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(Last updated: March 22, 2013)

Publications

2012

Ondieki, JG, Khainga SO, Owilla F, Nangole FW.  2012.  OUTCOME OF FOAM VERSUS GAUZE DRESSINGS IN NEGATIVE PRESSURE WOUND THERAPY FOR THE MANAGEMENT OF ACUTE TRAUMATIC WOUNDS WITH SOFT TISSUE LOSS AT KENYATTA NATIONAL HOSPITAL., 2012 Jul. East African medical journal. 89(7):230-40. Abstract

Wounds have provided a challenge to the clinicians for centuries and this scenario persists to the 21st century. Negative pressure wound therapy (NPWT) is one of the latest additions in wound management. It has been widely adopted in developed countries with foam as the default wound dressing although it has some limitations.
OLIECH, JS, Owillah F, Oliech PJ, Ludia Mattakwa C.  2012.  Symptomatic and Uroflometry Outcomes Of Tamsulosin and Dutasteride Combination In Management of Benign Prostatic Hypertrophy in the Black Race. Abstract

Benign prostatic hyperplasia (BPH) incidence and progression has been shown to vary by race, geography and ethnicity with African-Americans having a more aggressive disease than other races. Combination drug therapy has been shown to be a favorable option for medical therapy of symptomatic BPH but data is lacking on the effects of this therapy in black race patients locally. This study aims to assess the early (six months) response, by both International-Prostate Symptom Score (IPSS) and peak urinary flow rate (QMax), to combination drug therapy of Tamsulosin and Dutasteride for management of symptomatic BPH in a predominantly African black race population cohort as a pilot study. Patients and Methods: Dutasteride 0.5mg and Tamsulosin 0.4mg once daily were administered orally to 52 patients aged 45years and above of black race with confirmed BPH for six months. The main outcome measures of change in mean QMax and IPSS were assessed at three months and six months. Secondary outcome measures were mean Total Prostate Specific Antigen (tPSA) and Prostate Volume (PV) changes. Drug compliance by Modified Morisky Scores (1) and adverse/side effects reported were documented. Paired sample t test and Pearson correlation as well as ANOVA were used to analyze the data. Results: There was a statistically and clinically significant increase in mean QMax by 13.3ml/sec and decrease in mean IPSS by 14.5 points at six months. There was a fairly rapid reduction in mean Total PSA of 0.9ng/ml as early as two months and a slower fall in mean PV of 10.224mls most evident at the last follow-up. Safety and tolerability of the drugs was consistent with previous experience and majority of the patients portrayed an excellent drug compliance profile. Conclusion: These results suggest the efficacy of combination drug therapy of Dutasteride and Tamsulosin for moderate-to-severe BPH in the black race. These patients seem to have a more drastic and rapid mean IPSS, QMax and PV response to therapy than reported for other races but their mean total PSA decrease was less. Combination drug therapy is therefore recommended as a useful alternative to surgery in management of BPH in the black race.

2006

A, DROWILLAHFRANCIS.  2006.  Pattern and outcome of abdominal injuries at Kenyatta National Hospital, Nairobi.. East Afr Med J. 2006 Jan;83(1):37-43. : 1999 Abstract
OBJECTIVE: To establish the pattern and results of interventions in patients with abdominal injuries requiring admission. DESIGN: A descriptive, prospective, hospital-based study involving observation of patients from admission to final outcome of management as either discharged or deceased. SETTING: Kenyatta National Hospital, a tertiary teaching and referral hospital in Nairobi, Kenya, from November 2004 to February 2005 in the adult general surgical wards. PATIENTS: Eighty consecutive admissions of adult patients with either blunt or penetrating abdominal injuries. MAIN OUTCOME MEASURES: Type and cause of injury, demographic data, temporal parameters, morbidity and mortality. RESULTS: The 80 patients had a male to female ratio of 12.3:1, the majority were in the third decade of life with a range 15-56 years and mean of 28.2 years. Penetrating to blunt abdominal injuries had 2:1 ratio with the leading causes of injury being stab wounds, gunshot wounds and road traffic accidents. Blunt abdominal injuries had a higher tendency to extra-abdominal injuries. Duration prior to presentation to hospital and surgery depended on severity of injury. Modes of management varied between attending surgical firms. There was a 20% change in the mode of management and a 16.1% rate of negative laparotomy. Penetrating injuries had a better interventional outcome. Penetrating abdominal injuries had higher rates of complications while the blunt injuries had higher rates of mortality. Overall, both the complication and mortality rates were 12.5%. Correlates of mortality included delay before surgery, associated injuries, need for blood transfusion, admission to intensive care unit and duration prior to admission. Abdominal injury patients stayed an average of 6.4 days with the blunt injuries with complications staying close to twice as much as their penetrating counterparts. CONCLUSION: Abdominal injuries are a predominantly male disease with the majority in the third decade of life. As opposed to previous studies, gunshot wounds are now a significant cause of abdominal injuries in Kenyatta National Hospital (KNH). The rate-of negative laparotomies has come down by 10% over the past 15 years. The outcome of management depends on the severity and type, of injury sustained.
GUNVANTRAY, PROFJANIPANKAJ, M MRMUSAUPETER, A DROWILLAHFRANCIS.  2006.  Musau P, Jani PG, Owillah FA.Pattern and outcome of abdominal injuries at Kenyatta National Hospital, Nairobi.East Afr Med J. 2006 Jan;83(1):37-43.East Afr Med J. 2006 Jan;83(1):37-43.. East Afr Med J. 2006 Jan;83(1):37-43.. : 1999 Abstract
OBJECTIVE: To establish the pattern and results of interventions in patients with abdominal injuries requiring admission. DESIGN: A descriptive, prospective, hospital-based study involving observation of patients from admission to final outcome of management as either discharged or deceased. SETTING: Kenyatta National Hospital, a tertiary teaching and referral hospital in Nairobi, Kenya, from November 2004 to February 2005 in the adult general surgical wards. PATIENTS: Eighty consecutive admissions of adult patients with either blunt or penetrating abdominal injuries. MAIN OUTCOME MEASURES: Type and cause of injury, demographic data, temporal parameters, morbidity and mortality. RESULTS: The 80 patients had a male to female ratio of 12.3:1, the majority were in the third decade of life with a range 15-56 years and mean of 28.2 years. Penetrating to blunt abdominal injuries had 2:1 ratio with the leading causes of injury being stab wounds, gunshot wounds and road traffic accidents. Blunt abdominal injuries had a higher tendency to extra-abdominal injuries. Duration prior to presentation to hospital and surgery depended on severity of injury. Modes of management varied between attending surgical firms. There was a 20% change in the mode of management and a 16.1% rate of negative laparotomy. Penetrating injuries had a better interventional outcome. Penetrating abdominal injuries had higher rates of complications while the blunt injuries had higher rates of mortality. Overall, both the complication and mortality rates were 12.5%. Correlates of mortality included delay before surgery, associated injuries, need for blood transfusion, admission to intensive care unit and duration prior to admission. Abdominal injury patients stayed an average of 6.4 days with the blunt injuries with complications staying close to twice as much as their penetrating counterparts. CONCLUSION: Abdominal injuries are a predominantly male disease with the majority in the third decade of life. As opposed to previous studies, gunshot wounds are now a significant cause of abdominal injuries in Kenyatta National Hospital (KNH). The rate-of negative laparotomies has come down by 10% over the past 15 years. The outcome of management depends on the severity and type, of injury sustained.

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