagers and older mothers in sub-Saharan Africa: evidence from DHS." Social Science & Medicine. 2006; 64:1311-1325. AbstractWebsite

The antihypertensive effect of the fixed combination of timolol, a beta-blocking agent, hydrochlorothiazide, a thiazide diuretic, and amiloride, a potassium sparing agent, was compared against that of methyldopa in an open study lasting 16 weeks in 32 ambulatory African patients with previously untreated diastolic blood pressure of 95-120 mm Hg. A significant fall in mean diastolic and systolic blood pressure was achieved in both groups up to 8 weeks of treatment and was sustained in the timolol-hydrochlorothiazide-amiloride group during the entire follow-up. In the methyldopa group, mean diastolic and systolic blood pressure rose during follow-up. At 16 weeks the fall in mean diastolic and systolic blood pressure was significantly greater in the timolol-hydrochlorothiazide-amiloride treated patients than in the methyldopa group. Adverse reactions were more frequent and severe in the methyldopa group than in timolol-hydrochlorothiazide-amiloride treated patients. It is concluded that the fixed drug combination of timolol-hydrochlorothiazide-amiloride (Moducren) is effective in controlling mild to moderate hypertension in Africans and is better tolerated than methyldopa in these patients. It is further noted that hypertensive patients can be treated with a combination tablet once a day. This is of crucial significance as it would promote better compliance and, hence, minimize the sequelae of poorly controlled hypertension.

Magaji V, Johnston JM. "Inpatient {Management} of {Hyperglycemia} and {Diabetes}." Clinical Diabetes. 2011;29:3-9. AbstractWebsite

IN BRIEF Control of hyperglycemia in hospitalized patients is important for optimal clinical outcomes, but can be very challenging. This article provides practical recommendations for insulin therapy for common situations that arise during hospitalization.

Magal1 RP, N.Wambua2 B. "Risk Assessment of the Coping and Adaptation Mechanisms for Pastoralists to Climate Change and Variability: A Case Study of Kongelai Ward, West Pokot County, Kenya." Asian Journal of Agriculture and Food Sciences(ISSN: 2321 – 1571). 2017;Volume 05(Issue 02, April 2017).
Magal1 RP, N.Wambua2 B, 3 SM. "Risk Assessment of Traditional Strategies, Values and Practices of Pastoralists to Climate Change and Variability: A Case of West Pokot County, Kenya." Asian Journal of Agriculture and Food Sciences (ISSN: 2321 – 1571). 2017;Volume 05(ssue 04, August 2017).
Magale HI, Kassim IA, Odera SA, Omolo MJ, Jaoko WG, Jolly PE. "Antibiotic susceptibility of organisms causing urinary tract infection in patients presenting at Kenyatta national hospital, Nairobi." East African medical journal. 2015;92:333-337. Abstract
n/a
Magambo JK, T.M. W, et al. "Prevalence of intestinal parasites among the children in southern Sudan." East Afriican Medical Journal. 1998;75:288-290.
Magambo, J.K., T.M. W, et al. "Prevalence of human hydatid disease in southern Sudan." African Journal of Health Sciences. 1996;3:154-156.
Magambo JK, T.M. W, et al. "Hydatid disease in Toposland, southern Sudan." . African Journal of Health Sciences. 1998;5:129-132.
Magambo MJS;, Waithaka K. "The Influence Of Plant Density On Dry Matter Production And Partitioning And Yield In Young Clonal Tea In Kenya."; 1985. Abstract

Dry matter production and partitioning and yields in clonal tea bushes planted at 3 different spacings (0.30 x 0.30 m; 0.61 x 0.61 m; and 1.22 x 1.22m) and brought into plucking at 2 different heights (0.25 m and 0.50 m) were investigated. After 36 months of growth the bushes at close spacing (0.30 x 0.30 m) produced 1.1 and 2 times dry matter than bushes grown at medium (0.61 x 0.61 m) and wide (1.22 x 1.22 m) spacings, respectively. The bushes at close spacing had less leaf percentage of total dry matter than those at medium and wide spacings. However, the bushes at wide spacing had less frame percentage of total dry matter than those at close spacing. There were no significant differences in the root percentages between bushes at the 3 spacings. The harvest index of the bushes grown at close spacing was 13% and 16% higher than those of the bushes at medium and wide spacings, respectively. Similarly, bushes at close spacing produced yields 2 and 3 times more than bushes at medium and wide spacings, respectively. The bushes at wide spacing had significantly higher leaf/frame ratio than those bushes at close spacing. Lowering the plucking surface height reduced total dry matter in all bushes grown at the 3 spacings. The results suggest that the harvest index and yields of tea bushes can be greatly increased by reducing the size of individual bushes through increasing plant density per unit area.

Magambo JK, Wachira TM, et al. "Cellular immunity in Echinococcus granulosus cyst." African Journal of Health Sciences. 1995;1:250.
Magambo JK, T.M. W, et al. "Prevalence of malaria in southern Sudan." African Journal of Health Sciences. 1996;3:151-153.
Magambo MJS;, Waithaka K. "The Effect Of Conventional Methods Of Growing Tea On Yields."; 1985. Abstract

Tea bushes are manipulated so as to form strong woody frames with the largest possible plucking surface area. Studies on dry matter production and partitioning of tea bushes have shown that the harvest index is low in old bushes and high in young bushes. The low indexes in old bushes are partly due to large amounts of wood in the primary frame which provide a large cambial sink for photosynthates. Reducing the plant size by maintaining bushes at low heights greatly increased yields per unit area of plucking surface. Thus, maintaining large bushes does not necessarily mean high yields. The impression from dry matter production and partitioning studies is the need for a thorough reinvestigation and revision of the conventional methods of growing tea which encourage the development of unnecessary large amounts of woody tissues.

Magambo, J.K., T.M W, et al. "Ultra-structural study of Echinococcus granulosus larval forms." African Journal of Health Sciences. 1995;2:381-384.
Magambo JK, T.M. W, et al. "Prevalence of Onchocerca olvurus in southern Sudan. ." African Journal of Health Sciences. 1996;3:149-150.
Magati PO, Kibwage JK, Gor SO, Ruigu G, Omwansa W. "A Cost - Benefit Analysis of Substituting Bamboo for Tobacco: A Case Study of Smallholder Tobacco Farmers in South Nyanza, Kenya." Science Journal of Business Management. 2012:1-8.
MAGDALENE DROPONDOMARY. "Barrientos, S., Opondo, M. and Smith, S., (2005), .". In: The Journal of Corporate Citizenship - Special Issue of on Corporate Citizenship in Africa, Issue 18, Summer 2005, pp. 87-92. University of Nairobi.; 2005. Abstract

Four hundred and forty-six children attending nursery schools in Nairobi were examined for caries and gingivitis. Assessment of social class was based on the occupation of the head of the child's household. Amongst 3-year-old children, 62% were caries-free and the mean dmft was 1.35. Amongst 5-year-olds 50% were caries-free and the mean dmft was 1.88. Thirty-seven per cent of the children had evidence of gingivitis, with the proportion changing little with age. There was no evidence of either caries or gingivitis being significantly related to social class, although children in the higher classes had more filled teeth.

MAGDALENE DROPONDOMARY. "Barrientos, S., Opondo, M. and Smith, S., (2005), .". In: The Journal of Corporate Citizenship - Special Issue of on Corporate Citizenship in Africa, Issue 18, Summer 2005, pp. 87-92. University of Nairobi.; 2005. Abstract

Four hundred and forty-six children attending nursery schools in Nairobi were examined for caries and gingivitis. Assessment of social class was based on the occupation of the head of the child's household. Amongst 3-year-old children, 62% were caries-free and the mean dmft was 1.35. Amongst 5-year-olds 50% were caries-free and the mean dmft was 1.88. Thirty-seven per cent of the children had evidence of gingivitis, with the proportion changing little with age. There was no evidence of either caries or gingivitis being significantly related to social class, although children in the higher classes had more filled teeth.

MAGDALENE DROPONDOMARY. "Dolan, C.S. and Opondo, M., (2005), .". In: The Journal of Corporate Citizenship - Special Issue of on Corporate Citizenship in Africa, Issue 18, Summer 2005, pp. 87-92. University of Nairobi.; 2005. Abstract

Four hundred and forty-six children attending nursery schools in Nairobi were examined for caries and gingivitis. Assessment of social class was based on the occupation of the head of the child's household. Amongst 3-year-old children, 62% were caries-free and the mean dmft was 1.35. Amongst 5-year-olds 50% were caries-free and the mean dmft was 1.88. Thirty-seven per cent of the children had evidence of gingivitis, with the proportion changing little with age. There was no evidence of either caries or gingivitis being significantly related to social class, although children in the higher classes had more filled teeth.

MAGDALENE DROPONDOMARY. "Barrientos, S., Opondo, M. and Smith, S., (2005), .". In: Participation in the Kenya Cut Flower Industry. University of Nairobi.; 2005. Abstract

Four hundred and forty-six children attending nursery schools in Nairobi were examined for caries and gingivitis. Assessment of social class was based on the occupation of the head of the child's household. Amongst 3-year-old children, 62% were caries-free and the mean dmft was 1.35. Amongst 5-year-olds 50% were caries-free and the mean dmft was 1.88. Thirty-seven per cent of the children had evidence of gingivitis, with the proportion changing little with age. There was no evidence of either caries or gingivitis being significantly related to social class, although children in the higher classes had more filled teeth.

MAGDALENE DROPONDOMARY. "Dolan, C.S. and Opondo, M., (2005), .". In: The Journal of Corporate Citizenship - Special Issue of on Corporate Citizenship in Africa, Issue 18, Summer 2005, pp. 87-92. University of Nairobi.; 2005. Abstract

Four hundred and forty-six children attending nursery schools in Nairobi were examined for caries and gingivitis. Assessment of social class was based on the occupation of the head of the child's household. Amongst 3-year-old children, 62% were caries-free and the mean dmft was 1.35. Amongst 5-year-olds 50% were caries-free and the mean dmft was 1.88. Thirty-seven per cent of the children had evidence of gingivitis, with the proportion changing little with age. There was no evidence of either caries or gingivitis being significantly related to social class, although children in the higher classes had more filled teeth.

Magembe EM. Genetic diversity analysis among cowpea [vigna unguiculata (l.) walp] accessions from Sub-Saharan Africa using simple sequence repeats (ssr's).; 2008. Abstract

Cowpea is one of the most important legumes in the world. 1t is the second most
important pulse crop in tropical Africa after common beans (Phaseolus vulgaris). Cowpea
is valued for the high protein content of its grains which is about 25%. In Africa, where
animal protein is not always freely available/ affordable, cowpea provides a valuable
source of proteins. Cowpea diversity and relatedness in Africa is poorly understood. This
lack of knowledge and information inhibits the use of novel germplasm and novel alleles
in breeding programs and results in potential crop improvement bottlenecks. A core set of
1430 accessions of cowpea landraces from Sub-Saharan Africa were identified from the
International Institute of Tropical Agriculture's (lIT A) global cowpea collection (15003
accessions). In this study sixteen SSR markers were used to evaluate the genetic diversity
cowpea landraces in Sub-Saharan Africa.
Within the core set a total of 125 alleles were detected with the mean number of alleles
per marker being 7.8. The number of alleles per SSR ranged from 2 to 18. The mean
polymorphism information content (PIC) was 0.4531 with the most informative marker
being VM70 with a PIC of 0.8636 while the least informative marker was VM54 with a
PIC of 0.0376. The overall level of genetic diversity, measured as heterozygosities was
medium to low, with an average gene diversity of 0.4988. The gene diversity (H) ranged
from 0.0383 for VM54 to 0.8760 for VM70. The genetic diversity in West Africa was
higher than North Africa indicated by H of 0.4987 and 0.4129 respectively. The mean
observed heterozygosity was low (0.0953) as expected from a predominantly inbreeding
species. Gene differentiation (FsT) among populations was low (0.095) suggesting free
gene flow between populations, a result confirmed by genetic distance (DA), and
phylogenetic analysis. In, contrast, FJS which can be taken variously as a measure of
heterozygote deficiency and departure from the Hardy-Weinberg equilibrium, but also as
a measure of inbreeding, was found to be extremely high at 0.797.

Magero D, Makau NW, Amolo GO, Lutta S, Okoth MDO, Mwabora JM, Musembi RJ, Maghanga CM, Gateru R. Hydrogen as an alternative fuel: An ab-initio study of Lithium Hydride and Magnesium Hydride. United Kenya Club; 2013. Abstract

Limited energy resources and growing pollution associated with conventional energy production have stimulated the search for cleaner, cheaper and more efficient energy technologies. Hydrogen as a fuel is seen as one of the promising energy technologies alternative to fossil fuel. Metal hydrides have been suggested as potential candidates for the bulk storage of hydrogen. In this study, ab-initio calculations of metal hydrides that are promising candidates for hydrogen storage applications, that is, magnesium hydride (MgH2) and lithium hydride (LiH) was carried out using the Quantum Espresso computer code. The calculated quantities were the equilibrium structural parameters namely, the electronic properties as well as the thermodynamic properties. The calculated lattice parameters for MgH2 were a = 4.54 Å and c = 3.019 Å. Both values of a and c are in good agreement with experimental values of a = 4.501 Å and c = 3.01 Å. The calculated lattice parameter for LiH was a = b = c = 3.93 Å. The lattice parameter of LiH shows a correlation of approximately -3.79% with the experimental value of 4.083 Å. Thermodynamic properties of LiH were investigated by performing density functional theory within the quasi harmonic approximation. The temperature dependence of the heat capacity at constant volume CV, the Helmholtz free energy ∆F, the internal energy ∆E and the entropy ∆S was obtained. The thermodynamic properties and formation enthalpies are in good agreement with the experimental data.

Mageto IG, Omoni GM, Cabelus NB, Inyega JO. "Training needs assessment for forensic nursing practice in Kenya. ." Kenyan Journal of Nursing and Midwifery . 2017.
Mageto IG, Musandu JO, Chege MN, Mwaura, F; Wamalwa J. "Factors influencing ethical decision making among psychiatric nurses at Mathari Hospital in Nairobi." Kenya Nursing Journal. 2010.
Mageto IG, Omoni GM, Cabelus NB, Inyega JO. "Intergrating forensic nursing science in nursing education in Kenya." Nurse education in practice. 2016.
Mageto IG, Omoni, G. M., Cabelus NB, Inyega JO. "Training needs assessment for forensic nursing in Kenya." Kenyan Journal of Nursing and Midwifery. 2017;2(1):54-63.
Mageto IG, Omoni GM, Cabelus NB, Inyega JO. "Intergrating forensic nursing science in nursing education in Kenya." Nurse education in practice. 2015.
Mageto IG, Omoni GM, Cabelus NB, Inyega JO. "Preparedness and practice of forensic nursing in Kenya." International Journal of Nursing Education. 2017.
Mageto IG, Omoni GM, Cabelus NB, Inyega JO. "Integrating forensic nursing science in nursing education in Kenya." Nurse education in practice. 2015.
Mageto IG, Omoni GM, Cabelus NB, Inyega JO. "Preparedness and practice of forensic nursing in Kenya." . International Journal of nursing Education: . 2017.
Mageto LM, Ombui JN, Mutua FK. "Prevalence and risk factors for campylobacter infection of chicken in peri-urban areas of Nairobi, Kenya." J. Dairy, Veterinary and Animal Research . 2018;7: .(1):22-27.
Mageto IG, Omoni GM, Cabelus NB, Inyega JO. "Training needs assessment for forensic nursing practice in Kenya." Kenyan Journal of Nursing and Midwifery . 2017.
Mageto IG, Omoni GM, Cabelus NB, Inyega JO. "Preparedness and practice of forensic nursing in Kenya." International Journal of Nursing Education. 2017.
Mageto IG, Musandu JO, Chege MN, Mwaura, F; Wamalwa J. "Factors influencing ethical decision making among psychiatric nurses at Mathari Hospital in Nairobi." Kenya Nursing Journal. 2010.
Mageto E.K, D. Makumbi, and K. Njoroge, Nyankanga R. "Genetic analysis of early-maturing maize (Zea Mays L.) inbred lines under stress and nonstress conditions." Journal of Crop Improvement. 2017; DOI: 10.1080/15427528.2017.1315625(31:4, ):560-588.
Magimba AR, Kaaya SF, Kilonzo G, editor Ndetei, D.M. "Ethno-Psycho-Pharmocology and its Implications in the African Context."; 2006.
MAGIRI WANJIEEUNICE. FACTORS THAT AFFECT SCIENCE TEACHING IN PRIMARY SCHOOLS IN KIAMBU DISTRICT. NAIROBI: KENYATTA UNIVERSITY; 1988. Abstract

Med(PTE-science Education)
ABSTRACT
The purpose of the study was to investigate factors that affect science teaching in primary schools in Kenya. The study was carried out in Kiambu district, Ndumberi zone, an area with nineteen(19) primary schools. The research was carried out in (2) phases, a pilot study followed by the main study.
The pilot study involved nine (9) teachers selected from two (2) schools. The purpose of pilotting was to review the survey questionaire and to gain experience in the preparation for the main study. The sample for the main study consisted of thirty (30) teachers, selected from (10) schools. Ten (10) of the teachers were senior science teachers who responded to all the three (3) selections of the survey questionaire.
The rest (20) teachers responded to section 1 and 2 only. The data collected was reported and analysed using descriptive statistics, mainly averages and percentages. The findings confirmed the existence of certain factors that affected science teaching such as, an accute shortage of apparatus and other teaching materials which compelled teachers to resort to theoretical approaches of teaching science. Further, teachers hardly improvised instructional materials and when they did, the materials were not stored for future use. Also teachers complained of not getting adequate assistance from the local Teachers Advisory Sub-centre. When a new curriculumn was introduced,teacherts had to cope with late supplies of vital materials like syllabi and inadequate inservicing.
However, teachers had a positive opinion towards courses offered in Teacher Training Colleges and would welcome the idea of subject specialization. Owing to the challenges facing science education in primary schools in kiambu municipality, teachers would welcome solutions to alleviate these problems. Identification of a source of funds and Inservice Education for the science teachers would be some of the relevant steps to take.

Magoha GAO. "Epidemiological and clinical aspects of carcinoma of the penis at Kenyatta National Hospital. ." East African Medical Journal. 1995;72: 360-364.
Magoha GAO, EN Opot. "Testicular cancer at Kenyatta National Hospital." East African Medical Journal, 77: 80-85, 2000.. 2000;77(2):80-85. Abstract

OBJECTIVE: To determine the prevalence, clinical characteristics, management methods and prognosis of testicular cancer at Kenyatta National Hospital. DESIGN: Retrospective case study of testicular cancer patients over a fifteen year period. SETTING: Kenyatta National Hospital, a referral and teaching hospital. PARTICIPANTS: All histologically confirmed testicular cancer patients recorded at the Histopathology Department of Kenyatta National Hospital between 1983 and 1997. RESULTS: The mean age was 34.8 years with a peak incidence in the 30-44 year age group. History of cryptochirdism was obtained in 10.26% of the patients. Thirty one patients (79.49%) presented with painless testicular swellings, eleven (28.08%) with pain, nine (23.08%) with scrotal heaviness, six (15.38%) with abdominal swellings and one (2.56%) each with gynaecomastia and eye swelling. On examination 32 patients (82.05%) had testicular masses, ten (25.64%) had abdominal masses, seven (17.91%) had supraclavicular and cervical lymphadenopathy, and one each (2.56%) had gynaecomastia and eye mass respectively. More than eighty nine per cent had germ cell cancers with seminoma accounting for 67.35%, teratoma 12.24%, embroyonal carcinoma 8.16%, rhabdomyosarcoma 6.12% and malignant germ cell tumour, orchioblastoma and dysgerminoma each accounted for 2.04%. Three patients (7.7%) had orchidectomy and radiotherapy and chemotherapy, sixteen (41.03%) had orchidectomy and radiotherapy, six (15.38%) had orchidectomy and chemotherapy, ten (25.64%) had radiotherapy and chemotherapy, three (7.7%) and two (5.13%) had only chemotherapy and radiotherapy respectively. No cisplastin based chemotherapy regime was used. Follow up was effected for eighteen patients (46.15%) and seven patients (38.89%) were alive after five years. CONCLUSION: Prognosis with current regimes was poor with survival of only 38.89% after five years. Cisplastin based chemotherapy with up to 90% cure rates should be included as a component of testicular cancer management at Kenyatta National Hospital. PIP: This retrospective study was undertaken to determine the prevalence, clinical characteristics, management methods and prognosis of testicular cancer at Kenyatta National Hospital, Nairobi. All histologically confirmed testicular cancer patients recorded at the Histopathology Department between 1993 and 1997 were analyzed. The mean age was 34.8 years with a peak incidence in the 30-44 year age group. About 10.26% of patients had history of cryptochirdism. The clinical symptoms presented were painless testicular swelling (n = 31, 79.49%), testicular pain (n = 11, 28.08%), scrotal heaviness (n = 9, 23.08%), abdominal swelling (n = 6, 15.38%), gynecomastia (n = 1, 2.56%), and eye swelling (n = 1, 2.56%). On examination, 32 patients (82.05%) had testicular masses, 10 (25.64%) had abdominal masses, 7 (17.91%) had supraclavicular and cervical lymphadenopathy, 1 had gynecomastia, and 1 had an orbital mass. More than 89% of patients had germ cell cancers with seminoma accounting for 67.35%, teratoma for 12.24%, embryonal carcinoma for 8.16%, rhabdomyosarcoma for 6.12%, and malignant germ cell tumor, orchioblastoma, and dysgerminoma each accounting for 2.04%. The various methods of treatment include orchidectomy and radiotherapy and chemotherapy in 3 patients (7.7%), orchidectomy and radiotherapy in 16 patients (41.03%), orchidectomy and chemotherapy in 6 patients (15.38%), and radiotherapy and chemotherapy in 10 patients (25.64%). No cisplatin-based chemotherapy was used. 18 patients were followed up, of whom 7 were alive after 5 years. Prognosis with current regimens was poor, with a 38.89% survival ratio in 5 years. Hence, cisplatin-based chemotherapy with up to 90% cure rates should be included in the testicular cancer management in this hospital.

Magoha GAO. "Overview of prostate cancer in indigenous black Africans and blacks of African ancestry in Diaspora." East African Medical Journal :. 2007;Vol 84 No. 9 (Supplement). Abstract

Objective: To carry out an overview of prostate cancer in indigenous back Africans in sub-Saharan Africa and blacks of African ancestry in diaspora.
Data Source: Review of all published literature on prostate cancer on indigenous black Africans and Africans in diaspora was carried out through medline and index medicus searches.
Data Selection: Published data of prostate cancer in indigenous black Africans and black men in diaspora from 1935-2007 were included in the review.
Data Extraction: Abstracts of articles identified were assessed, read and analysed to determine their possible suitability and relevance to the title under review.
Data Synthesis: After establishing relevance from the abstract, the entire paper was read, and the significant points included in the review.
Conclusion: Prostate cancer incidence and magnitude in black Africans was grossly misunderstood and underestimated in the past. Prostate cancer incidence is on the increase and currently is perhaps the most common urological malignancy affecting black Africans. Its incidence and clinical characteristics is similar to that of the Africans in diaspora but different from all other races. There currently exists significant evidence which suggests a common enhancing genetic predisposition in black men to prostate cancer. There is very urgent need for further investigation of this phenomenon through randomised controlled muIticentre studies involving indigenous black Africans and black men in diaspora.

Magoha GAO. "Implications and therapeutic considerations for BPH of the anatomical basis of incidental carcinoma of the prostate. .". In: Proc. Assoc. Surg. East Africa, March 1996. EAMJ; 1996. Abstract

Benign prostatic hyperplasia (BPH) is a common disease affecting elderly men with 70% of men over 70 years showing microscopic evidence of hyperplasia. Transurethral resection of the prostate is the gold standard treatment. Medical management of BPH has involved the use of plant extracts, amino acids, kampo and animal organ preparations in various countries with unsatisfactory results. The use of alpha adrenergic antagonists dates back twenty years representing a major breakthrough in the treatment by relaxation of the dynamic contraction of smooth muscle component of prostatic obstruction. The evolution of alpha antagonist therapy resulted in clinical trials with selective antagonists such as prazosin, alfuzosin, indoramin, terazosin and doxazosin all of which achieve similar effective relief of obstructive symptoms as phenoxybenzamine, but with fewer side effects related to postural hypotension. 5-alpha reductase inhibitors, finasteride and episteride, recently synthesised act on the static component of obstruction caused by the enlarging prostate. They inhibit conversion of testosterone to the potent intracellular androgen dihydrotestosterone (DHT) resulting in the reduction of prostate volume and improvement of obstructive symptoms. Clinical trials with finasteride for three years indicate that 63% of patients had a reduction of greater than 20% in prostatic volume and 42% had a decrease of greater than 30% with a mean increase peak flow rate of 2.4 mls/s equivalent, to 20 years reversal of disease progression.

Magoha GAO, Magoha OB. "Current global status of female genital mutilation." East Afr Med J. . 2000;77(5):268-72. Abstract

OBJECTIVE: To provide an overview of the current global status of female genital mutilation (FGM) or female circumcision practised in various countries. DATA SOURCE: Major published series of peer reviewed journals writing about female genital mutilation (FGM) over the last two decades were reviewed using the index medicus and medline search. A few earlier publications related to the FGM ritual as practised earlier were also reviewed including the various techniques and tools used, the "surgeons or perpetrators" of the FGM ritual and the myriad of medical and sexual complications resulting from the procedure. Global efforts to abolish the ritual and why such efforts including legislation has resulted in little or no success were also critically reviewed. CONCLUSION: FGM remains prevalent in many countries including African countries where over 136 million women have been 'circumcised' despite persistent and consistent efforts by various governments, WHO and other bodies to eradicate the ritual by the year 2000 AD. This is as a result of deep rooted cultures, traditions and religions. Although FGM should be abolished globally, it must involve gradual persuasion which should include sensitisation and adequate community-based educational and medical awareness campaign. Mere repression through legislation has not been successful, and women need to be provided with other avenues for their expression of social status approval and respectability other than through FGM.

Magoha GAO. "Incidental carcinoma in surgically resected prostates in Nigerians. ." Nigerian Quarterly Journal of Hospital Medicine. 1985;(3):9-12. Abstract

A histological analysis of 306 prostates resected for benign hyperplasis at the Lagos University Teaching Hospital revealed incidental carcinoma in 10.46% by routine sectioning technique. Carcinoma in situ of the prostate accounted for 59.4%, well differentiated adenocarcinoma 18.7%, poorly differentiated adenocarcinoma 9.4% each, and squamous cell carcinoma 3.1.%. Treatment was expectant for carcinoma in situ while stilboestrol and or orchidectomy was used for all other histological types. The results show that expectant treatment is effective and adequate for in situ carcinoma, and that poorly differentiated and undifferentiated prostatic carcinoma has poor prognisis compared to well differentiated carcinoma after similar treatment

Magoha GAO. "Adult male circumcision: results of a standardized procedure in Kisumu District, Kenya. ." British Journal of Urology: Vol. 96: 1109-1113, 2005.. 2005;96:1109-1113. Abstract

OBJECTIVE: To provide an overview of the current global status of female genital mutilation (FGM) or female circumcision practised in various countries. DATA SOURCE: Major published series of peer reviewed journals writing about female genital mutilation (FGM) over the last two decades were reviewed using the index medicus and medline search. A few earlier publications related to the FGM ritual as practised earlier were also reviewed including the various techniques and tools used, the "surgeons or perpetrators" of the FGM ritual and the myriad of medical and sexual complications resulting from the procedure. Global efforts to abolish the ritual and why such efforts including legislation has resulted in little or no success were also critically reviewed.
CONCLUSION: FGM remains prevalent in many countries including African countries where over 136 million women have been 'circumcised' despite persistent and consistent efforts by various governments, WHO and other bodies to eradicate the ritual by the year 2000 AD. This is as a result of deep rooted cultures, traditions and religions. Although FGM should be abolished globally, it must involve gradual persuasion which should include sensitisation and adequate community-based educational and medical awareness campaign. Mere repression through legislation has not been successful, and women need to be provided with other avenues for their expression of social status approval and respectability other than through FGM.

Magoha GAO. "Effect of Ageing on androgen levels in elderly males.". In: East African Medical Journal, 74: 642-644, 1997. EAMJ; 1997. Abstract

The past four decades have brought with it modern medical technology accompanied by better quality and longer life resulting in the increase in number of aged males in this locality. It has now been well established by various investigators that there is a statistically significant decline of the biologically available level of serum testosterone with ageing. This decline in androgen levels is more manifest in the free testosterone levels compared to the total serum testosterone levels which are routinely measured in the laboratory. Not withstanding this statistical decline the serum testosterone levels in the majority of aged men often fall within the normal range (300-1000 ng/dl) of eugonadal young males. This age related decline is usually associated with decline in sexual function in ageing men manifesting as erectile dysfunction. However, it has now been established beyond doubt that age itself rather than the androgen decline is the most influential variable of sexual activity in old men.

Magoha GAO, Afulo OK, Mwanda WO. "Autologous transfusion in surgical patients at Kenyatta National Hospital, Nairobi." East Afr Med J. . 2001;78(11):564-7. Abstract

OBJECTIVE: To identify autotransfusion strategies and their basis in elective surgery patients. DESIGN: A cross sectional prospective study. SETTING: General surgery and orthopaedic wards, Kenyatta National Hospital, Nairobi. SUBJECTS: Adult patients of both sexes planned for elective surgery. MAIN OUTCOME MEASURE: Forevery patient, the following were enquired about and documented: age in years, sex, ethnicity, religion, occupation and educational standard. Blood values of haemoglobin, platelet counts, total and differential white cell counts, urea, electrolytes and liver function tests were assayed. Others were the number of units of blood donated before the operation, the type of surgery performed, time taken from diagnosis to performing the operation and whether the blood was transfused preoperatively, intraoperatively and postoperatively. RESULTS: A total of sixty three cases constituting five per cent of all surgical patients admitted during the period of study were evaluated. Of these 53 (84%) were males and ten (16%) females. The age range was 15 to 65 years with a peak at 45-49 years. There were more Christians (90%) than Muslims (10%). In all, 32 (51.6%) had primary school education, 23 (36.5%) secondary school education, seven (11.3%) no formal education and one (1.6%) had attained college level. Employment pattern showed 50% were civil servants, 30% were self employed and 20% were unemployed. The duration of disease ranged from 1-24 weeks with two peaks at two weeks and six weeks. Orthopaedic cases constituted 78.7% and general surgery 21.3%. Preoperative haemoglobin ranged from 13.5-14.2 g/dl. Transfusions were given intraoperatively to 41 (66.1%) and to 12 (33.9%) postoperatively. Mean duration of hospitalisation was 13 days (range 5 to 21 days). 98.4% deposited only one unit while 1.6% deposited four units of blood. Only one patient required additional transfusion from homologous donors. CONCLUSION: The strategies and basis for autotransfusion have been demonstrated among a majority of adult patients requiring orthopaedic procedures. Major determinants are shown to be baseline blood count profiles and time to operation.

Magoha GAO, Ngugi PM, Kiptoon D. "Urolithiasis in Nairobi, Kenya." East African Medical Journal. 2010;87(10). AbstractNCBI

Background: Urolithiasis is an emerging problem in Kenya previously thought to be very rare and in which the use of modern methods of treatment has not been widely practiced
Objective: To review the presentation and management of patients presenting with urolithiasis in Nairobi, Kenya
Design: A retrospective study Setting: The Nairobi hospital and Upper Hill Medical Centre a day care facility next to the Nairobi hospital
Subjects: One hundred and twenty five males and fifty three females aged 9 to 75 years
Results: One hundred and seventy eight patients were treated for urolithiasis over a five-and- half year period. Their mean age was 44.8 years, and the median was 45 years The 178 patients required 262 procedures to achieve stone clearance. One hundred and two patients had ESWL, with an overall stone clearance rate of 95%. Twentythree
patients had PCNL; 18 as the first procedure and 5 after failed ESWL. Fifty-one patients had ureteroscopic
Management: Fourty seven had laser or pneumatic lithotripsy while four had stone removal by Dormia basket. Seven patients had bladder calculi managed by either cystolitholapaxy or forceps retrieval.
Conclusions: This study demonstrates a higher annual incidence of urolithiasis in Nairobi than earlier literature. Study demonstrates that ESWL and ureteroscopic methods are highly effective in the treatment of renal and ureteral calculi as day care procedures.

Magoha GAO. "Transperineal Trucut needle biopsy of the prostate: A prospective Study. ." Medicom,. 1990;10:12-13. Abstract

A prospective study involving ninety (90) transperineal TruCut Tm needle biopsies of the prostate in eighty (80) patients has revealed that the repeated use of this needle until it becomes ineffective does not affect its diagnostics accuracy, and is not associated with more complications. Each needle was used on five patients before being discarded. A positive correlation of 95% was found between the clinically malignant prostates on rectal examination and histopathologic diagnosis. Four biopsies did not provide adequate tissue for histological diagnosis giving an overall failure rate of 4.4%. No complications were reported except fro haematuria in two patients (2.5%) and a perineal haematoma in one patient (1.25%).

Magoha GAO. "Management of Fournier's gangrene at the Kenyatta National Hospital, Nairobi.". In: East Afr Med J. 1998 Jun;75(6):370-3. EAMJ; 1998. Abstract

A prospective study involving the management of forty six patients with Fournier's gangrene was carried out at the Kenyatta National Hospital, Nairobi over a period of two years. The age range was nine to 81 years with a mean of 40.27 years indicating that the lesion is common and affects all age groups in this locality. The majority of patients (60.86%) presented with advanced lesions involving scrotal ulcers (45.65%) and gangrene (15.22%). Results of bacterial culture from scrotal wound swabs isolated multiple organisms in 8.15% of the patients, a point which should be taken into consideration during antibiotic selection. Forty one patients (89.13%) had surgical procedures in addition to antibiotics and other supportive measures. Five other patients (10.87%) who presented with early lesions had medical treatment only with antibiotics, antipyretics and analgesics. The average duration of hospitalisation was sixteen days. Two patients (4.35%) one of whom was HIV positive died from septicaemia during the study period. Recurrent scrotal infection occurred in two patients (4.35%) after discharge from the hospital and were treated satisfactorily at the surgical outpatient clinic.

Magoha GAO. The effect of exogenous testosterone on the testicular histology in male rats. . EAMJ; 1983. Abstract

Primary malignant lymphomas of the female breast are rare up to date such tumors have been described in the male. Majority of the malignant tumors of the breast are the well known infiltrating duct carcinoma. This is report of a mammary non-Hodgkins malignant lymphoma in a 35 year old Nigerian female. This tumor had a rapid progression terminating in death seven months after histological diagnosis. The clinical presentation, treatment, prognosis and the differential diagnosis with medullary and poorly differentiated carcinoma of the breast are discussed.

Magoha GAO, Ngumi ZW. "Renal transplantation during the twentieth century." East Afr Med J. . 2001;78(6)::317-21. Abstract

OBJECTIVES: To provide an overview of the various advancements and problems associated with both live and cadaver donor renal allograft transplantation during the twentieth century.
DATA SOURCE: Major published reviews on renal transplantation during the the last five decades of the twentieth century were reviewed using Medline internet search and the Index Medicus. The developments in immunosuppressive therapy associated with renal transplantation, the problem of the shortage of both live and cadaveric organ donors and post-transplant complications were examined. The future of renal transplantation including cross species transplantation (xenotransplantation) is discussed.
CONCLUSION: Renal transplantation has evolved over the years to become a very successful and routine procedure. However, the transplant waiting lists have remained long due to a continuously shrinking kidney donor pool which is due to improved results of neurosurgical procedures, better emergency and intensive care services and the failure to adequately prevent and treat post transplant chronic renal failure.

Magoha GAO. "Local infiltration and spermatic cord block for inguinal, scrotal and testicular surgery. .". In: East African Medical Journal, 75: 575-577, 1998. EAMJ; 1998. Abstract

This was a prospective study involving 372 male patients. Surgical procedures including simple inguinal hernia repair, inguinal lymph node biopsy, hydrocelectomy, testicular biopsy, testicular fixation, orchidectomy and scrotal exploration were performed under local anaesthesia using various quantities of 0.5% xylocaine with adrenaline depending on the procedure, in the form of spermatic cord block and local infiltration nerve blocks. No premedication was given to any patient and only five patients (1.34%) were given intraoperative sedation due to anxiety. No complication directly attributed to the anaesthetic agent used or the technique of spermatic cord and nerve blocks were reported during the study. Three hundred and sixty patients (96.77%) were operated on as outpatients and were happy and satisfied to return home on the same day. This experience confirms that spermatic cord block accompanied by local infiltration with 0.5% xylocaine with adrenaline is simple, safe and effective technique that should be used more widely in outpatient urological and general surgical settings in this locality. It provides excellent intra-scrotal and inguinal anaesthesia. Furthermore, the technique is cost effective, and personnel effective since no anaesthetist is required for the procedure which is usually carried out by the surgeon. This would enable many more people to afford the surgical procedures.

Magoha GOA. "The status of medical ethics in Kenya today.". In: Medicus, 14: 75-78, 1995. EAMJ; 1995. Abstract

Thirty one patients with carcinoma of penis were studied retrospectively at Kenyatta National Hospital, Nairobi, over a 20-year period (1971-1990). The majority of patients presented late with symptomatology of over one year duration. 88% of patients with carcinoma were uncircumcised, while the three (12%) patients who were circumcised but developed carcinoma were all circumcised late in adolescence and adulthood, confirming that late circumcision may not protect one from developing penile carcinoma as reported in literature. These findings also indicate that carcinoma of penis may be rare in this locality but is still common among the uncircumcised African tribes.

Magoha GAO, Ngumi ZW. "The training of surgeons in Kenya at the University of Nairobi, Kenyatta National Hospital. .". In: East African Medical Journal, 76: 462-464, 1999. EAMJ; 1999. Abstract

OBJECTIVE: To determine the number of surgeons trained by the Department of Surgery, Faculty of Medicine, College of Health Sciences, University of Nairobi, since its inception in 1967.
DESIGN: This was a retrospective (1975-1987) and prospective study (1988-1999).
SETTING: Kenyatta National Hospital, a National Referral Hospital and University of Nairobi Teaching Hospital.
SUBJECTS: All surgeons trained by the Department of Surgery of the University of Nairobi for postgraduate MMed in general surgery, anaesthesia,
ENT surgery and ophthalmology from 1975 to March 1999. RESULTS: Two hundred and eighty-five surgeons with Master of Medicine degree were trained by the Department of Surgery of the University of Nairobi between 1975 and March 1999. They included 181 (63.51%) general surgeons; 46 (16.14%) anaesthetists; 35 (12.28%) ophthalmologists and 23 (8.07% ear, nose and throat (ENT) surgeons. One hundred and seventy-six, (61.75%) were from retrospective studies; 94 (32.98%) were from prospective studies while 15 (5.26%) were from both retrospective and prospective studies. Two hundred and thirty-two (81.40%) surgeons were Kenyans while 53 (18.60%) were foreigners. The majority, 42 (79.24%) of the foreigners were from other African countries. Thirty one (58.50%) were from neighbouring Uganda, Sudan, Tanzania, Ethiopia and Zambia. There was also one PhD in anaesthesia and one MD in urology during the same period.
CONCLUSION: The University of Nairobi, Department of Surgery based at Kenyatta National Hospital has played a very significant and leading role in the training of surgeons for Kenya and even other African and foreign countries since its inception. Of the forty surgeons who constitute the academic staff in the Departments of General Surgery, Orthopaedic Surgery and Ophthalmology of the University of Nairobi, thirty-five surgeons (87.50%) have been trained by the Faculty of Medicine at KNH.
PIP: This study was carried out as a retrospective (1975-87) and prospective study (1988-99) to determine the number of surgeons trained by the Department of Surgery, Faculty of Medicine, College of Health Sciences, University of Nairobi, Kenya, since its inception in 1967. Over the 25-year period (1975-99), the Department of Surgery of the University of Nairobi trained a total of 285 surgeons with a Master of Medicine degree. These included 181 (63.51%) general surgeons, 46 (16.14%) anesthetists, 35 (12.28%) ophthalmologists, and 23 (8.07%) ear, nose, and throat surgeons. 176 of the dissertations (61.75%) were from retrospective studies, 94 (32.98%) were from prospective studies, and 15 (5.26%) were from combined prospective and retrospective studies. 53 (18.60%) of these surgeons were foreigners, with the majority (79.24%) coming from other African countries. The neighboring countries of Uganda, Sudan, Tanzania, Ethiopia, and Zambia accounted for 31 (58.50%) of the foreign surgeons. There was also one Doctor of Philosophy in anesthesia and one Master's Degree in urology during the same period.

Magoha GAO. "The Management of Early Prostate Cancer: A Review." East African Medical Journal. 2007;Vol 84 (No. 9). Abstract

Objective: To carry out a review of the management of early (clinically localised) prostate cancer.
Data Source: Review of all published literature on the management of early prostate cancer was carried out through medline and index medic us searches.
Data Selection: Published data of the management of early prostate cancer over the last three decades were included in the review.
Data Extraction: Abstracts of articles identified were assessed, read and analysed to determine their relevance to the title under review.
Data Synthesis: After establishing relevance from the abstract, the entire paper was read, and the significant points included in the review.
Conclusion: Greater number of men are currently being diagnosed with early prostate cancer. This is due to widespread use of Prostate Specific Antigen (PSA) screening available worldwide. Radical treatment including radical prostatectomy and radical radiation therapy have proven curative value for a significant number of men with localised disease. Survival outcomes indicate that radical prostatectomy offers more reliable cure than radiation therapy for clinically localised disease.

Immediate treatment related morbidity of radical prostatectomy and radiation therapy is currently quite low. Both treatment methods have similar impact on erectile function and continence. Rectal complications are however unique to radiation therapy. Surgical and radiation therapy delivery techniques should be further improved to reduce treatment related morbidity and quality of life outcomes.

Magoha GAO. "Torsion of the testis and testicular appendages: A diagnostic dilemma or ignorance? Proceedings of the second biennial conference of the Pan African Urological Surgeons Association (PAUSA) held in Nairobi, page 10, 1995.". In: Proceedings of the second biennial conference of the Pan African Urological Surgeons Association (PAUSA) held in Nairobi, page 10, September 1995. EAMJ; 1995. Abstract

Scrotal explorations were performed on 110 patients with clinical suspicion of testicular torsion over an eight-year period from January 1988 to January 1995 at the various government and private hospitals within Nairobi metropolis. Ninety five (86.36%) patients had testicular torsion. 14 (12.73%) patients had epididymo-orchitis and one (0.91%) patient had normal testis. The mean age was 20.5 years. Forty six (48.42%) patients were young adults of over 21 years of age. The overall salvage rate was low at 21% with an orchidectomy rate of 79%. All the patients (40%) who presented to the surgeon more than 48 hours from the onset of symptoms lost their testicles. This may be due to the fact that in this study, forty three (45.26%) patients were placed on antibiotics and analgesics without prior scrotal or external genital examination by the first doctor to examine them before eventual referral to the surgeon. Recurrent torsion was reported in four (4.21%) patients who had previous testicular fixation in the locality.

Magoha GAO. "Science Technology and Innovation for Africa's development." Journal of Discovery and Innovation . 2006;18(3):269-274. Abstract

To provide an overview of the aetiology, investigations and the various treatment methods currently available in the management of haemospermia. DATA SOURCE: Review of literature was effected through medline and index medicus search of major published indexed journals and books. DATA SELECTION: Published data on haemospermia, hemospermia, haematospermia and semen over the last five decades (1967-2007) were utilised. DATA EXTRACTION: Abstracts of selected articles were read and analysed to determine their possible contribution and relevance to this article. DATA SYNTHESIS: All relevant articles were reviewed in full and contribution extracted for this review as necessary. CONCLUSION: Haemospermia (haematospermia) is a relatively frequent, distressing and frightening symptom in sexually active men. It is usually a benign self-limiting condition resolving within several weeks except for the few with underlying aetiology including prostate malignancy and idiopathic. Patients presenting with haemospermia should have a detailed medical history, physical examillation including blood pressure measurement, genital and digital rectal examination. Persistent and recurrent haemospermia is best investigated by TRUS, CT, MRI, urethrocystoscopy, and biopsy and histological confirmation of malignancies. Specific treatment depends on the underlying pathological cause but often involves only minimal investigations and simple reassurance.

Magoha GAO. "Measurement of serum C-Reactive protein concentration after renal transplantation. ." Journal of Nephrology, Dialysis and Transplantation 2. 1987:39-41. Abstract

A prospective study of serial serum C-reactive protein (CRP) concentrations was made on 21 patients who had received renal allografts. CRP was raised during 27 of 32 rejection episodes and in all of five episodes of rejection associated with infection. CRP values were persistently elevated in three irreversible rejection episodes. Significantly raised CRP concentrations were documented in 14 of 20 episodes of infection. In some cases CRP was a predictive indicator of rejection or infection. In all cases of infection or rejection associated with a rise in CRP, CRP values fell following successful treatment with appropriate agents. Serial CRP measurement used in conjunction with other clinical and biochemical parameters appears to be valuable clinically following renal transplantation.

Magoha GAO. "Epidemiological and clinical aspects of incidental carcinoma of the prostate in Africans: experience at the Lagos University Teaching Hospital, Lagos and the Kenyatta National Hospital, Nairobi.East Afr Med J. 1995 May;72(5):283-7." Epidemiological and clinical aspects of incidental carcinoma of the prostate in Africans: experience at the Lagos University Teaching Hospital, Lagos and the Kenyatta National Hospital, Nairobi.East Afr Med J.. 1995;72(5):283-7. Abstract

Twenty patients in Lagos and 24 patients in Nairobi with incidental carcinoma of the prostate in resected glands for benign hyperplasia were studied at the Lagos University Teaching Hospital (1978-1982) and at Kenyatta National Hospital (1988-1992), respectively. The age range for the Lagos group was 45-78 years with a mean age of 61 years and a peak incidence in the seventh decade (60-69 year age group) compared to the Nairobi group with age range of 50-89 years with a mean age of 66 years and a peak incidence in the eighth decade (70-79 year age group). Both groups had predominantly well differentiated low grade stage TIA (AI) incidental carcinoma of the prostate, being 80% in the Lagos group and 79.2% in the Nairobi group. High grade undifferentiated stage TIB (A2) incidental carcinoma of the prostate was present in 20% of the Lagos group and 20.8% of the Nairobi group. In both groups, the majority of patients (80%) in the Lagos group and (79.2%) in the Nairobi group presented late with similar symptoms of prostatic obstruction.

Magoha GAO. "Sildenafil (Viagra) in the management of male erectile dysfunction in Nairobi. ." East African Medical Journal, 77: 76-79, 2000.. 2000;77:76-79. Abstract

OBJECTIVE: To evaluate the effectiveness of sildenafil (Viagra) in the treatment of male erectile dysfunction in Nairobi.
DESIGN: Prospective open label extension study. SETTING: Urology clinics at the Nairobi Hospital, Kenyatta National Hospital and the author's private clinic in Hurlingham, Nairobi.
PARTICIPANTS: Two hundred and nineteen adult male patients with erectile dysfunction.
RESULTS: The age range was 33-80 years with a mean of 62.5 years and a peak incidence in the 60-69 year age group. One hundred and nineteen patients (54.34%) had organic causes, 85 patients (38.81%) had psychogenic causes and 15 patients had mixed causes. Two hundred patients (91.32%) had improved sexual function after treatment with viagra. This improvement was sustained during the study period of sixteen weeks and included improved erectile and orgasmic functions and overall sexual satisfaction. One hundred and fifty seven of these patients responded to therapy with 50 mg of viagra; 40 patients with 25 mg and three patients with 100 mg of therapy. Nineteen patients (8.68%) had no improvement in sexual function after viagra administration. Seven patients (3.2%) had adverse effects which were mild and transient. They included mild headaches in three patients, mild dyspepsia in two patients and facial flushing and nausea and vomiting in one patient, respectively.
CONCLUSION: Oral sildenafil (Viagra) is an effective well tolerated and simple treatment for male erectile dysfunction in the majority of cases. The cost of treatment at about ten United States dollars for the 50 mg tablet is prohibitive and may limit its wide use by many deserving patients in this locality.
PIP: This prospective open-label extension study was carried out to evaluate the effectiveness of sildenafil (Viagra) in the treatment of male erectile dysfunction in Nairobi, Kenya. A total of 219 adult male patients with erectile dysfunction were instructed to take 50 mg, 25 mg, or 100 mg of sildenafil orally 1 hour prior to planned sexual activity, but not more than once every 24 hours. Patients were reviewed at 4-week intervals for 16 weeks to assess the efficacy and adverse effects of the drug. The age range was 33-80 years with a mean of 62.5 years and a peak incidence in the 60-69 year age group. The causes of erectile dysfunction were organic (n = 119, 54.34%), psychogenic (n = 85, 38.81%), and mixed (n = 15). 200 patients (91.32%) had improved sexual function after treatment with Viagra. This improvement included improved erectile and orgasmic functions and overall sexual satisfaction. 157 patients responded to the 50-mg treatment regimen; 40, to the 25-mg regimen; and 3, to the 100-mg regimen. No improvement in sexual function was reported in 19 patients (8.68%) after Viagra administration. In addition, 7 patients reported mild and transient adverse effects of the drug, including mild headache, dyspepsia, facial flushing, nausea, and vomiting. In conclusion, oral sildenafil (Viagra) is an effective well-tolerated and simple treatment for male erectile dysfunction in the majority of cases. However, the cost of treatment may prohibit and limit its wide use by many deserving patients in this area.

Magoha GAO. "Ten years experience with chronic prostatitis in Africans. ." East African Medical Journal. 1996;73:176-178. Abstract

This is a prospective study of seventy three patients with chronic prostatitis over a ten year period (1984-1994. The study was carried out at various hospitals in Lagos Nigeria and Nairobi Kenya. The mean age was 39.3 years. Chronic bacterial prostatitis was diagnosed in 15 patients (20.5%) of which 11 patients (73.3%) had Escherichia coli as the causative pathogen. Four of these patients (36.4%) were symptom and culture free after 12 weeks therapy with trimethoprimsulfamethoxazole. Four of the other seven patients not responding to trimethoprim (57.1%) became symptom and culture free after four weeks therapy with ciproflaxacin. Non bacterial prostatitis including prostatodynia was diagnosed in 58 patients (79.5%). Only 15 of these patients (25.8%) reported some subjective relief of symptoms on emperic therapy with doxycycline with complete relapse on discontinuation of therapy. Further therapy with non steroidal anti-inflammatory ibuprofen and anticholinergic oxybutinin chloride proved effective in alleviating symptoms in 40 patients (68.96%), but all relapsed on discontinuation of therapy emphasizing the ineffective and unsatisfactory nature of the present emperic treatment regimens as the cause of non bacterial prostatitis remains unknown.

Magoha GAO. "Management and survival in advanced prostate cancer in Nairobi." East Afr Med J.. 2000;77(5):260-3. Abstract

OBJECTIVE: To evaluate the management and survival of patients with advanced prostate cancer in this locality. DESIGN: A prospective case study. SETTING: Kenyatta National Referral Hospital and the Nairobi and Mater Hospitals. PATIENTS: Fifty nine patients with advanced cancer of prostate (extra prostatic locally advanced and metastatic cancer). RESULTS: Transperineal trucut needle biopsies of the prostate revealed 15 patients (25.42%) had poorly differentiated cancers with Gleasons scores greater than 7. Fifteen patients (25.42%) had moderately differentiated cancers with Gleason scores of 6; and twenty nine other patients (49.2%) had well differentiated cancers with Gleason scores of 4 and below. Surgical castration was effected on 15 patients four of whom also had 50 mg of oral bicalutamide (casodex) daily. Thirty six patients were treated with subcutaneous goserelin (zoladex) depot 3.6 mg every 28 days. Ten of these patients also had 50 mg oral casodex daily in addition to the zoladex. Three patients in this group also had external radiotherapy for severe bone pains. Only eight patients were treated with oral diethylstilboestrol 3 mg daily. All the 15 patients with undifferentiated cancers died within 12 months. Of the 22 patients surviving at 48 months irrespective of the method of treatment, 20 of them had well differentiated cancers with Gleasons scores of 4 or less. CONCLUSION: Survival in the undifferentiated and poorly differentiated prostrate cancer Gleasons grades 4 and 5 with a score of over 7 is poor irrespective of the mode of treatment as all the patients in this group were dead within 12 months of diagnosis. Twenty patients (90.90%) of the surviving patients at 48 months had well differentiated cancers Gleasons grades 1 and 2 with scores of 4 or less indicating better prognosis for these tumours which are known to be slow growing with a much longer tumour doubling time.

East Afr Med J. 2000 May;77(5):260-3.

Magoha GAO. "Incidental carcinoma in surgically resected prostates in Nigerians.(3): 9-12, 1985.." Nigerian Quarterly Journal of Hospital Medicine . 1985;(3):9-12. Abstract

A histological analysis of 306 prostates resected for benign hyperplasis at the Lagos University Teaching Hospital revealed incidental carcinoma in 10.46% by routine sectioning technique. Carcinoma in situ of the prostate accounted for 59.4%, well differentiated adenocarcinoma 18.7%, poorly differentiated adenocarcinoma 9.4% each, and squamous cell carcinoma 3.1.%. Treatment was expectant for carcinoma in situ while stilboestrol and or orchidectomy was used for all other histological types. The results show that expectant treatment is effective and adequate for in situ carcinoma, and that poorly differentiated and undifferentiated prostatic carcinoma has poor prognisis compared to well differentiated carcinoma after similar treatment

Magoha GAO. "Sterilisation and disinfection of Instruments used in Urology:.". In: In Nosocomial and Health Care Associated Infections in Urology pages 121-150, Eds. Naber K.G., Pechere J.C., Kumizawa J., Khoury S., Gerberding J.L., and Schaeffer A.J., WHO and IUCC Health Publication 2001. EAMJ; 2001. Abstract

The last two decades have seen a phenomenal increase in the number of urological endoscopic and laparoscopic procedures. An increasing number of operations are now being performed using minimally invasive techniques and consequently it is infeasible to provide one instrument for each patient on the operating list. With the advent of minimally invasive urology the variety of endoscopes and accessories available have also multiplied. However these instruments are costly and many of them are designed for single use. This poses a problem in developing countries where cost containment is imperative. Ideally a single use item should not be reused and reprocessed unless the reprocessor is able to apply and observe all the stringent technical requirements necessary to ensure the integrity and safety in the re-processed item. Patient to patient transmission of infection has been documented after improper disinfections of urological equipment. With increasing workloads in urologic endoscopy and laparoscopy, the need for stringent guidelines for cleaning and disinfection of urological instruments is important in the prevention of health care associated infections. The methods of disinfection, chosen must relate to the risks of infection associated with particular procedure, the availability and affordability of the cleaning, disinfection decontamination and sterilization equipment, the time available for reprocessing. This review will commence with a brief review of sterilization and disinfection processes used for single and multi-use medical devices and instruments employed in urological practice. Industry and hospital standards will be discussed with the emphasis on the outcome for the patient in developed and developing countries. A short discussion of new material in the R & D pipeline will be included with a view to sterilization and disinfection processes in the future. The transmission of infectious organisms is widespread within a hospital or medical office setting. In countries such as many in the African continent, AIDS is so prevalent that risk of contamination of instruments and devices used on patients is very high. Therefore, it is critical that staff responsible for cleaning, disinfecting and sterilizing equipment used in urological and general surgical practise, be well-trained, diligent and thorough. This means ensuring that each device used on every patient has been reliably sterilized. Furthermore, it is essential that proper methodologies be used to process instruments and devices, and that process monitoring be carried out on a continual basis. Manufacturers of devices and instruments need to consider short term and long-term costs for sterilization and disinfection processors. This includes examining whether certain single use devices can in fact be reused under some conditions. While government agencies must regulate and monitor processes, it would be helpful if a United Nations type consensus was created. This would help manufacturers in the global market-place, and would likely make it easier for practitioners to operate.

Magoha GAO. "Prostate cancer." East Afr Med J. . 2007:84.
Magoha GAO. "Screening and Early detection for prostate cancer." East African Medical Journal.. 1997;74: 664-666. Abstract

Prostate cancer is the most common malignancy in men. Mortality due to prostate cancer has continued to increase over the past five decades despite all the different options of treatment at the disposal of the urologist, such as, surgery, radiotherapy, chemotherapy and biotherapy. Presently, effective therapy for prostate cancer is only possible with early diagnosis of the disease still localised within the prostate. Recent studies have demonstrated that the present screening techniques including Digital Rectal Examination (DRE), Serum Prostate Specific Antigen (PSA) concentration, Transrectal Ultrasound (TRUS) and Random Ultrasonically guided multiple prostatic biopsies can detect some potentially curable asymptomatic localised cancers. The main goal of a cancer screening test is to help reduce mortality. To date, it has been established that screening increases early detection and survival but there is no evidence that screening reduces mortality. If in future early detection and intervention is proved to provide real benefit apart from the overdiagnosis of latent non aggressive tumours, then the mortality from prostate cancer could begin to decline in the next decade. However, if our current armamenteria of therapies continue to be ineffective in treating men with prostate cancer, the current emphasis on screening and early detection will decline.

Magoha GAO. "Sterilisation and disinfection of Instruments used in Urology." Nosocomial and Health Care Associated Infections in Urology. 2001:121-150. Abstract

The last two decades have seen a phenomenal increase in the number of urological endoscopic and laparoscopic procedures. An increasing number of operations are now being performed using minimally invasive techniques and consequently it is infeasible to provide one instrument for each patient on the operating list. With the advent of minimally invasive urology the variety of endoscopes and accessories available have also multiplied. However these instruments are costly and many of them are designed for single use. This poses a problem in developing countries where cost containment is imperative. Ideally a single use item should not be reused and reprocessed unless the reprocessor is able to apply and observe all the stringent technical requirements necessary to ensure the integrity and safety in the re-processed item. Patient to patient transmission of infection has been documented after improper disinfections of urological equipment. With increasing workloads in urologic endoscopy and laparoscopy, the need for stringent guidelines for cleaning and disinfection of urological instruments is important in the prevention of health care associated infections. The methods of disinfection, chosen must relate to the risks of infection associated with particular procedure, the availability and affordability of the cleaning, disinfection decontamination and sterilization equipment, the time available for reprocessing. This review will commence with a brief review of sterilization and disinfection processes used for single and multi-use medical devices and instruments employed in urological practice. Industry and hospital standards will be discussed with the emphasis on the outcome for the patient in developed and developing countries. A short discussion of new material in the R & D pipeline will be included with a view to sterilization and disinfection processes in the future. The transmission of infectious organisms is widespread within a hospital or medical office setting. In countries such as many in the African continent, AIDS is so prevalent that risk of contamination of instruments and devices used on patients is very high. Therefore, it is critical that staff responsible for cleaning, disinfecting and sterilizing equipment used in urological and general surgical practise, be well-trained, diligent and thorough. This means ensuring that each device used on every patient has been reliably sterilized. Furthermore, it is essential that proper methodologies be used to process instruments and devices, and that process monitoring be carried out on a continual basis. Manufacturers of devices and instruments need to consider short term and long-term costs for sterilization and disinfection processors. This includes examining whether certain single use devices can in fact be reused under some conditions. While government agencies must regulate and monitor processes, it would be helpful if a United Nations type consensus was created. This would help manufacturers in the global market-place, and would likely make it easier for practitioners to operate.

Magoha GAO. "Prognosis in poorly differentiated carcinoma of the prostate. ." Nairobi Journal of Medicine. 1990;16:17-19. Abstract

A study of 47 Nigerian patients with prostatic carcinoma at the Lagos University Teaching Hospital revealed that 17(36.17%) had poorly differentiated carcinoma, Gleason’s Grade VI. Fourteen patients (28.79%) had moderately differentiated carcinoma, Gleason’s Grade III, while two other patients (4.25%) had well differentiated glands but with more atypia and less well circumscribed boundaries, Gleason’s Grade II. The last twelve patients (25.53%) had very well differentiated carcinoma Gleason’s Grade I.
Nine of the eleven patients (81.81%) who died during the study period had poorly differentiated and undifferentiated prostatic carcinoma, Gleason’s Grade V. The other two deaths were from moderately differentiated tumours, Gleason’s Grade II and I.
These findings show poor prognosis for poorly differentiated and undifferentiated carcinoma of the prostrate in Nigerian Africans similar to previous reports in Caucasians by other authors (6,7,6,11).

Magoha GA, Ngumi ZW. "Training of surgeons in Kenya at the University of Nairobi teaching hospital.". 1999. Abstract

To determine the number of surgeons trained by the Department of Surgery, Faculty of Medicine, College of Health Sciences, University of Nairobi, since its inception in 1967. DESIGN: This was a retrospective (1975-1987) and prospective study (1988-1999). SETTING: Kenyatta National Hospital, a National Referral Hospital and University of Nairobi Teaching Hospital. SUBJECTS: All surgeons trained by the Department of Surgery of the University of Nairobi for postgraduate MMed in general surgery, anaesthesia, ENT surgery and ophthalmology from 1975 to March 1999. RESULTS: Two hundred and eighty-five surgeons with Master of Medicine degree were trained by the Department of Surgery of the University of Nairobi between 1975 and March 1999. They included 181 (63.51%) general surgeons; 46 (16.14%) anaesthetists; 35 (12.28%) ophthalmologists and 23 (8.07% ear, nose and throat (ENT) surgeons. One hundred and seventy-six, (61.75%) were from retrospective studies; 94 (32.98%) were from prospective studies while 15 (5.26%) were from both retrospective and prospective studies. Two hundred and thirty-two (81.40%) surgeons were Kenyans while 53 (18.60%) were foreigners. The majority, 42 (79.24%) of the foreigners were from other African countries. Thirty one (58.50%) were from neighbouring Uganda, Sudan, Tanzania, Ethiopia and Zambia. There was also one PhD in anaesthesia and one MD in urology during the same period. CONCLUSION: The University of Nairobi, Department of Surgery based at Kenyatta National Hospital has played a very significant and leading role in the training of surgeons for Kenya and even other African and foreign countries since its inception. Of the forty surgeons who constitute the academic staff in the Departments of General Surgery, Orthopaedic Surgery and Ophthalmology of the University of Nairobi, thirty-five surgeons (87.50%) have been trained by the Faculty of Medicine at KNH. PIP: This study was carried out as a retrospective (1975-87) and prospective study (1988-99) to determine the number of surgeons trained by the Department of Surgery, Faculty of Medicine, College of Health Sciences, University of Nairobi, Kenya, since its inception in 1967. Over the 25-year period (1975-99), the Department of Surgery of the University of Nairobi trained a total of 285 surgeons with a Master of Medicine degree. These included 181 (63.51%) general surgeons, 46 (16.14%) anesthetists, 35 (12.28%) ophthalmologists, and 23 (8.07%) ear, nose, and throat surgeons. 176 of the dissertations (61.75%) were from retrospective studies, 94 (32.98%) were from prospective studies, and 15 (5.26%) were from combined prospective and retrospective studies. 53 (18.60%) of these surgeons were foreigners, with the majority (79.24%) coming from other African countries. The neighboring countries of Uganda, Sudan, Tanzania, Ethiopia, and Zambia accounted for 31 (58.50%) of the foreign surgeons. There was also one Doctor of Philosophy in anesthesia and one Master's Degree in urology during the same period.

Magoha GAO, Ayumba BR. "Epidemiological aspects of Fournier's gangrene at Kenyatta National Hospital, ." East Afr Med J. 1998 Oct;75(10):586-9.. 1998;75(10):586-9. Abstract

This was a retrospective epidemiological study of 171 patients with scrotal (Fournier's gangrene) at Kenyatta National Hospital over eleven year period. The age range was 11 days to 90 years with a mean of 35.38 years. This is different from other reports of a mean of 40.6 years in the older literature and a mean of 50 years in the more recent series. The ethnic distribution of Fournier's gangrene revealed equal susceptibility among all ethnic groups in this locality. Scrotal and genitourinary symptoms were the commonest being present in one hundred and two patients (59.7%). The onset of symptoms was insidious in 95 patients (55.6%), and abrupt in 76 patients (44.4%). Most patients (84.2%) presented after more than 48 hours of the onset of symptoms. One hundred and two patients (59.65%) presented with localised physical signs compared to sixty nine patients (40.35%) who presented with extended lesions. Sources of the lesion were known in 82.5% of the patients. Genitourinary sources accounted for 42.1%, extragenitourinary 29.2%, and mixed 11.11% among the known causes. Diabetes mellitus was the leading major illness associated with Fournier's gangrene, presenting in 11 patients (6.42%). Seven other patients (4.09%) had HIV infection.

Magoha GAO. "Adult male circumcision: results of a standardized procedure in Kisumu District, Kenya." British Journal of Urology. 2005;96:1109-1113. Abstract

OBJECTIVE: To provide an overview of the current global status of female genital mutilation (FGM) or female circumcision practised in various countries. DATA SOURCE: Major published series of peer reviewed journals writing about female genital mutilation (FGM) over the last two decades were reviewed using the index medicus and medline search. A few earlier publications related to the FGM ritual as practised earlier were also reviewed including the various techniques and tools used, the "surgeons or perpetrators" of the FGM ritual and the myriad of medical and sexual complications resulting from the procedure. Global efforts to abolish the ritual and why such efforts including legislation has resulted in little or no success were also critically reviewed.
CONCLUSION: FGM remains prevalent in many countries including African countries where over 136 million women have been 'circumcised' despite persistent and consistent efforts by various governments, WHO and other bodies to eradicate the ritual by the year 2000 AD. This is as a result of deep rooted cultures, traditions and religions. Although FGM should be abolished globally, it must involve gradual persuasion which should include sensitisation and adequate community-based educational and medical awareness campaign. Mere repression through legislation has not been successful, and women need to be provided with other avenues for their expression of social status approval and respectability other than through FGM.

Magoha GAO. "The effect of rectal examination on serum acid phosphatase levels in benign and malignant prostatic disease." Postgraduate Medical Journal . 1982;(58):763-766. Abstract

Serum acid phosphatase was measured in patients with enlarged benign and malignant prostate before and after rectal examination. Amongst the patients with benign glands, rectal examination did not produce any significant false elevation of the enzyme. Rectal examination, however, caused a rise in the enzyme level in a few untreated cancer patients and in cancer patients who has become refractory to hormonal therapy. This rise would help rather than mislead in the diagnosis of malignant prostate and also in the identifying treated patients who had become refractory to treatment. Thus, when serum acid phosphatase is properly determined, elevated levels should always arouse suspicion of malignant prostate or other lesions associated with high enzyme level even is such determination was preceded by rectal examination. There appears to be no merit in the teaching that the determination of serum acid phosphatase should be delayed after rectal examination.

Magoha GAO. "Cancer of the male genital tract." East African Medical Journal. 1995;72:545-546. Abstract

Partial penectomy is effective in the treatment of T1 and T2 penile carcinoma with 80% five-year survival rates in the absence of inguinal metastases, and the residual stump is serviceable for upright micturition and sexual function. The use of micrographic surgery first introduced by Mohs in 1941 for small distally located lesions of upto one centimetre diametre achieves results comparable to partial penectomy. Carbon dioxide and Neodymium-Yag lasers have also been used in the treatment of T1 and T2 tumours with 89% five year survival rates. Radiotherapy is also ideal for the treatment of T1 and T2 primary penile carcinoma because failure is corrected with salvage partial penectomy. In T3 disease with extensive local growth total penectomy and removal of scrotal contents followed by perineal reconstruction with scrotal flap is associated with 90% five year survival rates. In advanced T4 tumours with fixed inguinal nodes (N3), hemipelvectomy or hemicorporectomy with combination cytotoxic chemotherapy is considered in selected cases. Various cytotoxic agents like bleomycin, vincristine and methotrexate have been used in adjuvant and neoadjuvant therapy with mixed results. Pre operative radiotherapy is useful in the treatment of patients with metastatic groin lymph nodes of greater than or equal to 4 cm in size. Radiotherapy also provides effective palliation in patients with advanced regional and/or distant metastases. Groin block dissection is commonly performed to treat groin node metastasis and to stage nodal disease in patients with clinically negative groins. The procedure is however associated with significant morbidity resulting in complications such as wound infection and skin necrosis leading to wound breakdown and lymphoedema.(ABSTRACT TRUNCATED AT 250 WORDS)

Magoha GAO. "Finasteride in the treatment of patients with moderate symptoms of benign prostatic Hyperplasia.". In: East African Medical Journal, 75: 260-263, 1998. EAMJ; 1998. Abstract

This was a prospective study involving 27 patients with moderate symptoms of benign prostatic hyperplasia (BPH) treated continuously with 5 mg of finasteride daily for one year. There was improvement in clinical BPH symptoms in 22 patients (81.48%), increase in urinary flow rates by a mean of 2.2 mls/sec in 20 patients (74.07%) and a mean decrease in prostate volume of 20.9% in 25 patients (92.59%) comparable to the findings of the other investigators. No patient on finasteride therapy developed acute urinary retention suggesting reduced risk. The reversal in BPH progression stems from the ability of finasteride to reduce prostate volume thus relieving urinary obstruction and to decrease BPH symptoms and increase urinary flow rates. Finasteride therapy was well tolerated in this study. No adverse effect was observed except impotence in one patient (3.7%) and loss of libido in another patient (3.7%). For symptomatic relief in men with moderate obstructive symptoms of BPH, finasteride should be considered an effective alternative to watchful waiting. These findings warrant further investigations and may signal a positive change in the role of medical therapy in the future long term management of BPH.

Magoha GAO. "Low dose clomiphane citrate therapy in oligospermic men with idiopathic primary infertility. ." Nairobi Journal of Medicine.. 1988;15:42-45. Abstract

Eighty-one Nigerian patients with testicular torsion presented at the Urology Unit of the Lagos University Teaching Hospital between May 1983 and May 1985. The majority (62%) were young adults of 21 years and above with a mean of 21.3 +/- 5.2 years. Fifty-four testes found to be clinically non viable at exploration were excised and microscopically confirmed as haemorrhagic infarction due to the torsion. Twenty-six clinically viable testes at exploration were salvaged giving a low salvage rate of 32%. This appears to be due to delayed or mistaken diagnosis by the first doctor to see the patient as a result of low index of suspicion. The clinical importance of high index of suspicion for testicular torsion in all patients with testicular pain of recent onset irrespective of age is emphasized in this locality.

Magoha GAO. "Ureteric Injuries. ." East African Medical Journal, 76: 181-183, 1999.. 1999;76:181-183. Abstract

OBJECTIVE: To determine the number of surgeons trained by the Department of Surgery, Faculty of Medicine, College of Health Sciences, University of Nairobi, since its inception in 1967.
DESIGN: This was a retrospective (1975-1987) and prospective study (1988-1999).
SETTING: Kenyatta National Hospital, a National Referral Hospital and University of Nairobi Teaching Hospital.
SUBJECTS: All surgeons trained by the Department of Surgery of the University of Nairobi for postgraduate MMed in general surgery, anaesthesia,
ENT surgery and ophthalmology from 1975 to March 1999. RESULTS: Two hundred and eighty-five surgeons with Master of Medicine degree were trained by the Department of Surgery of the University of Nairobi between 1975 and March 1999. They included 181 (63.51%) general surgeons; 46 (16.14%) anaesthetists; 35 (12.28%) ophthalmologists and 23 (8.07% ear, nose and throat (ENT) surgeons. One hundred and seventy-six, (61.75%) were from retrospective studies; 94 (32.98%) were from prospective studies while 15 (5.26%) were from both retrospective and prospective studies. Two hundred and thirty-two (81.40%) surgeons were Kenyans while 53 (18.60%) were foreigners. The majority, 42 (79.24%) of the foreigners were from other African countries. Thirty one (58.50%) were from neighbouring Uganda, Sudan, Tanzania, Ethiopia and Zambia. There was also one PhD in anaesthesia and one MD in urology during the same period.
CONCLUSION: The University of Nairobi, Department of Surgery based at Kenyatta National Hospital has played a very significant and leading role in the training of surgeons for Kenya and even other African and foreign countries since its inception. Of the forty surgeons who constitute the academic staff in the Departments of General Surgery, Orthopaedic Surgery and Ophthalmology of the University of Nairobi, thirty-five surgeons (87.50%) have been trained by the Faculty of Medicine at KNH.
PIP: This study was carried out as a retrospective (1975-87) and prospective study (1988-99) to determine the number of surgeons trained by the Department of Surgery, Faculty of Medicine, College of Health Sciences, University of Nairobi, Kenya, since its inception in 1967. Over the 25-year period (1975-99), the Department of Surgery of the University of Nairobi trained a total of 285 surgeons with a Master of Medicine degree. These included 181 (63.51%) general surgeons, 46 (16.14%) anesthetists, 35 (12.28%) ophthalmologists, and 23 (8.07%) ear, nose, and throat surgeons. 176 of the dissertations (61.75%) were from retrospective studies, 94 (32.98%) were from prospective studies, and 15 (5.26%) were from combined prospective and retrospective studies. 53 (18.60%) of these surgeons were foreigners, with the majority (79.24%) coming from other African countries. The neighboring countries of Uganda, Sudan, Tanzania, Ethiopia, and Zambia accounted for 31 (58.50%) of the foreign surgeons. There was also one Doctor of Philosophy in anesthesia and one Master's Degree in urology during the same period.

Magoha GAO. "Descriptive case series of patients presenting with cancer of the prostate and their management at Kenyatta National Hospital." ;East African Medical Journal . 2007;Vol 84(No. 9 ). Abstract

Objective : To study clinical prostate cancer in this locality with particular interest in incidence, clinical presentation and treatment.
Design: A descriptive prospective study.
Setting: Kenyatta National Referral and Teaching Hospital affiliated to College of Health Sciences of the University of Nairobi between November 1998 and October 1999.
Patients: Sixty five patients with clinical prostate cancer were included in the study.Results: Age was reliably confirmed in 64 out of the 65 patients. 87.5 % of the patients were aged over 61 years with a peak incidence in the 66-70 year age group and a mean age of 67 years. Crude hospital incidence of 76.5 patients per 100,000 patients and a crude hospital death rate of 5.8 patients per 100,000 patients is reported. The majority of patients (87.5%) presented late with advanced disease stages III(C) and IV(D) prostate cancer.
Conclusion: The crude hospital incidence of cancer of the prostate is on the increase in this locality with a finding of76.5 per hundred thousand patients, higher than that reported by earlier researchers in this locality and elsewhere. This study suggests that prostate cancer incidence and the magnitude of risk in our locality must have been grossly underestimated in the past. The prostate cancer rate in Kenyans may be as great as noted in black men in the United States, Jamaica, Nigeria and Cameroon which may suggest some common enhancing genetic predisposition. There is need to further investigate this phenomenon. Cancer of the prostate in this locality presents late with clinically advanced disease.

Magoha GAO. "Testicular Cancer in Nigerians.". In: East African Medical Journal, 72: 554-556, 1995. EAMJ; 1995. Abstract

This is a report of prospective study of eight patients with testicular tumours seen at the Urology Unit of the Lagos University Teaching Hospital over a five-year period (1979-1983). The mean age was 32.7 years. Four patients (50%) had germ cell tumours including embryonal carcinoma 25%, seminoma 12.5% and malignant teratoma undifferentiated (MTU) 12.5%. The seminoma in this group originated from a testis which was previously undescended but brought into the scrotum at six years of age. The other four patients (50%), had non germ cell tumours. Two of these patients (25%) had paratesticular tumours including rhabdomyosarcoma of paratesticular adnexae and liposarcoma. One (12.5%) had adenomatoid tumour of the epididymis while the last patient (12.5%) had malignant fibrous mesothelioma of the tunica vaginalis. This study reaffirms the fact that testicular tumours are rare in blacks and that Nigeria has the lowest incidence reported at 0.1 per 100,000 per annum.

Magoha GAO. "Appendicitis at Kenyatta National Hospital, Nairobi. ." East Afr Med J. . 2005;82(10):526-30. Abstract

BACKGROUND: Appendicitis still remains a diagnostic challenge particularly in women and extremes of age. The incidence of appendicectomy for suspected appendicitis is higher but declining in the developed countries in contrast with a low but increasing incidence in Africa. OBJECTIVE: To describe the characteristics of appendicitis at Kenyatta National Hospital, with emphasis on epidemiological oddities. DESIGN: A prospective descriptive study. SETTING: Kenyatta National Hospital, a 2000 bed teaching and referral hospital in Nairobi, Kenya SUBJECTS: One hundred and eighty nine patients managed for suspected acute appendicitis between July 2000 and June 2001. RESULTS: There were 116 males and 73 females. The peak incidence was in the third decade. Sixty four percent of patients were below 30 years of age. The elderly (< 60 years of age) accounted for 1.6% of cases. The rate of false appendicectomy was 18.0%. This rate of negative appendicectomies was 12.9% for males and 30.1% for females. The rate of perforation/gangrene was 29.7%. Hospital stay averaged 6.4 days. Overall morbidity was 12.3%. It was 19.4% in perforated appendicitis and 7.6% in non-perforated appendicitis. There was no mortality. CONCLUSION: The incidence of appendicitis has increased at Kenyatta National Hospital over the last 30 years. The disease is common in men in their third decade. These odd characteristics warrant further investigations.

Magoha GAO. "Missed Torsion of the testis." Health Journal.. 1999;3:52-55. Abstract

Thirty patients with a mean age of 21.3 years were referred to the urologist with missed testicular torsion. Twenty four patients first presented to medical doctors, whereas six patients presented to paramedical staff. Only eight patients had their external genitalia examined. All the 30 patients were empirically placed on antibiotics and analgesic therapy on assumption that they had orchitis. Fourteen patients presented to the author with unilateral complete disappearance of the testis (atrophy); seven patients presented with unilateral reduction in testicular size, and another seven presented with both testes disappeared (atrophied) after various episodes of missed acute torsion of testis.

Magoha GAO. "Bilateral primary malignant lymphoma of the testis: A case report. .". In: East African Medical Journal, 73: 151-152, 1996. EAMJ; 1996. Abstract

A nineteen year old Kenyan male presented with a twelve month history of rapidly progressing painless swelling of both testicles. Pre-operative clinical and laboratory evaluation resulted in clinical suspicion of bilateral testicular tumour confirmed by ultrasonography. Bilateral inguinal orchidectomy was effected and histology confirmed bilateral primary malignant lymphoma of the testis in a nineteen year old regarded as a rare and unusual presentation.

Magoha GAO. "Early postoperative outcomes of patients undergoing prostatectomy for benign prostatic hyperplasia at Kenyatta National Hospital, Nairobi." East African Medical Journal . 2007;84(9). Abstract

Objective: To describe early postoperative complications of prostatectomy. Design: A descriptive prospective study. Setting: Kenyatta National Hospital between 6thOctober 2003 and 21s1June 2004. Subjects: Eighty five men undergoing prostatectomy for the relief of lower urinary tract obstruction due to benign prostatic hyperplasia. Procedures included suprapubic transvesical prostatectomy, retropubic prostatectomy and transurethral resection of the prostate (TURP).
Main outcome measures: Co-morbidity, intra-operative and early postoperative complications, need for re-operation, 30-day mortality, duration of postoperative catheterisation, and duration of postoperative hospital stay. Results: Eighty five patients were included in the study and their age range was 46-85 years (mean 66 years). Sixty nine (81%) of the patients underwent open prostatectomy, and sixteen (19 %) underwent TURP. Twenty six patients had co-existing medical conditions, the most common being hypertension (29%) and diabetes mellitus (13%). The most common intra-operative complication during prostatectomy was haemorrhage which occurred in ten patients (11.8 %). One patient had perforation of the bladder during transurethral resection and required a laparotomy to repair the bladder. Wound sepsis was the most common postoperative complication following open prostatectomy (35 %

Magoha GAO. Primary carcinoma of the prostate in Nigerians as seen at the Lagos University Teaching Hospital. . Lagos: Lagos University Teaching Hospital; 1985. Abstract

A prospective study of serial serum C-reactive protein (CRP) concentrations was made on 21 patients who had received renal allografts. CRP was raised during 27 of 32 rejection episodes and in all of five episodes of rejection associated with infection. CRP values were persistently elevated in three irreversible rejection episodes. Significantly raised CRP concentrations were documented in 14 of 20 episodes of infection. In some cases CRP was a predictive indicator of rejection or infection. In all cases of infection or rejection associated with a rise in CRP, CRP values fell following successful treatment with appropriate agents. Serial CRP measurement used in conjunction with other clinical and biochemical parameters appears to be valuable clinically following renal transplantation.

Magoha GAO. "Management of carcinoma of the penis: A review. ." East African Medical Journal,. 1995;72:547-550. Abstract

Partial penectomy is effective in the treatment of T1 and T2 penile carcinoma with 80% five-year survival rates in the absence of inguinal metastases, and the residual stump is serviceable for upright micturition and sexual function. The use of micrographic surgery first introduced by Mohs in 1941 for small distally located lesions of upto one centimetre diametre achieves results comparable to partial penectomy. Carbon dioxide and Neodymium-Yag lasers have also been used in the treatment of T1 and T2 tumours with 89% five year survival rates. Radiotherapy is also ideal for the treatment of T1 and T2 primary penile carcinoma because failure is corrected with salvage partial penectomy. In T3 disease with extensive local growth total penectomy and removal of scrotal contents followed by perineal reconstruction with scrotal flap is associated with 90% five year survival rates. In advanced T4 tumours with fixed inguinal nodes (N3), hemipelvectomy or hemicorporectomy with combination cytotoxic chemotherapy is considered in selected cases. Various cytotoxic agents like bleomycin, vincristine and methotrexate have been used in adjuvant and neoadjuvant therapy with mixed results. Pre operative radiotherapy is useful in the treatment of patients with metastatic groin lymph nodes of greater than or equal to 4 cm in size. Radiotherapy also provides effective palliation in patients with advanced regional and/or distant metastases. Groin block dissection is commonly performed to treat groin node metastasis and to stage nodal disease in patients with clinically negative groins. The procedure is however associated with significant morbidity resulting in complications such as wound infection and skin necrosis leading to wound breakdown and lymphoedema.(ABSTRACT TRUNCATED AT 250 WORDS)

Magoha GAO. "Nocturnal enuresis." East African Medical Journal,. 2000;77:633-634. Abstract

OBJECTIVE: To identify autotransfusion strategies and their basis in elective surgery patients. DESIGN: A cross sectional prospective study. SETTING: General surgery and orthopaedic wards, Kenyatta National Hospital, Nairobi. SUBJECTS: Adult patients of both sexes planned for elective surgery. MAIN OUTCOME MEASURE: Forevery patient, the following were enquired about and documented: age in years, sex, ethnicity, religion, occupation and educational standard. Blood values of haemoglobin, platelet counts, total and differential white cell counts, urea, electrolytes and liver function tests were assayed. Others were the number of units of blood donated before the operation, the type of surgery performed, time taken from diagnosis to performing the operation and whether the blood was transfused preoperatively, intraoperatively and postoperatively. RESULTS: A total of sixty three cases constituting five per cent of all surgical patients admitted during the period of study were evaluated. Of these 53 (84%) were males and ten (16%) females. The age range was 15 to 65 years with a peak at 45-49 years. There were more Christians (90%) than Muslims (10%). In all, 32 (51.6%) had primary school education, 23 (36.5%) secondary school education, seven (11.3%) no formal education and one (1.6%) had attained college level. Employment pattern showed 50% were civil servants, 30% were self employed and 20% were unemployed. The duration of disease ranged from 1-24 weeks with two peaks at two weeks and six weeks. Orthopaedic cases constituted 78.7% and general surgery 21.3%. Preoperative haemoglobin ranged from 13.5-14.2 g/dl. Transfusions were given intraoperatively to 41 (66.1%) and to 12 (33.9%) postoperatively. Mean duration of hospitalisation was 13 days (range 5 to 21 days). 98.4% deposited only one unit while 1.6% deposited four units of blood. Only one patient required additional transfusion from homologous donors. CONCLUSION: The strategies and basis for autotransfusion have been demonstrated among a majority of adult patients requiring orthopaedic procedures. Major determinants are shown to be baseline blood count profiles and time to operation.

Magoha GAO. "Aetiology, diagnosis and management of haemospermia." East Afr Med J. 2007 . 2007;(Dec;84(12):):589-94. Abstract

To provide an overview of the aetiology, investigations and the various treatment methods currently available in the management of haemospermia. DATA SOURCE: Review of literature was effected through medline and index medicus search of major published indexed journals and books. DATA SELECTION: Published data on haemospermia, hemospermia, haematospermia and semen over the last five decades (1967-2007) were utilised. DATA EXTRACTION: Abstracts of selected articles were read and analysed to determine their possible contribution and relevance to this article. DATA SYNTHESIS: All relevant articles were reviewed in full and contribution extracted for this review as necessary. CONCLUSION: Haemospermia (haematospermia) is a relatively frequent, distressing and frightening symptom in sexually active men. It is usually a benign self-limiting condition resolving within several weeks except for the few with underlying aetiology including prostate malignancy and idiopathic. Patients presenting with haemospermia should have a detailed medical history, physical examillation including blood pressure measurement, genital and digital rectal examination. Persistent and recurrent haemospermia is best investigated by TRUS, CT, MRI, urethrocystoscopy, and biopsy and histological confirmation of malignancies. Specific treatment depends on the underlying pathological cause but often involves only minimal investigations and simple reassurance

Magoha GAO. "Medical management of benign prostatic hyperplasia (BPH)." East African Medical Journal 73: 453-456,1996.. 1996;73:453-456. Abstract

Benign prostatic hyperplasia (BPH) is a common disease affecting elderly men with 70% of men over 70 years showing microscopic evidence of hyperplasia. Transurethral resection of the prostate is the gold standard treatment. Medical management of BPH has involved the use of plant extracts, amino acids, kampo and animal organ preparations in various countries with unsatisfactory results. The use of alpha adrenergic antagonists dates back twenty years representing a major breakthrough in the treatment by relaxation of the dynamic contraction of smooth muscle component of prostatic obstruction. The evolution of alpha antagonist therapy resulted in clinical trials with selective antagonists such as prazosin, alfuzosin, indoramin, terazosin and doxazosin all of which achieve similar effective relief of obstructive symptoms as phenoxybenzamine, but with fewer side effects related to postural hypotension. 5-alpha reductase inhibitors, finasteride and episteride, recently synthesised act on the static component of obstruction caused by the enlarging prostate. They inhibit conversion of testosterone to the potent intracellular androgen dihydrotestosterone (DHT) resulting in the reduction of prostate volume and improvement of obstructive symptoms. Clinical trials with finasteride for three years indicate that 63% of patients had a reduction of greater than 20% in prostatic volume and 42% had a decrease of greater than 30% with a mean increase peak flow rate of 2.4 mls/s equivalent, to 20 years reversal of disease progression.

Magoha GAO. "Sildenafil (Viagra) in the treatment of male erectile dysfunction in Nairobi." East Afr Med J. 2000;77(2):76-9. Abstract

OBJECTIVE: To evaluate the effectiveness of sildenafil (Viagra) in the treatment of male erectile dysfunction in Nairobi. DESIGN: Prospective open label extension study. SETTING: Urology clinics at the Nairobi Hospital, Kenyatta National Hospital and the author's private clinic in Hurlingham, Nairobi. PARTICIPANTS: Two hundred and nineteen adult male patients with erectile dysfunction. RESULTS: The age range was 33-80 years with a mean of 62.5 years and a peak incidence in the 60-69 year age group. One hundred and nineteen patients (54.34%) had organic causes, 85 patients (38.81%) had psychogenic causes and 15 patients had mixed causes. Two hundred patients (91.32%) had improved sexual function after treatment with viagra. This improvement was sustained during the study period of sixteen weeks and included improved erectile and orgasmic functions and overall sexual satisfaction. One hundred and fifty seven of these patients responded to therapy with 50 mg of viagra; 40 patients with 25 mg and three patients with 100 mg of therapy. Nineteen patients (8.68%) had no improvement in sexual function after viagra administration. Seven patients (3.2%) had adverse effects which were mild and transient. They included mild headaches in three patients, mild dyspepsia in two patients and facial flushing and nausea and vomiting in one patient, respectively. CONCLUSION: Oral sildenafil (Viagra) is an effective well tolerated and simple treatment for male erectile dysfunction in the majority of cases. The cost of treatment at about ten United States dollars for the 50 mg tablet is prohibitive and may limit its wide use by many deserving patients in this locality.
PIP: This prospective open-label extension study was carried out to evaluate the effectiveness of sildenafil (Viagra) in the treatment of male erectile dysfunction in Nairobi, Kenya. A total of 219 adult male patients with erectile dysfunction were instructed to take 50 mg, 25 mg, or 100 mg of sildenafil orally 1 hour prior to planned sexual activity, but not more than once every 24 hours. Patients were reviewed at 4-week intervals for 16 weeks to assess the efficacy and adverse effects of the drug. The age range was 33-80 years with a mean of 62.5 years and a peak incidence in the 60-69 year age group. The causes of erectile dysfunction were organic (n = 119, 54.34%), psychogenic (n = 85, 38.81%), and mixed (n = 15). 200 patients (91.32%) had improved sexual function after treatment with Viagra. This improvement included improved erectile and orgasmic functions and overall sexual satisfaction. 157 patients responded to the 50-mg treatment regimen; 40, to the 25-mg regimen; and 3, to the 100-mg regimen. No improvement in sexual function was reported in 19 patients (8.68%) after Viagra administration. In addition, 7 patients reported mild and transient adverse effects of the drug, including mild headache, dyspepsia, facial flushing, nausea, and vomiting. In conclusion, oral sildenafil (Viagra) is an effective well-tolerated and simple treatment for male erectile dysfunction in the majority of cases. However, the cost of treatment may prohibit and limit its wide use by many deserving patients in this area.

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