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Publications

2012

Munoli, R.N; Praharaj, BSK; SM.  2012.  Localized exfoliating rash with paresthesia possibly due to clonazepam..

2011

Omosa-Manyonyi, GS, Anzala O, Jaoko W, Ogutu H, Wakasiaka S, Malogo R, Nyange J, Njuguna P, Ndinya-Achola JO, Bhatt K, Bashir F, Oyaro M, Schmidt C, Priddy F, Fast P.  2011.  Reasons for Ineligibility in phase 1 and 2A HIV Vaccine Initiative (KAVI), Kenya. Abstract

With the persistent challenges towards controlling the HIV epidemic, there is an ongoing need for research into HIV vaccines and drugs. Sub-Saharan African countries - worst affected by the HIV pandemic - have participated in the conduct of clinical trials for HIV vaccines. In Kenya, the Kenya AIDS Vaccine Initiative (KAVI) at the University of Nairobi has conducted HIV vaccine clinical trials since 2001

2010

M, PROFBHATTKIRNA.  2010.  Antoinette K Tshefu, Oumar Gaye, Kassoum Kayentao, Ricardo Thompson, Kirana M Bhatt, Sanie SS Sesay, Dorina G Bustos, Emiliana Tjitra, George Bedu-Addo, Isabelle Borghinin-fuhrer, Stephan Duparc, Chang Sik Shin, Lawrence Fleckenstein and the Pyronaridine/. A journal of the Arid lands information network, April 1993.. : The Lancet 375:1457- 1467 Abstract
n/a

2009

Jaoko, W, OGUTU H, WAKASIAKA S, MALOGO R, NDAMBUKI R, NYANGE J, OMOSA-MANYONYI G, FAST P, SCHMIDT C, VERLINDE C, SMITH C, Bhatt KM, Ndinya-Achola JO, Anzala O.  2009.  Pregnancy rates among female participants in phase I and phase IIA AIDS vaccine clinical trials in Kenya. Abstract

Female participants in AIDS candidate vaccine clinical trials must agree to use effective contraception to be enrolled into the studies, and for a specified period after vaccination, since the candidate vaccines’ effects on the embryo or foetus are unknown.country settings. Effective female-controlled contraceptives, administered at the clinical trial site, may empower female participants to better control their fertility, leading to more complete clinical trial data.

2008

M, PROFBHATTKIRNA.  2008.  Walter Jaoko, Frederick N. Nakwagala, Omu Anzala, Gloria Omosa Manyonyi, Josphine Birungi, Annet`Nanvuba, Farah Bashir, Kirana Bhatt, Hilda Ogutu, Sabina Waksiaka, Lucy Matu, Wambui Waruingi, Jane Odada, Micah Oyaro, Jackton Indagasi, Jeckonia Ndinya Acho. A journal of the Arid lands information network, April 1993.. : Vaccine 26:2788- 2795 Abstract
n/a

2006

M, PROFBHATTKIRNA.  2006.  Bhatt KM, Samia BM, Bhatt SM, Wasunna KM.Efficacy and safety of an artesunate/mefloquine combination, (artequin) in the treatment of uncomplicated P. falciparum malaria in Kenya. East Afr Med J. 2006 May;83(5):236-42.. East Afr Med J. 2006 Jun;83(6):295-305.. : Vaccine 26:2788- 2795 Abstract
BACKGROUND: Although artesunate and mefloquine have been used as monotherapies in the treatment of malaria in Kenya for a long time, there is insufficient data on the clinical outcome when used as combination therapy in this population. OBJECTIVE: To derive data on the efficacy and safety profile of artesunate-mefloquine combination in the treatment of uncomplicated Plasmodium falciparum malaria in Kenya. DESIGN: An open label single arm clinical trial. SETTING: Bungoma district Hospital. Study area was Bungoma District of Kenya, an endemic area of malaria. The study was conducted between January 2004 and April 2004. SUBJECTS: A total of 200 males and females with uncomplicated plasmodium falciparum malaria weighing 35kg and above were recruited in the study. RESULTS: In the evaluable patient population the day 28 cure rate was 98.4% while day 14 and 7 cure rates were 98.4% and 99.2% respectively. There was rapid relief of symptoms the median time of fever clearance was one day and the most common drug related adverse events were headache dizziness and asthenia. There was no significant derangement in the haematological, biochemical and ECG parameters in the patients on treatment. CONCLUSION: Artesunate-mefloquine combination given simultaneously was found to be highly effective and safe in the treatment of uncomplicated malaria.
M, PROFBHATTKIRNA.  2006.  Bronchoscopic study on aetiology of chronic cough in HIV-infected adults with negative sputum smears for Mycobacterium tuberculosis at Kenyatta National Hospital, Nairobi. East Afr Med J. 2006 Jun;83(6):295-305.. East Afr Med J. 2006 Jun;83(6):295-305.. : Vaccine 26:2788- 2795 Abstract
OBJECTIVE: To establish the aetiology of chronic cough in HIV-infected patients with negative sputum smears for Acid Fast Bacilli (AFB). DESIGN: A cross-sectional descriptive study. SETTING: Kenyatta National Hospital, a tertiary referral centre in Kenya SUBJECTS: Sixty five HIV-infected adults presenting with chronic cough and negative sputum smears for AFBs. RESULTS: Sixty-two patients were included in the final analysis. Aetiology of chronic cough was established in 42 (68%) patients. Pneumocystis jiroveci, bacterial pneumonia and Mycobacterium tuberculosis were diagnosed in 22 (35.5%), 17 (27.4%) and 14 (22.5%) patients respectively. Majority (98%) of patients with a diagnosis had multiple causes established in them. Ciprofloxacin had activity against 91% of the isolated organisms while Penicillin was active against 35% only. CONCLUSION: This study documents Pneumocystis jiroveci pneumonia as a common cause of morbidity in a subset of HIV infected patients with chronic cough and negative sputum smears for AFB in Kenya

2002

M, PROFBHATTKIRNA.  2002.  Bhatt KM, Bhatt SM.Anthrax revisited. East Afr Med J. 2002 Jul;79(7):364-7.. East Afr Med J. 2006 Jun;83(6):295-305.. : Vaccine 26:2788- 2795 Abstract
BACKGROUND: Anthrax is an ancient disease affecting animals and humans. Sporadic cases of anthrax and small epidemics have been seen from time to time in different parts of the world and in Africa. However many clinicians are not very familiar with the various presentations and management of anthrax. It is relevant for the health care workers to re-familiarise themselves with all aspects of anthrax, with the impending threat of bioterrorism. OBJECTIVE: To familiarise healthcare workers on all aspects of anthrax. STUDY SELECTION: To describe epidemiology pathogenesis, clinical features, management and prevention of anthrax including measures to take when weapons grade anthrax is suspected. DATA SYNTHESIS: Three forms of the disease are recognised, cutaneous, inhalational and intestinal. Cutaneous anthrax is the most common form. Inhalation anthrax is the most severe form of anthrax. The treatment of anthrax in most cases is penicillin, however with the threat of bioterrorism, intentional releases of anthrax spores in the environment has caused much concern. Weapons grade anthrax of more virulent strain and resistant to commonly used antibiotics is possible. CONCLUSION: In view of the different clinical presentations and outcomes it is important that health care workers re-familiarise themselves with the disease and in the event of bioterrorism are able to take appropriate measures.

2000

M, PROFBHATTSHRIKANTBABU, M PROFBHATTKIRNA.  2000.  January . The African Journal of Hospital Medicine. Vol.17 No. 1 pg.11-13. : Vaccine 26:2788- 2795 Abstract
BACKGROUND: Anthrax is an ancient disease affecting animals and humans. Sporadic cases of anthrax and small epidemics have been seen from time to time in different parts of the world and in Africa. However many clinicians are not very familiar with the various presentations and management of anthrax. It is relevant for the health care workers to re-familiarise themselves with all aspects of anthrax, with the impending threat of bioterrorism. OBJECTIVE: To familiarise healthcare workers on all aspects of anthrax. STUDY SELECTION: To describe epidemiology pathogenesis, clinical features, management and prevention of anthrax including measures to take when weapons grade anthrax is suspected. DATA SYNTHESIS: Three forms of the disease are recognised, cutaneous, inhalational and intestinal. Cutaneous anthrax is the most common form. Inhalation anthrax is the most severe form of anthrax. The treatment of anthrax in most cases is penicillin, however with the threat of bioterrorism, intentional releases of anthrax spores in the environment has caused much concern. Weapons grade anthrax of more virulent strain and resistant to commonly used antibiotics is possible. CONCLUSION: In view of the different clinical presentations and outcomes it is important that health care workers re-familiarise themselves with the disease and in the event of bioterrorism are able to take appropriate measures.
M, PROFBHATTSHRIKANTBABU, M PROFBHATTKIRNA.  2000.  2000 - Evaluation of efficacy and tolerance of . East Afr Med J. 2006 Jun;83(6):295-305.. : Vaccine 26:2788- 2795 Abstract
BACKGROUND: Anthrax is an ancient disease affecting animals and humans. Sporadic cases of anthrax and small epidemics have been seen from time to time in different parts of the world and in Africa. However many clinicians are not very familiar with the various presentations and management of anthrax. It is relevant for the health care workers to re-familiarise themselves with all aspects of anthrax, with the impending threat of bioterrorism. OBJECTIVE: To familiarise healthcare workers on all aspects of anthrax. STUDY SELECTION: To describe epidemiology pathogenesis, clinical features, management and prevention of anthrax including measures to take when weapons grade anthrax is suspected. DATA SYNTHESIS: Three forms of the disease are recognised, cutaneous, inhalational and intestinal. Cutaneous anthrax is the most common form. Inhalation anthrax is the most severe form of anthrax. The treatment of anthrax in most cases is penicillin, however with the threat of bioterrorism, intentional releases of anthrax spores in the environment has caused much concern. Weapons grade anthrax of more virulent strain and resistant to commonly used antibiotics is possible. CONCLUSION: In view of the different clinical presentations and outcomes it is important that health care workers re-familiarise themselves with the disease and in the event of bioterrorism are able to take appropriate measures.

1999

M, PROFBHATTKIRNA.  1999.  May /June 1999 Aspects of Malaria. Bhatt K.M. Medical review Journal of Medicine. Vol. 5 No.2 pg. 20-23.. The African Journal of Hospital Medicine. Vol.17 No. 1 pg.11-13. : Vaccine 26:2788- 2795 Abstract
BACKGROUND: Anthrax is an ancient disease affecting animals and humans. Sporadic cases of anthrax and small epidemics have been seen from time to time in different parts of the world and in Africa. However many clinicians are not very familiar with the various presentations and management of anthrax. It is relevant for the health care workers to re-familiarise themselves with all aspects of anthrax, with the impending threat of bioterrorism. OBJECTIVE: To familiarise healthcare workers on all aspects of anthrax. STUDY SELECTION: To describe epidemiology pathogenesis, clinical features, management and prevention of anthrax including measures to take when weapons grade anthrax is suspected. DATA SYNTHESIS: Three forms of the disease are recognised, cutaneous, inhalational and intestinal. Cutaneous anthrax is the most common form. Inhalation anthrax is the most severe form of anthrax. The treatment of anthrax in most cases is penicillin, however with the threat of bioterrorism, intentional releases of anthrax spores in the environment has caused much concern. Weapons grade anthrax of more virulent strain and resistant to commonly used antibiotics is possible. CONCLUSION: In view of the different clinical presentations and outcomes it is important that health care workers re-familiarise themselves with the disease and in the event of bioterrorism are able to take appropriate measures.

1996

M, PROFBHATTSHRIKANTBABU, M PROFBHATTKIRNA.  1996.  K.M. Bhatt and Bhatt S.M., Recent development in the management of opportunistic infections in AIDS. Medics 1996; vol. 15, 11 . AIDS. Medics 1996; vol. 15, 11 . : Vaccine 26:2788- 2795 Abstract

Meningococcal meningitis has been recognised as serious problem for almost 200 years. In Africa the disease occurs in epidemics periodically during the hot and dry weather in the "meningitis belt" and in east Africa, which is outside this belt the epidemics tend to occur during the cold and dry months. The infection is mainly transmitted from person to person by nasopharyngeal carriers in crowded places like refugee camps and army barracks. The rural/urban migration, the basic structural conditions of housing in squatter settlements and slums together with an overcrowded transport system have also contributed to the transmission of meningococcal meningitis. The earlier treatment of meningococcal meningitis was by the way of repeated CSF drainage. The first important advance in the treatment was intrathecal injection of antimeningococcal serum. A major break through in the treatment was the introduction of sulphonamides which was the preferred treatment until emergence of resistance to sulphonamides in mid 1960's. Penicillin remains the drug of choice currently. Mass immunisation of selected communities using polyvalent A and C polysaccharide vaccine is a useful control measure. Chemoprophylaxis is generally not recommended during epidemics. Given the current population densities and rural/urban migration together with financial constraints, future epidemic in Kenya may be more explosive unless strict surveillance programmes are maintained.
M, PROFBHATTSHRIKANTBABU, M PROFBHATTKIRNA.  1996.  K.M. Bhatt, Bhatt S.M. and N.B. Mirza, Meningococcal meningitis E.A.M. J. 1996; Vol. 73, 35 . E.A.M. J. 1996; Vol. 73, 35 . : Vaccine 26:2788- 2795 Abstract

Meningococcal meningitis has been recognised as serious problem for almost 200 years. In Africa the disease occurs in epidemics periodically during the hot and dry weather in the "meningitis belt" and in east Africa, which is outside this belt the epidemics tend to occur during the cold and dry months. The infection is mainly transmitted from person to person by nasopharyngeal carriers in crowded places like refugee camps and army barracks. The rural/urban migration, the basic structural conditions of housing in squatter settlements and slums together with an overcrowded transport system have also contributed to the transmission of meningococcal meningitis. The earlier treatment of meningococcal meningitis was by the way of repeated CSF drainage. The first important advance in the treatment was intrathecal injection of antimeningococcal serum. A major break through in the treatment was the introduction of sulphonamides which was the preferred treatment until emergence of resistance to sulphonamides in mid 1960's. Penicillin remains the drug of choice currently. Mass immunisation of selected communities using polyvalent A and C polysaccharide vaccine is a useful control measure. Chemoprophylaxis is generally not recommended during epidemics. Given the current population densities and rural/urban migration together with financial constraints, future epidemic in Kenya may be more explosive unless strict surveillance programmes are maintained.
M, PROFBHATTSHRIKANTBABU, M PROFBHATTKIRNA.  1996.  Bhatt K.M., Bhatt S.M., Omonge E, Oteko L. and Andriel M. Efficacy of a sequential Artesunate suppository . E.A.M. J. 1996; Vol. 73, 35 . : Vaccine 26:2788- 2795 Abstract

Meningococcal meningitis has been recognised as serious problem for almost 200 years. In Africa the disease occurs in epidemics periodically during the hot and dry weather in the "meningitis belt" and in east Africa, which is outside this belt the epidemics tend to occur during the cold and dry months. The infection is mainly transmitted from person to person by nasopharyngeal carriers in crowded places like refugee camps and army barracks. The rural/urban migration, the basic structural conditions of housing in squatter settlements and slums together with an overcrowded transport system have also contributed to the transmission of meningococcal meningitis. The earlier treatment of meningococcal meningitis was by the way of repeated CSF drainage. The first important advance in the treatment was intrathecal injection of antimeningococcal serum. A major break through in the treatment was the introduction of sulphonamides which was the preferred treatment until emergence of resistance to sulphonamides in mid 1960's. Penicillin remains the drug of choice currently. Mass immunisation of selected communities using polyvalent A and C polysaccharide vaccine is a useful control measure. Chemoprophylaxis is generally not recommended during epidemics. Given the current population densities and rural/urban migration together with financial constraints, future epidemic in Kenya may be more explosive unless strict surveillance programmes are maintained.

1995

Bhatt, SM;, Cabellos, C;, Nadol, JB Jr;, Halpin C;, Lauretano A;, Xu WZ;, Tuomanen E.  1995.  The impact of dexamethasone on hearing loss in experimental pneumococcal meningitis.. Abstract

Bacterial meningitis, particularly that resulting from Streptococcus pneumoniae, is a common cause of acquired profound sensorineural deafness in children. The pathogenesis of meningogenic hearing loss has been investigated in an experimental rabbit model. In this study significant deafness was documented within the first 15 hours of infection. Initiation of antibiotic therapy at this time diminished the severity of hearing loss in most animals. The addition of dexamethasone to antibiotic therapy prevented the development of profound deafness. These results suggest this model will be useful in developing antiinflammatory strategies to improve the outcome of bacterial meningitis.
M, PROFBHATTKIRNA.  1995.  1995 - Views on HIV and Herpes Zoster - K.M Bhatt and Z.W Njoroge. Medical Review. Pg. 20.. AIDS. Medics 1996; vol. 15, 11 . : Vaccine 26:2788- 2795 Abstract

Meningococcal meningitis has been recognised as serious problem for almost 200 years. In Africa the disease occurs in epidemics periodically during the hot and dry weather in the "meningitis belt" and in east Africa, which is outside this belt the epidemics tend to occur during the cold and dry months. The infection is mainly transmitted from person to person by nasopharyngeal carriers in crowded places like refugee camps and army barracks. The rural/urban migration, the basic structural conditions of housing in squatter settlements and slums together with an overcrowded transport system have also contributed to the transmission of meningococcal meningitis. The earlier treatment of meningococcal meningitis was by the way of repeated CSF drainage. The first important advance in the treatment was intrathecal injection of antimeningococcal serum. A major break through in the treatment was the introduction of sulphonamides which was the preferred treatment until emergence of resistance to sulphonamides in mid 1960's. Penicillin remains the drug of choice currently. Mass immunisation of selected communities using polyvalent A and C polysaccharide vaccine is a useful control measure. Chemoprophylaxis is generally not recommended during epidemics. Given the current population densities and rural/urban migration together with financial constraints, future epidemic in Kenya may be more explosive unless strict surveillance programmes are maintained.
M, PROFBHATTKIRNA.  1995.  1995 - Current Malarial chemotherapy. Bhatt K. M.. The New African Journal of Medicine - Vol:11. Pg.11-12.. AIDS. Medics 1996; vol. 15, 11 . : Vaccine 26:2788- 2795 Abstract

Meningococcal meningitis has been recognised as serious problem for almost 200 years. In Africa the disease occurs in epidemics periodically during the hot and dry weather in the "meningitis belt" and in east Africa, which is outside this belt the epidemics tend to occur during the cold and dry months. The infection is mainly transmitted from person to person by nasopharyngeal carriers in crowded places like refugee camps and army barracks. The rural/urban migration, the basic structural conditions of housing in squatter settlements and slums together with an overcrowded transport system have also contributed to the transmission of meningococcal meningitis. The earlier treatment of meningococcal meningitis was by the way of repeated CSF drainage. The first important advance in the treatment was intrathecal injection of antimeningococcal serum. A major break through in the treatment was the introduction of sulphonamides which was the preferred treatment until emergence of resistance to sulphonamides in mid 1960's. Penicillin remains the drug of choice currently. Mass immunisation of selected communities using polyvalent A and C polysaccharide vaccine is a useful control measure. Chemoprophylaxis is generally not recommended during epidemics. Given the current population densities and rural/urban migration together with financial constraints, future epidemic in Kenya may be more explosive unless strict surveillance programmes are maintained.

1994

M, PROFBHATTKIRNA.  1994.  Bhatt KM.Laboratory diagnosis of malaria – overview. Afr J Med Pract. 1994 Mar-Apr;1(1):12.. East Afr Med J. 1994 May;71(5):334-5. : Vaccine 26:2788- 2795 Abstract
PIP: Features of the laboratory diagnosis of malaria are described. Microscope equipment is absolutely essential. Clinical symptoms are inadequate for the proper diagnosis of malaria. Screening for malaria involves identification of all cases where high fever is present in endemic areas. Diagnosis is complicated because many people take antimalarial drugs which reduce the chances of detecting malarial parasites. Confirmation should be made before treatment is administered. A thick blood slide can be quickly and cheaply taken without much training of health personnel. The disadvantage of thick stains is the difficulty in identifying "plasmodium" strains. When a thin smear with Giemsa and Leishmanin stain is used, a light infection may be missed. Thin smears require trained personnel and time, which in peak seasons may be impractical. Urinary tract and viral infections may be confused with malaria. Evidence of parasites can be discerned from thick stains. Modern assay techniques are also available. There are enzyme linked immunosorbent assays (ELISA) and immunofluorescent assay techniques (IFAT), which are frequently used in large scale seroepidemiological studies. DNA probes have the limitation of radioisotope handling problems. Acridine orange fluorescent microscopy with capillary centrifuged blood is a technique which improves the viability of Giemsa stain procedures. This technique is desirable because of the sensitivity and speed of diagnosis. The quantitative buddy coat (GBC) technique is superior to Giemsa stained thick blood film in identifying malaria, but it is not reliable with mixed infections. Advanced techniques are not readily available in local settings. The recommendation is to continue use of thick or thin blood film and trained health personnel. Laboratory results must be interpreted in the context of when the flood film was prepared, prior drug administration, and clinical manifestations.
M, PROFBHATTKIRNA, O PROFOBELARTHUR.  1994.  Cryptosporidiosis in HIV positive patients at Kenyatta National Hospital, Nairobi, Kenya. East Afr Med J. 1994 May;71(5):334-5. East Afr Med J. 1994 May;71(5):334-5. : Vaccine 26:2788- 2795 Abstract
Blackwater fever was an important cause of morbidity and mortality in the beginning of this century particularly in West and Central Africa. There has been a marked reduction in the incidence of blackwater fever since 1950 and only sporadic cases occur nowadays. At the Kenyatta National Hospital, three cases of blackwater fever have been seen in the past four years whereas not a single case had been reported between 1975 and 1988. Two of the patients fit into the classical description of blackwater fever and one was possibly due to drug induced haemolysis in a G6PD deficiency patient.
M, PROFBHATTSHRIKANTBABU, M PROFBHATTKIRNA.  1994.  K.M. Bhatt., Bhatt S.M., Tombe, Blackwater fever at the Kenyatta National Hospital in Kenya: E.A.M.J. 1994; Vol. 71, 755 . E.A.M.J. 1994; Vol. 71, 755 . : Vaccine 26:2788- 2795 Abstract
Blackwater fever was an important cause of morbidity and mortality in the beginning of this century particularly in West and Central Africa. There has been a marked reduction in the incidence of blackwater fever since 1950 and only sporadic cases occur nowadays. At the Kenyatta National Hospital, three cases of blackwater fever have been seen in the past four years whereas not a single case had been reported between 1975 and 1988. Two of the patients fit into the classical description of blackwater fever and one was possibly due to drug induced haemolysis in a G6PD deficiency patient.
M, PROFBHATTKIRNA.  1994.  Bhatt K.M., Bhatt S.M..: Recurrent polyneuropathy in pregnancy: A case report. East Afr. Med. J. 1994; Vol. 71, 614 . East Afr. Med. J. 1994; Vol. 71, 614 . : Vaccine 26:2788- 2795 Abstract
A 33-year old female patient presented with recurrent polyneuropathy during two consecutive pregnancies and recovered completely after spontaneous abortion the first time and after a normal delivery the second time. The patient has had a tubal ligation since then and has remained well up to date.

1993

M, PROFBHATTKIRNA.  1993.  Feb. 1993 - Clinical surprises and challenges of severe malaria at Kenyatta National Hospital - Kenya. M Tombe, Bhatt, K. M., AOK Obel. EAMJ Vol. 70 pg 117-119.. EAMJ Vol. 70 pg 117-119.. : Vaccine 26:2788- 2795 Abstract
While conducting a clinical trial study from July, 1989 to February 1990, we noted with surprise some clinically challenging manifestations of severe falciparum malaria at Kenyatta National Hospital, Kenya. Of the 33 cases we studied, this paper summarises two fatal cases of malaria, one case presenting with hyperglycaemia and one with severe anaemia.

1992

M, PROFBHATTKIRNA.  1992.  Bhatt KM, Mirza NB.Rat bite fever: a case report of a Kenyan. East Afr Med J. 1992 Sep;69(9):542-3. Review.. EAMJ Vol. 69 no. 9 pg 542-543.. : Vaccine 26:2788- 2795 Abstract
Rat bite fever has not been reported from Kenya previously. A case of 17 year old Kenyan male who was diagnosed to have rat bite fever after a bite of domestic rat is described. The history, clinical features and demonstration of spirillum like organisms from a thick blood film suggest infection due to spirillum minus. The patient recovered completely after a course of penicillin and gentamicin.
M, PROFBHATTKIRNA.  1992.  Tombe M, Bhatt KM, Obel AO.Quinine loading dose in severe Falciparum malaria at Kenyatta National Hospital, Kenya. East Afr Med J. 1992 Dec;69(12):670-4.. EAMJ Vol. 69 no. 9 pg 542-543.. : Vaccine 26:2788- 2795 Abstract
From July 1989 to February 1990, 17 non-pregnant patients with severe falciparum malaria, aged 14 years and above received an initial intravenous quinine dihydrochloride loading dose of 20 mg/kg in 500 mls of normal saline or 5% dextrose infused over 4 hours followed by 100mg/kg infused 8 hourly for at least 24 hours. Sixteen comparable controls were similarly treated but without an initial loading dose. Oral quinine bisulfate 10mg/kg 8 hourly was substituted for a total of 7 days when patients were well enough. There was no significant difference in clinical and parasitological response between the two groups. Fever clearance time in hours was 44.00 +/- 13.92 (mean +/- SD) in the study group and 51.43 +/- 19.63 (mean +/- SD) in the control group (p > 0.05). Parasite clearance time in hours was 42.40 +/- 9.75 (mean +/- SD) in the study group and 47.05 +/- 7.69 (mean +/- SD) in the control group (p > 0.05). One patient from each group died. Mild toxic effects were common in both groups. Transient partial hearing loss occurred significantly more in the study than control group (p < 0.05). Hypoglycaemia during treatment occurred in 3 (18%) patients in the study group and 1 (6%) in the control group. The mean trough and peak plasma quinine levels in 3 patients per group was persistently higher than 9mg/L after first infusion. We conclude that though fairly well tolerated, quinine loading dose appears to have no advantage over the standard treatment for severe falciparum malaria at Kenyatta National Hospital, Nairobi, Kenya.
M, PROFBHATTKIRNA.  1992.  Sept. 1992 - Rat bite fever - A case of a Kenyan. Bhatt, K. M. and NB Mirza. EAMJ Vol. 69 no. 9 pg 542-543.. EAMJ Vol. 69 no. 9 pg 542-543.. : Vaccine 26:2788- 2795 Abstract
Rat bite fever has not been reported from Kenya previously. A case of 17 year old Kenyan male who was diagnosed to have rat bite fever after a bite of domestic rat is described. The history, clinical features and demonstration of spirillum like organisms from a thick blood film suggest infection due to spirillum minus. The patient recovered completely after a course of penicillin and gentamicin.

1991

M, PROFBHATTKIRNA.  1991.  Okelo GB, Sang D, Bhatt KM.The treatment of diffuse cutaneous leishmaniasis: a report of two cases. East Afr Med J. 1991 Jan;68(1):67-8. No abstract available.. EAMJ Vol. 69 no. 9 pg 542-543.. : Vaccine 26:2788- 2795 Abstract
Rat bite fever has not been reported from Kenya previously. A case of 17 year old Kenyan male who was diagnosed to have rat bite fever after a bite of domestic rat is described. The history, clinical features and demonstration of spirillum like organisms from a thick blood film suggest infection due to spirillum minus. The patient recovered completely after a course of penicillin and gentamicin.

1988

Bhatt, KM.  1988.  HIV infection at KNH Medicus.
M, PROFBHATTKIRNA.  1988.  Feb. 1988 - Diagnosis and treatment of pneumonia in patients with chronic respiratory disease. Bhatt K. M. The Nairobi Journal of Medicine. Vol. 13 no. 2.. The Nairobi Journal of Medicine. Vol. 13 no. 2.. : Vaccine 26:2788- 2795 Abstract
Rat bite fever has not been reported from Kenya previously. A case of 17 year old Kenyan male who was diagnosed to have rat bite fever after a bite of domestic rat is described. The history, clinical features and demonstration of spirillum like organisms from a thick blood film suggest infection due to spirillum minus. The patient recovered completely after a course of penicillin and gentamicin.

1987

M, PROFBHATTKIRNA.  1987.  Okelo GB, Bhatt KM.A case of trichinosis seen at the Kenyatta National Hospital (KNH). East Afr Med J. 1987 Feb;64(2):155. No abstract available.. East Afr Med J. 1987 Dec;64(12):821-4.. : Vaccine 26:2788- 2795 Abstract
Rat bite fever has not been reported from Kenya previously. A case of 17 year old Kenyan male who was diagnosed to have rat bite fever after a bite of domestic rat is described. The history, clinical features and demonstration of spirillum like organisms from a thick blood film suggest infection due to spirillum minus. The patient recovered completely after a course of penicillin and gentamicin.
M, PROFBHATTKIRNA.  1987.  A retrospective study of the mortality from malaria during 1984-1985 at the Kenyatta National Hospital. East Afr Med J. 1987 Dec;64(12):821-4.. East Afr Med J. 1987 Dec;64(12):821-4.. : Vaccine 26:2788- 2795 Abstract
Rat bite fever has not been reported from Kenya previously. A case of 17 year old Kenyan male who was diagnosed to have rat bite fever after a bite of domestic rat is described. The history, clinical features and demonstration of spirillum like organisms from a thick blood film suggest infection due to spirillum minus. The patient recovered completely after a course of penicillin and gentamicin.
M, PROFBHATTKIRNA.  1987.  1987 - Evaluation of Elisa system in the diagnosis of leishmaniasis. Thesis for MSc. in Clinical Tropical Medicine. Bhatt K. M.. The Nairobi Journal of Medicine. Vol. 13 no. 2.. : Vaccine 26:2788- 2795 Abstract
Rat bite fever has not been reported from Kenya previously. A case of 17 year old Kenyan male who was diagnosed to have rat bite fever after a bite of domestic rat is described. The history, clinical features and demonstration of spirillum like organisms from a thick blood film suggest infection due to spirillum minus. The patient recovered completely after a course of penicillin and gentamicin.

1985

Klauss, V; Bhatt, SM.  1985.  Lipaemia retinalis: a case report..
M, PROFBHATTSHRIKANTBABU, M PROFBHATTKIRNA.  1985.  Bhatt S.M. and Bhatt K.M.: Treatment of plasmodium falciparum malaria Medicus 1985; vol. 4 No. 8: 23 . Medicus 1985; vol. 4 No. 8: 23 . : Vaccine 26:2788- 2795 Abstract
PIP: Malaria is the most prevalent and devastating public health problem in Africa despite much research and control effort over the last two decades. In most parts of Africa, individuals should take 200 mg of Proguanil daily together with chloroquine 5 mg/kg per week as prophylaxis. Pregnant women and individuals with underlying disease such as sickle cell making them susceptible to severe or complicated malaria, however, should take just 200 mg Proguanil daily. In hard-core multi-drug resistance areas, mefloquine 250 mg once weekly together with chloroquine 300 mg weekly is recommended as prophylaxis. Since no anti-malarial drug confers absolute protection against infection, however, using mosquito nets impregnated with permethrin, insecticides, and mosquito repellents is also advocated for those at high risk of severe malaria. The need also exists to treat cases of malaria when prevention is unsuccessful. Chloroquine in total dose 25 mg/Kg over three days is the first choice treatment of uncomplicated malaria in 4-aminoquinoline sensitive areas. Amodiaquine 25 mg/Kg over three days is the second line treatment, while pyrimethamine/sulphonamide combinations are useful in areas where there is resistance to 4-aminoquinalines. Finally, quinine 10 mg/kg every eight hours for seven days is the treatment of choice for severe and complicated malaria.
M, PROFBHATTKIRNA.  1985.  1985 - Retrospective study of morality in malaria during 1984 - 1985 at Kenyatta National Hospital (KNH). GBA Okelo, AK Kemtai, Bhatt K. M. .EAMJ Vol. 64 pg 21.. EAMJ Vol. 64 pg 21.. : Vaccine 26:2788- 2795 Abstract
Rat bite fever has not been reported from Kenya previously. A case of 17 year old Kenyan male who was diagnosed to have rat bite fever after a bite of domestic rat is described. The history, clinical features and demonstration of spirillum like organisms from a thick blood film suggest infection due to spirillum minus. The patient recovered completely after a course of penicillin and gentamicin.

1984

M, PROFBHATTKIRNA.  1984.  Rees PH, Kager PA, Kyambi JM, Ayim EN, Bhatt KM, Schattenkerk JK.Splenectomy in kala-azar. Trop Geogr Med. 1984 Sep;36(3):285-92.. Trop Geogr Med. 1984 Mar;36(1):21-35.. : Vaccine 26:2788- 2795 Abstract
At the beginning of the century, splenectomy was used in the treatment of kala-azar, but now is rarely needed, the major indication being for drug resistant kala-azar. Inadvertent splenectomy prior to the diagnosis of kala-azar continues to occur, probably because of a reluctance to perform splenic aspiration in the investigation of splenomegaly. Five Kenyan children underwent splenectomy for drug resistant kala-azar. All were immediately improved, but one died of overwhelming post splenectomy infection (OPSI) two months later and another of a malignant lymphoma seven months after surgery. The other three patients appear to be cured. Splenectomy was considered in a sixth child with kala-azar because of a Salmonella abscess in the spleen, but the abscess ruptured catastrophically before surgery could be arranged.
M, PROFBHATTKIRNA.  1984.  Bhatt KM, Bhatt SM, Okello GB, Watkins WM.Chloroquine resistant Plasmodium falciparum malaria in a local Kenyan: a case report. East Afr Med J. 1984 Oct;61(10):745-7. No abstract available.. Trop Geogr Med. 1984 Mar;36(1):21-35.. : Vaccine 26:2788- 2795 Abstract
PIP: Malaria is the most prevalent and devastating public health problem in Africa despite much research and control effort over the last two decades. In most parts of Africa, individuals should take 200 mg of Proguanil daily together with chloroquine 5 mg/kg per week as prophylaxis. Pregnant women and individuals with underlying disease such as sickle cell making them susceptible to severe or complicated malaria, however, should take just 200 mg Proguanil daily. In hard-core multi-drug resistance areas, mefloquine 250 mg once weekly together with chloroquine 300 mg weekly is recommended as prophylaxis. Since no anti-malarial drug confers absolute protection against infection, however, using mosquito nets impregnated with permethrin, insecticides, and mosquito repellents is also advocated for those at high risk of severe malaria. The need also exists to treat cases of malaria when prevention is unsuccessful. Chloroquine in total dose 25 mg/Kg over three days is the first choice treatment of uncomplicated malaria in 4-aminoquinoline sensitive areas. Amodiaquine 25 mg/Kg over three days is the second line treatment, while pyrimethamine/sulphonamide combinations are useful in areas where there is resistance to 4-aminoquinalines. Finally, quinine 10 mg/kg every eight hours for seven days is the treatment of choice for severe and complicated malaria.
M, PROFBHATTKIRNA.  1984.  Clinical, haematological and parasitological response to treatment of visceral leishmaniasis in Kenya. A study of 64 patients. Trop Geogr Med. 1984 Mar;36(1):21-35.. Trop Geogr Med. 1984 Mar;36(1):21-35.. : Vaccine 26:2788- 2795 Abstract
PIP: Malaria is the most prevalent and devastating public health problem in Africa despite much research and control effort over the last two decades. In most parts of Africa, individuals should take 200 mg of Proguanil daily together with chloroquine 5 mg/kg per week as prophylaxis. Pregnant women and individuals with underlying disease such as sickle cell making them susceptible to severe or complicated malaria, however, should take just 200 mg Proguanil daily. In hard-core multi-drug resistance areas, mefloquine 250 mg once weekly together with chloroquine 300 mg weekly is recommended as prophylaxis. Since no anti-malarial drug confers absolute protection against infection, however, using mosquito nets impregnated with permethrin, insecticides, and mosquito repellents is also advocated for those at high risk of severe malaria. The need also exists to treat cases of malaria when prevention is unsuccessful. Chloroquine in total dose 25 mg/Kg over three days is the first choice treatment of uncomplicated malaria in 4-aminoquinoline sensitive areas. Amodiaquine 25 mg/Kg over three days is the second line treatment, while pyrimethamine/sulphonamide combinations are useful in areas where there is resistance to 4-aminoquinalines. Finally, quinine 10 mg/kg every eight hours for seven days is the treatment of choice for severe and complicated malaria.
M, PROFBHATTKIRNA.  1984.  Clinical malaria in Nairobi. East Afr Med J. 1984 Apr;61(4):303-5. East Afr Med J. 1984 Apr;61(4):303-5. : Vaccine 26:2788- 2795 Abstract
PIP: Malaria is the most prevalent and devastating public health problem in Africa despite much research and control effort over the last two decades. In most parts of Africa, individuals should take 200 mg of Proguanil daily together with chloroquine 5 mg/kg per week as prophylaxis. Pregnant women and individuals with underlying disease such as sickle cell making them susceptible to severe or complicated malaria, however, should take just 200 mg Proguanil daily. In hard-core multi-drug resistance areas, mefloquine 250 mg once weekly together with chloroquine 300 mg weekly is recommended as prophylaxis. Since no anti-malarial drug confers absolute protection against infection, however, using mosquito nets impregnated with permethrin, insecticides, and mosquito repellents is also advocated for those at high risk of severe malaria. The need also exists to treat cases of malaria when prevention is unsuccessful. Chloroquine in total dose 25 mg/Kg over three days is the first choice treatment of uncomplicated malaria in 4-aminoquinoline sensitive areas. Amodiaquine 25 mg/Kg over three days is the second line treatment, while pyrimethamine/sulphonamide combinations are useful in areas where there is resistance to 4-aminoquinalines. Finally, quinine 10 mg/kg every eight hours for seven days is the treatment of choice for severe and complicated malaria.
M, PROFBHATTSHRIKANTBABU, M PROFBHATTKIRNA.  1984.  Bhatt K.M., Bhatt S.M., Okelo, G.B.A. & Watkings, W.H.: Chloroquin resistant falciparum malaria in local Kenya: A case report. E. Afr. Med. J .1984; Vol. 61 No. 61 No. 10: 745 . E. Afr. Med. J .1984; Vol. 61 No. 61 No. 10: 745 . : Vaccine 26:2788- 2795 Abstract
PIP: Malaria is the most prevalent and devastating public health problem in Africa despite much research and control effort over the last two decades. In most parts of Africa, individuals should take 200 mg of Proguanil daily together with chloroquine 5 mg/kg per week as prophylaxis. Pregnant women and individuals with underlying disease such as sickle cell making them susceptible to severe or complicated malaria, however, should take just 200 mg Proguanil daily. In hard-core multi-drug resistance areas, mefloquine 250 mg once weekly together with chloroquine 300 mg weekly is recommended as prophylaxis. Since no anti-malarial drug confers absolute protection against infection, however, using mosquito nets impregnated with permethrin, insecticides, and mosquito repellents is also advocated for those at high risk of severe malaria. The need also exists to treat cases of malaria when prevention is unsuccessful. Chloroquine in total dose 25 mg/Kg over three days is the first choice treatment of uncomplicated malaria in 4-aminoquinoline sensitive areas. Amodiaquine 25 mg/Kg over three days is the second line treatment, while pyrimethamine/sulphonamide combinations are useful in areas where there is resistance to 4-aminoquinalines. Finally, quinine 10 mg/kg every eight hours for seven days is the treatment of choice for severe and complicated malaria.
M, PROFBHATTSHRIKANTBABU, M PROFBHATTKIRNA.  1984.  Bhatt K.M., Bhatt S.M., Kanja C. & Kyobe J. Urinary leucocytes in bladder schistosomiasis. E. Afr. Med. J . 1984; Vol. 61 No. 6: 446 . E. Afr. Med. J . 1984; Vol. 61 No. 6: 446 . : Vaccine 26:2788- 2795 Abstract
PIP: Malaria is the most prevalent and devastating public health problem in Africa despite much research and control effort over the last two decades. In most parts of Africa, individuals should take 200 mg of Proguanil daily together with chloroquine 5 mg/kg per week as prophylaxis. Pregnant women and individuals with underlying disease such as sickle cell making them susceptible to severe or complicated malaria, however, should take just 200 mg Proguanil daily. In hard-core multi-drug resistance areas, mefloquine 250 mg once weekly together with chloroquine 300 mg weekly is recommended as prophylaxis. Since no anti-malarial drug confers absolute protection against infection, however, using mosquito nets impregnated with permethrin, insecticides, and mosquito repellents is also advocated for those at high risk of severe malaria. The need also exists to treat cases of malaria when prevention is unsuccessful. Chloroquine in total dose 25 mg/Kg over three days is the first choice treatment of uncomplicated malaria in 4-aminoquinoline sensitive areas. Amodiaquine 25 mg/Kg over three days is the second line treatment, while pyrimethamine/sulphonamide combinations are useful in areas where there is resistance to 4-aminoquinalines. Finally, quinine 10 mg/kg every eight hours for seven days is the treatment of choice for severe and complicated malaria.

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