KNH-UoN Ethics and Research Committee

BACKGROUND:

Many burns are preventable but there is no published local prospective data on the epidemiological pattern of burns that would form the basis of care and formulation of burn prevention strategies.

OBJECTIVES:

To determine the epidemiological pattern of burns and assess the awareness of burn risk and preventive measures among patients admitted at Kenyatta National Hospital (KNH) with burns.

DESIGN:

Cross-sectional study.

SETTING:

Kenyatta National Hospital.

PATIENTS:

One hundred and nine consecutive burn patients admitted at Kenyatta National Hospital.

RESULTS:

The mean age was 14.4 years (median 7.0, range 0.2-66 years). Mean total body surface area burned (TBSA) was 22.3% (median 13.0, range 1-95%). Children under five years were 48.6% with more scalds compared to adults. Open flames burns, involvement of accelerants and assault were prominent among adults. Education level above primary school was associated with higher risk awareness compared with primary level education or below.

CONCLUSION:

The pattern of burns noted resembles other reported series but the role of accelerants and assault appears enhanced in this study. Public education campaigns aimed at burns reduction could be tailored to the educational level of target population.

To provide an overview of the various advancements and problems associated with both live and cadaver donor renal allograft transplantation during the twentieth century. DATA SOURCE: Major published reviews on renal transplantation during the the last five decades of the twentieth century were reviewed using Medline internet search and the Index Medicus. The developments in immunosuppressive therapy associated with renal transplantation, the problem of the shortage of both live and cadaveric organ donors and post-transplant complications were examined. The future of renal transplantation including cross species transplantation (xenotransplantation) is discussed. CONCLUSION: Renal transplantation has evolved over the years to become a very successful and routine procedure. However, the transplant waiting lists have remained long due to a continuously shrinking kidney donor pool which is due to improved results of neurosurgical procedures, better emergency and intensive care services and the failure to adequately prevent and treat post transplant chronic renal failure.

OBJECTIVES:
To determine how common cancer of penis is in this locality compared to all other malignant tumours and urological malignancies, and to determine and comment on the various methods of treatment available at KNH.
DESIGN:
A retrospective case study.
SETTING:
Kenyatta National Referral Hospital, Nairobi.
SUBJECTS:
All patients with histologically confirmed cancer of penis at the Kenyatta National hospital between January 1970 and December 1999.
RESULTS:
There were 55 patients with penile cancer representing 0.1% of all malignancies during the study period. The mean age was 47.9 years with a peak incidence between 40-61 year age groups. Penile cancer was the most rare urological tumour representing 5.1%. The most common was prostate cancer (56.0%), followed by bladder cancer (25.0%), kidney cancer (7.9%), and testicular cancer (6.1%). Thirty eight patients (69.1%) presented with advanced disease, Jacksons stages III and IV. The majority (96.4%) of the patients had glandular and preputial involvement. Histologically, 56.4% had well differentiated squamous cell carcinoma, (23.6%) had moderately differentiated and (20.0%) had undifferentiated carcinoma. Forty patients (72.7%) were circumcised, nine patients (16.4%) were circumcised as adolescents and three patients (5.5%) circumcised as adults. Twenty five patients had partial penectomy with radiotherapy and or chemotherapy. Eight patients had total penectomy and radiotherapy while four patients had local excision and radiotherapy. Eleven other patients had radiotherapy either alone or combined with chemotherapy. Two patients had circumcision only and inguinal lymphadenectomy was effected on five patients after penectomy and radiotherapy.
CONCLUSION:
Penile cancer is rare and the least common urological malignancy in this locality. It occurs in younger men with a mean age of 47.9 years, and presents as advanced Jackson's stages III and IV disease. The majority of patients had penectomy and local excision followed by radiotherapy.

To determine the number of surgeons trained by the Department of Surgery, Faculty of Medicine, College of Health Sciences, University of Nairobi, since its inception in 1967. DESIGN: This was a retrospective (1975-1987) and prospective study (1988-1999). SETTING: Kenyatta National Hospital, a National Referral Hospital and University of Nairobi Teaching Hospital. SUBJECTS: All surgeons trained by the Department of Surgery of the University of Nairobi for postgraduate MMed in general surgery, anaesthesia, ENT surgery and ophthalmology from 1975 to March 1999. RESULTS: Two hundred and eighty-five surgeons with Master of Medicine degree were trained by the Department of Surgery of the University of Nairobi between 1975 and March 1999. They included 181 (63.51%) general surgeons; 46 (16.14%) anaesthetists; 35 (12.28%) ophthalmologists and 23 (8.07% ear, nose and throat (ENT) surgeons. One hundred and seventy-six, (61.75%) were from retrospective studies; 94 (32.98%) were from prospective studies while 15 (5.26%) were from both retrospective and prospective studies. Two hundred and thirty-two (81.40%) surgeons were Kenyans while 53 (18.60%) were foreigners. The majority, 42 (79.24%) of the foreigners were from other African countries. Thirty one (58.50%) were from neighbouring Uganda, Sudan, Tanzania, Ethiopia and Zambia. There was also one PhD in anaesthesia and one MD in urology during the same period. CONCLUSION: The University of Nairobi, Department of Surgery based at Kenyatta National Hospital has played a very significant and leading role in the training of surgeons for Kenya and even other African and foreign countries since its inception. Of the forty surgeons who constitute the academic staff in the Departments of General Surgery, Orthopaedic Surgery and Ophthalmology of the University of Nairobi, thirty-five surgeons (87.50%) have been trained by the Faculty of Medicine at KNH. PIP: This study was carried out as a retrospective (1975-87) and prospective study (1988-99) to determine the number of surgeons trained by the Department of Surgery, Faculty of Medicine, College of Health Sciences, University of Nairobi, Kenya, since its inception in 1967. Over the 25-year period (1975-99), the Department of Surgery of the University of Nairobi trained a total of 285 surgeons with a Master of Medicine degree. These included 181 (63.51%) general surgeons, 46 (16.14%) anesthetists, 35 (12.28%) ophthalmologists, and 23 (8.07%) ear, nose, and throat surgeons. 176 of the dissertations (61.75%) were from retrospective studies, 94 (32.98%) were from prospective studies, and 15 (5.26%) were from combined prospective and retrospective studies. 53 (18.60%) of these surgeons were foreigners, with the majority (79.24%) coming from other African countries. The neighboring countries of Uganda, Sudan, Tanzania, Ethiopia, and Zambia accounted for 31 (58.50%) of the foreign surgeons. There was also one Doctor of Philosophy in anesthesia and one Master's Degree in urology during the same period.

The anaesthetic management of a case of carotic artery rupture is reported. The need for quick action in patient handling in all hospital departments and adequate monitoring during surgery are emphasized