Diabetic ketoacidosis: clinical presentation and precipitating factors at Kenyatta National Hospital, Nairobi

2006 ◽  
Vol 82 (12) ◽  
Author(s):  
CF Otieno ◽  
PK Mbugua ◽  
JK Kayima ◽  
AA Amayo ◽  
SO McLigeyo
Keyword(s):  
Diabetic Ketoacidosis ◽  
Clinical Presentation ◽  
Precipitating Factors ◽  
National Hospital ◽  
Kenyatta National Hospital

scholarly journals Outcomes of Children and Adolescents Admitted with Diabetic Ketoacidosis at Kenyatta National Hospital (KNH), Kenya

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Sophie Nyaombe Musoma ◽  
Anjumanara Omar ◽  
Beatrice Chepngeno Mutai ◽  
Paul Laigong
Keyword(s):  
Serum Creatinine ◽  
Children And Adolescents ◽  
Diabetic Ketoacidosis ◽  
Urine Output ◽  
High Serum ◽  
National Hospital ◽  
Altered Level ◽  
Kenyatta National Hospital ◽  
Risk Of Mortality ◽  
Level Of Consciousness

Background. Diabetic ketoacidosis (DKA) is an acute, major, life-threatening complication that mainly occurs in patients with type 1 diabetes mellitus and is the foremost cause of death in these children. Overall mortality in children with DKA varies from 3.4% to 13.4% in developing countries. There is a need to understand outcomes among children with DKA in sub-Saharan African countries. Objective. To determine the death rate and clinical outcomes of children and adolescents aged 0-18 years managed for DKA at Kenyatta National Hospital (KNH). Study Methods. This was a retrospective study carried out among children aged 0–18 years admitted with DKA at KNH between February 2013 and February 2018. The study site was the central records department at KNH. The inclusion criteria were children aged 0-18 years admitted with a diagnosis of DKA based on the ISPAD guidelines biochemical criteria. Results. Out of the 159 files reviewed, the median age of children was 13 years (IQR 10-15). 41.1% of patients had severe DKA while 35.7% had moderate DKA. We reported a mortality of 6.9% while 93.1% of children recovered and were discharged home. The median duration of hospital stay was 8 days. High risk of mortality was reported among children who had high serum creatinine (OR 5.8 (95% CI 1.6-21.2)), decreased urine output (OR 9.0 (95% CI 2.2-37.3)), and altered level of consciousness (OR 5.2 (95% CI 1.1-25.1)). Conclusion. DKA-associated mortality in our study was low at 6.9%. High serum creatinine, decreased urine output, and altered level of consciousness were associated with a significantly higher risk of mortality.

scholarly journals Analysis of Organophosphorus compound poisoning patients attending CMS-TH, Bharatpur, Nepal

2012 ◽  
Vol 7 (4) ◽  
pp. 9-19
Author(s):  
S Laudari ◽  
BS Patowary
Keyword(s):  
Clinical Presentation ◽  
Statistical Significance ◽  
Medical Emergency ◽  
Precipitating Factors ◽  
Medical Sciences ◽  
Treatment And Prevention ◽  
Female Predominance ◽  
Organophosphorus Poisoning ◽  
Planning Treatment ◽  
Psychiatric Problems

Organophosphorus (OP) compound poisoning is a medical emergency. It is important to know its nature, clinical presentation, severity and outcome in order to take up appropriate measures including proper planning, treatment and prevention. This study was aimed to assess the clinical profile of organophosphorus poisoning. This is a prospective hospital based study conducted at CMS-T.H., Bharatpur, Nepal. The study included 111 patients of organophosphorus poisoning during the period November 2008 to July 2011. The incidence was commoner in females than males with female:male ratio being 1.47:1. Majority of the patients(58.56%) belonged to the age group 16 to 30 years with female predominance(2.25:1). Modes of poisoning were suicidal in the majority (94.59%), accidental in 4.50%. and homicidal in 0.90%. Psychiatric problems were the major precipitating factors. Majority of patients(62.16%) had moderate poisoning (POP scale: 4-7).On admission, dyselectrolytemia and respiratory failure were found in 74.77% and 21.62% respectively.8 patients expired (7.69%). Large amount of OP poison ingestion (>40ml) and increased severity of poisoning (POP scale) were found to have statistical significance with the rate of mortality. Journal of College of Medical Sciences-Nepal,2011,Vol-7,No-4, 9-19 DOI: http://dx.doi.org/10.3126/jcmsn.v7i4.6736

Pediatric Medical Emergencies and Injury Prevention Practices in the Pediatric Emergency Unit of Kenyatta National Hospital, Nairobi, Kenya

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Justin G. Myers ◽  
Uzoma A. Nwakibu ◽  
Katherine M. Hunold ◽  
Ali Akida Wangara ◽  
Jason Kiruja ◽  
...  
Keyword(s):  
Injury Prevention ◽  
Pediatric Emergency ◽  
Emergency Unit ◽  
National Hospital ◽  
Kenyatta National Hospital ◽  
Medical Emergencies

Final report of Breast Cancer Care Registry at the Kenyatta National Hospital, Nairobi.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12552-e12552
Author(s):  
Nicholas Anthony Othieno-Abinya ◽  
Alice Musibi ◽  
Catherine Nyongesa ◽  
Benjamin Njihia ◽  
Andrew Gachii ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Disease ◽  
Ductal Carcinoma ◽  
Clinical Care ◽  
Significant Proportion ◽  
Relative Survival ◽  
Final Report ◽  
Early Disease ◽  
National Hospital ◽  
Kenyatta National Hospital

e12552 Background: Breast cancer is the commonest cancer among women in Kenya. We wanted to examine breast cancer seen at the Kenyatta National Hospital in relation to local factors that influence prognosis and quality of life, local variations in treatment and outcomes; describe the clinical care patterns, monitor the safety of the therapies provided to patients in a routine clinic setting. Methods: A prospective study of patients with breast cancer between 11.08.2011 and 11.09.2014 inclusive. Data included demographic details, diagnostic and staging procedures, stage, treatment and outcome. Estimates of relative survival used period approach. hi-square tests and analysis of variance (ANOVA) were utilised to make comparisons. Cross sectional data are presented in proportions, means and medians. Results: Four hundred patients were included, age range 20 to 83, median 49 years. Out 312, 65 (20.8%) were obese. Eight of 397 (2%) were smokers and 22(5.5%) took alcohol. Early disease was diagnosed in 269 out of 354 (76%) and metastatic disease in 85(24%). Breast lump presented in 388 out of 400 (97%), breast pain in 104 out of 388 (26.8%). Fifteen of 394 (3.8%) had second breast cancer, 4 (1%) had had ovarian cancer and 9 (2.3%) had had had other malignancy. History of breast cancer in first and second-degree relative was elicited in 41 out of 394 (10.4%). Ductal carcinoma NOS was commonest in 343 (88.2%), lobular carcinoma in 9(2.5%). Cases by T stage were T1 - 25(7.2%), T2 -130(37.4%), T3 - 96(27.6%), T4 - 87(25%). Of 322 cases, 187(58.1%) were ER positive and 175 (54.4%) PR positive. Her2 positive cases were 78 out of 322 (24.2%). Neo adjuvant and adjuvant chemotherapy mainly consisted of combinations of cyclophosphamide and doxorubicin [AC] +/- a taxane[AC→T] ( mainly by medical oncologists) or AC+ 5-FU [CAF] (mainly by clinical oncologists). Of 305 cases 272 (89.2%) completed adjuvant therapy, 8(2.6%) died during treatment. Median overall survival was 57.1 months (95% CI; 55.6 to 59.5 months). For metastatic disease, median PFS was worse for patients < 40 years. Conclusions: Pathology and biology mirrored global situation, over 75% of patients had non metastatic disease. A significant proportion of early disease patients did not complete treatment.

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