East African medical journal
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Multicenter Study Comparative Study
Asphyxia of the newborn in east, central and southern Africa.
Very scanty information is available in East, Central and Southern Africa on the incidence and risk factors associated with asphyxia of the newborn. A multicentre prospective study involving 4267 deliveries in eight countries was undertaken over a three month period, in maternity units of the central hospitals to determine the incidence; maternal, service and logistic risk factors for asphyxia of the newborn as determined by an abnormally low apgar score. 30% of births were by primigravida mothers, of whom 67% were teenagers. A birth by a teenager had a higher risk for low birth weight. ⋯ These should include identification of the at risk mother, proper referral and management while adhering to correct established procedures. There is also need to develop appropriate and relevant technologies for perinatal and neonatal care through research undertaken in the region. It is also concluded that the co-operation and joint effort between the obstetricians, paediatricians and the nursing staff who all contributed to the collection of this data is a cost effective approach to research in perinatal health and consequently in instituting interventions.
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Historical Article
Evolution of paediatric oncology over the years: overview with a focus on sub-Saharan Africa and examples from the Kenyan experience.
In this paper on "The Evolution of Paediatric Oncology Over the Years", a historical perspective is outlined regarding the subspecialty of paediatric oncology on a global basis. The evolution of paediatric oncology units and their role in the progress of cancer management in children is highlighted. ⋯ The development of a paediatric oncology unit at the Kenyatta National Hospital in Nairobi, Kenya has been focused on, pointing out challenges, constraints and success that are associated in the initiation and nurturing of such units in developing countries. Lastly, Burkitt's lymphoma is singled out for discussion to illustrate problems that are abound in cancer management in children in sub-Saharan Africa.
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Multicenter Study Clinical Trial
Evaluation of diprivan as an intravenous anaesthetic induction agent: experiences in Nairobi, Kenya.
Diprivan in its emulsion formulation as an intravenous induction agent was studied in 125 patients undergoing general anaesthesia for short duration, minor procedures, at Kenyatta National Hospital, Nairobi, Kenya. The drug was found to be effective as it caused loss of consciousness in all the studied patients within 40 seconds when injected intravenously. The induction period was associated with pain at injection site in 31.2%, some muscle movements in 15.2% and hiccups in 8.8% of all the cases. There was a significant fall in mean arterial blood pressure in all the cases at two minutes after induction of anaesthesia with no observed concomitant changes in pulse rate.
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Over a 3-month period, 114 infants were analysed to establish the reliability and usefulness of the maturity scoring for mid-arm circumference (MAC) and head circumference using the Dubowitz system as standard. Total maturity scores of the two methods showed highly significant correlation with gestational age. There was also a highly significant correlation between total maturity scores of both methods. ⋯ The model, however, was a significantly more rapid method of assessment. The clinical usefulness of the model was reinforced by its ability to distinguish between appropriately grown preterm low-birth weight (LBW) and growth retarded term LBW infants. The model is a rapid, reliable and useful method of determination of maturity at birth.