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Publications


2004

M., PROFKYAMBIJ.  2004.  Kyambi JM.Issues involved in pre-operative consent.East Afr Med J. 2004 Jul;81(7):329-30.. East Afr Med J. 2004 Jul;81(7):329-30.. : East African Orthopaedic Journal Abstract
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2001

Bickler, SW, Kyambi JM, Rode H.  2001.  Pediatric surgery in sub-Saharan Africa. Abstract

Pediatric surgery in sub-Saharan Africa is disadvantaged by the large number of sick children, disease patterns specific to the region, late presentation, and advanced pathology. In addition, it is practiced in an environment of limited resources and facilities and other health priorities. Obstacles to better pediatric-surgical care (PSC) include a general lack of interest in surgical conditions affecting African children, its poorly defined role, and a lack of political commitment by governments and international agencies to see surgical care of children improve. Pediatric-surgical practice in Africa must be cognizant of the factors that limit delivery of surgical services and work toward developing cost-effective strategies that benefit the largest number of children. Demonstrating that childhood surgical conditions are a significant public health-care problem is the most likely way to change health-care policy and to ensure adequate resources for PSC. Other priorities should be to define a cost-effective package of pediatric surgical services, improve PSC at the community level, and strengthen pediatric surgical-education.

M., PROFKYAMBIJ.  2001.  Kyambi JM.A case for day-care surgery.East Afr Med J. 2001 Apr;78(4):169.. East Afr Med J. 2001 Apr;78(4):169.. : East African Orthopaedic Journal Abstract
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1998

M., PROFKYAMBIJ.  1998.  Kyambi JM.Intussusception.East Afr Med J. 1998 Jan;75(1):1.. East Afr Med J. 1998 Jan;75(1):1.. : East African Orthopaedic Journal Abstract
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1993

M., PROFKYAMBIJ.  1993.  Kyambi JM.Surgery: a historical perspective.. East Afr Med J. 1993 Jun;70(6):348-56.. : East African Orthopaedic Journal Abstract
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M., PROFKYAMBIJ.  1993.  Barrack SM, Kyambi JM, Ndungu J, Wachira N, Anangwe G, Safwat S.Intestinal atresia and stenosis as seen and treated at Kenyatta National Hospital, Nairobi.East Afr Med J. 1993 Sep;70(9):558-64.. East Afr Med J. 1993 Sep;70(9):558-64.. : East African Orthopaedic Journal Abstract

In this retrospective study carried out covering the period, 1978-1991, 62 neonates were seen, diagnosed and treated for intestinal atresia which included: duodenal atresia and stenosis, small bowel atresia and atresia of large bowel. Locations of obstruction were duodenal in 17 patients, jejunal in 25 patients, jejuno-ileal in 5 and colon in two. Duodenal atresia was noted in 9 infants and duodenal stenosis due to annular pancreas, Ladd's bands with malrotation of bowel in 8. Associated anomalies which were observed were anorectal malformations in 2 and malrotation in 2 infants. Birth weights ranged from 1450 gm to 3000 gm. Prematurity was recorded in 11 infants. Diagnosis of intestinal atresia in our patients was made clinically and radiologically. Intestinal atresia in neonates was differentiated from other causes of obstruction such as Meconium Ileus, Hirschsprung's disease, neonatal volvulus, rectal atresia in anorectal malformations. Treatment of infants with intestinal atresia was surgical. Surgical techniques used depended on pathological findings. In 36 patients, complications such as functional obstructions with vomiting and failure to thrive, malabsorption, aspiration, bronchopneumonia, sepsis were observed. Overall mortality rate in our cases was 25 (41.9%) out of 62 patients.

1990

M., PROFKYAMBIJ.  1990.  Kyambi J. Pediatric surgery in Kenya.. J Pediatr Surg. 1990 Oct;25(10):1085-7.. : East African Orthopaedic Journal Abstract

In this retrospective study carried out covering the period, 1978-1991, 62 neonates were seen, diagnosed and treated for intestinal atresia which included: duodenal atresia and stenosis, small bowel atresia and atresia of large bowel. Locations of obstruction were duodenal in 17 patients, jejunal in 25 patients, jejuno-ileal in 5 and colon in two. Duodenal atresia was noted in 9 infants and duodenal stenosis due to annular pancreas, Ladd's bands with malrotation of bowel in 8. Associated anomalies which were observed were anorectal malformations in 2 and malrotation in 2 infants. Birth weights ranged from 1450 gm to 3000 gm. Prematurity was recorded in 11 infants. Diagnosis of intestinal atresia in our patients was made clinically and radiologically. Intestinal atresia in neonates was differentiated from other causes of obstruction such as Meconium Ileus, Hirschsprung's disease, neonatal volvulus, rectal atresia in anorectal malformations. Treatment of infants with intestinal atresia was surgical. Surgical techniques used depended on pathological findings. In 36 patients, complications such as functional obstructions with vomiting and failure to thrive, malabsorption, aspiration, bronchopneumonia, sepsis were observed. Overall mortality rate in our cases was 25 (41.9%) out of 62 patients.

1987

M., PROFKYAMBIJ.  1987.  Kasili EG, Kyambi JM, Onyango JN, Kitonyi GW, Owade JN, Njenga GJ.Nephroblastoma: an example of cancer curable by appropriate intervention even in developing countries.. East Afr Med J. 1987 Dec;64(12):828-35.. : East African Orthopaedic Journal Abstract

In this retrospective study carried out covering the period, 1978-1991, 62 neonates were seen, diagnosed and treated for intestinal atresia which included: duodenal atresia and stenosis, small bowel atresia and atresia of large bowel. Locations of obstruction were duodenal in 17 patients, jejunal in 25 patients, jejuno-ileal in 5 and colon in two. Duodenal atresia was noted in 9 infants and duodenal stenosis due to annular pancreas, Ladd's bands with malrotation of bowel in 8. Associated anomalies which were observed were anorectal malformations in 2 and malrotation in 2 infants. Birth weights ranged from 1450 gm to 3000 gm. Prematurity was recorded in 11 infants. Diagnosis of intestinal atresia in our patients was made clinically and radiologically. Intestinal atresia in neonates was differentiated from other causes of obstruction such as Meconium Ileus, Hirschsprung's disease, neonatal volvulus, rectal atresia in anorectal malformations. Treatment of infants with intestinal atresia was surgical. Surgical techniques used depended on pathological findings. In 36 patients, complications such as functional obstructions with vomiting and failure to thrive, malabsorption, aspiration, bronchopneumonia, sepsis were observed. Overall mortality rate in our cases was 25 (41.9%) out of 62 patients.

1985

M., PROFKYAMBIJ.  1985.  Kinoti SN, Anabwani G, Esamai FO, Kyambi JM.Congenital diaphragmatic hernia at Kenyatta National Hospital. Case studies and appraisal of clinical features and management.East Afr Med J. 1985 Nov;62(11):823-9.. East Afr Med J. 1985 Nov;62(11):823-9.. : East African Orthopaedic Journal Abstract

In this retrospective study carried out covering the period, 1978-1991, 62 neonates were seen, diagnosed and treated for intestinal atresia which included: duodenal atresia and stenosis, small bowel atresia and atresia of large bowel. Locations of obstruction were duodenal in 17 patients, jejunal in 25 patients, jejuno-ileal in 5 and colon in two. Duodenal atresia was noted in 9 infants and duodenal stenosis due to annular pancreas, Ladd's bands with malrotation of bowel in 8. Associated anomalies which were observed were anorectal malformations in 2 and malrotation in 2 infants. Birth weights ranged from 1450 gm to 3000 gm. Prematurity was recorded in 11 infants. Diagnosis of intestinal atresia in our patients was made clinically and radiologically. Intestinal atresia in neonates was differentiated from other causes of obstruction such as Meconium Ileus, Hirschsprung's disease, neonatal volvulus, rectal atresia in anorectal malformations. Treatment of infants with intestinal atresia was surgical. Surgical techniques used depended on pathological findings. In 36 patients, complications such as functional obstructions with vomiting and failure to thrive, malabsorption, aspiration, bronchopneumonia, sepsis were observed. Overall mortality rate in our cases was 25 (41.9%) out of 62 patients.

1984

M., PROFKYAMBIJ.  1984.  Riyat MS, Kasili EG, Kyambi JM.Experience in the management of sinus histiocytosis with massive lymphadenopathy. East Afr Med J. 1984 Apr;61(4):288-94.. East Afr Med J. 1984 Apr;61(4):288-94. : East African Orthopaedic Journal 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., PROFKYAMBIJ.  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 Sep;36(3):285-92. : East African Orthopaedic Journal 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., PROFKYAMBIJ.  1984.  Kasili EG, Kyambi JM, Onyango JN Treatment of childhood malignancies in Kenya.. East Afr Med J. 1984 Sep;61(9):663-74.. : East African Orthopaedic Journal Abstract

In this retrospective study carried out covering the period, 1978-1991, 62 neonates were seen, diagnosed and treated for intestinal atresia which included: duodenal atresia and stenosis, small bowel atresia and atresia of large bowel. Locations of obstruction were duodenal in 17 patients, jejunal in 25 patients, jejuno-ileal in 5 and colon in two. Duodenal atresia was noted in 9 infants and duodenal stenosis due to annular pancreas, Ladd's bands with malrotation of bowel in 8. Associated anomalies which were observed were anorectal malformations in 2 and malrotation in 2 infants. Birth weights ranged from 1450 gm to 3000 gm. Prematurity was recorded in 11 infants. Diagnosis of intestinal atresia in our patients was made clinically and radiologically. Intestinal atresia in neonates was differentiated from other causes of obstruction such as Meconium Ileus, Hirschsprung's disease, neonatal volvulus, rectal atresia in anorectal malformations. Treatment of infants with intestinal atresia was surgical. Surgical techniques used depended on pathological findings. In 36 patients, complications such as functional obstructions with vomiting and failure to thrive, malabsorption, aspiration, bronchopneumonia, sepsis were observed. Overall mortality rate in our cases was 25 (41.9%) out of 62 patients.

1982

M., PROFKYAMBIJ.  1982.  Meme JS, Njai DM, Kyambi JM, Kung'u A.Antral mucosal diaphragm: an obstructing lesion of the stomach.East Afr Med J. 1982 Feb;59(2):161-4.. East Afr Med J. 1982 Feb;59(2):161-4.. : East African Orthopaedic Journal 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.

1981

M., PROFKYAMBIJ.  1981.  Kyambi JM, Kasili EG, Onyango JN, Kitonyi GW.The management of Wilms' tumour in Kenya.East Afr Med J. 1981 Jun;58(6):424-30.. East Afr Med J. 1981 Jun;58(6):424-30.. : East African Orthopaedic Journal 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., PROFKYAMBIJ.  1981.  Nightingale KW, Ayim EN, Kyambi JM, Amolo JG, Miller JR.The three cases of conjoined twins of Nairobi 1976-1979.East Afr Med J. 1981 Dec;58(12):960-6.. East Afr Med J. 1981 Dec;58(12):960-6.. : East African Orthopaedic Journal 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.

1980

M., PROFKYAMBIJ.  1980.  Otieno LS, Awori NW, Bagshawe A, Abdullah MS, Kyambi JM, Ndirangu JK.The first renal transplant in Kenya.East Afr Med J. 1980 Jun;57(6):369-73.. East Afr Med J. 1980 Jun;57(6):369-73.. : East African Orthopaedic Journal 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.

1978

M., PROFKYAMBIJ.  1978.  Kellermann K, Bliesener JA, Kyambi JM. Positive ventriculography using water-soluble contrast media in infants with myelomeningocele and hydrocephalus.Neuropadiatrie. 1978 Feb;9(1):49-58.. Neuropadiatrie. 1978 Feb;9(1):49-58.. : East African Orthopaedic Journal Abstract
Ventriculography with meglumine iocarmate (Dimer X) or Metrizamide (Amipaque was carried out in 15 infants with myelomeningocele and progressive hydrocephalus. In all cases, an Anold-Chiari-Malformation type II was diagnosed with compression of the structures of the posterior cranial cavity and their displacement within or below the level of the foramen magnum. The aqueduct was always patent but laterally compressed. In the region of the third ventricle there was often encountered an enlargement of the massa intermedia with indentation of the lamina terminalis and enlargement of the recessus suprapinealis. Aspects of pathogenesis of the malformation and possible causes of hydrocephalus originating from these findings are discussed. Methods and advantages of positive ventriculography using water-soluble media are presented.

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