1. Julius Ogeng’o, is a Professor of Human Anatomy and Deputy Vice Chancellor Academic Affairs University of Nairobi. He is a Medical Doctor specialized in Human Anatomy, and holds BSc, MBChB, PhD, MD and DSc degrees from the University of Nairobi.

2. Prof. Ogeng’o is an accomplished researcher and fluent author with hundreds of scientific publications in peer reviewed journals. The publications cover vascular anatomical variations, vascular structure, cardiovascular pathology, neuropathology and stroke, human variability and general contemporary health issues including COVID-19. He is the Editor – in – Chief of the Anatomy Journal of Africa.

3. Julius Ogeng’o is a seasoned Human Anatomy teacher who has authored the dissection manuals and texts used by Undergraduate and Postgraduate medical students. He is also the author of OG Anatomy.org, one of the best online Human Anatomy learning platforms. He has supervised and mentored thousands of undergraduate and postgraduate students.

4. He is former Director of the University of Nairobi's Centre for Self Sponsored Programmes, Managing Director of University of Nairobi Enterprises and Services; and Chairman of Department of Human Anatomy. He has wide management experience, characterized by extensive knowledge, skills and competencies in strategic frameworks for administration of University Education, resource management; visionary and transformative result oriented leadership, management of academic programmes, managerial skills, strategy formulation and implementation.


Prof. Ogeng'o Julius A.

1. Julius Ogeng’o, is a Professor of Human Anatomy and Deputy Vice Chancellor Academic Affairs University of Nairobi. He is a Medical Doctor specialized in Human Anatomy, and holds BSc, MBChB, PhD, MD and DSc degrees from the University of Nairobi.

Prof. Ogeng'o Julius A.



J, O’o, BN B, V M, I C.  2022.  The Unusual High Origin Radial Artery in a Black Kenyan Population; a Cadaveric Study. Ethiop J Health SCI. 32(2):445-452. Abstract223352-article_text-545874-1-10-20220328.pdfWebsite

BACKGROUND: The anatomy of the radial artery draws great interests among anatomists for its frequent involvement in variations. Equally, these variations have gained significant attention from clinicians because of the preference to use the radial artery for catheterization. The commonest of radial artery variations involve its site of origin. In published literature, data on this variations exist, but the prevalence of such variations in a Kenyan population has hitherto been unknown.
METHODS: Sixty-two upper limbs from 50 formalin-fixed cadavers were studied during dissection in the Department of Human Anatomy, University of Nairobi.
RESULTS: Fifty-four (87.1%) radial arteries arose within the cubital fossa, while eight (12.9%) had a high origin. Out of the eight high arteries, two (3.2%) branched off from the axillary artery, another two (3.2%) were branches of the proximal third of the brachial artery and four (6.5%) arose from the middle third of the brachial artery. The high origin radial arteries were more common on the right upper limbs (5 out of the 8 cases). Both axillary and brachial origins were seen bilaterally.
CONCLUSION: The present study details important variations in the anatomy of the radial artery in a Kenyan population. With the radial artery being utilized during clinical, surgical and radiological interventions so frequently, an increased understanding and anticipation of such topographic variances is paramount.

J, O’o, J M, I O, T A.  2022.  Anatomical Variations of the Fifth Lumbar Artery in a sample Kenyan population. Ann Afr surg. 19(2):100-107. AbstractWebsite

Background: Anatomical variations of lumbar arteries predispose them to iatrogenic injury during endovascular intervention or surgery. Due to limited morphological data on lumbar arteries in our setting, we aimed to determine their variant anatomy among Kenyans.

Methods: We performed the study on 90 cadaveric specimens and 120 computed tomography (CT) scans. Cadavers were dissected to expose the aorta and the lumbar arteries emerging from them. The number, origins, location relative to the vertebral bodies, and relations to aortic bifurcation were determined in cadavers and CT scans. Data were analyzed using SPSS (version 21.0).

Results: On average, 3 (3/90 [3.3%]), 4 (63/90 [70%]) or 5 (24/90 [26.7%]) pairs of lumbar arteries were observed among the cadaveric specimens, whereas 4 (100/120 [83.3%]) or 5 (20/120 [16.7%]) pairs were observed in CTs. Differences in the number of pairs observed in the cadaveric versus CT study were not statistically significant (P = .542). There were no sex differences in the number of lumbar artery pairs observed in CT scans (P = .178). The first 3 lumbar artery pairs had a single-origin, whereas the fourth lumbar artery had a common-stem origin. The first, second, and third lumbar arteries mostly originated at the upper third of their respective vertebral bodies. The fourth lumbar artery predominantly originated at the lower third.

Conclusion: Our study's findings show unique variation in the lumbar arteries' relation to the vertebral bodies and the distances between artery pairs.

Level of evidence: IV (cross-sectional study).

Clinical relevance: Variations in the anatomy of the lumbar arteries should be taken into consideration, especially in surgical or interventional procedures to avoid inadvertent injury of the vessels.


FW, N, K O, A A, J O, GW A.  2021.  Multiple Cytokines Elevated in Patients with Keloids: Is It an Indication of Auto-Inflammatory Disease? J. Inflam Res. 14(7):2465-2470. AbstractWebsite

Background: Inflammation seems to play a major role in the pathophysiology of keloids. However, the role of cytokines in keloid pathophysiology has not been fully evaluated with only a few cytokines studied. We undertook this study to compare various cytokines in patients with keloids and a control group of patients without keloids nor family history of keloids so as to determine which cytokines are elevated and could thus be critical in keloid formation.

Methods: This was a cross-sectional study of patients with keloids and a control group of those without. Patients in both groups were matched for age, sex and body mass index. Their plasma was analyzed for both inflammatory and anti-inflammatory cytokines using the Bio-flex ElisaTM method. Comparisons of cytokines means in both groups were done using Student's t-test.

Results: A total of 84 participants with 42 participants in each group were followed during the study. Male to female ratio was 1:2. Age ranges were similar with a mean of 29.6 years. A total of 28 cytokines were assayed. Statistically significant differences were noted in 15 of the 28 cytokines assayed with 11 being elevated more in keloid patients with only four in the non-keloid forming group. Among elevated cytokines in keloid patients were granulocyte colony-stimulating factors, granulocyte-monocyte-colony-stimulating factors, interleukins 4, 6 and 13.

Conclusion: Patients with keloids have significantly higher cytokines compared with non-keloid forming patients. This finding suggests that keloid formation could be influenced by multiple inflammatory cytokines, an indication that the patient's immune system could play a role in keloid formation akin to auto-inflammatory disease.

JW, G, J O’o, P G.  2021.  Pattern and Clinical Presentation of Endometriosis Among the Indigenous Africans. J Gynecol Obstet . 9(9):92-99. AbstractWebsite

Background: Endometriosis is enigmatic clinical entity which is described as the existence of the endometrial tissue external of the uterine cavity. Endometriosis constitutes a serious health issue due to its high affliction of 10% in reproductive age women and its clinical manifestation of infertility and chronic pelvic pain. Despite of years of research, the causative factor and understanding of ambidextrous endometriosis pathology remains elusive, perplex and disconnected. Worldwide, there is clear documentation of prevalence of endometriosis in the development countries, however, the prevalence of endometriosis in most of black Africa is unknown. The current perspective is that indigenous African are rarely affected by endometriosis. Objective: To determine the prevalence, pattern and clinical presentation of endometriosis in indigenous African women with the primary outcome measure being the prevalence of laparoscopic visually diagnosed, histologically confirmed endometriosis and clinical presentation. Methodology: This was a prospective analytical cross-selection study in 2 hospitals in Nairobi city, Kenya. The sample size was 443 women and the duration of the study was from March 2018 to March 2021. The inclusion criteria was women aged at least 18 years up to 49 years undergoing laparoscopic surgery and willing to take part in the study. The patient’s history, clinical and laparoscopic findings and histological diagnosis were recorded and analysed using Social SPSS version 22.0. Results: The mean age of the 443 patients recruited was 33 years. The prevalence of histological confirmed endometriosis in indigenous Africans was 6.8%. Laparoscopic visualization diagnosis had a positive predictive value of 39%. Dysmenorrhoea, chronic pelvic pain scale 8-10 and dyspareunia were significant symptoms of endometriosis P<0.001. Nulliparous patients significantly had a risk of having endometriosis p<0.001. The patients with menarche at 13 years and below had a significant risk of having endometriosis p=0.001. Physical findings on clinical examination of adnexal tenderness and findings of nodules in the pouch of Douglas were significant in relation to endometriosis p<0.001. The most common site of the histological endometriosis implants were on the Pouch of Douglas (30%) and the most common form of endometriosis was superficial (43%). Conclusion: The prevalence of endometriosis in Indigenous Africa is 6.8%. Laparoscopic visualization diagnosis had low a positive predictive value of 39%. Nulliparity, menarche at the age of 13 and below, dysmenorrhoea, chronic pelvic pain scale 8-10 and dyspareunia were significantly associated with endometriosis. The most common site for endometriosis is the of Pouch of Douglas whilst the most common form of endometriosis was superficial.

AM, J, CAZ J, AEB H, JA O’o.  2021.  Bilateral Ligation of the Anterior Branch of the Hypogastric Artery in Massive Obstetric Hemorrhage Secondary to Septic Abortion (Case Report). J Gynecol Obstet. 3(9):92-99. AbstractWebsite

Hemorrhage is the main cause of Maternal Mortality (MM) (27%) followed by hypertensive disorders and sepsis (12%). Septic abortion is considered an intermediate risk factor for the development of Massive Obstetric Hemorrhage (MOH). The algorithm for the management of postpartum hemorrhage due to uterine atony that includes systematic pelvic devascularization has been described, but this management is really planned for resolution of the pregnancy after the 20th week of gestation, since an HMO due to abortion is un usual. We present the case of a 21-year-old patient who self-medicates a prostaglandin analog at 2 months of pregnancy, achieving only a threat of abortion, goes to the emergency room 3 months later with a diagnosis of septic shock, USG and MRI are performed with altered results, only of hepatomegaly, delayed abortion of 8 weeks of evolution and gestational trophoblastic disease. Emergency MVA was performed due to profuse bleeding, placement of a Bakri balloon and clamping of the uterine arteries without results, for which an emergency exploratory laparotomy (LAPE) was performed with ligation of the anterior trunk of the internal iliac artery, being a successful procedure, without the need for Obstetric Hysterectomy (HO). The patient is managed in intensive care and in the end the diagnosis of TSG is ruled out. Bilateral Hypogastric Artery Ligation (BHAL) in the case of Massive Obstetric Hemorrhage (MOH) secondary to delivery or cesarean section is commonly used, however it is not a technique to report when bleeding is secondary to abortion. In these cases, it is also a viable, successful, fertility-preserving surgical procedure, and an alternative to Obstetric Hysterectomy (OH) when other less invasive methods such as uterine artery clamping or Bakri balloon have failed.

I, C, P S, B N, M M, JA O’o.  2021.  Laparoscopic surgery during the COVID-19 pandemic: detection of SARS-COV-2 in abdominal tissues, fluids, and surgical smoke. Langenbecks Arch Surg. 406(4):1007-1014. AbstractWebsite

Background: There are still concerns over the safety of laparoscopic surgery in coronavirus disease 2019 (COVID-19) patients due to the potential risk of viral transmission through surgical smoke/laparoscopic pneumoperitoneum.

Methods: We performed a systematic review of currently available literature to determine the presence of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) in abdominal tissues or fluids and in surgical smoke.

Results: A total of 19 studies (15 case reports and 4 case series) comprising 29 COVID-19 patients were included. The viral RNA was positively identified in 11 patients (37.9%). The samples that tested positive include the peritoneal fluid, bile, ascitic fluid, peritoneal dialysate, duodenal wall, and appendix. Similar samples, together with the omentum and abdominal subcutaneous fat, tested negative in the other patients. Only one study investigated SARS-COV-2 RNA in surgical smoke generated during laparoscopy, reporting negative findings.

Conclusions: There are conflicting results regarding the presence of SARS-COV-2 in abdominal tissues and fluids. No currently available evidence supports the hypothesis that SARS-COV-2 can be aerosolized and transmitted through surgical smoke. Larger studies are urgently needed to corroborate these findings.

JW, G, J O’o, P G.  2021.  Endometriosis Diagnosis correlation of Laparoscopic visualization and histopathology confirmation in low Resource setting. Open J Obs Gyne. 11(7):845-852. Abstractojog_2021071515313873.pdfWebsite


Background: Endometriosis is enigmatic clinical entity which is described as the location of the endometrial tissue external of the uterine cavity. Endometriosis constitutes a serious health issue due to its high affliction of 10% of reproductive women. With limited resources in Africa, it is essential to assess whether diagnosis of endometriosis by laparoscopic visualization can be used as a substitute for histology. Objective: To correlate the diagnosis of endometriosis by laparoscopic visualization and the histological confirmation of the biopsy taken. Methods: A prospective cross sectional study with a sample size of 443 was undertaken in the diagnosis of endometriosis among Africans in Nairobi, Kenya from March 2019 to March 2021. Women undergoing laparoscopy were screened for endometriosis by visualization and a biopsy was taken for histopathology. Diagnosis of endometriosis by visualization was correlated with histological confirmed endometriosis. Results: Women with a diagnosis of endometriosis through laparoscopic visualization were found to be 77 (17.4%) and 30 (6.8%) had positive histology for endometriosis. Laparoscopic visualization diagnosis had a low positive predictive value of 39%. Conclusion: Laparoscopic visualization diagnosis had a low positive predictive value of 39% and this did not correlate with histopathologic diagnosis. It is essential to perform biopsy with histopathology for the confirmation of endometriosis.

FW, N, Ouyang K AA, J O'o, GW A, D Z.  2021.  Does Keloid Histology Influence Recurrence? Am J Dermatol. doi. 10(PMID: 33464754.) AbstractWebsite

Keloids are fibroproliferative disorders characterized by high recurrence rates, with few factors known to influence the same. We conducted a study to determine whether keloid histology influences recurrence. This was a prospective longitudinal study to determine whether histopathological parameters of keloid influence recurrence. Patients with keloids managed by surgical excision were followed up at Kenyatta National Hospital between August 2018 and July 2020. The excised keloids were processed for histology using hematoxylin,/eosin, Masson, and trichrome stains. The slides were analyzed for inflammatory cells, fibroblasts, and capillary density using the hot spot technique and correlated to keloid recurrence. Postoperative follow-up was for a minimum of 1 year. A total of 90 patients with 104 keloids were recruited in the study. Overall keloid recurrence rate was 28.6%. There was a correlation between the absolute count of more than 50 per High power field of lymphocytes, fibroblasts, and macrophages with recurrence of the disease. The sensitivity and specificity for the above parameters were lymphocytes 48% and 81%, macrophages 57% and 83%, mast cells 32% and 33%, and fibroblasts 41% and 91%, respectively. There was no correlation between mast cells and vascularity status with recurrence. Routine histology should, therefore, be performed to determine these parameters. Close monitoring and second-line therapy should be considered for patients with elevated macrophages and/or lymphocytes so as to reduce the risk of recurrence.


Akinyemi, R, Sarfo F, Abd-Allah F, Ogun Y, Ogeng'o J.  2020.  Conceptual framework for establishing the African Stroke Organization . AbstractWebsite


Africa is the world's most genetically diverse, second largest, and second most populous continent, with over one billion people distributed across 54 countries. With a 23% lifetime risk of stroke, Africa has some of the highest rates of stroke worldwide and many occur in the prime of life with huge economic losses and grave implications for the individual, family, and the society in terms of mental capital, productivity, and socioeconomic progress. Tackling the escalating burden of stroke in Africa requires prioritized, multipronged, and inter-sectoral strategies tailored to the unique African epidemiological, cultural, socioeconomic, and lifestyle landscape. The African Stroke Organization (ASO) is a new pan-African coalition that brings together stroke researchers, clinicians, and other health-care professionals with participation of national and regional stroke societies and stroke support organizations. With a vision to reduce the rapidly increasing burden of stroke in Africa, the ASO has a four-pronged focus on (1) research, (2) capacity building, (3) development of stroke services, and (4) collaboration with all stakeholders. This will be delivered through advocacy, awareness, and empowerment initiatives to bring about people-focused changes in policy, clinical practice, and public education. In the spirit of the African philosophy of Ubuntu "I am because we are," the ASO will harness the power of diversity, inclusiveness, togetherness, and team work to build a strong, enduring, and impactful platform for tackling stroke in Africa.

Ouko, I, Obimbo MM, Kigera J, Ogeng’o JA.  2020.  Valve distribution of the popliteal vein: A structural basis for deep venous thrombosis? AbstractWebsite


To describe the relationship between number and distribution of valves.

Sixty-six popliteal vein specimens were used for the study after routine dissection at the Department of Human Anatomy, University of Nairobi. The extents of the popliteal vein were identified at the adductor hiatus and soleal arch, cut at these points and then longitudinally sliced open. The number and distribution of valves were then recorded. Data were presented using photomacrographs and tables.

The median number of valves was 1 (mean 0.8; range 0–2), with the lower part of the popliteal vein as the most consistent valve position. Most striking was the valve absence noted in 27 (41%) of the veins.

These findings suggest that a significant proportion of popliteal veins do not have valves thus providing a credible structural link that may predispose the popliteal vein to deep venous thrombosis in the study population.

Ogeng’o, J, Ouko I, Wambui A, Amuti T.  2020.  A case Report on unusual elongation of the Sustentaculum tali.. Anatomy Journal of Africa. 9(1):1678-1680.


T, A, L O, I O, I O, J O’o.  2019.  Anatomical Pattern of Dorsal Metatarsal Arteries in a black Kenyan Population. J Morphol Sci. Abstract

Introduction Knowledge of anatomical variations in the origin and in the course of the dorsal metatarsal arteries (DMTAs) is valuable for many procedures, including reconstructive surgeries and flap selection. However, there is a paucity of data on these arteries among black Africans. Materials and Methods The present study studied the origin and the location of DMTAs in 30 formalin-fixed cadaveric feet of adult black Kenyans at the Department of Human Anatomy of the University of Nairobi, Nairobi, Kenya. Results Dorsal metatarsal arteries were present in all of the cases. Of the right dorsalis pedis artery (DPA), in the majority of the cases, the 1st DMTA arose as the continuation of the DPA, while the 2nd to 4th DMTAs were given off as branches from the arcuate artery (AA). On the left feet, in the majority of the cases, the 1st DMTA arose as the continuation of the DPA, while the rest were given off as branches from the AA. In relation to the dorsal interossei muscles, all of the the arteries were either within the muscle fibers (53%) or beneath them (47%), on the right side. On the left side, the 1st DMTA was above the muscles in 40% of the cases; within the muscles in 53%; and beneath the muscles in 7%. The 2nd and 3rd DMTAs were above the muscles in 57% and in 53% of the cases, respectively. Conclusion These results reveal that the DMTAs show variation in their origin and position relative to the dorsal interossei muscles. These variations display bilateral asymmetry.

O.Akinyemi, R, O.Owolabi M, MasafumiIhara, AlbertinoDamasceno, AdesolaOgunniyi, CatherineDotchin, Stella-MariaPaddick, Ogeng’o J, RichardWalker, N.Kalaria R.  2019.  Stroke, Cerebrovascular Diseases and Vascular Cognitive impairement in Africa. Brain res Bull. 145:97–108.. Abstract

With increased numbers of older people a higher burden of neurological disorders worldwide is predicted. Stroke and other cerebrovascular diseases do not necessarily present with different phenotypes in Africa but their incidence is rising in tandem with the demographic change in the population. Age remains the strongest irreversible risk factor for stroke and cognitive impairment. Modifiable factors relating to vascular disease risk, diet, lifestyle, physical activity and psychosocial status play a key role in shaping the current spate of stroke related diseases in Africa. Hypertension is the strongest modifiable risk factor for stroke but is also likely associated with co-inheritance of genetic traits among Africans. Somewhat different from high-income countries, strokes attributed to cerebral small vessel disease (SVD) are higher >30% among sub-Saharan Africans. Raised blood pressure may explain most of the incidence of SVD-related strokes but there are likely other contributing factors including dyslipidaemia and diabetes in some sectors of Africa. However, atherosclerotic and cardioembolic diseases combined also appear to be common subtypes as causes of strokes. Significant proportions of cerebrovascular diseases are ascribed to various forms of infectious disease including complications of human immunodeficiency virus. Cerebral SVD leads to several clinical manifestations including gait disturbance, autonomic dysfunction and depression. Pathological processes are characterized by arteriolosclerosis, lacunar infarcts, perivascular spaces, microinfarcts and diffuse white matter changes, which can now all be detected on neuroimaging. Except for isolated cases of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy or CADASIL, hereditary arteriopathies have so far not been reported in Africa. Prevalence estimates of vascular dementia (2–3%), delayed dementia after stroke (10–20%) and vascular cognitive impairment (30–40%) do not appear to be vastly different from those in other parts of the world. However, given the current demographic transition in both urban and rural settings these figures will likely rise. Wider application of neuroimaging modalities and implementation of stroke care in Africa will enable better estimates of SVD and other subtypes of stroke. Stroke survivors with SVD type pathology are likely to have low mortality and therefore portend increased incidence of dementia.

Ogeng’o, JA, Ongeti KW.  2019.  AORTIC ARCH ORIGIN OF THE VERTEBRAL ARTERY MAY HAVE CLINICAL IMPLICATIONS. Anatomy Journal of Africa . 8(2):1484-1485.
Ogeng’o, JA, Mpekethu N, Gichangi P, Olabu B, Odula P, Munguti J, Misiani M.  2019.  VARIANT ANATOMY OF THE TESTICULAR ARTERY AMONG BLACK KENYANS. Anatomy Journal of Africa . 8(1):1358–1367. Abstractvariant_anatomy_of_the_testicular_artery_among.pdf

Variant anatomy of the testicular artery is important for safe surgery in the retroperioneal area, and
accurate diagnosis of testicular and renal disease. The pattern of origin, number, course and branching
display ethnic and geographical variations. Data from black African populations and especially Eastern
Africa is scarce. The objective of this study was, therefore, to describe the topography of the intraabdominal
part of testicular artery in a sample of the Kenyan population. This was a descriptive crosssectional
study on one hundred (100) testicular arteries at the Department of Human Anatomy, University
of Nairobi. The samples were obtained from autopsy cases and cadaveric specimens. Standard midline
abdominal incisions were made, flaps of the anterior abdominal wall reflected and the intestines,
mesentery and pariental peritoneum retracted systematically to expose the testicular arteries. Their site
and level of origin, number, course and branching were examined. Macrographs of representative
variations were taken using a high resolution digital camera. The results were analysed using SPSS
version 21, and are presented using macrographs and frequency tables. Thirty three (33%) of the arteries
displayed a variant anatomy, with regard to their site of origin (8%), number (4%), course (14%) and
branching pattern (7%). Among the 14 cases of aberrant course, five (5%) arched over the left renal
vein, eight (8%) were retrocaval and one (1%) had a retroureteric course. Seven (7%) bifurcated within
the abdomen. The level of origin along the aorta varied from 1 centimetre above the renal arteries to 5.5
centimetres below them while the vertebral level of origin ranged from T12 to L4. This shows that the
testicular artery among Kenyans displays a high prevalence of variant anatomy characterized by origin
from the accessory renal artery, high level of aortic origin, duplication, retrocaval course and
intraabdominal; division. Preopertaive evaluation of renal and gonadal vasculature is recommended to
minimize misdiagnosis and inadvertent injury retroperitoneal surgery.

Ogeng’o, J, Amuti T, Rwegasira E, Ouko I, Ongeti K.  2019.  THE ANATOMICAL PATTERN OF THE DORSALIS PEDIS ARTERY AMONG BLACK KENYANS. Anatomy Journal of Africa. 8(1):1444-1451. Abstract

Knowledge of the anatomical pattern of dorsalis pedis artery is important during evaluation of peripheral
circulation, peripheral vascular disease, microvascular flap, ankle and foot surgery. Reports from other
populations on the pattern show wide disparity suggesting ethnic and geographical differences. Data
from black African populations is scanty. This study therefore examined the anatomical pattern of dorsalis
pedis artery among adult black Kenyans. The cadaveric dissection study on 30 formalin fixed specimens
evaluated the origin, position, course and branching pattern of the dorsalis pedis artery. The data were
analysed using SPSS for means, frequency and standard deviation. Student t – test was used to determine
side differences at 95% confidence interval where P – Value of <5% was taken as statistically significant.
The artery was consistently present, as a continuation of the anterior tibial artery. It ran 4.6 mm ± 2.1
mm from the medial malleolus, and about 2.5 ± 0.3mm from the medial border of the base of the first
metatarsal bone. The mean was 4.76 mm on the right, and 4.56 mm on the left. The difference was
statistically significant (P<0.05). Three branching patterns were observed. The conventional pattern was
observed in only 47% of cases. The extensor hallucis longus tendon most frequently crossed the artery
above the ankle joint. There were no cases of crossing below the ankle. These observations reveal that
the dorsalis pedis artery is consistently present, high, relatively medialised, and displays an atypical
branching pattern. Due care should be taken during surgery. Preoperative ultrasound evaluation is

Ogeng’o, J, Obimbo M, Munguti J, Cheruiyot I, Olabu B, Kariuki BN.  2019.  Remembering Prof. Hassan Saidi: The Pillar for Young Anatomists and Trainee Doctors. Ann Afr Surg. 16(1):38–39. Abstractremembering_prof._hassan_saidi_the_pillar_for_young_anatomists.pdfThe ANNALS of AFRICAN SURGERY

The late Prof. Hassan Saidi (rest in peace) was a father, husband, an administrator and a surgeon. To many in the medical fraternity, he was a teacher and a mentor. As a mentor, many know of the impact he had on resident surgeons in training, but his contribution to shaping the minds of young anatomists and trainee doctors is often underestimated (1). Prof. Saidi taught in the Department of Human Anatomy, University of Nairobi, for 28 years (7 of which he was the chairman). He had also served previously as the coordinator for the Bachelor of Medicine and Surgery (MBChB) and Intercalated Bachelor of Science, Human Anatomy programs (BSc Anat) (2).

Ogeng’o, JA, Obimbo MM, Zhou Y, McMaster MT, Cohen CR, QURESHI ZAHIDA, Ong’ech J, Fisher SJ.  2019.  Placental Structure in Preterm Birth Among HIV-Positive Versus HIV-Negative Women in Kenya. J Acquir Immune Defic Syndr . 80(1):94–102. Abstractplacental_structure_in_preterm_birth_among_hiv-positive.pdfWolters Kluwer Health, Inc

Background: Preterm birth (PTB) is a major cause of infant
morbidity and mortality in developing countries. Recent data suggest
that in addition to Human Immunodeficiency Virus (HIV) infection,
use of antiretroviral therapy (ART) increases the risk of PTB. As the
mechanisms remain unexplored, we conducted this study to
determine whether HIV and ART were associated with placental
changes that could contribute to PTB.
Setting: We collected and evaluated placentas from 38 HIVpositive
women on ART and 43 HIV-negative women who had
preterm deliveries in Nairobi, Kenya.
Methods: Anatomical features of the placentas were examined at
gross and microscopic levels. Cases were matched for gestational
age and compared by the investigators who were blinded to maternal
HIV serostatus.
Results: Among preterm placentas, HIV infection was significantly
associated with thrombosis (P = 0.001), infarction (P = 0.032),
anomalies in cord insertion (P = 0.02), gross evidence of membrane
infection (P = 0.043), and reduced placental thickness (P = 0.010).
Overall, preterm placentas in both groups were associated with
immature villi, syncytial knotting, villitis, and deciduitis. Features of
HIV-positive versus HIV-negative placentas included significant
fibrinoid deposition with villus degeneration, syncytiotrophoblast
delamination, red blood cell adhesion, hypervascularity, and reduction
in both surface area and perimeter of the terminal villi.
Conclusions: These results imply that HIV infection and/or ART
are associated with morphological changes in preterm placentas that
contribute to delivery before 37 weeks. Hypervascularity suggests
that the observed pathologies may be attributable, in part, to hypoxia.
Further research to explore potential mechanisms will help elucidate
the pathways that are involved perhaps pointing to interventions for
decreasing the risk of prematurity among HIV-positive women.
Key Words: preterm birth, term birth, placenta, HIV, ART

Alexander, O’o J, Shitandi OB, Kerubuo MM, Ngure KB.  2019.  Pattern of stroke in a rural Kenyan hospital. Malawi Medical Journal . 31(1):50-55. Abstractpattern_of_stroke_in_a_rural_kenyan_hospital.pdfCC BY-NC-ND

The pattern of stroke in rural population differs from that in urban ones. Although there are many studies on this condition in sub-Saharan Africa, few studies about stroke pattern in a Kenyan rural area exist.. This study therefore aims at describing the characteristics of stroke in a rural Kenyan hospital.
Patients and Methods
The study was conducted on 227 consecutive patients admitted with a World Health Organization (WHO) diagnosis of stroke in Kangundo Hospital, a level IV facility in Machakos, Eastern Kenya, between April 2015 and September 2016. The sub-type and anatomical distribution of stroke as well as the age, gender of the patients were recorded prospectively. Diagnosis was made through physical neurological examination and confirmed by Computerized Tomography (CT) scan imaging. Only those with complete bio-data, past medical and social history, clinical and physical findings of the patients and imaging results were included. The data were entered into a pre-formatted questionnaire, analysed for means, standard deviations and frequencies, and are presented in tables and bar charts.
Out of 3200 medical admissions, 227 (7.09%) had a confirmed diagnosis of stroke. Ischaemic stroke was more common (67.4%) than haemorrhagic stroke (32.6%). It affected mainly the anterior circulation, especially the middle cerebral artery (39%). The mean age of patients was 68.8 years, (Range 32 – 96). It was more common in females (62%) than in males (38%). Hypertension was the most common (74%) risk factor followed by alcohol abuse (63%), tobacco smoking (48%) and diabetes mellitus (42%).
Ischaemic stroke was the more common major cause of morbidity in the rural hospital studied in Kenya. It occurred most commonly among elderly females, with the most frequent comorbidities being hypertension. In addition, modifiable lifestyle factors like alcohol abuse and cigarette smoking contributed to the prevalence; hence we recommend the control of blood pressure and glucose as well as lifestyle modification to reduce the scourge in our studied population.


Amuti, TM, Butt F, Otieno BO, Ogeng'o JA.  2018.  The relation of the extracranial spinal accessory nerve to the sternocleidomastoid muscle and the internal jugular vein. Cranial Maxillofac Trauma Reconstruction. Craniomaxillofacial Trauma & Reconstruction. 12(2):108-111. Abstract

The spinal accessory nerve (SAN) exhibits variant anatomy in its relation to the internal jugular vein (IJV) as well as the sternocleidomastoid muscle (SCM). These variations are important in locating the nerve during surgical neck procedures to avoid its inadvertent injury. These variations, however, are not conserved among different populations and data from the Kenyan setting are partly elucidated. This study, therefore, aims to determine the variant anatomical relationship of the SAN to the SCM and IJV in a select Kenyan population. Forty cadaveric necks were studied bilaterally during routine dissection and the data collected were analyzed using SPSS version 21. Means and modes were calculated for the point of entry of the SAN into the posterior triangle of the neck as well as for its relation to the SCM. Side variations for both of these were analyzed using Student's t -test. Data relating the SAN to the IJV were represented in percentages and side variations were analyzed using the chi-square test. The SAN point of entry into the posterior triangle of the neck was 5.38 cm (3.501-8.008 cm) on the left side and 5.637 cm (3.504-9.173 cm) on the right side ( p  = 0.785) from the mastoid process. The nerve perforated the SCM in four cases (10%) on the left side and in eight cases (20%) on the right ( p  = 0.253). The SAN lay predominantly medial to the IJV on both sides of the neck, 87.5% on the left side of the neck versus 82.5% on the right ( p  = 0.831). In conclusion, the variant relation of the SAN to the IJV and SCM as observed in this setting is an important consideration during radical neck procedures and node biopsies.

Ogeng’o, JA, Muthoka JM, Hassanali J, Malek AA, Mandela P.  2018.  Sex differences in histomorphology of the human carotid body. MOJ Anat & Physiol.. 5(2):74–78. Abstractsex_differences_in_histomorphology_of_the_human_carotid_body.pdfmedcrave

Knowledge of sex differences in the histomorphology of the carotid body is important in understanding observed differences in respiratory function and disorders. There are few studies on sex differences in the carotid body. This study therefore aimed at describing these differences in the histomorphology features of the human carotid body.
Thirty six random carotid bodies from cardiovascular disease free individuals (20 male, 16 female) obtained during autopsy at the Department of Human Anatomy, University of Nairobi were studied. Specimens obtained within 48 hours of death were fixed in 10% formaldehyde solution and processed routinely for paraffin embedding. Seven micron thick serial sections were stained with H&E, Mason’s trichrome and examined with light microscope. Stereology was done to determine area occupied by parenchyma, stroma and vasculature. Data were analyzed using SPSS version 13.0. The student’s t test was used to compare sex differences. The data are represented using tables and macrographs.
The human carotid body is highly cellular with two varieties of cells namely; chief and sustentacular. It is heavily vascularised and densely innervated. Females showed higher concentration of chief cells, more profuse vascularization and denser innervation when compared with their aged matched male counterparts. The aging changes characterized by fibrosis, cellular degeneration vascular and neural attenuation are less severe in females.
Sex histomorphological differences in the human carotid body characterized by higher population of chief cells, density of vascularity, innervation and blunted age related morphological attenuation underpin differences in its function and disease.
Keywords: gender differences, carotid body, cells, vascularization

Ogeng’o, J, H.Saidi, Kaisha W, Olabu B, Mumin A.  2018.  Morphology of the Left Atrial Appendage: Prevalence and Gender Diff erence in a Kenyan Population. Journal of Morphological Sciences. 35(1):1–86. Abstractmorphology_of_the_left_atrial_appendage_prevalence_and_gender_difference_in_a_kenyan_population.pdf

Introduction Urinary incontinence (UI) is the involuntary urine loss, with the
prevalence of 17% to 24% in women over 65 years-old. It has a multifactorial cause,
being a condition that affects many people in all ages mainly postmenopausal women,
it is also found in athlete women who have a high level of training associated mainly to
high impact activities.
Objective The aim of this study is to conduct a literature review that relates the
influence of physical activity on functional performance and on UI among women on
the stage of aging.
Method The bibliographical review was done in Medline, Scielo, Pubmed and Sports-
Disco databases using the keywords physical activity or exercise, postmenopause or
aging and urinary incontinence and stress urinary incontinence.
Conclusion Elderly women engaged in a regular exercise program have a lower
incidence of UI.

AJ, O’o, Z Q, M O.  2018.  Infection in pregnancy; understanding impact on placental microenvironment and preterm birth: a review. JOGECA . 29(1) Abstract

Background: Pregnancy increases susceptibility to and severity of infections caused by certain microbes and
parasites. The presence of these infectious agents at the maternofetal interface may lead to adverse pregnancy
outcomes including preterm birth either via direct action of the microbes or indirectly via alteration of the placental
Objective: To summarize the literature regarding the role of various infectious agents in alteration of placental
microenvironment and predisposition to preterm birth.
Method: A review search using Google scholar, PubMed, Cochrane Library and Trip database was conducted at the
University of California San Francisco. A total of 880 abstracts were reviewed and a total of 95 studies were included.
Studies were included if they reported any information on infection during pregnancy, effect on placenta or fetal
membranes or risk of preterm birth.
Results: The current evidence indicates that various infectious agents affect pregnancy and alter placental
microenvironment at the maternofetal interface. Severity of these infections increases with gestation. Additionally,
these infections are associated with the risk of adverse obstetric outcomes including preterm birth.
Conclusion: Prevention, early detection and treatment of these infections including those that are asymptomatic is
important in maintaining integrity of the placenta and in reducing the burden of preterm births.

Ogeng’o, JA, Pulei AN, Olabu BO, Fidel O Gwala.  2018.  HIBISCUS EXTRACT MITIGATES SALT INDUCED CAROTID ADVENTITIAL CHANGES IN RATS. Anatomy Journal of Africa. 8(1):1342–1350. Abstract

The tunica adventitia is an active vascular compartment that actively participates in modulation of
vascular structure, function and pathophysiology. Adventitial thickness has recently been accepted as a
surrogate marker of atherosclerosis. The effects of salt and chemicals that ameliorate those effects are
important in understanding vascular structure, function and pathology. There are few studies on
hibiscus and high salt induced vascular pathology. This study, therefore, investigated the effects of
hibiscus on salt induced vascular changes on rat carotid artery. The experimental animals were divided
into 3 groups of 8 animals each – (i) controls; (ii) high salt diet alone and (iii) high salt + hibiscus
extract for a period of eight weeks. At ages 2, 5 and 8weeks 2 – 3 animals were sacrificed for study.
They were anaesthetized with ether and perfused with formal saline. Specimens were then obtained
from the middle of common carotid artery, fixed in 5% formaldehyde solution, processed routinely for
paraffin embedding and 5-micron thick sections stained with Hematoxylin / Eosin and also with Mason’s
Trichome/ Aniline blue. Adventitial thickness and volumetric densities of collagen were measured using
morphometric techniques. High salt consumption induced statistically significant increase in adventitial
thickness from 297.45μm at week 2 to 659.4μm in week 8. In hibiscus fed rats, this increase
progressively reduced to 482.55μm in week 8. Volumetric density of collagen was 57% in high salt fed
rats but reduced to 45.66% in hibiscus fed rats (p<0.001). The increase in tunica adventitial thickness
and collagen density which is induced by high salt can be mitigated by hibiscus extract. This implies
that hibiscus has potential to restore salt induced vascular injury. Further studies are recommended to
refine the extract.

Ogeng’o, JA, Mwachaka PM, Odhiambo DE, Elbusaidy SSHR, Olabu B, Martin Inyimili.  2018.  Geometric Features of Vertebrobasilar Arterial System in Adult Black Kenyans. Int. J. Morphol. 36(2):544-550. Abstract

SUMMARY: Geometric features of vertebrobasilar system influence occurrence of posterior circulation atherosclerosis,
aneurysms, stroke and neuroradiological procedures. These features show ethnic variation, but data from black Africans in Sub Saharan
Africa are scarce. This study aimed to describe geometric features of vertebrobasilar system in a black Kenyan population. It was a
descriptive cadaveric study at Department of Human Anatomy, University of Nairobi. One hundred and seventy three formalin-fixed
adult brains of individuals (99 male; 74 female; Age range 20 - 79) who had died of non cerebrovascular causes were studied. Level and
angle of confluence of vertebral artery; diameter, length and bifurcation angles of basilar artery were measured. Data were analysed by
SPSS version 21 for windows. The student t – test was used to determine the sex differences at 95 % confidence interval. Data are
presented in macrographs, tables and bar charts. Confluence of vertebral arteries occurred at the sulcus bulbopontinus in 79.8 %; rostral
to it in 11.5 % and caudal to it in 8.7 % of cases. Mean angle of vertebral artery confluence was 46.7º and 68.9º in males and females
respectively (p£0.042). Mean length of the basilar artery was 26.8 mm; 26.3 mm in males and 27.1 mm in females (p=0.465). Mean
diameter was 3.52 mm; 3.32 mm in males and 3.72 mm in females (p=0.002). The mean angle of basilar artery bifurcation was 120.3º ±
15.2; 99.3º ± 32.9 in males and 140.3º ± 16.1 in females (p=0.024). It was wider than 90º in 82.9 % of males and 95.9 % females
(p=0.032). In 85 (49.1 %) it was wider than 120º. The vertebrobasilar system in the Kenyan population has geometric features that
constitute risk factors for atherosclerosis. These features display sex dimorphism which may explain differences in prevalence of
atherosclerosis and aneurysms. Neurosurgeons and neurologists should be aware of these differences. Individuals with risk prone geometric
features should be followed up for atherosclerosis.


S, OB, A O’o J.  2017.  SEX DIFFERENCES IN DIAMETER OF THE CORONARY SINUS OSTIUM: CORRELATION WITH WEIGHT OF THE HEART. Anatomy Journal of Africa.. 6(1):862-866. Abstractsex_differences_in_diameter_of_the_coronary_sinus.pdfWebsite

Diameter of the coronary sinus ostium is important in the designing of cannulation devices used in cardiac
resynchronization therapy and percutaneous mitral valve annuloplasty. Population variation of the
diameter may account for the failure rate of these procedures. Studies of the coronary sinus ostium from
African populations are scarce and altogether absent for Kenya. Therefore, this study aimed at
determining sex differences in the diameter of coronary sinus ostium and its correlation with the weight
of the heart. Seventy-four hearts of adult black Kenyans [43 male, 31 females; age range 20 – 70 years]
obtained during autopsy at the Department of Human Anatomy, University of Nairobi, Kenya were
weighed. The coronary sinus ostium was identified and its transverse and supero-inferior diameters
measured in millimeters. The measurements were analyzed using SPSS version 17. Sex comparison was
established using student’s t test. Association between diameter and heart weight was established using
Pearson’s correlation test and considered significant at a p-value of ≤0.05. Data were presented using
scatter plots. Transverse and supero-inferior diameters of the ostium were 11.04±1.88mm and
9.50±1.80mm respectively. The mean diameter was 10.27 mm. These correlated positively with weight
of the heart. When corrected for weight of the hearts, the transverse and supero-inferior diameters were
larger in females (0.042 and 0.036 respectively) than in males (0.034 and 0.03 respectively). The
diameter of coronary sinus ostium is larger in females and shows positive correlation with weight of the
heart. These data should be considered during design and use of cardiac devices introduced through
the coronary sinus.

Awad, O, Malek A, Ogeng’o J.  2017.  DIFFERENTIAL EFFECTS OF CHRONIC IRON DEFICIENCY ANAEMIA ON JUNCTIONAL AND LABYRINTHINE ZONES OF PLACENTA IN SPRAGUE DAWELY RAT. Anatomy Journal of Africa. . 6(1):840–846.. Abstractdifferential_effects_of_chronic_iron_deficiency.pdfWebsite

Iron deficiency anaemia causes adverse pregnancy outcome. Studies reveal its generalized effects on
histomorphometry of the placenta, without details on specific zones nor effect of gestational age. These data are
important for planning intervention. This study was, therefore, designed to describe the histomorphometric changes
associated with iron deficiency anaemia on placenta of albino rat. Fourty nine (49) Sprague – Dawely albino rats
were randomly separated into experimental and control groups. The experimental group was rendered anaemic by
removing 1.5 ml of blood per bleed on five alternate days. Placentas were collected on gestational days 17, 19 and
21. Five cubic milimetre segments were fixed in 10 % buffered formaldehyde solution; dehydrated in ethanol and
embedded in paraffin wax. Five micron thick sections were cut, deparaffinized and stained with Hematoxylin and
Eosin. Micrographs were taken using Leica ICC 50 digital photomicrographic camera attached to a computer at
magnification x40 and the thickness of the labyrinth and junctional zones measured. Student t- test was used to
compare values for the experimental and control groups. The labyrinth in the chronic anaemia group was thinner
than in the control group at gestational days 17, 19 and 21. The junctional zone, on the other hand, was consistently
thicker in anaemic than in the control animals. The difference in thickness of junctional zone varied with gestational
age. At gestational day 17, the zone was significantly thicker in the anaemic group (628.9 μ) than in the control
(381 μ). On day 19 and 21, however, the difference was not statistically significant. In conclusion, the effects of
chronic iron deficiency anaemia on the labyrinth differ from those on the junctional zone of the placenta. This
differential effect appears to depend on the function and gestational age. The decrease in thickness of the labyrinth
may be designed to maintain placental diffusion capacity while increased thickness of the junctional zone constitutes
a compensatory physical and nutritional adaptation to hypoxia.

Ogeng’o, J, Ominde BS, Ongeti K, Olabu B, Obimbo M, Mwachaka P.  2017.  REAPPRAISAL OF THE STRUCTURE OF ARTERIAL TUNICA ADVENTITIA AND ITS INVOLVEMENT IN ATHEROSCLEROSIS. Anatomy Journal of Africa. . 6(1):824–833. Abstractreappraisal_of_the_structure_of_arterial_tunica.pdfWebsite

Tunica adventitia was previously considered an inert fibrous layer only involved in nutritional and physical
support of the arterial wall. Recent studies reveal that it is an important dynamic layer actively involved
in the regulation of vascular structure, function, response to injury and disease processes especially
atherosclerosis. Many anatomical studies on arteries, however, still make only peripheral reference to it,
without elucidating its detailed structure. Knowledge of the latter is important in understanding
pathobiology and interventional approaches to atherosclerosis. This review, therefore, aims at
consolidating contemporary literature on the structure and clinical significance of the arterial tunica
adventitia. Google literature search was done using the key words tunica adventitia combined with:
artery, aorta, cells, cell types, collagen, elastic fibres, vasa vasora, lymphatics, nerves, atherosclerosis.
There is overwhelming evidence that the tunica adventitia comprises multiple types of collagen and
elastic fibres arranged in various directions, a wide variety of cells including fibroblasts, smooth muscle,
pericytes, myofibroblasts, leukocytes, mononuclear phagocytic, defence, mesenchymal stem and mast
cells; vasa vasora including microvasculature, lymphatics and neural elements. The exact cellular, fibre
composition and orientation vary between various arteries and regions of the same vessel. Its
components are involved in the initiation, progression and complications of atherosclerosis. In conclusion,
the tunica adventitia is an active dynamic layer which, besides mechanical and nutritive functions; has
metabolic, regulatory and defence roles that are critical in arterial homeostasis and atherosclerosis.
Vascular studies should always include detailed analysis of the biology of the tunica adventitia.

Ogeng’o, J.  2017.  Lessons from a case of tubal twin pregnancy. Anatomy Journal of Africa.. 6(1):817-819. Abstract

Unilateral tubal twin pregnancy illustrates and amplifies fundamental phenomena in developmental and
reproductive anatomy. Knowledge of this condition is also important to practicing obstetricians and
gynaecologists because it may constitute a diagnostic challenge, management dilemma, complex ethical
issues and increased risk for maternal morbidity and mortality (Benn et al., 2016). Previously considered
a rare occurence, recent data suggest that the condition is not uncommon (Svirsky et al., 2010). Indeed,
there are many reports (Vohra et al., 2014), including several from Sub-Saharan Africa (Makinde and
Ogunniyi, 1990). The case reported by Pulei et al., in Anat J Afr 2017; 6 (1) reveals several unique
features in the profile of risk factors, location, chorionicity and amnionicity, mode and time of
presentation, condition of the tube, diagnosis and fetal viability. There was no evidence of the
conventional risk factors (Sivalingam et al., 2011). This is consistent with several other reported cases
where it occurred spontaneously (Abi Khalil et al., 2016). In the present case, however, the patient had
multiple intramural and subserosal leiomyomata. Intramural myomata are known to disrupt uterine
contractility which may interfere with transport of the ovum and hence predispose to ectopic pregnancy
(Ajibade et al., 2012). It is probable, therefore, that this was the predisposing factor. Accordingly, it may
be useful to monitor patients with uterine fibroids for potential to suffer ectopic pregnancy. Family
history of twinning may have been useful, and is advocated, in view of the fact that it is one of the major
predisposing factors.

Ogeng’o, JA, Ongeti KW, Olabu BO, Ominde BS.  2017.  Involvement of multiple cell lineages in Atherogenesis. Anatomy Journal of Africa.. 6(1):924-933. Abstractinvolvement_of_multiple_cell_lineages_in.pdfWebsite

Atherogenesis is a multicellular event. Early reports concentrated on the role of endotheliocytes, monocyte -
macrophages and smooth muscle cells. Recognition of the immuno-inflammatory nature of the process,
however, expanded the scope of cellular involvement and more recent reviews emphasize the role of immune
and inflammatory cells. In addition, recent studies reveal that other cells are also involved. Elucidation of all
the types of cells involved is valuable to inform therapeutic interventions for this disease, but most accounts
concentrate on cells which are the target of the study and may fail to include other cells. This review therefore
aimed at consolidating information on the various cells involved in atherogenesis. Review of contemporary
literature was done for cells in the vessel wall and in blood to check for their potential role in atherogenesis.
It has been shown that atherogenesis involves all the cells present in the various coats of the vessel wall –
endotheliocytes, smooth muscle cells, fibroblasts, stem cells, pericytes, mast cells, dendritic cells,
macrophages and immigrant cells usually found in blood, namely monocytes, neutrophils, lymphocytes,
platelets and red blood cells. These cells promote atherogenesis by secreting several products which influence
inflammation, migration, proliferation and secretory activity of each other in a manner that synergises their
activities. Therapeutic interventions should target the various cell types.

Kariuki, BN, Saidi H, Ndung’u B, Kaisha W, Ogeng’o J.  2017.  INFLUENCE OF AGE ON GALLBLADDER MORPHOMETRY. Anatomy Journal of Africa. . 6(2):987-994. Abstractinfluence_of_age_on_gallbladder_morphometry.pdf

Morphometric properties of the gallbladder such as length, diameter and volume are determinants of gallbladder
function. These parameters are altered with age and may explain the age-related reduction in gallbladder
contractility associated with gallstone formation. Ninety-two gallbladder specimens of subjects aged between 21
and 84 were sourced from City mortuary and the Department of Human anatomy during autopsy. For each
gallbladder specimen, measurements of length and circumference were taken to the accuracy of 0.1millimetres
(mm) and used to calculate the gallbladder volume. These measurements were standardized using
measurements of liver length and weight. Data were recorded by age categories in age groups of 21-30, 31-40,
41-50, 51-60 and 61 or more years. The mean gallbladder volume was 47.948 (±19.080) cm3 and showed a
statistically significant increase with age (p <0.001). There was also a significant increase of gallbladder length
(p =0.01) and diameter (p <0.001). A positive correlation was observed between gallbladder length, diameter
and volume; 0.282, 0.485 and 0.480 respectively (p = 0.01). The gallbladder volume which is a function of
length and diameter, shows a statistically significant increase with age. Notably, there is a marked increase in
these parameters after the fifth decade. This could explain the exponential increase in prevalence of cholelithiasis
by 4 to 10 times after the fifth decade of life.

Ogeng’o, JA, Olabu BO, Mwachaka PM, Ominde BS, Inyimili MI.  2017.  What is the origin of the labyrinthine artery among black Kenyans? Anatomy Journal of Africa . 6(2):982-986. Abstractwhat_is_the_origin_of_the_labyrinthine_artery_among.pdfWebsite

Origin of labyrinthine artery is important because it influences the presentation of occlusion of anterior inferior
cerebellar and basilar arteries. It shows ethnic and geographical variation, but there is no data from black African
populations. This study, therefore examined the pattern of origin of labyrinthine artery in adult black Kenyans.
Three hundred and fourty six arteries from one hundred and seventy-three formalin fixed brains were examined
by dissection at the Department of Human Anatomy University of Nairobi, Kenya. Labyrinthine artery arose from
basilar artery in 260 (75.1%); as common trunk with anterior inferior cerebellar artery in 48 (13.9%) and from
the latter in 38 (11.0%) of cases. There was no side and gender difference in the pattern of origin. This implies
that majority of labyrinthine arteries arise from basilar artery, different from that in oriental, Indo-Asian and
Caucasian populations, in which it arises from the anterior inferior cerebellar artery. Preoperative evaluation of
basilar artery branching is recommended.

Ogeng’o, JA.  2017.  GALLSTONE DISEASE: A CALL TO AWARENESS IN SUBSAHARAN AFRICA. Anatomy Journal of Africa. 6(2):914-915. Abstract

Gallstone disease (GSD) is a major global health problem that causes high morbidity and mortality constituting a significant
economic burden in developed countries (Shaffer, 2006; Stinton and Shaffer, 2012; Njeze, 2013). It was previously
considered rare in sub-Saharan Africa (Stinton and Shaffer, 2012; Njeze, 2013). Its prevalence, however, is steadily rising
and has already attained considerable proportions in a number of countries perhaps consequent to epidemiological and
demographic transitions (Eze et al., 2016). This condition is important for several reasons – First, it is one of the most
common causes of upper gastrointestinal morbidity and may mimic / be associated with gastritis, peptic ulcer disease, hiatal
hernia, esophagitis, gastroesophageal reflux disease, duodenitis; acute and chronic pancreatitis, hepatitis and portal vein
thrombosis among others (Sabitha et al., 2016). Secondly, it is a predisposing / risk factor for overall mortality and other
diseases including various gastrointestinal cancers, non-alcoholic fatty liver disease; cardiovascular diseases (CVD)
especially coronary heart, cerebrovascular, peripheral vascular diseases, arterial stiffness and heart failure (Yu et al., 2017).
The risk for CVD is independent of age, gender and other comorbidities (Olaiya et al., 2013). Thirdly, patients with GSD
appear to have a higher prevalence of cardiovascular risk factors such as obesity, type 2 diabetes mellitus; dyslipidemia,
hyperinsulinemia, sedentary life style and gut microbiota dysbiosis (Lv et al., 2015).

Ogeng’o, J, ONGETI K, Mwachaka P.  2017.  Features of atherosclerosis of common carotid arteries among black Kenyans. J. Morphol. Sci . 34(2):54-57. Abstractfeatures_of_atherosclerosis_of_common_carotid_arteries_among_black_kenyans.pdf

Introduction: Data on the features of atherosclerosis of common carotid artery are important for informing strategies against ischaemic stroke in Subsaharan Africa, but are scarce. Materials and Methods: This study therefore investigated, by light microscopy, the presence of features of atherosclerosis in the left common carotid artery among 108 black Kenyans [76 males; 32 females; Mean age 36.4, range 22-82 years] who suffered violent death. Specimens from the distal segment of the artery were prepared for routine paraffin embedding, and 5μ sections stained with Mason’s Trichome. Results: At least one feature of atherosclerosis was observed in 22 (20.4%) cases. Intimal hyperplasia alone was present in all the 22 cases followed by Intimal hyperplasia and degeneration of internal elastic lamina 19 (17.6%); Intimal hyperplasia combined with disintegration of internal elastic lamina and medial degeneration 17 (15.7%). Thickening of tunica adventitia with neovascularization were present in 8 (7.4%) of cases. All the features were more frequent in males than females (1.4:1) and those over 40 years old. Eight of the cases (36.4%) were in individuals aged below 40 years. Conclusion: Multiple features of atherosclerosis in common carotid artery are present in over 20% of the asymptomatic black Kenyans studied. They occur more frequently in males, and affect individuals younger than 40 years. These features appear in all three layers of the vessel wall, suggesting that the disease has attained several stages of severity in this population. We recommend early screening for the disease in individuals at risk.

Awad, O, Ochieng SJ, Malek A, Ogeng’o J.  2017.  Chronic anaemia causes degenerative changes in trophoblast cells of the rat placenta. Anatomy . 11(2) Abstractchronic_anaemia_causes_degenerative_changes.pdfWebsite

Objectives: Iron deficiency anaemia causes adverse pregnancy outcome. There are few studies on effects of anaemia on the
structure of trophoblastic cells which are important in placental function. These data are important for understanding the
function and disorders of the placenta. The aim of this study was to investigate the ultrastructural cellular changes associated
with iron deficiency anaemia in rat placenta.
Methods: Forty-nine female Sprague-Dawley rats were randomly separated into experimental and control groups. The
experimental group was rendered anaemic by removing 1.5 ml of blood per bleed on five alternate days, and the placentas
were collected on gestational days 17, 19 and 21. For light microscopy, five cubic millimeter segments were fixed in 10%
buffered formaldehyde solution; dehydrated in ethanol and embedded in paraffin wax. Five micron thick sections were cut,
deparaffinized and stained with Hematoxylin and Eosin. For transmission electron microscopy, 1 mm3 sections were fixed in
2.5% phosphate buffered glutaraldehyde, post fixed in 2% osmium tetroxide, dehydrated in ethanol, cleared in propylene
and embedded in epon resin. Ultrathin sections stained with uranyl acetate and lead citrate were examined with JEOL electron
Results: Cytotrophoblast, syncytiotrophoblast and giant trophoblastic cells of placentas of anaemic rats showed cytoplasmic
and nuclear vacuolation with loss of cell margins. In addition, there was atrophy of microvilli on the cell surface, as well
nuclear chromatolysis, nucleolar degeneration and appearance of dark bodies.
Conclusion: Chronic anaemia causes trophoblastic cell degeneration. This may undermine the functional integrity of the
cells and constitute part of the mechanism for poor fetal outcome.

Cheruiyot, I, Bundi B, Munguti J, Olabu B, Ngure B, Ogeng’o J.  2017.  PREVALENCE AND ANATOMICAL PATTERN OF THE MEDIAN ARTERY AMONG ADULT BLACK KENYANS. Anatomy Journal of Africa . 6(3):1015-1023. Abstractprevalence_and_anatomical_pattern_of_the_median_artery_among_adult_black_kenyans.pdf

Knowledge of the anatomy of median arteries is important in the diagnosis and management of carpal tunnel and pronator teres syndromes, reconstructive surgery in the forearm, minimizing inadvertent vascular injury as well as in limiting operative complications due to unexpected bleeding. The anatomical pattern displays ethnic differences but there are few studies on black Africans. This study therefore sought to describe the anatomy of median arteries in an adult black Kenyan population. A total of sixty two (62) upper limbs from thirty one (31) formalin-fixed cadavers were studied at the Department of Human Anatomy, University of Nairobi, Kenya. The prevalence, origin, types, relationship with median nerves and termination were determined. Median arteries were observed in 37 (59.7%) cases. Of these, the palmar type comprised 12 (32.4%) and antebrachial type 25 (67.6%) cases. It occurred bilaterally in 14 (45.2%) cases. The most common origin was the common interosseous artery (21; 56.8%) followed by anterior interosseous (13; 35.1%) and ulnar 3 (8.1%) arteries. The artery pierced the median nerve in 7 (18.9%) cases. The palmar type terminated by uniting with the ulnar artery to form a median-ulnar type of superficial palmar arterial arch in 8 (21.6%) cases and directly gave rise to the first, second and third common digital arteries in 4 (10.8%). In conclusion, the median artery occurs in nearly 60% of the population, much higher than in prevailing literature reports. Prevalence of the palmar type of median arteries and that of median arteries piercing median nerves are also higher than in other populations. Accordingly, presence of median artery and consequently other vascular and median nerve variations should be considered in the differential diagnosis of forearm entrapment neuropathies and due caution taken during forearm surgical procedures. We recommend preoperative ultrasound evaluation of the forearm and hand vascular system.

Ogeng’o, J, Ominde BS, Ongeti KW, Olabu B, Maseghe P, Machira J, Murunga A.  2017.  HISTOMORPHOLOGICAL FEATURES OF ATHEROSCLEROSIS IN THE LEFT ANTERIOR DESCENDING CORONARY ARTERIES AMONG BLACK KENYANS. Anatomy Journal of Africa . 6(3):1033–1044. Abstracthistomorphological_features_of_atherosclerosis_in.pdf

The pattern of coronary artery atherosclerosis is valuable in informing mitigation strategies for coronary
heart disease. Histomorphological data on this disease among Africans living in Sub Saharan Africa are,
however, scarce. The left anterior descending is one of the most commonly afflicted arteries. This
study, therefore, examined the left anterior descending artery of 213 black Kenyans [Mean age 36.8
years, range 5 – 82 years] who had died of non cardiovascular causes for features of atherosclerosis.
The individuals were divided into male and female, then into 10-yr age groups. Specimens were
obtained from the proximal segment of the artery during autopsy at the Department of Human
Anatomy University of Nairobi, Kenya. They were processed routinely for paraffin embedding and
sectioning. Five micron sections were stained with Haematoxylin/Eosin and Mason’s trichrome and
examined with light microscope. Micrographs of representative features were taken using a high
resolution digital camera. At least one feature of atherosclerosis was present in 54 (25.4%) of the
individuals. The features observed included severe intimal hyperplasia (34; 63%), disintegration of the
internal elastic lamina [30; 55.6%]; atherosclerotic plaque (20; 37%), adventitial thicknening (14;
26%) and mural neovascularization (10; 18.5%). The mean age of those with features of
atherosclerosis was 38.4 years, range 6 – 62 years with 25 (46.3%) being aged 40 years and below. Of
these, the male: female ratio was 1.7:1. In conclusion, features of atherosclerosis are present in over
25% of the population studied. The disease affects young people, including women. Proactive
preventive measures including follow – up should commence early, and involve both men and women

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