East African medical journal
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A retrospective study of 21 sexually abused children admitted to the Kenyatta National Hospital, Nairobi, Kenya, between January 1984 and December 1985 is presented. The peak incidence of sexual abuse was in the age group of 10-15 years (38.1%) followed by the 5-9 years age group (28.6%). ⋯ Fourteen out of the twenty one (66.7%) victims, presented with injuries ranging from perineal tears (19%), vaginal tears (19%), recto-vaginal fistulae (RVP) (4.8%) and vesico-vaginal-fistulae (VVF) and abdominal haematoma (4.8%). The victims presented to hospital within two days of the event usually accompanied by their mothers.
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The symptoms, neurological deficits and aetiology of cerebellar ataxia were reviewed in 30 children aged from 4 to 16 years, who had been extensively investigated. Fourteen (46.6%) children had perinatal problems, and in 6 (20%), ataxia resulted from these perinatal events. Besides unsteady gait, a common presenting complaint was delayed motor milestones, noted in 15 (50%) patients. ⋯ Hypotonia, found in 11 (36.6%) children, was the third most common sign after gait and truncal ataxia. A variety of aetiological factors was identified, the two most frequent being hydrocephalus in 7 (23.3%) children, and perinatal problems in 6 (20%). The findings are discussed against the background of current literature on the subject.
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This study was conducted during 1987-1988 academic year in the rural areas of Tihama Saudi Arabia to assess the average duration of breast feeding and the effect of some factors. A multi-way analysis of variance approach was used to examine the effect of mother's age, parity and education on the duration of breast feeding. ⋯ The results showed that 98.3% support breast feeding and 78.9% of the sample were illiterates. These findings are discussed in relation to previous work.
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Clinical Trial
Pressure therapy in treatment of hypertrophic scar, burn contracture and keloid: the Kenyan experience.
A preliminary report of the results of pressure therapy for hypertrophic scar, burn contracture and keloid is presented. Thirty four patients over a four year period were treated with four types of pressure therapy. ⋯ This method obviated the need for repetitive surgery and no recurrence was noted. Pressure therapy is advocated as an adjunct measure for all cases of hypertrophic scarring, burn contracture and keloid.
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This review of surgical ouput in eastern Africa and other developing countries, is based mainly on published, and to a small extent, on unpublished sources, such as hospital annual reports. It is noted that poorly standardized classification of surgical operations is a problem in recording and reporting, and that one internationally agreed classification would be useful in comparative studies. Rates of major surgical operations in sub-Saharan Africa are 70-500 per 100,000 population per year with inguinal hernia repair, caesarean section, hydrocele operation and surgical management of injuries as the most common major operations. ⋯ Almost nothing is known about minor surgery performed at health centres and dispensaries or about surgical cases referred to hospital, and population-based rates of minor surgery cannot therefore be calculated. Resources are scarce, but can be more effectively utilized. Further research should include: (a) population-based output of major and minor operations in different countries and regions; (b) outcome after a few selected operations, preferably selected in consultation with researchers studying medical care outcome in other countries; (c) availability and use of surgery-related resources such as manpower, equipment and supplies; and (d) assessment of needs for surgery using household health survey methods.