Bio

Prof. J.A.O Mulimba

Currently the Chairman of Orthopaedic Surgery

Personal Information

Fellow of College of Surgeons of East, Central and Southern Africa (COSECSA) FCS (ECSA)

Fellow of the Royal College of Surgeons of Edniburgh; FRCS Ed; Scotland, UK.

Areas Of Specialization

Orthopaedic and Trauma Surgeon.

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Publications


2010

MULIMBA, JAO.  2010.  Rehabilitation in Orthopaedic practice.

2009

MULIMBA, JAO.  2009.  Intramedullary treatment of fractures.

2008

Gakuu, IO;, MULIMBA JAO.  2008.  Intramedullary interlocking nailing fixation for forearm fractures: Kenyan experience: Initial report. Abstract

Objective: To evaluate treatment results of intramedullary fixation of radius and ulna diaphyseal fractures using interlocking nailing - system locked proximaly and distally by screws. Methodology: Between December 2007 and May 2008, six patients (4 males and 2 females) with displaced diaphyseal forearm fractures underwent intramedullary fixation using interlocking nails. The nails were introduced into the ulna via a 1.5cm long incision at the tip of the olecranon splitting distal fibres of the triceps. The distal radius was entered via a 3cm longitudinal incision lateral to the Lister's tubercle. Locking for the proximal and distal radius and ulna was done with the forearm positioned appropriately. This produced a stable osteosynthesis and no casting was needed. Physiotherapy was started immediately and patient follow-up with check X-rays post-operation then at 6, 12 and 18 weeks. The time to union, functional recovery and complications was assessed. Results: All the data was available for analysis. Nine fractures achieved stable osteosynthesis and proceeded to union by eight to twelve weeks. No infection was noted, and no neurological lesions were documented. The other two fractures have not yet united as we go to the press. Incidentally they were the compound Gustillo III fractures. Based on the Anderson criteria all the patients attained excellent results. Conclusion: The newly introduced interlocking system for diaphyseal fractures of the forearm o'ffer a stable intramedullary fixation with excellent results. Further studies need to be done to confirm continuation of this good initial observation.

MULIMBA, JAO.  2008.  Infection with methicillin resistant staphylococcus aureus: Case report. Abstract

Infection in surgery causes delay in wound healing, increased suffering to the patient and increases cost of treatment. In developed countries, because of very good facilities, infection has been cut down to 0.5-5%. The biggest problem has been infection with methicillin resistant staphylococcus aureus (MRSA). The biggest brunt has been borne in arthroplasty units, sometimes assuming epidemic proportions. Arthroplasty in Africa is still in its nascent stage but is rapidly increasing. Infection with MRSA is not yet widely reported, but one knows it is on the way. In this communication, a case is reported of MRSA infection in a fracture of femur with metallic implants and its management. Literature on the subject has been surveyed and will hopefully serve as a preparation for management of such cases whenever they arise in the more expensive treatment cases of arthroplasty.

2007

MULIMBA, JAO.  2007.  Is Hip Arthroplasty Viable in A Developing African Country? East and Central African Journal of Surgery,. 12(1):30-32. Abstract

Arthroplasty is an established management of various joint disorders in developed countries. Poverty has caused African countries to remain behind in this sphere of management and condemned sufferers to a life of misery and immobility. In this review, the viability of total hip arthroplasty (THR) is examined. The need, constraints and difficulties encountered in this field of surgery are examined. There are only a few cases of THR done previously and literature on this has been scarce. It is hoped that if the arrangement suggested in this review is established it will be possible to carry out this branch of Orthopaedic surgery in various countries of our region.

2004

Mulimba, JO.  2004.  The problems of low back pain in Africa. Abstract

Discussed in this paper are 227 African patients seen in a private clinic in the period August 1982 to March 1987. During the same period 2201 patients were seen. This constitutes 10%. Most of the sufferers were in the third to fifth decades. The male to female ratio was 1:1.7. The housewife, farmer and the professions of secretaries, teachers and nurses constituted the majority. Under our set up the single most useful investigation was a rediculogram. The various methods of conservative treatment are discussed. The operative methods deployed are also discussed as are indications

2003

1998

MULIMBA, JOA.  1998.  Osteogenic Sarcoma. East Afr Med J. 1996 Feb;73(2):88-90.. : Springerlink Abstract

Osteogenic Sarcoma at Kenyatta Naitonal Hospital Medicom 13(1): 15, 1998

1997

MULIMBA, JOA.  1997.  Training of Surgeons for Primary Health Care. South African Journal of Surgery 35 (3) 142, August 1997.. South African Journal of Surgery 35 (3) 142, August 1997. : Springerlink Abstract

It has been the view of the Association of Surgeons of East Africa (ASEA) that, like primary health care, there is primary surgery. The unit of provision of primary surgery is the district hospital. The training of surgeons for district hospitals starts at the undergraduate level, leading to the attainment of Bachelor of Medicine and Bachelor of Surgery (M.B. Ch.B.) degree. After internship the doctor works in a district or provincial hospital for 2-3 years, then trains for the degree of Master of Medicine (M. Med. (Surg.)) for a period of 3 years. The training involves rotation through all branches of surgery, so that the surgeon should be able to handle all aspects of routine surgery in a district hospital. To equip the surgeon further, a period in an outside setting is considered advisable. There are arrangements for regional surgical colleges to standardise the form of surgical training in the ASEA region. To keep surgeons in touch with the outside world, specialist training is done outside the region, but arrangements are being made for localised specialised units to offer this training.

1994

AO Mulimba, Othieno-Abinya NA, Nyong’o AO.  1994.  A 15 – YEAR RETROSPECTIVE ANALYSIS OF OSTEOGENIC SARCOMA IN KENYA. Africa Journal Medical Practice. 1(3) Abstract

Cases of osteogenic sarcoma were studied as reported in the Kenya Cancer Registry covering a period of 15 years between January 1976 and December 1990. There were 271 cases with 113 (41.5%) coming from the Kikuyu community. The male to female ratio was 1.3 to 1 and the median age was 17 years. The tribal bias suggests either a genetic aetiology or a common environmental factor.

Afri J Med Prac, 1994; 1 (3): 73-7

Introduction

Osteosarcoma is the most common sarcoma of bone worldwide. It occurs mainly during childhood and adolescence. during childhood and adolescence. 1-3 A biphasic pattern is observed with this tumour. The childhood and adolescent tumour is commonly observed arising in the epiphyses of long bone during the growth spurt . A small peak occurs in the elderly which is commonly associated with paget ‘s diseases or arises in prior radiation therapy ports or associated with exposure to thorotrast.4

Apart from the Kenyatta National Hospital (KNH) based study by Gakuu in 1980, 5 no information is available on the clinic-epidemiological picture of asteosarcoma in East Africa. A study was therefore, designed to look into some preliminary information about osteosarcoma in Kenya.

Materials and Methods

The source if this information was the Kenya Cancer registry (January 1975 to December 1990). Details were scrutinized about histology, sex, hospital of reporting, tribe, age and involved site(s).

Results
There were a total of 271 cases of osteogenic sarcoma consisting of 151 males and 177 females (Male : Female = 1.3:1). Three cases had no gender identified. The Kikuyu predominate (42%) followed by Kamba (12%) as province, as shown in table 1. Most cases were reported from Nairobi province, as shown in table 2.

Cases were registered in all age groups (range 3 – 87 years) though the second decade accounted for 140 out of 244 (57%) of those whose ages were known (table 3). The median age was 17 years and mean age 19.5 years. Age distribution by tribes was fairly similar (table 4). The femur and tibia were most commonly involved, followed by the jaws (figure1).

Head and face involvement was then analyzed in greater details. The median age this time was 22 and mean age 27.3, only 26.5%of cases being recorded in second decade and 38.2% in third decade (Table 5). The Kikuyu were stillleading in head and facial involvement. It is however noteworthy that 40% of Luos now presented this way (table 6).

1984

1983

MULIMBA, JAO.  1983.  Injection osteomyelitis in Children..
MULIMBA, JAO.  1983.  Fractures of the Humerus E.A.M.J. 60 (12): 843, 1983.. E.A.M.J. 60 (12): 843, 1983.. : Springerlink Abstract

It has been the view of the Association of Surgeons of East Africa (ASEA) that, like primary health care, there is primary surgery. The unit of provision of primary surgery is the district hospital. The training of surgeons for district hospitals starts at the undergraduate level, leading to the attainment of Bachelor of Medicine and Bachelor of Surgery (M.B. Ch.B.) degree. After internship the doctor works in a district or provincial hospital for 2-3 years, then trains for the degree of Master of Medicine (M. Med. (Surg.)) for a period of 3 years. The training involves rotation through all branches of surgery, so that the surgeon should be able to handle all aspects of routine surgery in a district hospital. To equip the surgeon further, a period in an outside setting is considered advisable. There are arrangements for regional surgical colleges to standardise the form of surgical training in the ASEA region. To keep surgeons in touch with the outside world, specialist training is done outside the region, but arrangements are being made for localised specialised units to offer this training.

1982

1980

MULIMBA, JAO.  1980.  Bacteriology of Tonsils of Keynyatta National Hospital. E.A.M. J. 57 (4): 252, 1980.. E.A.M. J. 57 (4): 252, 1980.. : Springerlink Abstract

It has been the view of the Association of Surgeons of East Africa (ASEA) that, like primary health care, there is primary surgery. The unit of provision of primary surgery is the district hospital. The training of surgeons for district hospitals starts at the undergraduate level, leading to the attainment of Bachelor of Medicine and Bachelor of Surgery (M.B. Ch.B.) degree. After internship the doctor works in a district or provincial hospital for 2-3 years, then trains for the degree of Master of Medicine (M. Med. (Surg.)) for a period of 3 years. The training involves rotation through all branches of surgery, so that the surgeon should be able to handle all aspects of routine surgery in a district hospital. To equip the surgeon further, a period in an outside setting is considered advisable. There are arrangements for regional surgical colleges to standardise the form of surgical training in the ASEA region. To keep surgeons in touch with the outside world, specialist training is done outside the region, but arrangements are being made for localised specialised units to offer this training.

1979

MULIMBA, JAO.  1979.  An unusual presentation of multiple myeloma. Proc. Ass. of Surg. E.A. 2: 194,1979.. Ass. of Surg. E.A. 2: 194,1979.. : Springerlink Abstract

It has been the view of the Association of Surgeons of East Africa (ASEA) that, like primary health care, there is primary surgery. The unit of provision of primary surgery is the district hospital. The training of surgeons for district hospitals starts at the undergraduate level, leading to the attainment of Bachelor of Medicine and Bachelor of Surgery (M.B. Ch.B.) degree. After internship the doctor works in a district or provincial hospital for 2-3 years, then trains for the degree of Master of Medicine (M. Med. (Surg.)) for a period of 3 years. The training involves rotation through all branches of surgery, so that the surgeon should be able to handle all aspects of routine surgery in a district hospital. To equip the surgeon further, a period in an outside setting is considered advisable. There are arrangements for regional surgical colleges to standardise the form of surgical training in the ASEA region. To keep surgeons in touch with the outside world, specialist training is done outside the region, but arrangements are being made for localised specialised units to offer this training.

1977

MULIMBA, JAO.  1977.  A histological microbiological and immunological study of patients undergoing tonsillectomy for recurrent Sore throats at the Kenyatta national hospital.. Abstract

A histological, microbiological, virological and immunological study of tonsils removed from patients Buffering recurrent attacks of sore throat was done. The study was done on patients seen in Ear., Nose and Throat (E. N. T.) Clinic and wards of Kenyatta National Hospital (K.N.H.) over a period of three months, September to November, 1977. The
patients' ages ranged between 2 years and 38 years. First 29 tonsils were examined histologically, no specific diagnostic features were demonstrable in any. Of 54 throat swabs taken in the clinic only 9 grew pathogens i.e. 6%. Of the 63 tonsils and
63 throat swabs iros same patients examined microbio-logically, 40 tonsils grew pathogens as compared to only 17 throat swabs. No fungi were isolated in any
specimen although they were looked for.67 specimens of tonsillar arid adenoid mater ial were cuItured for viruses, only 9 grew adenoviruses types 1, 2 and 5. 25 tonsillar and adenoid materials were examined immunologically for lymphocyte activity the result
of which was compared w ith lymphocyte activity in the peripheral blood of the same patients. Serum globulin levels were determined in 30 patients. These levels were generally low. The results were analysed, the literature on the various aspects of management of recurrent attacks of sore throat was examined; and this was followed by
discussion. COG81usions wsre drawn based on the above views expresseJ by many authors of articles on this issue

1975

MULIMBA, JAO.  1975.  Wound infections in a General Surgical Unit of the Kenyatta National Hospital. Nairobi Med. Journal , 1975.. Nairobi Med. Journal , 1975.. : Springerlink Abstract

It has been the view of the Association of Surgeons of East Africa (ASEA) that, like primary health care, there is primary surgery. The unit of provision of primary surgery is the district hospital. The training of surgeons for district hospitals starts at the undergraduate level, leading to the attainment of Bachelor of Medicine and Bachelor of Surgery (M.B. Ch.B.) degree. After internship the doctor works in a district or provincial hospital for 2-3 years, then trains for the degree of Master of Medicine (M. Med. (Surg.)) for a period of 3 years. The training involves rotation through all branches of surgery, so that the surgeon should be able to handle all aspects of routine surgery in a district hospital. To equip the surgeon further, a period in an outside setting is considered advisable. There are arrangements for regional surgical colleges to standardise the form of surgical training in the ASEA region. To keep surgeons in touch with the outside world, specialist training is done outside the region, but arrangements are being made for localised specialised units to offer this training.

1970

MULIMBA, JAO.  1970.  Horrobin D. , Burstyn C., Kahuho S., Mulimba J. , The effect of Progesterone on the Response of cardiovascular system to intravenous infusion of aldosterone. J. Obs. and Gyn. Brit. Comm. 77: 928, 1970.. J. Obs. and Gyn. Brit. Comm. 77: 928, 1970.. : Springerlink Abstract

It has been the view of the Association of Surgeons of East Africa (ASEA) that, like primary health care, there is primary surgery. The unit of provision of primary surgery is the district hospital. The training of surgeons for district hospitals starts at the undergraduate level, leading to the attainment of Bachelor of Medicine and Bachelor of Surgery (M.B. Ch.B.) degree. After internship the doctor works in a district or provincial hospital for 2-3 years, then trains for the degree of Master of Medicine (M. Med. (Surg.)) for a period of 3 years. The training involves rotation through all branches of surgery, so that the surgeon should be able to handle all aspects of routine surgery in a district hospital. To equip the surgeon further, a period in an outside setting is considered advisable. There are arrangements for regional surgical colleges to standardise the form of surgical training in the ASEA region. To keep surgeons in touch with the outside world, specialist training is done outside the region, but arrangements are being made for localised specialised units to offer this training.

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