Bio

Publications


2009

Kitonyi, GW, Kitonyi JM.  2009.  Radiation synovectomy: treatment option for haemophiliac patients with chronic haemarthrosis : a review. Abstract

Ablation of the synovium with radiopharmaceuticals, referred to as radiation synovectomy, (RS),has emerged as a simple affordable and safe procedure that is highly effective in preventing chronic disabling end stage arthritis in haemophilia patients. Objective: To provide a review of the principles and role of radiation synovectomy, (RS), in the management ofhaemophiliacpatients with chronichaemarthrosis, and to consider the possibility of this treatment option in Kenyan patients with haemophilia. Data sources: A literature search through the internet using Boolean commands, PubMed interface to MEDLINE, Evidence, the Cochrane library. Papers from reputable haematology and radiation medicine journals, as well as conference presentations of the World Federation of Hemophilia were also included. Data selection: The searches for papers, abstracts and reviews were limited to English language, haemophilia, haemarthrosis, synovectomy, RS, radiopharmaceuticals for RS and safety of RS. Data extraction: All abstracts, and most of the papers were reviewed. Only those abstracts, papers and conference materials from reputable sources were used for this paper. Data synthesis: All available papers and abstracts were reviewed for the most up to date information. The indications, requirements, procedure and safety aspects of RS were examined. The merits of alternative forms of synovectomy were considered. In the light of this information, the feasibility ofRS as a treatment option for haemophilia patients in Kenya was considered. Conclusion: Radiation synovectomy has been carried out on thousands of haemophilia patients with chronic haemathrosis over the last 20 years. Experience accumulated in numerous centres in America, Europe, Asia, North and South Africa indicates that majorityofhaemophilia patients undergoing RS are spared life long crippling arthritis and deformity. The principle safety concern of the potential for late radiation- related malignancy has been mitigated by appropriate choice of radiopharmaceuticals, and carefully executed procedure. The effectiveness, simplicity and affordability of RS make it particularly suitable for treatment of haemophilia patients in developing countries like Kenya.

2008

Kitonyi, G W; Oburra, IHO; JM, Wambugu PM;, Oburra HO;, Ireri JM.  2008.  Hereditary haemorrhagic telangiectasia in a black adult male: case report. Abstract

Hereditary haemorrhagic telangiectasia, (HHT) or Rendu-Osler-Weber disease is a genetic autosomal dominant disorder that is characterised by telangiectasias, (small vascular malformations), in mucocutaneous tissues and arterial venous malformations, (AVMs), in various internal organs. Although HHT is relatively common in whites, the disorder has been reported to be rare in people of black African descent. Majority of HHT patients present with recurrent epistaxis, which in a significant proportion of patients is severe, warranting repeated blood transfusions and iron supplementation. Telangiectasias are most frequent on the tongue, hands, nose, lips and the gastrointestinal tract (GIT). AVMs occur in internal organs, particularly the lungs, brain, and the liver. Early and correct diagnosis of HHT is crucial as patients derive benefit from certain specific treatment modalities. Besides, AVMs which occur in various organs pose serious complications that may lead to death and therefore require early detection. We report a 55 year old black African male with HHT who presented with severe recurrent epistaxis and haematochezia leading to severe anaemia requiring repeated blood transfusions. His son, daughter and a maternal uncle experience milder recurrent epistaxis. The management of this patient and a brief review of the clinical features and management of HHT is presented. Our aim is to raise awareness of the occurrence of HHT in Kenya, in order to enhance early diagnosis and appropriate management

1995

M., PROFKITONYIJOSEPHK.  1995.  Kitonyi JM.Cost effectiveness in routine radiological investigations.East Afr Med J. 1995 Feb;72(2):77.. East Afr Med J. 1995 Feb;72(2):77.. : Vaccine 26:2788- 2795 Abstract
PMID: 7796758 [PubMed - indexed for MEDLINE]
M., PROFKITONYIJOSEPHK.  1995.  Kitonyi JM.Radiological behaviour of the thymus in chest infection in the underfives. East Afr Med J. 1995 Feb;72(2):81-2.. East Afr Med J. 1995 Feb;72(2):81-2.. : Vaccine 26:2788- 2795 Abstract
The thymus in the paediatric chest will often give radiological appearances of very intriguing nature. It is known to react dramatically to stress factors such as infection or trauma. Gross hypertrophy following atrophy has been documented in many cases. In this paper the author scrutinizes one hundred anteroposterior chest radiographs of children under the age of five years suspected of having chest infection. Thymocardiac ratio is determined. It is concluded that in children under five years, the thymus generally decreases in size with age and that often the thymus will undergo atrophy as a primary response to infection. PMID: 7796759 [PubMed - indexed for MEDLINE]
M., PROFKITONYIJOSEPHK.  1995.  Kitonyi JM Thymocardiac ratio in African underfives East Afr Med J. 1995 Feb;72(2):81-2.. East Afr Med J. 1995 Feb;72(2):81-2.. : Vaccine 26:2788- 2795 Abstract
The thymus in the paediatric chest will often give radiological appearances of very intriguing nature. It is known to react dramatically to stress factors such as infection or trauma. Gross hypertrophy following atrophy has been documented in many cases. In this paper the author scrutinizes one hundred anteroposterior chest radiographs of children under the age of five years suspected of having chest infection. Thymocardiac ratio is determined. It is concluded that in children under five years, the thymus generally decreases in size with age and that often the thymus will undergo atrophy as a primary response to infection.

1994

M., PROFKITONYIJOSEPHK.  1994.  Kitonyi, J.M.K. Radiological manifestations of pulmonary TB in HIV. Proceedings: KAR Annual Scientific Conference, Nyeri June 1994.. KAR Annual Scientific Conference, Nyeri June 1994.. : Vaccine 26:2788- 2795 Abstract
PMID: 7796758 [PubMed - indexed for MEDLINE]

1993

M., PROFKITONYIJOSEPHK.  1993.  Kitonyi J.M.K The Basic Radiological System (BRS) Experience in Kenya. East Afr Med J. 1993 Dec;70(12):793-6.. East Afr Med J. 1993 Dec;70(12):793-6.. : Vaccine 26:2788- 2795 Abstract

While Diagnostic Radiology has become increasingly indispensible in sound clinical patient management the cost and maintenance of radiological equipment has continued to soar, reaching almost unaffordable levels in developing countries. As an attempt to provide some measure of remedy to the above problem, the World Health Organization in the early 80's introduced the basic radiological system (BRS) concept. The BRS is supposed to meet such criteria as being relatively cheap, of low maintenance cost easy operability and suitable in rural areas where electrical power supply may not be constant. In addition it should be able to perform 80% of all conventional radiological examinations. In this paper the author gives a critical account of the BRS experience in Kenya. Proposals for possible future considerations and modifications in order to achieve near ideal BRS X-ray machine are also advanced.

M., PROFKITONYIJOSEPHK.  1993.  Kitonyi JM. The basic radiological system experience in Kenya.East Afr Med J. 1993 Dec;70(12):793-6.. East Afr Med J. 1993 Dec;70(12):793-6.. : Vaccine 26:2788- 2795 Abstract

While Diagnostic Radiology has become increasingly indispensible in sound clinical patient management the cost and maintenance of radiological equipment has continued to soar, reaching almost unaffordable levels in developing countries. As an attempt to provide some measure of remedy to the above problem, the World Health Organization in the early 80's introduced the basic radiological system (BRS) concept. The BRS is supposed to meet such criteria as being relatively cheap, of low maintenance cost easy operability and suitable in rural areas where electrical power supply may not be constant. In addition it should be able to perform 80% of all conventional radiological examinations. In this paper the author gives a critical account of the BRS experience in Kenya. Proposals for possible future considerations and modifications in order to achieve near ideal BRS X-ray machine are also advanced.

M., PROFKITONYIJOSEPHK.  1993.  Onyango F.E., Wafula E.M., Kitonyi J.M.K et al. Hypoxaemia in young Kenyan children with acute lower respiratory infection.BMJ. 1993 Mar 6;306(6878):612-5.. BMJ. 1993 Mar 6;306(6878):612-5. Comment in: BMJ. 1993 May 15;306(6888):1342.. : Vaccine 26:2788- 2795 Abstract

OBJECTIVES–To determine the prevalence, clinical correlates, and outcome of hypoxaemia in acutely ill children with respiratory symptoms. DESIGN–Prospective observational study. SETTING–Paediatric casualty ward of a referral hospital at 1670 m altitude in Nairobi, Kenya. SUBJECTS–256 Infants and children under 3 years of age with symptoms of respiratory infection. MAIN OUTCOME MEASURES–Prevalence of hypoxaemia, defined as arterial oxygen saturation < 90% determined by pulse oximetry, and condition of patient on the fifth day after admission. RESULTS–Over half (151) of the children were hypoxaemic, and short term mortality was 4.3 times greater in these children. In contrast, the relative risk of a fatal outcome in children with radiographic pneumonia was only 1.03 times that of children without radiographic pneumonia. A logistic regression model showed that in 3-11 month old infants a respiratory rate > or = 70/min, grunting, and retractions were the best independent clinical signs for the prediction of hypoxaemia. In the older children a respiratory rate of > or = 60/min was the single best clinical predictor of hypoxaemia. The presence of hypoxaemia predicted radiographic pneumonia with a sensitivity of 71% and specificity of 55%. CONCLUSIONS–Over half the children presenting to this referral hospital with respiratory symptoms were hypoxaemic. A group of specific clinical signs seem useful in predicting hypoxaemia. The clear association of hypoxaemia with mortality suggests that the detection and effective treatment of hypoxaemia are important aspects of the clinical management of acute infections of the lower respiratory tract in children in hospital in developing regions. PIP: In 1989, pediatricians followed 256 children 7 days to 36 months old with symptoms of respiratory infection at Kenyatta National Hospital (1670 m altitude) in Nairobi, Kenya. The symptoms were serious enough to warrant hospital admission for 209 of these children. The most common clinical diagnoses were pneumonia (53%) and bronchiolitis (33%). 59% of the children admitted to the hospital were hypoxemic (arterial oxygen saturation or + to 90%). 10% of all admitted children died. 90.4% of them were hypoxemic with arterial oxygen saturations ranging from 40-88%. Children with hypoxemia were 4.3 times more apt to die within 5 days than those with no hypoxemia (p = .02). On the other hand, children with radiographic pneumonia had a relative risk of short-term mortality of only 1.03. Hypoxemia on admission predicted short-term mortality with 90% sensitivity and 34% specificity. It predicted pneumonia with 71% sensitivity and 55% specificity (p .0001). Children who lived for at least 5 days had arterial oxygen saturations ranging from 41-98. Even though all of the children with clinically evident cyanosis were less than a year old, 89% of the hypoxemic infants less than 1 year old did not exhibit cyanosis. Mothers' reports of blueness in newborns and infants less than 2 months was the best predictor of hypoxemia (62% accuracy; p .05). For children 3-11 months old, the best predictors of hypoxemia, with an accuracy of 70%, were a respiratory rate of at least 70/minute (odds ratio [OR] 2.6; p .001). For children at least 12 months old, the sole best predictor was a respiratory rate of at least 60/minute (70% accuracy; OR 5.1; p .01). This study should be followed by well-designed studies of the clinical effectiveness of proper treatment with oxygen in preventing mortality in hypoxemic infants and children.

1990

M., PROFKITONYIJOSEPHK.  1990.  Kitonyi J.M.K.Diagnostic Radiology, yesterday, today and tomorrow.(Editorial) African Journal of Hospital Medicine, 1990, 10, 5-6.. African Journal of Hospital Medicine, 1990, 10, 5-6.. : Vaccine 26:2788- 2795 Abstract

While Diagnostic Radiology has become increasingly indispensible in sound clinical patient management the cost and maintenance of radiological equipment has continued to soar, reaching almost unaffordable levels in developing countries. As an attempt to provide some measure of remedy to the above problem, the World Health Organization in the early 80's introduced the basic radiological system (BRS) concept. The BRS is supposed to meet such criteria as being relatively cheap, of low maintenance cost easy operability and suitable in rural areas where electrical power supply may not be constant. In addition it should be able to perform 80% of all conventional radiological examinations. In this paper the author gives a critical account of the BRS experience in Kenya. Proposals for possible future considerations and modifications in order to achieve near ideal BRS X-ray machine are also advanced.

1988

M., PROFKITONYIJOSEPHK.  1988.  Kitonyi J.M.K.The determination of Hepatic blood Flow and its clinical significance African Journal of Hospital Medicine 1988, 7, 162.. African Journal of Hospital Medicine 1988, 7, 162.. : Vaccine 26:2788- 2795 Abstract

While Diagnostic Radiology has become increasingly indispensible in sound clinical patient management the cost and maintenance of radiological equipment has continued to soar, reaching almost unaffordable levels in developing countries. As an attempt to provide some measure of remedy to the above problem, the World Health Organization in the early 80's introduced the basic radiological system (BRS) concept. The BRS is supposed to meet such criteria as being relatively cheap, of low maintenance cost easy operability and suitable in rural areas where electrical power supply may not be constant. In addition it should be able to perform 80% of all conventional radiological examinations. In this paper the author gives a critical account of the BRS experience in Kenya. Proposals for possible future considerations and modifications in order to achieve near ideal BRS X-ray machine are also advanced.

1987

Waweru, SE, Meme JS, Kinuthia DM, Kitonyi GW.  1987.  Absence of HIV seropositivity in children with sickle cell anaemia at Kenyatta National Hospital, Nairobi, Kenya. AbstractWebsite

OBJECTIVE: To find out whether frequent blood transfusions increase the risk of transfusion-related HIV infection in children with Sickle cell anaemia. METHODS: One hundred and ninety-eight children with Sickle cell anaemia were transfused 1-13 times (mean 2,4) between 1982 and 1987. In Kenya routine screening of blood banks for HIV infection began in 1987. The HIV status of these children was compared with 231 non-transfused children: 106 with Sickle cell anaemia and 125 children with haemoglobin AA. In both transfused and non-transfused children age ranges were similar and were 1-12 years. All children were tested with Wellcozyme Elisa test in duplicate. All tests were performed at least 6 months after the last transfusion. Sixty five transfused sicklers were rechecked one year later. RESULTS: All 429 children were HIV negative. CONCLUSIONS: Out findings suggest that HIV seropositivity is low in Kenyan children. Furthermore, even though blood was unscreened in 1982 - 1987 transfusion did not increase the risk of HIV infection in our study children

1986

Kariuki, JKN, Khwa-Otsyla BO, Kitonyi J.  1986.  An unusual intra-renal arterio-venous fistula: a case report.
M., PROFKITONYIJOSEPHK.  1986.  Kitonyi J.M.K The sex incidence of renal calculosis in Kenyatta National Hospital.East Afr Med J. 1986 Mar;63(3):163-7.. East Afr Med J. 1986 Mar;63(3):163-7.. : Vaccine 26:2788- 2795 Abstract

While Diagnostic Radiology has become increasingly indispensible in sound clinical patient management the cost and maintenance of radiological equipment has continued to soar, reaching almost unaffordable levels in developing countries. As an attempt to provide some measure of remedy to the above problem, the World Health Organization in the early 80's introduced the basic radiological system (BRS) concept. The BRS is supposed to meet such criteria as being relatively cheap, of low maintenance cost easy operability and suitable in rural areas where electrical power supply may not be constant. In addition it should be able to perform 80% of all conventional radiological examinations. In this paper the author gives a critical account of the BRS experience in Kenya. Proposals for possible future considerations and modifications in order to achieve near ideal BRS X-ray machine are also advanced.

M., PROFKITONYIJOSEPHK.  1986.  Kitonyi J.M.K. BRS as a co-operate component of Radiography Training Proceedings: WHO BRS study.Group Report. Harare, Zimbabwe May 1986.. WHO BRS study.Group Report. Harare, Zimbabwe May 1986.. : Vaccine 26:2788- 2795 Abstract

While Diagnostic Radiology has become increasingly indispensible in sound clinical patient management the cost and maintenance of radiological equipment has continued to soar, reaching almost unaffordable levels in developing countries. As an attempt to provide some measure of remedy to the above problem, the World Health Organization in the early 80's introduced the basic radiological system (BRS) concept. The BRS is supposed to meet such criteria as being relatively cheap, of low maintenance cost easy operability and suitable in rural areas where electrical power supply may not be constant. In addition it should be able to perform 80% of all conventional radiological examinations. In this paper the author gives a critical account of the BRS experience in Kenya. Proposals for possible future considerations and modifications in order to achieve near ideal BRS X-ray machine are also advanced.

1985

M., PROFKITONYIJOSEPHK.  1985.  Kariuki J.K. and Kitonyi J.M.K An unusual intra-renal A-V fistula East Afr Med J. 1986 Apr;63(4):281-4.. East Afr Med J. 1986 Apr;63(4):281-4.. : Vaccine 26:2788- 2795 Abstract

While Diagnostic Radiology has become increasingly indispensible in sound clinical patient management the cost and maintenance of radiological equipment has continued to soar, reaching almost unaffordable levels in developing countries. As an attempt to provide some measure of remedy to the above problem, the World Health Organization in the early 80's introduced the basic radiological system (BRS) concept. The BRS is supposed to meet such criteria as being relatively cheap, of low maintenance cost easy operability and suitable in rural areas where electrical power supply may not be constant. In addition it should be able to perform 80% of all conventional radiological examinations. In this paper the author gives a critical account of the BRS experience in Kenya. Proposals for possible future considerations and modifications in order to achieve near ideal BRS X-ray machine are also advanced.

1981

M., PROFKITONYIJOSEPHK.  1981.  Kitonyi J.M.K Reactions and cardiovascular changes at excretion urography East Afr Med J. 1981 Dec;58(12):942-5.. East Afr Med J. 1981 Dec;58(12):942-5.. : Vaccine 26:2788- 2795 Abstract

While Diagnostic Radiology has become increasingly indispensible in sound clinical patient management the cost and maintenance of radiological equipment has continued to soar, reaching almost unaffordable levels in developing countries. As an attempt to provide some measure of remedy to the above problem, the World Health Organization in the early 80's introduced the basic radiological system (BRS) concept. The BRS is supposed to meet such criteria as being relatively cheap, of low maintenance cost easy operability and suitable in rural areas where electrical power supply may not be constant. In addition it should be able to perform 80% of all conventional radiological examinations. In this paper the author gives a critical account of the BRS experience in Kenya. Proposals for possible future considerations and modifications in order to achieve near ideal BRS X-ray machine are also advanced.

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