Bio

Prof. Ogeng'o Julius A.

BSc; MBChB; PhD; MD, DSc
Professor of Human Anatomy
BIO

Prof. Ogeng'o Julius A.

Publications


2019

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
recommended.

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

Background
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.
Results
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%).
Conclusion
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.

2018

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
microenvironment.
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.

2017

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
microscope.
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

2016

Ominde, BS, Ogeng’o JA.  2016.  REGIONAL DIFFERENCES IN THE MURAL STRUCTURE OF THE HUMAN CORONARY SINUS. Anatomy Journal of Africa.. 5(1):666-671. Abstractregional_differences_in_the_mural_structure_of_the.pdf

physico-mechanical properties and the basis for extent of atrial fibrillation and ablation. These features
are only scarcely reported. This study therefore aimed at describing regional differences in the mural
structure of coronary sinus among black Kenyans. This was a descriptive cross-sectional study on
coronary sinuses from fifteen hearts obtained during autopsy on adult black Kenyans at the Department
of Human Anatomy, University of Nairobi. Five-millimeter-long specimens were taken from the proximal,
middle and terminal segments of the coronary sinus and processed routinely for paraffin embedding and
sectioning. Seven-micron thick sections were stained with Masson’s Trichrome to demonstrate connective
tissue and smooth muscle while Weigert’s Resorcin Fuschin stain was used to demonstrate elastic fibres.
The slides were examined with a light microscope and photomicrographs taken with a high resolution
digital camera. The results are presented in micrographs. The wall comprised three layers namely
internal, middle and external. Regional differences were observed in the middle layer. In the proximal
segment, there were concentrically oriented smooth muscles scattered within connective tissue. The
middle and terminal segments on the other hand comprised cardiac muscle oriented both concentrically
and longitudinally. The muscle was separated by connective tissue rich in elastic fibres and abundant
vasa vasora. The external layer comprised connective tissue.
In conclusion the middle layer of the wall of the coronary sinus displays regional differences. The smooth
muscle at the proximal segment may confer contractility to enhance blood flow while the cardiac muscle
in the other segments enables it to function in synchrony with the right atrium during atrial systole. The
complex arrangement of circular and longitudinal muscle facilitates blood flow and may also constitute a
sphincter mechanism.

Ogeng’o, JA, Masaki CO, Malek AA, Were FN, Olabu BO, Misiani MK, Murunga AK.  2016.  ANATOMICAL FEATURES OF RENAL ARTERY IN A BLACK KENYAN POPULATION: CORRELATION WITH MARKERS OF ATHEROSCLEROSIS. Anatomy Journal of Africa. . 5(1):650-660. Abstractanatomical_features_of_renal_artery_in_a_black.pdfWebsite

Knowledge of anatomical features of the renal artery is important in prediction, management and control
of atherosclerotic renal artery stenosis. These features show population variations but data from black
African populations are scarce. The aim of this study was therefore to describe the anatomical features
of the renal artery in a black Kenyan population. Six hundred and ten (610) single renal arteries from
305 adult black Kenyans [206 males, 99 females; age range 22 – 79 years] were studied by dissection
at Department of Human Anatomy, University of Nairobi, Kenya. Specimens with macroscopic features
of stenosis and dilatation were excluded. The implantation angle, length and branching pattern were
studied. These features were correlated with intima-media thickness and luminal diameter. The latter
were determined by micrometry on Eosin/hematoxylin stained 5 micron sections obtained from the
proximal segment of the renal artery. Data was analysed by SPSS version 16.0. Student’s t-test, was
used to test for statistical significance at 95% confidence interval where P value of < 0.05 was taken as
significant. The results are presented in a bar graph, tables and macrographs. The mean implantation
angle was 940±150 (range 580-1250). In 26.7% cases, the angle was more than 1000. Mean length was
34±1.4 mm with 21.6 % of arteries measuring ≤ 20 mm. Variant branching pattern was present in 40.5
% of cases. It comprised trifurcation (33 %), quadrifurcation (6.6 %) and pentafurcation (0.8 %). Higher
implantation angle, short arteries and variant branching were associated with statistically significant
higher intima - media thickness and luminal diameter. These results suggest that higher implantation
angle, shorter length and variant branching pattern constitute geometric risk factors for renal artery
atherosclerosis. Ultrasound screening for individuals with suboptimal geometric features for renal artery
atherosclerosis is recommended.

JA, O’o, PM M, BO O, NM O’o, J G.  2016.  Hexafurcation of Basilar Artery in a Black Kenyan Population. Austin Journal of Anatomy. 3(1):1046. Abstracthexafurcation_of_basilar_artery_in_a_black_kenyan.pdfAustin Publishing Group

The Basilar Artery (BA), usually terminates by dividing into two posterior cerebral arteries [1,2]. Variant terminations described include double posterior cerebral arteries and common trunks for Posterior Cerebral Arteries (PCA) and Superior Cerebellar Arteries (SCA) trifurcation, quadrifurcation and pentafurcation [3-5]. Such variant branching patterns of arteries predisposes them to atherosclerosis and aneurysms [6,7], and may complicate surgery at basilar bifurcation angle and clivus [8]. The abnormalities may also alter the relationships with and compress occulomotor nerve [9]. There are, however, few reports on variant termination of the basilar artery. We recently reported up to 5 branches. In all cases of trifurcation, qudrifurcation and pentafurcation, the variation was due to duplication and rostral shift of superior cerebellar artery [4]. Potentially, more than five branches is possible but hitherto unreported in spite its importance. This study, therefore investigated the pattern of termination of the basilar artery in a black Kenyan population, for cases where there were more than five terminal branches.

Ogeng’o, J.  2016.  VARIATIONS OF PULMONARY VEINS AND THEIR CLINICAL RELEVANCE. Anatomy Journal of Africa. . 5(2):702-703. Abstract

Variations of pulmonary veins (PV) were previously considered rare, only documented as isolated case reports.
Recent cadaveric, autopsy, CT, MDCT and MRI studies have revealed substantial variations with respect to their
number and drainage pattern into the left atrium (Marom et al., 2004; Calkins et al., 2007; Wannasopha et al.,
2012; Harbi et al., 2014; Rajguru and Fulzele, 2016). The most commonly described variations include
supernumerary or less pulmonary veins and the corresponding arterial ostia. The article in this issue
(Kinfemichael and Dawit, 2016) presents a case of 5th pulmonary vein originating from the middle lobe of the
right lung. This is consistent with previous reports of supernumerary pulmonary veins and ostia (Marom et al.,
2004; Calkins et al., 2007; Prasanna et al., 2014). These vary from 2 – 7 (Wei et al., 2014; Yuan et al., 2015;
Rajguru and Fulzele, 2016; Kumzel – Piotrowska et al., 2016). The commonest cause of such variations is the
right middle pulmonary vein (Calkins et al., 2007; Klimek – Piotrowska et al., 2016). These variations have
informed various classifications based on number of pulmonary veins and ostia (Marom et al., 2004). One of the
most straight forward classifications was proposed by Shukla et al (2012). The principle of this classification in
the table below may be extended to include, say type VI or VII depending on the number of veins.

Muthoka, JM, Kaisha WO, Gikenye G, Ogengo JA.  2016.  Morphology and morphometry of the distal articular surface of lunate bone in a Kenyan population. Int. J. Morphol. 34(2):896-900. Abstractmorphology___and___morphometry___of___the___distal___articularsurface___of___lunate___bone___in___a___kenyan___population.pdf

The morphology and morphometry of the distal articular surface of the lunate exhibits inter-population variations.
They are of clinical importance to hand surgeons due to their influence on the occurrence of proximal pole arthrosis which is a cause
of ulnar-side wrist pain. The objective of the study was to determine the morphology and morphometry of the distal articular surface
of the lunate bone in an adult Kenyan population. A descriptive cross-sectional study at the Department of Human Anatomy, University
of Nairobi. Fifty-six human hands obtained for routine dissection were used. The morphology of the distal articular surface of the
lunate was classified as either Type I or Type II depending on the absence or presence of a medial facet for articulation with the hamate
respectively. The width of the wrists and of the medial facet in Type II lunates was measured with SOMETTM CN-25 1234 vernier
calipers (accurate to 1mm). Photomacrographs of representative lunate were taken. Data were analyzed using SPSS version 17.0. The
Pearson correlation test was used to check for any correlations. Type II lunate morphology was more common with a prevalence of 34
(61 %) while 19 (34 %) were Type I. The mean width of wrists with Type I lunate was 41.1±2.8 mm while those with Type II had a
mean width of 46.1±4.3 mm. The mean width of the medial facet in lunate type II was 4.4±1.4 mm. Lunotriquetral fusion was
demonstrated in 3 (5 %) wrists. Prevalence of Type II lunate was higher than Type I. Wrists with a Type II lunate were wider than those
with Type I. There was no correlation between the width of the wrist and the width of the medial facet of the lunate.

Ogeng’o, JA, Misiani MK, Olabu BO, Waisiko BM, Murunga A.  2016.  BRANCHING PATTERN OF THE LEFT ANTERIOR DESCENDING CORONARY ARTERY IN A BLACK KENYAN POPULATION. Anatomy Journal of Africa . 5(2):755-763. Abstractbranching_pattern_of_the_left_anterior_descending.pdf

Branching pattern of the left anterior descending coronary artery is important in explaining variations in
occurrence of coronary atherosclerosis, informing management strategies for coronary heart disease and
interventional cardiology. Data on African populations are, however, scarce. Since coronary heart disease
is increasing in Africa, the aim of this study was to describe branching pattern of the left anterior
descending coronary artery in an indigenous Kenyan population. Two hundred and eight hearts obtained
during autopsy were dissected at the Department of Human Anatomy, University of Nairobi, Kenya. The
entire left anterior descending coronary artery was exposed. Number of branches, pattern of termination
and level of bifurcation were determined. Images of representative patterns were taken using a high
resolution digital camera. Data are presented in macrographs and tables. The number of septal and
diagonal branches varied between 1 and 3. Termination occurred in the posterior interventricular sulcus
in 68.8% and at the apex in 23% cases. Most common mode of terminal branching was bifurcation
(76.9%) followed by trifurcation (11.3%), quadrifurcation (3.4%) and pentafurcation (1.5%). Bifurcation
occurred in the distal segment in 48.8% and in the proximal segment in 15% of cases. The left anterior
descending coronary artery displays high variability in number of septal and diagonal branches, level of
termination, mode of terminal branching and level of terminal bifurcation. These patterns may constitute
risk factors for atherosclerosis and should also be acknowledged during cardiac procedures. Pre –
operative ultrasound evaluation is recommended to minimize inadvertent iatrogenic injury.

Brian, W, Ogeng’o J, Kirsteen A, Ongeti K, Gichambira G, Olabu Beda.  2016.  MORPHOMETRY OF OSTEODURAL BRIDGEAND THE MYODURAL BRIDGE OF THE RECTUS CAPITIS POSTERIOR MAJOR IN A BLACK KENYAN POPULATION. Anatomy Journal of Africa. . 5(2):735-740. Abstractmorphometry_of_osteodural_bridgeand_the_myodural_bridge_of_the_rectus_capitis_posterior_major_in_a_black_kenyan_population.pdfWebsite

The connective tissue between the rectus capitis posterior major and the cervical dura, popularly known
as the myodural bridge has been postulated to contribute to dural tension monitoring. It prevents dural
enfolding thus preventing stimulation of dural nociceptors which would result in cervicogenic headaches.
Its length may be an indicator of its effectiveness; however, determination of its length radiographically
is difficult. The osteodural bridge, the connective tissue between the axis and dura can be measured
radiographically. The aim of the study was therefore to determine if there is a relationship between their
lengths. Thirty formalin fixed cadavers were meticulously dissected at the department of Human
Anatomy, University of Nairobi, to expose the suboccipital triangle. The lengths of the bridges were
measured using a pair of digital vernier caliper. The data was recorded, coded and analyzed using
Statistical Package for Social Sciences (SPSS) version 21.0. The means and standard deviations were
determined. Histograms and probability plots were generated to determine the normality of the data. A
Pearson’s correlation coefficient was generated to determine a correlation between the length of the
myodural bridge and osteodural bridge. Of the 30 cadavers dissected, all had the myodural bridge and
Osteodural bridge present. The mean length of the myodural bridge was 4.02+/- 0.395 mm. Mean length
of the osteodural bridge was 2.71 +/- 0.311 mm. There was a linear relationship of the equation y=1.02x
+ 1.26 (R2 =0.640). The length of the osteodural bridge may be used as a predictor of the myodural
bridge’s length.

BN, N, H S, JA O’o.  2016.  Preliminary data from a De Novo Trauma Registry. The ANNALS of AFRICAN SURGERY. 12(1):7–11. Abstractpreliminary_data_from_a_de_novo_trauma_registry.pdfWebsite

Background: Trauma remains a significant cause of morbidity and mortality globally. Trauma registries are a key component of trauma systems in developed countries which have promoted improvement of patient care and outcomes. The experience with trauma registries in low income countries is limited. The current study shares preliminary data from the Kenyatta National Hospital Trauma Registry whilst documenting the process of design to implementation. Methods: A de novo registry dataset was designed based on previous studies and programmed as a custom application for deployment to the site. Scope of data collected was demographic, details of injury, pre-hospital events, hospital care and outcomes. Data were summarized as percentages and means for analysis. Results: The development of the registry from concept to operational software took 12 months. Preliminary data revealed an average completion rate of 88.6%. Majority of patients were young males who were referred to the hospital. Accidental injury at home or on the roads was the most common cause of admission with majority of patients not receiving any pre-hospital care. Sixteen percent of patients died while admitted. Conclusion: The data obtained from this de novo registry largely aligns to previous institutional reports while revealing data points for increased focus during training for registry abstraction. This experience may form the platform for trauma quality improvement initiatives at the institution as well as scaling to other institutions to allow for collation of regional trauma data.

Ogeng’o, J, Olabu B, Ongeti K.  2016.  TRANSMEDIAL ZONATION AND REGIONAL VARIATIONS IN TUNICA MEDIA OF AORTA IN SHEEP (Ovis aries). Anatomy Journal of Africa. . 5(2):741-746. Abstracttransmedial_zonation_and_regional_variations_in.pdf

The sheep is a valuable model for cardiovascular studies and its aorta is frequently afflicted by
atherosclerosis and aneurysms. The structure of sheep aorta is, however, only seldom reported. This
study, therefore, aimed at describing the microscopic organization of the tunica media of the aorta in
sheep. Specimens obtained from the aortae of six healthy young adult sheep were fixed in 10%
formaldehyde solution and routinely processed for paraffin embedding and sectioning. Five micron
sections were stained with Weigert’s Resorcin Fuchsin/Van Gieson and examined with a light microscope.
Micrographs were taken with a high resolution digital camera. The tunica media in the ascending, arch
and thoracic regions comprised two zones namely a luminal elastic zone with continuous uniform elastic
lamellae and adventitial musculo-elastic one where there were muscle islands frequently interrupting the
elastic lamellae. The proportion of musculo-elastic zone with the muscle islands declined caudally. In the
abdominal region, however, the tunica media comprised regular continuous concentric elastic lamellae.
These results show that the aorta in sheep displays regional variations characterized by transmedial
zonation of the thoracic segments into an elastic luminal and musculo-elastic adventitial zones. These
differences may underpin the regional differences in physicomechanical properties and vulnerability of
the aorta to diseases such as atherosclerosis and aneurysm.

FB, A, PM M, PI M, J O’o.  2016.  Variant anatomy of the jugular Foramen: An osteological study. Academia Anatomica International. 2(2):38–43. Abstractvariant_anatomy_of_the_jugular_foramen_an_osteolog.pdf

Background:
Jugular foramen lesions are among the major complications
of skull base surgery. Morphological variations in the structure are pertinent
during interpretation of skull base radiographs and in surgical procedures
within the foramen. This study therefore aimed at describing the
morphology of the jugular foramen in a Kenyan population.
Methods:
One
hundred and five adult skulls from the Nairobi National Museums were
used. Jugular foramen septation, dome and dimen sions were studie d
extracranially. Statisti cal analysis was performed using SPSS (Version
21.1 IBM).
Results:
Septation was present in 202 (96.2%) jugular
foramina, type I partial septation being the most common (78.7%). A
dome was observed in 81 (38.6%) jugular foramina. Respectively, the
mean right and left anteroposterior dimensions were 11.17
±
2.05mm
vs.8.88
±
2.30mm (p <0.001), mediolateral dimensions 17.47
±
2.18mm vs.
15.30
±
2.53mm (p <0.001), jugular dome depth 12.38
±
2.64 mm vs.
11.25
±
2.15 mm (p=0.054), posterior wall thickness7.95
±
2.20mm vs.
9.68
±
1.98mm (p <0.001) and medial wall thickness 3.73
±
1.10 mm vs.
3.73
±
0.98mm (p = 0.992).
Conclusion:
Partial septation, asymmetry in
dimensions and a wide range in the dome depth of the jugular foramen
were frequent. Preoperative imaging of jugular foramen morphology is
therefore recommended to avoid inadvertent injury to its contents and
surrounding structures owing to variability.

JA, O’o, Murila F, Obimbo MM, R M, I T, Migiro S.  2016.  Motivation and barriers to Kangaroo mother care amongst health service providers in Kenya. JOGECA . 28(2):2-5. Abstractmotivation_and_barriers_to_kangaroo_mother_care_amongst_health_service_providers_in_kenya.pdf

Introduction: Kangaroo Mother Care (KMC) is a useful and cheap method of caring for low birth weight and premature newborn infants in economically underprivileged countries where access to incubators is limited. Data on knowledge of and barriers to this method amongst health care professionals are important in informing planning for newborn care health services but are largely lacking for African population.
Objective: This study aimed at assessing the knowledge of and barriers to Kangaroo Mother Care amongst health care providers in Kenya.
Method: A structured pretested questionnaire was administered to 155 health workers in Kenya to test the knowledge and barriers to KMC. Data were analyzed using SPSS version 15.0 for windows and results presented using tables, bar and pie charts.
Results: All the 155 health care professionals had heard of Kangaroo Mother Care. Almost half did not have sufficient information on benefits and requirements for KMC. Most respondents (91.2%) thought that personnel with special skills on the practice were needed to oversee it. The most common barriers to practice of Kangaroo Mother Care were inadequate skills (59%), uncooperative mothers (22%), reluctant health care provider (11%) and fear for the safety of the baby (8%).
Conclusion: Most of health professionals in Kenya are aware of Kangaroo Mother Care. Its practice is, however, hampered by their lack of know-how of its benefits, requirements and inadequate skills. Training programs to enlighten health care professionals are recommended

JA, O'o.  2016.   Neuro protective and antiatherogenic potential of Launaea taraxacifolia (wild lettuce).. Anat J Afr;. 5(1):i-ii. Abstractneuro_protective_and_antiatherogenic_potential_of_launaea_taraxacifolia.pdf

Histological and biochemical studies reveal that Launaea taraxacifoliadisplays chemoprotective effects against druginduced oxidative stress, neuronal death and alteration of brain microanatomy (Oweoye et al., 2015). In this issue of the Anatomy Journal Africa,Oweoye and Onwuka(2016)report further structural and chemical evidencethat extracts of this plant ameliorate lead induced neurotoxicity and postulate that theseneuroprotective effectsare due to its antioxidant activity. Anti oxidants protect against oxidative stress induced tissue damage. This suggests that extracts of this plant may affectmultiple organs. Readers of Anatomy Journal of Africa arethereforeencouraged to learn more about such plants and their potential effects.Launaea taraxacifolia,known as wild lettuce, is a leafy vegetable of the family of Asteraceae found in several African countries (Adebisi, 2004). The leaves are eaten fresh as salad or cooked as sauces. They are potential sources of nutrients because they are rich in flavonoids, cardiac glycosides, tarpenoids, tannins, steroids, saponins, cardemolides, β-catotenes; valuable minerals like copper, iron, zinc, sodium, magnesium, calcium, manganese, potassium and phosphorus; essential vitamins such as ascorbic acid, riboflavin, tecopherol; proteins; essential fatty acids and fibre (Adinortey et al., 2012; Gbadamosi et al., 2012; Olugbenga et al., 2015).The antiatherogenic effects of this plant are derived from its chemical composition which confer antioxidant, anti-inflammatory, hypolipidemic, hypotensive, hypoglycemic and free radical scavenging properties (Adewale et al., 2013; Adejuwon et al., 2014;Koukoui et al., 2015; Sanoussi et al., 2015). I advocate for more research on the compositin and therapeutic effects of this plant

JA, O'o, MK M, NM O'o, PM M, IK C, JW W.  2016.   Intima-media thickness of the common Femoral Artery in a Black Kenyan Population: Correlation with Age, Gender and Geometric Factors.. Glob J Hum Anat Physiol Res. 3:1-7. Abstractintima-media-thickness-of-left-anterior-descending-coronary-artery-in-a-black-kenyan-population-correlation-with-morphological-features-2161-0940.10001631.pdf Licensee Synchro Publishe

Abstract: Femoral artery intima - media thickness is a reliable surrogate marker of atherosclerosis and is important for prediction of coronary and peripheral vascular disease, but is seldom reported among black Sub Saharan African populations. This study, therefore, aimed at describing the intima - media thickness of the femoral artery in relation with age, gender and some of its geometric factors. Materials for this study were obtained during autopsy from 208 adult black Kenyans (154 males, 54 females, mean age 36.4 years) who had died of non cardiovascular causes. Those with history of cardiovascular risk factors were excluded. Femoral artery was exposed by dissection. Terminal branching pattern was recorded, and length and bifurcation angle measured. Materials for determination of intima - media thickness were processed routinely for paraffin embedding and sectioning. Five micron sections were stained with Mason’s trichrome, examined with light microscope and pictures taken. The images were digitized and intimal and medial thickness determined according to the protocol by Nakashima et al. [1]. The mean intima - media thickness was 0.76 ± 0.016 mm. It increased with age and was higher in males than females; for trifurcations (0.95 ± 0.032 mm) and also short arteries and those with wide bifurcation angles. Age and gender differences and those between arterial trifurcation and bifurcation attained statistical significance. In conclusion, the mean femoral intima-media thickness of the black Kenyan population studied is higher than those reported for Caucasian populations, increases with age and is higher in males and cases of trifurcation. This suggests that the study population is susceptible to atherosclerosis and that variant terminal branching pattern constitutes a geometric risk factor for atherosclerosis. We recommend ultrasound screening for those at risk.

2015

Ogeng’o, J.  2015.  POTENTIAL ANTIATHEROGENIC EFFECTS OF OCIMUM GRATISSIMUM. Anatomy Journal of Africa.. 4(2):i-iii. Abstractpotential_antiatherogenic_effects_of_ocimum_gratissimum.pdf

Knowledge of potential antiatherogenic effects of plant extracts is important to inform strategies of
improving alternative preventive and therapeutic approaches for atherosclerosis and related diseases
(Salvamani et al., 2014). As atherosclerosis emerges to be of major public health concern in Sub Saharan
Africa, there is need to mitigate the imminent epidemic of this disease through, for example, promotion
of safe use of plant products which are readily available. Ocimum gratissimum is a herbaceous plant
which belongs to the Labiatae family. It is indigeneous in tropical Africa where it is used to treat various
conditions including bacterial, fungal and parasitic infections; degenerative and cardiovascular diseases
(Mlitan et al., 2014; Yvette et al., 2014).
In the current issue of Anatomy Journal of Africa, Iyiola et al (2015) have detailed the chemical
components and uses of Ocimum gratissimum. They have demonstrated that chronic use of its extracts
causes neurodegeneration. This is consistent with toxicity associated with excessive or prolonged drug
use. These observations call for judicious use of the extracts, without negating the positive applications
of this plant, some of which manifest in morphological alterations, and hence interest among anatomists.
Indeed, antiatherogenic effects of plant products have been confirmed through histological observations
(El – Shatanovi et al., 2012).

UoN Websites Search