East African medical journal
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Neonatal morbidity and mortality is high in developing countries. Facilities for specific neonatal care are limited in Kenya with no neonatal intensive care unit in the public health institutions. The new born unit at Kenyatta National Hospital (KNH) cannot accommodate all neonates so a number of these are admitted to the general paediatric wards. ⋯ The mortality rate for neonates admitted to the general paediatric wards is high with almost half the deaths occurring in the first twenty four hours of admission. While the wards are doing commendable work, they need support by improving laboratory back up for improved diagnostic ability and to improve supportive care such as maintenance of fluid electrolyte balance, temperature regulation and access to intensive care facilities.
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Comparative Study
Comparison between sonographic and plain radiography in the diagnosis of small bowel obstruction at Mulago Hospital, Uganda.
To evaluate the role of sonography compared to plain radiography in the diagnosis of patients with suspected small bowel obstruction as well as to determine their specificity, sensitivity and accuracy in the Ugandan setting. ⋯ It was concluded that sonography is as accurate, specific and sensitive as plain radiography in the diagnosis of SBO as well as determining the level of obstruction in a Ugandan setting. Sonography was found to be more accurate at determining the cause of obstruction and detecting strangulation. It is recommended that sonography should be the initial imaging modality for patients presenting with suspected SBO and plain radiography should only be used as a complimentary investigation.
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To describe the emergency care of injuries at a main city hospital. ⋯ Injuries following road traffic accidents (RTAs) are common in Nairobi. The response to injury is slow and haphazard. The insitution of a care incorporating the city's health centers and pre-hospital triage may optimise care.
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Treatment of diabetes mellitus is based on the evidence that lowering blood glucose as close to normal range as possible is a primary strategy for reducing or preventing complications or early mortality from diabetes. This suggests poorer glycaemic control would be associated with excess of diabetes-related morbidity and mortality. This presumption is suspected to reach high proportions in developing countries where endemic poverty abets poor glycaemic control. There is no study published on Kenyan patients with diabetes mellitus about their glycaemic control as an audit of diabetes care. ⋯ The majority of ambulatory diabetic patients attending the out-patient diabetic clinic had poor glycaemic control. The group with the poorest level of glycaemic control were on OHA-only, while best control was observed amongst patients on diet-only, because of possible fair endogenous insulin production. Poor glycaemic control was presumed to be due to sub-optimal medication and deteriorating diabetes. There is need to empower patients with knowledge and resources to enhance their individual participation in diabetes self-care. Diabetes care providers and facilities also need capacity building to improve care of patients with diabetes.
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To gauge the views of mothers and other caregivers on the use of traditional remedies in the community. ⋯ The use of traditional remedies in children is common in communities around Umtata. There is need to study the composition and activity profiles of commonly used preparations so as to develop appropriate management protocols in case of toxicity.