Bio

Publications


2012

Bukola, F, Idi N, M’Mimunya M, Jean-Jose WM, Kidza M, Isilda N.  2012.  Unmet need for induction of labor in Africa: secondary analysis from the 2004 - 2005 WHO Global Maternal and Perinatal Health Survey (A cross-sectional survey). Abstract

Induction of labor is being increasingly used to prevent adverse outcomes in the mother and the newborn.This study assessed the prevalence of induction of labor and determinants of its use in Africa. Methods We performed secondary analysis of the WHO Global Survey of Maternal and Newborn Health of 2004 and 2005. The African database was analyzed to determine the use of induction of labor at the country level and indications for induction of labor. The un-met needs for specific obstetric indications and at country level were assessed. Determinants of use of induction of labor were explored with multivariate regression analysis. Results A total of 83,437 deliveries were recorded in the 7 participating countries. Average rate of induction was 4.4% with a range of 1.4 – 6.8%. Pre-labor rupture of membranes was the commonest indication for induction of labor. Two groups of women were identified: 2,776 women with indications had induction of labor while 7,996 women although had indications but labor was not induced. Induction of labor was associated with reduction of stillbirths and perinatal deaths [OR – 0.34; 95% CI (0.27 – 0.43)]. Unmet need for induction of labor ranged between 66.0% and 80.2% across countries. Determinants of having an induction of labor were place of residence, duration of schooling, type of health facility and level of antenatal care. Conclusion Utilization of induction of labor in health facilities in Africa is very low. Improvements in social and health infrastructure are required to reverse the high unmet need for induction of labor.

2010

Mutua, F, Revathi G, Machoki JM.  2010.  species distribution and antifungal sensitivity patterns of vaginal yeasts. Abstract

To identify yeast isolates in vaginal specimens to species level and determine their antifungal susceptibility patterns. Design: Cross-sectional laboratory-based study. Setting: The Aga Khan University Hospital (AKUH), Nairobi. Subjects: Yeast isolates from high vaginal swabs presented to the laboratory for culture and sensitivity were identified to species level using the API Candida system and subjected to broth microdilution susceptibility testing. Main outcome measures: Frequency tables and graphs were used to summarise the data. Susceptibility data was analysed by the non-parametric Fisher’s exact test. P<0.05 was considered statistically significant. Results: A total of 101 yeasts were studied. C.albicans was the prominent species (69.3%) followed by C. glabrata (12.9%), C. famata (5.0%), C. krusei (3.0%), Trichosporon species (3.0%) and S.cerevisiae (3.0%), C.parapsilosis (1.0%). Three (3.0%) of the isolates had profiles that fell between C. glabrata and C. famata. The percentages of C. albicans susceptible to flucytosine, amphotericin B, fluconazole and itraconazole were 94.3, 92.9, 100 and 90 respectively; that of non-albicans isolates were 93.5, 80.6, 77.4 and 29 respectively. There was no significant difference (p>0.05) between the susceptibility of C.albicans and non-albicans isolates to flucytosine and amphotericin B, however there was a significant difference (p<0.05) to fluconazole and itraconazole. Conclusions: C. albicans was the predominant cause of vulvovaginal candidiasis in this study, and demonstrated good susceptibility to antifungal agents tested. A significant number of non-albicans yeasts were identified; these demonstrated reduced susceptibility to all drugs, in particular to the azoles which are commonly used for treatment of vaginal candidiasis. The isolation of non-albicans yeasts may have clinical implication given their reduced susceptibility to antifungals

2007

Saidi, H, Mohammed U, Machoki M.  2007.  An unusual abdominal mass: case report.. Abstract

The causes of intra-abdominal masses associated with chronic abdominal pain range from the benign to malignant; common to bizarre and some raise major medical-legal issues. We present a case of a 40-year old African lady who presented with chronic right-sided abdominal pain with an associated mass on the right mid-abdomen. She had had a Caesarian section one year prior to presentation. Antecedent history of surgery and typical imaging features enabled a preoperative diagnosis of abdominal mass secondary to retained surgical gauze. The case illustrates the fallibility of the men and women in the operating theatres and the vital role of correct instrument and sponge counts.

2005

2004

Mwenda, JM, Machoki JM, Omollo E, Galo M, Langat DK.  2004.  The prevalence of anti-phospholipid antibodies in a selected population of Kenyan women and development of a non-human primate model. Abstract

The mechanisms by which anti-phospholipid antibodies (aPLs) may induce pregnancy losses, intrauterine growth retardation and pregnancy-induced hypertension are not clearly understood. Moreover, there is a controversy regarding the possible direct effects of these antibodies on the physiology of the placenta since the target antigens of these antibodies are intracellular antigens and are potentially inaccessible to the antibody. Also, controversy exists regarding the usefulness of the treatment regimens currently available. In this study, we present preliminary data on the prevalence of aPLs in a selected population (n = 80) of Kenyan women visiting Kenyatta National Hospital, Nairobi, Kenya for obstetrical complications including recurrent pregnancy losses. Our results showed approximately 13.8% of the patients were positive for anti-cardiolipin antibodies whereas 33.8% were positive for aPS. Additionally, we screened 72 non-human primates for presence of aPLs and our results showed that the olive baboon (Papio anubis) had the highest prevalence rate (52.2%, n = 23). Overall, our results suggest that the olive baboon may be a suitable animal model for studying the mechanism of action of the anti-phospholipid antibody and pregnancy complications associated with aPLs.

MIMUNYA, JN.  2004.  Kyama MC, D. Gynecol Obstet Invest 2004: 57:1-60.. Abstract

Sengis are testicondid endemic african mammals that constitute the order Macroscelidae. The epididymides of five male rufous sengis (Elephantulus rufescens) were studied both macroscopically and microscopically to describe the structure and possible features or adaptations making it a suitable site for sperm maturation and storage in testicondas. The epididymis had three distinct topographic regions; the caput, corpus and cauda epididymis. The caput and cauda epididymis were placed further apart; the former occuring as a longitudinal mass on dorsolateral border of the tesis while the latter occurred as a pear-shaped mass placed laterally between the rectum and the pelvic urethra, the two being connected by a slender corpus epiddidymis. The epithelium comprised of principal and basal cells with the former exhibiting numerous secretory granules and apical blebing in the caput. In the cauda, principal cells had numerous vacuoles and its lumen was densely packed with spermatozoa and occasional masses that appeaed to engulf spermatozoa. This study demonstrates that the pricipal cells of the caput of sengi produces materials either through merocrine or apocrine secretion, the latter being shown by apical blebs that are shed off as epididymosomes, which in turn transfers epididymis-secreted proteins to the plasma membrane of spermatozoa. Additionally, the study has shown that the cauda epididymis remarkably descends to a site probably cooler than the core body temperature for optimal sperm storage, and the numerous vacuoles indicating its involvement in fluid reabsortion and phagocytosis of residual bodies and damaged spermazoa.

Mwenda, JM, Machoki JM, Omollo E, Galo M, Langat DK.  2004.  The prevalence of endometriosis among African-American and African-indigenous women. Gynecol Obstet Invest 2004: 57:1-60.. Abstract

Sengis are testicondid endemic african mammals that constitute the order Macroscelidae. The epididymides of five male rufous sengis (Elephantulus rufescens) were studied both macroscopically and microscopically to describe the structure and possible features or adaptations making it a suitable site for sperm maturation and storage in testicondas. The epididymis had three distinct topographic regions; the caput, corpus and cauda epididymis. The caput and cauda epididymis were placed further apart; the former occuring as a longitudinal mass on dorsolateral border of the tesis while the latter occurred as a pear-shaped mass placed laterally between the rectum and the pelvic urethra, the two being connected by a slender corpus epiddidymis. The epithelium comprised of principal and basal cells with the former exhibiting numerous secretory granules and apical blebing in the caput. In the cauda, principal cells had numerous vacuoles and its lumen was densely packed with spermatozoa and occasional masses that appeaed to engulf spermatozoa. This study demonstrates that the pricipal cells of the caput of sengi produces materials either through merocrine or apocrine secretion, the latter being shown by apical blebs that are shed off as epididymosomes, which in turn transfers epididymis-secreted proteins to the plasma membrane of spermatozoa. Additionally, the study has shown that the cauda epididymis remarkably descends to a site probably cooler than the core body temperature for optimal sperm storage, and the numerous vacuoles indicating its involvement in fluid reabsortion and phagocytosis of residual bodies and damaged spermazoa.

2002

NAMAN, DRMIMUNYAJAMES.  2002.  Giuseppe Raviola, M. Medicine and Psychiatry 26: 55-86.. Abstract

This paper describes the experiences of physicians-in-training at a public hospital in Nairobi, Kenya, where medical professionals practice in an environment characterized by both significant lack of resources and patients with HIV/AIDS in historically unprecedented numbers. The data reported here are part of a larger study examining ethical dilemmas in medical education and practice among physicians in East Africa. A questionnaire and semi-structured interview were completed by fifty residents in four medical specialties, examining social and emotional supports, personal and professional sources of stress, emotional numbing and disengagement from patients and peers, and symptoms of post-traumatic stress and depression. The factors affecting resident well-being are found in this study to be more complex than previous interviews suggested. This study highlights the fact that as a result of working in an environment characterized by poor communication among hospital staff as well as a lack of resources and high numbers of patients with HIV/AIDS, residents' perceptions of themselves–their technical proficiency, their ability to care and feel for others and themselves, and for some their entire sense of self–are significantly affected. Also affected are the patients they work to treat.

NAMAN, DRMIMUNYAJAMES.  2002.  M. Infertility Management in AFRO and EMRO Regions: held in Nairobi,2002. Abstract
Sengis are testicondid endemic african mammals that constitute the order Macroscelidae. The epididymides of five male rufous sengis (Elephantulus rufescens) were studied both macroscopically and microscopically to describe the structure and possible features or adaptations making it a suitable site for sperm maturation and storage in testicondas. The epididymis had three distinct topographic regions; the caput, corpus and cauda epididymis. The caput and cauda epididymis were placed further apart; the former occuring as a longitudinal mass on dorsolateral border of the tesis while the latter occurred as a pear-shaped mass placed laterally between the rectum and the pelvic urethra, the two being connected by a slender corpus epiddidymis. The epithelium comprised of principal and basal cells with the former exhibiting numerous secretory granules and apical blebing in the caput. In the cauda, principal cells had numerous vacuoles and its lumen was densely packed with spermatozoa and occasional masses that appeaed to engulf spermatozoa. This study demonstrates that the pricipal cells of the caput of sengi produces materials either through merocrine or apocrine secretion, the latter being shown by apical blebs that are shed off as epididymosomes, which in turn transfers epididymis-secreted proteins to the plasma membrane of spermatozoa. Additionally, the study has shown that the cauda epididymis remarkably descends to a site probably cooler than the core body temperature for optimal sperm storage, and the numerous vacuoles indicating its involvement in fluid reabsortion and phagocytosis of residual bodies and damaged spermazoa.

1999

NAMAN, DRMIMUNYAJAMES.  1999.  Mary-jo Delvecchio Good, Esther Mwaikambo, M. Journal of the American Academy of Arts and Sciences.. Abstract

This paper describes the experiences of physicians-in-training at a public hospital in Nairobi, Kenya, where medical professionals practice in an environment characterized by both significant lack of resources and patients with HIV/AIDS in historically unprecedented numbers. The data reported here are part of a larger study examining ethical dilemmas in medical education and practice among physicians in East Africa. A questionnaire and semi-structured interview were completed by fifty residents in four medical specialties, examining social and emotional supports, personal and professional sources of stress, emotional numbing and disengagement from patients and peers, and symptoms of post-traumatic stress and depression. The factors affecting resident well-being are found in this study to be more complex than previous interviews suggested. This study highlights the fact that as a result of working in an environment characterized by poor communication among hospital staff as well as a lack of resources and high numbers of patients with HIV/AIDS, residents' perceptions of themselves–their technical proficiency, their ability to care and feel for others and themselves, and for some their entire sense of self–are significantly affected. Also affected are the patients they work to treat.

1996

NAMAN, DRMIMUNYAJAMES.  1996.  Co-editor. (With Dr. Joseph G. Karanja): 1996: Curricula in Obstetrics and Gynecology, University of Nairobi, for Master of Medicine in Obstetrics and Gynecology.. University of Nairobi, for Master of Medicine in Obstetrics and Gynecology. 1996. Abstract

This paper describes the experiences of physicians-in-training at a public hospital in Nairobi, Kenya, where medical professionals practice in an environment characterized by both significant lack of resources and patients with HIV/AIDS in historically unprecedented numbers. The data reported here are part of a larger study examining ethical dilemmas in medical education and practice among physicians in East Africa. A questionnaire and semi-structured interview were completed by fifty residents in four medical specialties, examining social and emotional supports, personal and professional sources of stress, emotional numbing and disengagement from patients and peers, and symptoms of post-traumatic stress and depression. The factors affecting resident well-being are found in this study to be more complex than previous interviews suggested. This study highlights the fact that as a result of working in an environment characterized by poor communication among hospital staff as well as a lack of resources and high numbers of patients with HIV/AIDS, residents' perceptions of themselves–their technical proficiency, their ability to care and feel for others and themselves, and for some their entire sense of self–are significantly affected. Also affected are the patients they work to treat.

NAMAN, DRMIMUNYAJAMES.  1996.  M. University of Nairobi, for Master of Medicine in Obstetrics and Gynecology. 1996. Abstract

This paper describes the experiences of physicians-in-training at a public hospital in Nairobi, Kenya, where medical professionals practice in an environment characterized by both significant lack of resources and patients with HIV/AIDS in historically unprecedented numbers. The data reported here are part of a larger study examining ethical dilemmas in medical education and practice among physicians in East Africa. A questionnaire and semi-structured interview were completed by fifty residents in four medical specialties, examining social and emotional supports, personal and professional sources of stress, emotional numbing and disengagement from patients and peers, and symptoms of post-traumatic stress and depression. The factors affecting resident well-being are found in this study to be more complex than previous interviews suggested. This study highlights the fact that as a result of working in an environment characterized by poor communication among hospital staff as well as a lack of resources and high numbers of patients with HIV/AIDS, residents' perceptions of themselves–their technical proficiency, their ability to care and feel for others and themselves, and for some their entire sense of self–are significantly affected. Also affected are the patients they work to treat.

NAMAN, DRMIMUNYAJAMES.  1996.  Co-editor. (With Dr. Joseph G. Karanja): 1996: Curricula in Obstetrics and Gynecology, University of Nairobi, for Third and Fifth year Undergraduate Medical Students.. University of Nairobi,Third and Fifth year Undergraduate Medical Students.1996. Abstract

This paper describes the experiences of physicians-in-training at a public hospital in Nairobi, Kenya, where medical professionals practice in an environment characterized by both significant lack of resources and patients with HIV/AIDS in historically unprecedented numbers. The data reported here are part of a larger study examining ethical dilemmas in medical education and practice among physicians in East Africa. A questionnaire and semi-structured interview were completed by fifty residents in four medical specialties, examining social and emotional supports, personal and professional sources of stress, emotional numbing and disengagement from patients and peers, and symptoms of post-traumatic stress and depression. The factors affecting resident well-being are found in this study to be more complex than previous interviews suggested. This study highlights the fact that as a result of working in an environment characterized by poor communication among hospital staff as well as a lack of resources and high numbers of patients with HIV/AIDS, residents' perceptions of themselves–their technical proficiency, their ability to care and feel for others and themselves, and for some their entire sense of self–are significantly affected. Also affected are the patients they work to treat.

1991

NAMAN, DRMIMUNYAJAMES.  1991.  M. Volume XIII Nemero 6 Giugno.. Abstract

This paper describes the experiences of physicians-in-training at a public hospital in Nairobi, Kenya, where medical professionals practice in an environment characterized by both significant lack of resources and patients with HIV/AIDS in historically unprecedented numbers. The data reported here are part of a larger study examining ethical dilemmas in medical education and practice among physicians in East Africa. A questionnaire and semi-structured interview were completed by fifty residents in four medical specialties, examining social and emotional supports, personal and professional sources of stress, emotional numbing and disengagement from patients and peers, and symptoms of post-traumatic stress and depression. The factors affecting resident well-being are found in this study to be more complex than previous interviews suggested. This study highlights the fact that as a result of working in an environment characterized by poor communication among hospital staff as well as a lack of resources and high numbers of patients with HIV/AIDS, residents' perceptions of themselves–their technical proficiency, their ability to care and feel for others and themselves, and for some their entire sense of self–are significantly affected. Also affected are the patients they work to treat.

1990

NAMAN, DRMIMUNYAJAMES.  1990.  M. International Journal of Gynecology and Obstetrics: 34: 55-59.. Abstract

This paper describes the experiences of physicians-in-training at a public hospital in Nairobi, Kenya, where medical professionals practice in an environment characterized by both significant lack of resources and patients with HIV/AIDS in historically unprecedented numbers. The data reported here are part of a larger study examining ethical dilemmas in medical education and practice among physicians in East Africa. A questionnaire and semi-structured interview were completed by fifty residents in four medical specialties, examining social and emotional supports, personal and professional sources of stress, emotional numbing and disengagement from patients and peers, and symptoms of post-traumatic stress and depression. The factors affecting resident well-being are found in this study to be more complex than previous interviews suggested. This study highlights the fact that as a result of working in an environment characterized by poor communication among hospital staff as well as a lack of resources and high numbers of patients with HIV/AIDS, residents' perceptions of themselves–their technical proficiency, their ability to care and feel for others and themselves, and for some their entire sense of self–are significantly affected. Also affected are the patients they work to treat.

1989

NAMAN, DRMIMUNYAJAMES.  1989.  M. M. Med. Thesis, University of Nairobi.. Abstract

This paper describes the experiences of physicians-in-training at a public hospital in Nairobi, Kenya, where medical professionals practice in an environment characterized by both significant lack of resources and patients with HIV/AIDS in historically unprecedented numbers. The data reported here are part of a larger study examining ethical dilemmas in medical education and practice among physicians in East Africa. A questionnaire and semi-structured interview were completed by fifty residents in four medical specialties, examining social and emotional supports, personal and professional sources of stress, emotional numbing and disengagement from patients and peers, and symptoms of post-traumatic stress and depression. The factors affecting resident well-being are found in this study to be more complex than previous interviews suggested. This study highlights the fact that as a result of working in an environment characterized by poor communication among hospital staff as well as a lack of resources and high numbers of patients with HIV/AIDS, residents' perceptions of themselves–their technical proficiency, their ability to care and feel for others and themselves, and for some their entire sense of self–are significantly affected. Also affected are the patients they work to treat.

NAMAN, DRMIMUNYAJAMES.  1989.  M. M. Med. Thesis, University of Nairobi.. Abstract

This paper describes the experiences of physicians-in-training at a public hospital in Nairobi, Kenya, where medical professionals practice in an environment characterized by both significant lack of resources and patients with HIV/AIDS in historically unprecedented numbers. The data reported here are part of a larger study examining ethical dilemmas in medical education and practice among physicians in East Africa. A questionnaire and semi-structured interview were completed by fifty residents in four medical specialties, examining social and emotional supports, personal and professional sources of stress, emotional numbing and disengagement from patients and peers, and symptoms of post-traumatic stress and depression. The factors affecting resident well-being are found in this study to be more complex than previous interviews suggested. This study highlights the fact that as a result of working in an environment characterized by poor communication among hospital staff as well as a lack of resources and high numbers of patients with HIV/AIDS, residents' perceptions of themselves–their technical proficiency, their ability to care and feel for others and themselves, and for some their entire sense of self–are significantly affected. Also affected are the patients they work to treat.

NAMAN, DRMIMUNYAJAMES.  1989.  M. Journal of Obstetrics and Gynecology, East and Central Africa: Vol. 8 (2) 83-86. Abstract

This paper describes the experiences of physicians-in-training at a public hospital in Nairobi, Kenya, where medical professionals practice in an environment characterized by both significant lack of resources and patients with HIV/AIDS in historically unprecedented numbers. The data reported here are part of a larger study examining ethical dilemmas in medical education and practice among physicians in East Africa. A questionnaire and semi-structured interview were completed by fifty residents in four medical specialties, examining social and emotional supports, personal and professional sources of stress, emotional numbing and disengagement from patients and peers, and symptoms of post-traumatic stress and depression. The factors affecting resident well-being are found in this study to be more complex than previous interviews suggested. This study highlights the fact that as a result of working in an environment characterized by poor communication among hospital staff as well as a lack of resources and high numbers of patients with HIV/AIDS, residents' perceptions of themselves–their technical proficiency, their ability to care and feel for others and themselves, and for some their entire sense of self–are significantly affected. Also affected are the patients they work to treat.

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