Bio

DR. AWORI KIRSTEEN

Born on 26th December 1972.

MALE

6 feet 6 inches tall

Publications


2013

Sammy, M;, Awori K;, Odula P;, Munguti J.  2013.  Histological Organization of the Portal Vein: a Structural Adaptation. Abstract

The extra hepatic portion of the portal vein has been known to physiologically act as a capacitance vessel while its intra hepatic portion behaves as a resistance vessel. However, the histological basis for these observations has not been clearly defined. The aim of this study was therefore to describe the histological organization of the portal vein in reference to the observed functional differences in its intra- and extra hepatic portions. Sections of the portal vein were harvested from 24 livers during autopsies at the Chiromo funeral parlor, University of Nairobi, Kenya. They were processed for light microscopic histological evaluation. The structure of both portions was then noted and described. The extra hepatic portion had circular, oblique and longitudinal muscle bundles in its tunica intima, media and adventitia respectively. On the other hand, the intra hepatic portion had abundant fibro-elastic fibers with longitudinal smooth muscles scattered in their tunica media and adventitia. From the results of the current study, the functional differences of both the extra-hepatic and intra-hepatic portions of the PV are accounted for by their different histological structures.

Munguti, J, Odula P, Awori K, Ogeng'o J, Sammy M.  2013.  Variant anatomy of the right portal vein in a black Kenyan population. Abstractkirsteen_awori.pdf

Surface mapping of the liver before invasive procedures depends on a proper understanding of its segmental vasculature. The right portal vein ramification and lengths show marked variations and these mostly involve its right posterior sectoral branch. Their incidence is variable among populations and altogether undocumented among Africans. One hundred livers obtained during autopsies and dissections at the Department of Human anatomy, University of Nairobi, were used in this study. Gross dissection was done to reveal and determine the branching pattern of the right portal vein and the origin of the right posterior sector branch. The lengths of the right portal vein were also measured and recorded. When present, the right portal vein terminated by bifurcation in 61% of the cases, trifurcated in 20.8% and quadrifircated in 18.2%. Its length was between 0.5cm and 4cm. The right posterior sector vein was given off the main portal vein in 34 cases, the common left portal vein trunk in 15 cases, and the right portal vein in 42 cases. In 9 cases, it was not observed at the porta hepatis. We report significant different incidences of the variant anatomy of the right portal vein compared to those found in previous studies and this should be borne in mind when doing surgical interventions

2011

Awori, K.O., PGANG.  2011.  Pattern of innervation of the upper gluteus maximus: Implication in prosthetic hip dislocation. The Annals of African Surgery. 5 (2):1-8.

2010

Gatonga, P, Ogeng'o JA, Awori KO.  2010.  Spinal cord termination in adult Africans: relationship with intercristal line and the transumbilical plane. Abstract

The level of cord termination and level of vertebral intersection of intercristal line and transumbilical plane (TUP), frequently used landmarks, show ethnic variation. The relationship of the spinal cord termination to these lines is vital in spinal surgery and anesthesia, but data on these parameters are scarce in the African population. The purpose of this work is to determine the level of cord termination and establish its relationship with intercristal line and TUP. One hundred and twelve specimens obtained from the department of Human Anatomy at the University of Nairobi were used in this study. The conus medullaris was exposed by laminectomy and its vertebral level together with those of intercristal line and TUP recorded. The distance of conus medullaris from intercristal plane was measured in millimeters. Data obtained were coded and analyzed using Statistical Package for Social Sciences (SPSS) for windows version 16.0 Chicago, Illinois, 2002. Student's t-test was used in the statistical assessment of gender differences. A P value of less than 0.05 was considered significant. The median level of termination of the cord was the upper third of L2, 51.9% of cases terminating below this. There was no statistically significant gender difference in the level of termination of the cord. The intercristal plane passed through L4/L5 disc (70.9%) and below (29.1%). The TUP corresponded with intercristal line in 78.2% of subjects. The mean distance of the spinal cord termination from intercristal line was 99 +/- 24 mm. The spinal cord terminates at or below the upper third of L2. Care should be exercised during lumbar punctures and spinal epidural anesthesia among Africans. Intecristal line and TUP are safe landmarks to use in location of conus medullaris.

Sinkeet, S, Ogeng’o J, Saidi H, Awori K.  2010.  Topography of The Posterior Communicating Artery in a Kenyan Population. Abstract

Configuration and branching pattern of the posterior communicating artery influence occurrence and approaches to management of aneurysms. Distribution of the various configurations and branching patterns shows population variations but reports from Africa are scanty. Configurations observed in the Kenyan population are comparable to those reported in the Caucasian populations. From an anatomical standpoint, the two are equally predisposed to development of aneurysms. Posterior third of PComA had the least number of branches suggesting that the pterional approach to basilar tip aneurysm among Kenyans may be a safer procedure.

KIRSTEEN, DRAWORI, OCHIENG' DRODULAPAUL.  2010.  The suprascapula notch: Its morphology and distance from the glenoid cavityin a Kenyan population. Folia morphol 2010; 69:241-5. : Folio Morphol

2009

Mwachaka, P, Odula PO, Awori K.  2009.  Variations in the pattern of formation of the abdominis rectus muscle sheath among Kenyans. Abstractodula_p.o._rectus_sheath.pdf

The pattern of formation of the human rectus sheath exhibits variations, it is not clear if these variations are population specific. This study aimed at describing the pattern of formation of the rectus sheath in a select Kenyan population. Formation of the rectus sheath was analyzed in eighty subjects (47 male, 33 female) during autopsies and cadaveric dissection. The anterior wall of the rectus sheath in all cases was aponeurotic and firmly attached to rectus abdominis muscle. The posterior wall of the rectus sheath was aponeurotic in 71 (88.5%) cases, the rest were musculoaponeurotic and only seen in males. In all cases the aponeurosis of internal oblique abdominis split into two lamina; a deep lamina that fused with the aponeurosis of transverses abdominis at the lateral border of rectus abdominis and a superficial lamina that fused with aponeurosis of external oblique abdominis mid-way between the medial and lateral borders of rectus abdominis muscle. The pattern of formation of the rectus sheath among Kenyans shows some variations which have not been reported by previous workers. Knowledge of these variations is important in surgery as this sheath is always incised when making most aabdominal incisions.

2008

Olabu, BO, Ogeng’o JA, Awori KO, Saidi H.  2008.  Variations in the formation of supraclavicular brachial plexus among Kenyans. Abstract

To describe the pattern and prevalence of variations that occur in the supraclavicular part of the brachial plexus in a Kenyan population The presence of four trunks and an accessory phrenic nerve passing through the subclavian vein are probably described and reported for the first time. However, most of the variations of the BP among Kenyans are similar to those reported in the other populations

HASSAN, PROFSAIDI, KIRSTEEN DRAWORI.  2008.  Anangwe D, Saidi H, Ogeng'o J, Awori KO. Anatomical variations of the carotid arteries in adult Kenyans. East Afr Med J. 2008 May;85(5):244-7.. Trop Doct. 2008 Apr;38(2):87-9.. : Folio Morphol Abstract
OBJECTIVE: To describe the topography and anatomical variations of the carotid arteries among Kenyans. DESIGN: A descriptive cross-sectional study. SETTING: Department of Human Anatomy, University of Nairobi. SUBJECTS: Eighty carotid arteries of forty cadavers were dissected. RESULTS: The bifurcation of the commonest carotid artery was high (above the reference points) in 63.8% of vessels and the external carotid was antero-lateral to the internal carotid artery in 30% of the vessels. A linguo-facial trunk was the most common variation of the external carotid artery. The origin of the right common carotid artery was high and low in 10% and 2.6% of vessels respectively. CONCLUSION: The carotid arteries show important variability and thus emphasise caution for clinicians during surgical procedures in the neck.
KIRSTEEN, DRAWORI.  2008.  Saidi H, Odula P, Awori K.Child maltreatment at a violence recovery centre in Kenya. Trop Doct. 2008 Apr;38(2):87-9.. Trop Doct. 2008 Apr;38(2):87-9.. : Folio Morphol Abstract

Kenyan media reports indicate escalating levels of child maltreatment, but the characteristics of the offence are undefined. At the Gender and Violence recovery Center of the Nairobi Women's Hospital, we analysed 342 consecutive children for age, gender, perpetrator characteristics, time and scene of assault and the nature of injuries between February 2003 and April 2004. The children comprised 43.5% of all assault survivors. The mean age was 10.0 years and about 20% of the children were < or =5 years. Most (71.5%) of the child sexual abuse (CSA) was perpetrated by people known to the victim. Intra-family CSA (incest) was highest among the one to five year olds. The proportion of assaults committed against boys reduced with the age of the child. Older children were more likely to be assaulted later in the day and by multiple perpetrators. Most recorded injuries were perineal. The majority of children are assaulted by people they had trusted. The epidemiological correlates of maltreatment differ for younger and older children. More effort is needed to further characterize child violence and protect this vulnerable section of the population.

2007

Olabu, B, Saidi H, OGENGO J, Kirsteen A.  2007.  Prevalence and distribution of the third coronary artery in Kenyans.
KIRSTEEN, DRAWORI.  2007.  Awori KO, Atinga JE.Lower limb amputations at the Kenyatta National Hospital, Nairobi. East Afr Med J. 2007 Mar;84(3):121-6.. East Afr Med J. 2007 Mar;84(3):121-6.. : Folio Morphol Abstract
OBJECTIVE: To determine the causes and pattern of lower limb amputations at the Kenyatta National Hospital. DESIGN: Descriptive prospective study. SETTING: The Kenyatta National Hospital between July 2003 and June 2004. RESULTS: A total of 77 lower limb amputations (LLA) were performed on 74 patients. The age ranged from seven months to 96 years (mean 44.8 +/- 22.5). Forty six patients (62.1%) were male. Majority of the patients (89.1%) had primary or no formal education, forty one (55.4%) were unemployed, with 39% self employed in the informal sector. Peripheral vascular diseases were the main indication for LLA (55.3%), 13 patients (17.5%) due to diabetes-related gangrene. Eighteen patients (24.3%) had tumours, mainly osteogenic sarcoma (16.2%), while trauma accounted for 18.9%. Forty two (55%) of the amputations were above-the-knee, 24 (31%) below-the-knee, four (5%) hip disarticulations and seven (9%) were foot amputations. CONCLUSION: This study found peripheral vascular diseases unrelated to diabetes to be the main indication for lower limb amputations at Kenyatta National Hospital contrary to previous institutional and loco-regional studies which report trauma as the leading cause. Further investigation into vascular causes is therefore recommended.

2006

Awori, KO, Saidi SH, Kiptoon DK.  2006.  Acute acalculous cholecystitis in an outpatient setting. AbstractWebsite

Acute acalculous cholecystitis (AAC) typically affects hospitalized patients with critical illness. Outpatient AAC is reported to occur in elderly males with cardiovascular comorbidities. We report the presentation of acute acalculous cholecystitis in two young African men admitted for the first time within days of each other. They reported short histories of right upper abdominal pain and had tender gallbladders. Sonography revealed gallbladder wall thickening. Open cholecystectomy and histology confirmed AAC.The postoperative outcome was excellent. Recognition of AAC in a subset of young male patients presenting de novo with right upper quadrant pain is stressed. Cholecystectomy has good prognosis in these cases.

2004

Awori, KO.  2004.  Assessment of the outcome of lower limb amputations as seen in Kenyatta National Hospital. Abstract

This study was designed to assess the outcome of lower limb amputations as managed at the Kenyatta National Hospital. A prospective analysis of consecutive patients who underwent lower limb amputations at the Kenyatta National Hospital between July 1st, 2003 and June 30th, 2004 was performed. Data on the management and outcome were collected using questionnaires administered to the patients while admitted and in the follow-up clinics. The main outcome measures were the duration of hospital stay, duration of wound healing, need for operative revision, need to convert to a higher amputation level, degree of mobility and the thirty-day postoperative mortality. A total of74 patients (46 males) underwent 77 lower limb amputations. The mean age at operation was 44.4 years (range 7 months - 96 years). Ninety one percent were major amputations; 42 AKA ( 3 bilateral), 24 BKA and 4 hip disarticulations. Open amputations comprised 23% of the total. Extremity gangrene due to peripheral vascular diseases was the main indication for amputation (55%). Anaemia was the most common co-morbid condition (27%) followed by diabetes (18%), while stump infection was the commonest complication (33%). The thirty-day mortality rate was 13.5%. The healing rate for BKA was significantly less than for AKA, with a 21% rate of eventual conversion of BKA to AKA. Most of the patients (70%) were ambulating on crutches The average duration of hospital stay was 29.3 days. There was no patient who was using a prosthetic limb during the study period.

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