Bio

PDF Upload: 

Publications


2011

Wangai, AM, Amayo EO, Olunya.O, Waa.S.  2011.  Late-onset Visual Loss in Osteopetrosis. Sultan Qaboos Univ Med Journal. 11(3):407-411. Abstract

Late-onset visual loss is a complication of nerve entrapment and increased intracranial pressure. We hereby describe the first case in Eastern Africa. A 23 year-old lady presented with sudden blindness, headaches and body weakness. She had previously had treatment for multiple unexplained fractures. Findings of optic nerve entrapment explained this blindness. This case highlights the need to have a high index of suspicion in cases of unexplained fractures with late-onset blindness.

2010

Ekwom, PE, Oyoo GO, Amayo EO, Muriithi IM.  2010.  1. Prevalence and characteristics of articular manifestations in human immunodeficiency virus infection.. east african medical journal. 87(10):408-14.

2009

Ochieng, PO, MCLIGEYO SO, Amayo EO, KAYIMA JK, Omonge EO.  2009.  Nephrotoxicity of amphotericin B in the treatment of cryptococcal meningitis in acquired immunodeficiency syndrome patients.. east african medical journal. 86(9):435-41.

2008

2006

Ndetei, DM, Maru HM, Amayo EO, Kaka ZA.  2006.  Agenesis of the corpus callosum with associated inter-hemispheric cyst and right frontal pachygyria presenting with psychiatric symptoms in a Kenyan Citation. AbstractWebsite

This case report presents a 26 year old man who had a history of childhood onset seizures, mild cognitive slowing and social withdrawal. He gradually developed symptoms of depression and attempted suicide once. He presented to the authors following a recurrence of his seizures. On examination they noted a normal general and neurological examination apart from some frontal lobe signs on mental status examination. He also had features of psychosis and labile mood. On CT brain scan he had agenesis of the corpus callosum (CC) with associated interhemispheric cyst and right frontal pachygyria. The authors suggest that clinicians in developing countries should be alert to organic disorders presenting with psychiatric symptoms.

Amayo, EO.  2006.  Neurological letter from Kenya. Practical neurology . 6:261-262.

2005

Amayo, EO, Otieno CF, OGOLA EN, Vaghela V.  2005.  Patterns of homocysteine in Kenyans with type 2 diabetes without overt cardiovascular disease at Kenyatta National Hospital, Nairobi. East Afr Med J. . 82(12):180-183.: African Wildlife Foundation. Nairobi AbstractWebsite

BACKGROUND: Increased total homocysteine (tHcy) is an independent risk factor for cardiovascular disease. The measurement of tHcy in blood is therefore of potential great importance especially in patients with type 2 diabetes. OBJECTIVE: To determine the total homocysteine levels in ambulatory patients with type 2 diabetes. DESIGN: Cross-sectional, prospective study. SETTING: Outpatient diabetic clinic of the Kenyatta National Hospital. SUBJECTS: Ambulatory patients with Type 2 diabetes without overt cardiovascular, renal, liver or other chronic disease. MAIN OUTCOME MEASURES: Serum levels of tHcy, HbA1c, lipids and socio-demographic characteristics. RESULTS: A total of 115 patients, 48% males, with type 2 diabetes were included in the study. The mean (sd) age of the males was 56.85 (8.96) years and of the females was 55.68 (8.93) years. The mean (sd) total serum homocysteine for males of 12.97 (6.06) micromol/l was significantly higher than that of the females of 10.64 (4.41) micromol/l. The cholesterol, glycated haemoglobin, the body mass index and blood pressure of the study subjects did not show any statistically significant influence on their homocysteine levels. However, increasing age and duration of diabetes showed a significant linear relationship with rising level of total serum homocysteine. Some study participants reported smoking habit but unreliably. CONCLUSION: There was a significant proportion of the study patients with high levels of serum homocysteine, although most of them were of low to intermediate risk category. It may be prudent to assay homocysteine levels in patients with type 2 diabetes who are either older or have had diabetes for long duration for potential intervention.

Otieno, CF, Mwendwa FW, Vaghela V, OGOLA EN, Amayo EO.  2005.  Lipid profile of ambulatory patients with type 2 diabetes mellitus at Kenyatta National Hospital, Nairobi.. East Afr Med J. . 82(12):180-183.: African Wildlife Foundation. Nairobi AbstractWebsite

BACKGROUND: Patients with type 2 diabetes are at high of cardiovascular events because they have abnormal lipid status compared to their non-diabetic counterparts. OBJECTIVE: To determine the quantitative lipid profile of ambulatory patients with type 2 diabetes mellitus. DESIGN: Prospective, cross-sectional descriptive study. SETTING: Out-patient diabetic clinic of the Kenyatta National Hospital. SUBJECTS: Ambulatory patients with type 2 diabetes but without obvious cardiovascular, renal or foot complications. RESULTS: A total of 213 patients with type 2 diabetes were studied, 56.8% were females. The age range of the study population was 34 to 86 years, mean(sd) age of females was 54.45 (9.4) years and that of males was 55.83 (9.3) years. The mean body mass index (BMI) of females was 27.85 (6.2) kg/m2 and 25.98 (5.8) kg/m2 for males. The female subjects were more obese than the males in this study. Over 70% of the study participants had total cholesterol > 4.2 mmol/l, 43.8% and 57.6% of the females and males respectively had LDL-C > 2.6 mmol/l , 25.6% of the females and 30% of the males had HDL-C < 1.00 mmol/l. Only a modest proportion of males (28.3%) and females (32.2%) had triglycerides > 1.7 mmol/l. The LDL-C showed a significant positive correlation with age, duration of diabetes, fasting blood glucose, and total cholesterol but no correlation with glycated haemoglobin, body mass index, gender and the mode of glucose-lowering treatment. CONCLUSION: There was significant proportion of quantitative dyslipidaemia in the study population especially with the Total–and LDL- cholesterols. Although treatment goals and lipid thresholds for cardiovascular risk in diabetes are not yet well-defined, even by the large randomized trials, high-risk patients with significant quantitative dyslipidaemia would require deliberate effort to correct the abnormal values to reduce the risk status. These high-risk patients without complications but already had significant dyslipidaemia, which enhances the risk of cardiovascular events, certainly required therapeutic intervention.

Lwai-Lume, L, Ogutu EO, Amayo EO, Kariuki S.  2005.  Drug susceptibility pattern of Helicobacter pylori in patients with dyspepsia at the Kenyatta National Hospital, Nairobi. : African Wildlife Foundation. Nairobi Abstract

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

OLONDE, PROFAMAYOERASTUS, FREDRICK DROTIENOCF.  2005.  Mwendwa FM, Otieno CF, Kayima JK, Amayo EO, Otieno PO.Risk factor profile and the occurrence of microvascular complications in short-term type 2 diabetes mellitus at Kenyatta National Hospital, Nairobi.East Afr Med J. 2005 Dec;82(12 Suppl):S163-72. East Afr Med J. 2005 Dec;82(12 Suppl):S163-72. : African Wildlife Foundation. Nairobi Abstract
BACKGROUND: Type 2 diabetes has a long pre-clinical period before diagnosis, during which there may be development of complications, both of microvascular and macrovascular types. OBJECTIVE: To determine the risk factor profile of hyperglycaemia, hypertension and dyslipidaemia in patients with short-term (=/ < 2 years) type 2 diabetes. DESIGN: Cross-sectional descriptive study over six months. SETTING: Outpatient diabetic clinic of Kenyatta National Hospital. SUBJECTS: Ambulatory patients with type 2 diabetes. RESULTS: One hundred patients were included. The mean (SD) duration of diabetes was 10.3 (7.5) months. There were 66% of the study subjects with obesity, 50% with hypertension, 29% had ideal glucose control and less than 40% had high LDL-cholesterol. Twenty eight (28%) who had polyneuropathy had significant differences in their older age, higher total and LDL-cholesterol compared with those who did not have polyneuropathy. Twenty five (25%) of the study patients had micro-albuminuria and only 1% had macro-albuminuria. There were no significant differences in the selected characteristics between study patients with and those without albuminuria. Only 7% of the study patients had retinopathy on direct ophthalmoscopy. CONCLUSION: Microvascular complications occurred in patients with type 2 diabetes of short duration of not more than two years. The risk factors of hypertension, poor glycaemic control, dyslipidaemia and cigarette smoking were present in a fair proportion of the study patients. Patients with type 2 diabetes should be actively screened for complications and the risk factors thereof, even if the diabetes was of recent onset.

2003

Otieno, CF, Amayo EO, MCLIGEYO SO, Nyamu PN.  2003.  Risk factors and prevalence of diabetic foot ulcers at Kenvatta National Hospital, Nairobi. Abstract

Diabetic foot ulcers contribute significantly to the morbidity and mortality of patients with diabetes mellitus. The diabetic patients with foot ulcers require long hospitalisation and carry risk of limb amputation. The risk factors for developing diabetic foot ulcers are manageable. In Kenya there is paucity of data on such risk factors. Objective: To determine the prevalence of diabetic foot ulcers and the risk factors in a clinic-based setting . Design: Cross-sectional study. Setting: Kenyatta National Hospital, Kenya. Subjects: Patients with both type 1 and 2 diabetes mellitus who had active foot ulcers in both outpatient and inpatient units. Main outcome measures: Diabetic foot ulcers glycated haemoglobin, neuropathy, peripheral vascular disease and fasting lipid profile. Results: One thousand seven hundred and eighty eight patients with diabetes mellitus were screened and 82(4.6%) were found to have foot ulcers. The males and females with diabetic foot ulcers were compared in age, duration of foot ulcers, blood pressure, glycaemic control, neurological disability score and their proportion. Diabetic foot ulcers occurred mostly in patients who had had diabetes for a long duration. The types of (occurence) ulcers were neuropathic (47.5%), neuroischaemic (30.5%) and ischaemic (18%). The neuropathic ulcers had significantly poorer glycaemic control compared to other types and the longest duration (23.3 weeks). Ischaemic ulcers had significantly higher total cholesterol and diastolic blood pressure compared to other ulcer types. Wagner stage 2 ulcers were the commonest (49.4%) but stage 4 ulcers had their highest neuropathic score (7.8/10) and longest duration (23.6weeks). Aerobic infective pathogens were isolated from 73.2% of the ulcers. Conclusion: The prevalence of diabetic foot ulcers was 4.6% in this tertiary clinic. The risk factors of diabetic foot ulcers in the study were poor glycaemic control, diastolic hypertension, dyslipidaemia, infection and poor self-care. These findings are similar to studies done in other environments and they are modifiable to achieve prevention, delay in formation or improved healing of foot ulcers in patients with diabetes. Therefore, specific attention should be paid to the management of these risk factors in patients with or without diabetes foot ulcers in this clinic.

OLONDE, PROFAMAYOERASTUS.  2003.  Hooker JA, Muhindi DW, Amayo EO, Mc'ligeyo SO, Bhatt KM, Odhiambo JA Diagnostic utility of cerebrospinal fluid studies in patients with clinically suspected tuberculous meningitis. Int J Tuberc Lung Dis. 2003 Aug;7(8):787-96.. Int J Tuberc Lung Dis. 2003 Aug;7(8):787-96.. : African Wildlife Foundation. Nairobi Abstract
OBJECTIVE: To compare yields of cerebrospinal fluid (CSF) studies in the diagnosis of tuberculosis meningitis (TBM). DESIGN: Prospective laboratory study, Kenyatta National Hospital, Kenya. STUDY POPULATION: Consecutive patients with 1) headache, neck stiffness and altered consciousness for more than 14 days, 2) above features plus evidence of tuberculosis elsewhere in the body, and 3) on standard antimeningitic drugs for one week without response, were included. Those with contraindications to lumbar puncture, confirmed causes of meningitis (except TB) and on anti-tuberculosis treatment were excluded. METHODS: CSF cell counts, glucose and protein were assayed. CSF was stained on ZN, cultured on LJ and BACTEC and subjected to PCR and LCR for Mycobacterium tuberculosis DNA sequences. Positive tests for M. tuberculosis were classified as definite and the rest as probable TBM. RESULTS: Fifty-eight patients with a mean age of 33.0 years were recruited. Mean CSF cell count was 71/microl and CSF lymphocyte count up 67%. Mean CFS protein and glucose were 2.10 g/l and 2.05 mmol/l, respectively. BACTEC was positive in 20 cases, LJ 12, LCR eight, and PCR and ZN one each. Twenty-six patients had definite and 32 probable TBM. Patients with definite TBM had significantly higher CSF protein, lower CSF glucose, higher CSF cell count and lower CSF lymphocytes. CONCLUSION: TBM can be confirmed in half of clinically suspected cases. More sensitive tests for confirmation of TBM are required.

2002

OLONDE, PROFAMAYOERASTUS, O DRKWASATHOMASO.  2002.  Amayo EO, Kwasa TO, Musau CK, Mugo N, Wambani J. Primary intracerebral haemorrhage complicated by cerebral abscess: case report. East Afr Med J. 2002 Mar;79(3):163-4.. East Afr Med J. 2002 Mar;79(3):163-4.. : African Wildlife Foundation. Nairobi Abstract
A case of primary intracerebral haemorrhage complicated by cerebral abscess is presented with a review of the literature.
N, PROFLULEGODFREY, OLONDE PROFAMAYOERASTUS.  2002.  Lule GN, Amayo EO. Irritable bowel syndrome in Kenyans. East Afr Med J. 2002 Jul;79(7):360-3.. East Afr Med J. 2002 Jul;79(7):360-3.. : African Wildlife Foundation. Nairobi Abstract

OBJECTIVE: To study the prevalence and clinical presentation of irritable bowel syndrome (IBS) in black Kenyans. DESIGN: A retrospective study. SETTING: Nairobi Hospital, an urban private institution. SUBJECTS: Case files of all patients presenting with abdominal pain. MAIN OUTCOME MEASURES: Prevalence of IBS using modified Manning's Symptomatic criteria in 223 consecutive adult patients presenting with abdominal pain and discomfort who had normal clinical findings and normal general and gastrointestinal investigations. RESULTS: Out of the 3472 patient files screened, there were 281 patients who fitted the diagnosis of irritable bowel syndrome giving an overall prevalence of 8%. The mean age was 40 years with range of 11 to 75 years with a peak prevalence in the 3rd decade. The male to female ratio of 1.4:1 being statistical significant at a p-value of 0.010. There was no statistical significant difference between the males and females in constipation and diarrhoea at p-value of 0.84 and 0.82 respectively. Fifteen percent of the patients were either on antidepressants or had been seen by a psychiatrist. Nine percent had undergone laparatomy for the abdominal pain. CONCLUSION: The Black African patient is equally as exposed to irritable bowel syndrome as is his counterpart in the western world and has similar morbidity patterns. The syndrome may account for over 10% of patients with abdominal pain presenting to gastroenterologists in Africa. Proper attention to symptomatology may lead to clinching the diagnosis without resorting to many unnecessary and expensive investigations.

OLONDE, PROFAMAYOERASTUS.  2002.  Amayo EO, Kayima JK, Joshi MD.OBJECTIVE: Platelet functions in patients with meningococcal meningitis at the Kenyatta National Hospital, Nairobi. East Afr Med J. 2002 Aug;79(8):405-7.. East Afr Med J. 2002 Aug;79(8):405-7.. : African Wildlife Foundation. Nairobi Abstract
OBJECTIVE: To determine platelet abnormalities in patients with menigococcal meningitis. DESIGN: Case control study. SUBJECTS: Fifty seven cases of mennigococcal meningitis based on a cerebrospinal fluid gram stain for gram negative diplococcus or positive culture were recruited. Fifty-seven controls matched for age and sex were also recruited. The following platelet functions tests were performed; platelet counts, platelet adhesiveness, platelet aggregation and clot retraction. RESULTS: Fifty seven patients (41 males and 16 females) with meningococcal meningitis were studied. Their mean age was 25.5 +/- 8.32 years with a range of 15 to 45 years. Five patients had purpura, four peripheral gangrene, eight conjunctival haemorrhages and one was in shock. There was a statistical significant difference in the platelet aggregation and clot retraction between the patients and controls at p-values of 0.0001 and 0.0002 respectively. There was no significant difference in the platelet count and adhesiveness between the patients and the controls at a p-value of 0.203 and 0.22 respectively. No association was found between the platelet functions and the clinical presentations. CONCLUSION: Patients with meningococcal meningitis have abnormalities in the platelet functions mainly in aggregation and adhesiveness
OLONDE, PROFAMAYOERASTUS.  2002.  Mary-Jo DelVecchio Good, Amayo E O, Machoki J. M, Mwaikambo E. Clinical realities and moral dilemmas. Contrasting perspectives from Academic medicine in Kenya, Tanzania and America Journal Of the American Academy of Arts and Sciences 2000: Vol 128,6,167-1. Journal Of the American Academy of Arts and Sciences 2000: Vol 128,6,167-196.. : African Wildlife Foundation. Nairobi Abstract
A case of primary intracerebral haemorrhage complicated by cerebral abscess is presented with a review of the literature.
OLONDE, PROFAMAYOERASTUS, FREDRICK DROTIENOCF.  2002.  Amayo E. O, Kwasa T. O, Otieno C. F Herpes zoster myelitis: report of two cases East African Medical Journal 2002: Vol.79,5,;279-280. East African Medical Journal 2002: Vol.79,5,;279-280. : African Wildlife Foundation. Nairobi Abstract
Two male patients aged 40 and 45 years with HIV infection and paraplegia are presented. The two had sub-acute onset paraplegia with a sensory level, which developed 10 days after herpes zoster dermatomal rash. They both had asymmetrically involvement of the lower limbs. Investigation including imaging of the spinal cord did not reveal any other cause of the neurological deficit. The two responded very well to treatment with acyclovir. Herpes zoster myelitis is a condition likely to rise with the upsurge of HIV infection and there is a need to identify the condition early. We also review the literature on the subject.
OLONDE, PROFAMAYOERASTUS.  2002.  Amayo E. O, Kwasa T. O, Musau C. K, Mugo G, Wambani. J. Primary intracerebral hemorrhage complicated by cerebral abscess: Case report and review of literature East African Medical Journal 2002.Vol 79,3;163-164. East African Medical Journal 2002.Vol 79,3;163-164. : African Wildlife Foundation. Nairobi Abstract
A case of primary intracerebral haemorrhage complicated by cerebral abscess is presented with a review of the literature.
OLONDE, PROFAMAYOERASTUS.  2002.  Nyamu PN, Otieno CF, Amayo E O, McLigeyo SO:Risk factors and prevalence of Diabetic foot ulcers at Kenyatta National Hospital , Nairobi East African Medical Journal 2002 Vol. 80 1,36-43. East African Medical Journal 2002 Vol. 80 1,36-43. : African Wildlife Foundation. Nairobi Abstract
BACKGROUND: Diabetic foot ulcers contribute significantly to the morbidity and mortality of patients with diabetes mellitus. The diabetic patients with foot ulcers require long hospitalisation and carry risk of limb amputation. The risk factors for developing diabetic foot ulcers are manageable. In Kenya there is paucity of data on such risk factors. OBJECTIVE: To determine the prevalence of diabetic foot ulcers and the risk factors in a clinic-based setting. DESIGN: Cross-sectional study. SETTING: Kenyatta National Hospital, Kenya. SUBJECTS: Patients with both type 1 and 2 diabetes mellitus who had active foot ulcers in both outpatient and inpatient units. MAIN OUTCOME MEASURES: Diabetic foot ulcers glycated haemoglobin, neuropathy, peripheral vascular disease and fasting lipid profile. RESULTS: One thousand seven hundred and eighty eight patients with diabetes mellitus were screened and 82 (4.6%) were found to have foot ulcers. The males and females with diabetic foot ulcers were compared in age, duration of foot ulcers, blood pressure, glycaemic control, neurological disability score and their proportion. Diabetic foot ulcers occurred mostly in patients who had had diabetes for a long duration. The types of (occurence) ulcers were neuropathic (47.5%), neuroischaemic (30.5%) and ischaemic (18%). The neuropathic ulcers had significantly poorer glycaemic control compared to other types and the longest duration (23.3 weeks). Ischaemic ulcers had significantly higher total cholesterol and diastolic blood pressure compared to other ulcer types. Wagner stage 2 ulcers were the commonest (49.4%) but stage 4 ulcers had their highest neuropathic score (7.8/10) and longest duration (23.6 weeks). Aerobic infective pathogens were isolated from 73.2% of the ulcers. CONCLUSION: The prevalence of diabetic foot ulcers was 4.6% in this tertiary clinic. The risk factors of diabetic foot ulcers in the study were poor glycaemic control, diastolic hypertension, dyslipidaemia, infection and poor self-care. These findings are similar to studies done in other environments and they are modifiable to achieve prevention, delay in formation or improved healing of foot ulcers in patients with diabetes. Therefore, specific attention should be paid to the management of these risk factors in patients with or without diabetes foot ulcers in this clinic.
OLONDE, PROFAMAYOERASTUS.  2002.  Amayo EO, Jowi JO, Njeru EK.Headache associated disability in Medical students at the Kenyatta National Hospital East African Medical Journal 2002 Vol. 79,10,519-523. East African Medical Journal 2002 Vol. 79,10,519-523. : African Wildlife Foundation. Nairobi Abstract
OBJECTIVE: To study headache associated disability in a group of medical students at the Kenyatta National Hospital. STUDY DESIGN: Cross sectional survey. RESULTS: Between October 1994 and January 1995 we conducted a survey on headache characteristics on medical students at both the Kenya Medical Training Centre and the Medical School of the University of Nairobi. Six hundred and twenty-five (87%) of the 711 students surveyed admitted having had at least one episode of headache in the last six months. Using the International headache society (IHS) case criteria 314 students (50%) had tension type headache, 240 (38%) migraine headache and 71(12%) unclassified headache. Eighty-six percent of the students with headache had their working ability disturbed to various degrees. Eighty-five percent of the students reported that their social activities were interfered with by headache. Migraine headaches had the greatest impact on both the working and social activities at a p-value of 0.0005 and 0.0004 respectively. One hundred and forty-one students (23.6%) had missed at least one day of work or school in the last one-year as a direct result of the headache. There was an association between headache severity with working ability and social effect. There was no association between the days students missed work or classes with the severity of the headache. No gender difference was found in the headache associated disability. CONCLUSION: Headache is a prevalent condition with disability both in working and social activities

1998

OLONDE, PROFAMAYOERASTUS.  1998.  Amayo EO, Kayima JK, Amayo AA. Transient Focal neurological deficits in patients with hypoglycemia and hyperglycemia; report of 4 cases East African Medical Journal 1998:Vol.75;53-54. East African Medical Journal 1998:Vol.75;53-54. : African Wildlife Foundation. Nairobi Abstract
A case of hypoglycaemia and three cases of hyperglycaemia presenting with focal neurological deficits are presented. The focal presentations were hemiparesis and focal convulsion that returned to normal upon correction of the blood sugar. Elderly patients not uncommonly present with transient focal neurologic deficits related to abnormalities in blood sugar levels. In these patients correction of blood sugar levels per se may ameliorate symptoms and signs making it unnecessary to investigate for cerebrovascular disease. In diabetic patients on insulin or oral hypoglycaemic agents focal neurologic deficit should alert the clinician on the possibility of hypoglycaemia.

1996

OLONDE, PROFAMAYOERASTUS.  1996.  McLigeyo SO, Oiiech J, Rana FS, Amayo EO, Monda SM.Renal vein and intracaval invasion by an adrenal phaeochromocytoma with extension Into the right atrium: a case study. Afr J Health Sci. 1996 May;3(2):60-3.. East African Medical Journal 1996: Vol 73;594-597. : African Wildlife Foundation. Nairobi Abstract
A 30 year old female with an unexpected right adrenal phaechromacytoma invading the renal vein, the inferior vena cava and extending into the right atrium is presented. She also had BuddChiari syndrome due to invasion of the hepatic veins by the tumour. Additionally, the tumour had metastasised to the liver and the lungs. Despite elevated 24 hour urinary vanillylmandelic acid (VMA) the patient was normotensive pre-operatively. The patient underwent right adrenalectomy and extended nephrectomy with milking of the tumaur from the inferior vena cava. Unfortunately, the patient developed multiple hypotensive episodes and adult respiratory distress syndrome post-operatively and died three weeks after surgery.
OLONDE, PROFAMAYOERASTUS.  1996.  Amayo EO, Jowi JO, Njeru EK. Migraine headaches in a group of medical students at the Kenyatta National Hospital Nairobi East African Medical Journal 1996: Vol 73;594-597. East African Medical Journal 1996: Vol 73;594-597. : African Wildlife Foundation. Nairobi Abstract
A survey was carried out on 711 medical students from both the medical school and the Kenya Medical Training Centre on headaches using a closed ended questionnaire. Six hundred and twenty five (88%) of the students reported to have at least one episode of headache in the last six months. Two hundred and forty (33.8%) of these were classified as migraine using the International Headache Society case definition. Seventy (29%) had migraine with aura, the rest being migraine without aura. The mean age was 22.7 +/- 5 years with a male to female ratio of 1:1.3. The majority of the respondents (43%) had an average of two to three headache episodes per month. The major triggering factors for the headache were physical activities, emotional disturbance and studying, each occurring in 21% of the student respondents. It was reported by 43.6% of the respondents that there was a member of their nucleus family with a similar headache. Only 40% of the respondents had sought medical attention for their headache in the last one year. The main reason for not seeking medical services was self medication in 56% of those who did not attend medical services. Only 27 (11%) of the respondents were currently on medication which consisted of simple analgesics and antimalarials. There were only two students who were on specific drugs for migraine. The majority of the respondents continued to be inadequately treated despite the development of wide range of effective treatment.
OLONDE, PROFAMAYOERASTUS.  1996.  Mbuya SO, Kwasa TO, Amayo EO, Kioy PG, Bhatt SM.Peripheral neuropathy in AIDS patients at Kenyatta National Hospital. East Afr Med J. 1996 Aug;73(8):538-40.. East African Medical Journal 1996: Vol 73;594-597. : African Wildlife Foundation. Nairobi Abstract
Between June and December 1992 forty AIDS patients as defined by the CDC criteria, admitted to the medical wards of the Kenyatta National Hospital, were studied to determine the prevalence and pattern of peripheral neuropathy. Their mean age was 33 +/- 3 years with a range of 16 to 55 years. Clinical and laboratory assessment were carried out both to confirm peripheral neuropathy and exclude other causes of peripheral neuropathy apart from AIDS. All the patients had nerve conduction and electromyographic studies done. Eighteen patients were asymptomatic while fourteen had both signs and symptoms. The commonest symptom was painful paresthesiae of the limbs (35%) while the commonest sign was loss of vibration sense (60%). When symptoms, signs, and electrophysiological studies were combined, all the patients fitted the definition of peripheral neuropathy. The commonest type of peripheral neuropathy was distal symmetrical peripheral neuropathy (DSPN) (37.5%). PIP: In Kenya, physicians evaluated 40 AIDS patients admitted to Kenyatta National Hospital during June-December 1992 to determine the prevalence and types of peripheral neuropathy in AIDS patients. 75% were 21-40 years old. 18 (45%) of the 40 AIDS patients had symptoms of peripheral neuropathy. Symptoms included increased sensitivity to stimulation (43%), hyperpathia (15%), and muscle or limb weakness (13%). 26 AIDS patients had signs of peripheral neuropathy, especially impaired sense of vibration (60%). 14 of these patients had both signs and symptoms. Electromyographic and nerve conduction velocity revealed peripheral neuropathy in 16 (40%) AIDS patients. The types of peripheral neuropathy included distal symmetrical peripheral neuropathy (37.5%), polyneuropathy, and mononeuritis multiplex. When the symptoms, signs, and electroneurophysiological test findings were considered, all 40 AIDS patients had evidence of peripheral neuropathy.

1995

Lindley, RI;, Amayo EO;, Marshall J;, Sandercock PA;, Dennis M;, Warlow CP.  1995.  Hospital services for patients with acute stroke in the United Kingdom: the Stroke Association Survey of consultant opinion.. Abstract

A national postal survey of all UK hospital consultant geriatricians, general physicians and neurologists was performed in 1992/3 in order to describe the provision of hospital stroke services in the United Kingdom and to assess whether the recommendations of the King's Fund consensus conference on stroke had been widely implemented. Of 3478 survey forms, 2923 (84%) were returned and, of these 1953 (67%) consultants indicated that they routinely cared for patients with acute stroke. On their stated estimates, the survey respondents had admitted approximately 107,000 patients with acute stroke in the previous year, 40% of whom were cared for by geriatricians. Sixty-three per cent (1239/1953) worked in District General Hospitals. Few (5%) had access to an acute stroke unit, and a majority (51%) of consultants were uncertain of the benefits of such units. Less than half (44%) had access to a specialized stroke rehabilitation unit, but a majority (68%) were certain of the benefits of stroke rehabilitation units. Although a majority of consultants had on-site CT scanning, about a third of all UK stroke patients were admitted to a hospital without on-site CT facilities. Most (90%) consultants would want a CT scan themselves if they had a stroke. Only about a third of consultants were aware of a recent audit of stroke care in their hospital, or had a hospital policy for the implementation of minimum standards of stroke care, and less than half routinely provided written information for patients or carers. This survey illustrated that five years after the publication of the King's Fund consensus statement on the treatment of patients with acute stroke UK hospital stroke services are still poorly organized. Access to CT scanning for stroke patients is improving, but is still insufficient

OLONDE, PROFAMAYOERASTUS.  1995.  Kwasa T O, Jowi J O, Amayo EO .Efficacy and tolerability of oral sumatriptan in the treatment of acute migraine East African Medical Journal 1995. Vol 72;479. East Afr Med J. 1995 Aug;72(8):479-82.. : African Wildlife Foundation. Nairobi Abstract
An open prospective study of the efficacy and tolerability of oral sumatriptan in the treatment of acute migraine attacks at the Kenyatta National Hospital, Nairobi, Kenya, is presented. Thirty two patients were initially recruited and 24 completed the trial giving a drop-out rate of 25%. The age range was 17 to 55 years with a mean of 35 years. Sumatriptan was found to be effective in 22 (92%) out of 24 patients. Side effects occurred in 38% (9/24) patients. These were mild and transient and included nausea, vomiting, numbness of limbs, fever and a feeling of heat in the head. It is concluded that oral sumatriptan is an effective drug in the treatment of acute migraine headaches. It has few side effects and is well tolerated by majority of patients.
OLONDE, PROFAMAYOERASTUS.  1995.  Lindley RI, Amayo EO, Marshall J, Sandercock PA, Dennis M, Warlow CP.Acute stroke treatment in UK hospitals: the Stroke Association survey of consultant opinion. J R Coll Physicians Lond. 1995 Nov-Dec;29(6):479-84.. J R Coll Physicians Lond. 1995 Nov-Dec;29(6):479-84.. : African Wildlife Foundation. Nairobi Abstract
The aim of the Stroke Association survey was to document United Kingdom consultant opinion of the immediate treatment for patients with acute stroke. A national postal survey of all UK hospital consultant general physicians, geriatricians and neurologist was carried out in 1992/3. We identified 1,953 consultants who routinely cared for patients with acute stroke; 39% of them regularly used aspirin for patients with acute stroke and 10% used low-dose subcutaneous heparin. Other treatments were rarely used. There was much uncertainty about the effectiveness of all currently available acute stroke treatments; 73% of physicians were prepared to start aspirin before a CT scan, but a much smaller proportion would start heparin therapy without one. Twenty-seven percent of consultants would actively treat hypertension in the initial 24 hours after stroke. Routine aspirin for secondary prevention after ischaemic stroke was widely accepted, but blood cholesterol lowering by drugs was not. In conclusion, aspirin and heparin alone are the only routinely used treatments for the immediate treatment of acute stroke; other treatments are used sparingly or not at all. The great uncertainty about the value of all available acute stroke treatments should encourage participation in randomised controlled trials.

1994

OLONDE, PROFAMAYOERASTUS.  1994.  Amayo EO, Kayima J, McLigeyo SO, Kioy PG.Autonomic dysfunction in patients with chronic renal failure.East Afr Med J. 1994 Apr;71(4):253-5.. East Afr Med J. 1994 Apr;71(4):253-5.. : African Wildlife Foundation. Nairobi Abstract
Autonomic nervous function was assessed in twenty two patients (16 males and 6 females) with chronic renal failure on conservative management. The presenting symptoms were postural dizziness in 10(45%), impotence in 4(18%) patients and 1 patient each with diplopia, urinary urgency and nocturnal diarrhoea. The following autonomic function tests were performed; valsalva manoeuvre, heart rate response to deep breathing, heart rate response to posture and postural change in blood pressure. Fifteen (68%) patients had abnormal autonomic function tests. Out of these patients, 14(93%) had abnormalities of the parasympathetic system and only one had abnormalities in the sympathetic system. There was a negative correlation between the creatinine levels and the following; valsalva ratio (r = -0.72 p < 0.001), heart rate response to standing (r = -0.56 p < 0.01) and heart rate response to deep breathing (r = -0.45 p < 0.05).

1993

OLONDE, PROFAMAYOERASTUS.  1993.  Amayo EO, Riyat MS, Okelo GB, Adam AM, Toroitich K.Disseminated histoplasmosis in a patient with acquired immunodeficiency syndrome (AIDS): a case report. East Afr Med J. 1993 Jan;70(1):61-2.. East Afr Med J. 1993 Jan;70(1):61-2.. : African Wildlife Foundation. Nairobi Abstract
A 27 year old female with AIDS and disseminated histoplasmosis is presented. The clinical features include fever, weight loss, productive cough, splenomegaly and moderate pallor. The initial working diagnosis was pulmonary tuberculosis. The diagnosis of disseminated histoplasmosis was made terminally from bone marrow aspirate examination. Disseminated histoplasmosis with its varied clinical picture is likely to be missed in a patient with AIDS, and therefore a high index of suspicion is necessary for diagnosis. PIP: A 27-year old female from Nairobi was admitted to the medical wards of the Kenyatta National Hospital in May 1991. She presented with a 4-week history of productive cough, fever, weight loss, and night sweats. She acknowledged a history of contact with a patient known to have pulmonary tuberculosis. She has never received a blood transfusion. She was single and para 3 + 0. Examination revealed a sick patient, with moderate pallor, fever of 38 degrees Celsius, and who was wasted with moderate dehydration and oral thrush. There was no finger clubbing, lymphadenopathy, or pedal edema. Chest examination revealed bilateral basal pneumonia. The spleen was palpable 4 cm below the costal margin; the liver was not enlarged. The rest of the examination was normal. On admission, complete blood count showed a haemoglobin of 5.4 g/dl, total white cells were 12.5 x 10-9/L, with 82% polymorphonuclear cells and 18% lymphocytes, erythrocyte sedimentation rate (ESR) was 85 mm/hour, and platelet count was normal. The anemia was normocytic, normochromic, and no malaria parasites were seen. Urea and electrolytes and liver function tests were normal. Sputum showed no acid fast bacilli on Ziel-Neelson Stain. HIV-1 antibodies were positive by enzyme-linked immunosorbent assay (ELISA) and Western blot. Bone marrow aspirate revealed a hypercellular marrow with reversed M:E ration, dyserythropoesis, reticulum cell hyperplasia, plentiful golden yellow pigment, and clumps of Histoplasma capsulatum. Chest X-ray showed bilateral basal pneumonia. She was treated with antibiotics and intravenous fluids, but she remained febrile, her general condition progressively deteriorated, and she died a week after admission. Treatment for histoplasmosis had not been commenced, and no postmortem examination was carried out.

1992

OLONDE, PROFAMAYOERASTUS.  1992.  Amayo EO, Owade JN, Aluoch JR, Njeru EK. Neurological complications of Sickle Cell Anaemia at the Kenyatta National Hospital : A 5 year retrospective study East African Medical Journal 1992: 69,660. East African Medical Journal 1992: 69,660. : African Wildlife Foundation. Nairobi Abstract
In a five year retrospective study of 360 patients with homozygous (SS) sickle cell disease, eighteen (5%) were found to have neurological complications. Their ages ranged from 7 months to 21 years with a mean of 11.1 +/- 6 years. Of those with neurological complications, twelve (67%) of the patients had cerebrovascular accident, six (33.3%) convulsions, three visual disturbance; one sensorineural deafness, one cerebellar degeneration and the last one confusion and hallucinations. Four of the patients had multiple neurological complications. There was only one patient with recurrence of neurological complications. Two patients were hypertransfused and up to the end of the study period none of them had any recurrence. The pattern of neurological complications are similar to that observed in other studies. However, in this study, there were fewer recurrences of neurological complications.

1991

OLONDE, PROFAMAYOERASTUS, O DRKWASATHOMASO.  1991.  Amayo EO, Kwasa TO.HIV and acute peripheral facial nerve palsy.East Afr Med J. 1991 Dec;68(12):948-51. East Afr Med J. 1991 Dec;68(12):948-51. : African Wildlife Foundation. Nairobi Abstract
Between April and December 1989, 32 consecutive patients referred to the neurology clinic with acute peripheral facial paralysis were studied. Patients with traumatic facial palsy, parotid gland disease, otitis media and meningitis were excluded. Each of the patients selected had HIV test done by ELISA and the positive ones confirmed by Western blot. 8 (25%) of the patients tested positive for HIV antibodies. Their mean age was 34 +/- 13 years with an age range of 15-53 years. 4 (50%) of the 8 seropositive patients had generalized lymphadenopathy, one herpes zoster, one generalized pruritic rash, two of the patients were asymptomatic. The seroprevalence of HIV antibodies in patients with acute peripheral facial paralysis is much lower than that reported in other African countries. PIP: Between April-December 1989, physicians at the neurology clinic of the Kenyatta National Hospital in Nairobi, Kenya recruited 32 patients who exhibited facial nerve palsy of lower motor neuron type and who did not have any trauma, inflammation of the middle ear, surgery, or disease of the parotid gland. 8 (25%) of the patients were HIV seropositive. Researchers did not retest any of the seronegative patients for HIV. 6 of the HIV seropositive cases had symptoms of early HIV infection: 4 generalized lymphadenopathy, 1 herpes zoster, and 1 generalized pruritic rash. The 2 other HIV seropositive patients did not have any symptoms other than facial paralysis. Several other studies have demonstrated an association between HIV infection and acute peripheral facial paralysis, especially in asymptomatic or AIDS related complex patients. In a study in Bangui, Central African Republic, HIV seroprevalence among patients with acute peripheral facial paralysis was 69%. The researchers could not identify the reason for the difference between the HIV seroprevalences of the 2 studies. Nevertheless physicians should expect to treat more cases of acute peripheral facial paralysis as the prevalence of HIV increases

1990

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

1988

Amayo, EO.  1988.  Clinical manifestation of Acquired Immune Deficiency Sydrome in adults as seen at the Kenyatta National Hospital. Abstract

50 confirmed AIDS patients admitted in the medical wards between March to December, 1987 were studied. Male to female ratio was 1:5:1. The mean age was 31 - 7 years. Females had an earlier peak at 21 - 25 years as compared to the males at 26 - 30 years. The commonest risk factor was heterosexual contact with multiple partners in 80% of the cases. The patients were of low socio-economic status. The commonest general signs and symptoms were unexplained weight loss in 92%, fever in 66% and generalized lymphnode enlargement in 24% of the cases. In the gastrointestinal system the cornnonestsigns and symptoms were oral thrush 66%, chronicdiarrhoea 60% and dysphagia in 50%, of the cases. 46% of the patients had chronic cough. The most significant radiological finding in the abnormalchest x-ray was pleural effussion in 50% of the cases. The central nervous system was involved in 36% of cases with meningitis being the commonest sign accounting for 28% of all the central nervous system signs.10% of the cases had Kaposi's sarcoma on histology of which 60% were of the aggressive form. The commonest skin manifestation was maculo-papular pruritic skin rash 56% of all the patients had hemoglobin less than 10g.dl.

OLONDE, PROFAMAYOERASTUS.  1988.  M. Med(Internal Medicine) Dissertation 1988. East Afr Med J. 1990 May;67(5):355-8.. : African Wildlife Foundation. Nairobi Abstract
Forty one consecutive patients (24 males and 17 females) with AIDS had their blood assayed for HBsAg, anti-HBs and anti-HBc by Reversed Passive Haemagglutination (RPHA), Passive Haemagglutination (PHA) and Enzyme Linked Immunosorbent Assay (ELISA) techniques respectively. 5 (12.2%) were found positive for HBsAg. 10 (24.4%) for anti-HBs and 31 (75.6%) for anti-HBc. 32 (78%) out of 41 patients with AIDS had serological evidence of exposure to hepatitis B virus (HBV). The prevalence of HBsAg found in this study is not different from what has been found in the Kenyan community without AIDS, while that of anti-HBs is much lower than what has been reported in the general community.

1981

Huang, TT; Lewis, SR, Amayo E;, Lewis SR.  1981.  A histological study of the lower tarsus and the significance in the surgical management of a involutional (senile) entropion. Abstract

The dimension of the lower tarsus diminishes with aging. Changes in the number and size of the meibomian glands and in the character of intermingling fibroconnective tissues are thought to be responsible. Furthermore, such alterations of the structural integrity play an important role in the pathogenesis of entropion encountered commonly in the elderly. We have advocated the use of an autogenous cartilage graft harvested from the ear to correct the deformity, especially in instances where the conventional methods of correction have failed.

UoN Websites Search