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Biomedical subjects

G N Lule

Publications and source records attributed to G N Lule.

32 records · Page 2Linked to original sources
PubMed1990

Extrapulmonary and disseminated tuberculosis in HIV-1-seropositive patients presenting to the acute medical services in Nairobi.

We studied 506 consecutive adult acute medical admissions to hospital in Nairobi; 95 (18.8%) were seropositive for HIV-1, and 43 new cases of active tuberculosis (TB) were identified. TB was clearly associated with HIV infection, occurring in 17.9% of seropositive patients compared with 6.3% of seronegatives [odds ratio (OR) 3.2; 95% confidence limits (CL) 1.6-6.5]. Extrapulmonary disease was more common in seropositive than seronegative TB patients (nine out of 17 versus five out of 26; OR 4.7; 95% CL 1.01-23.6); this accounted for most of the excess cases of TB seen in seropositive patients. Mycobacteraemia was demonstrated in two of eight seropositive TB patients but in none of 11 seronegative TB patients. No atypical mycobacteria were isolated. The World Health Organization (WHO) clinical case definition for African AIDS did not discriminate well between seropositive and seronegative TB cases. Five out of seven seropositive women with active tuberculosis had delivered children in the preceding 6 months and were lactating, compared with only one out of eight seronegative tuberculous women. An association between recent childbirth, HIV immunosuppression and the development of TB is suggested.

Adolescent↗
PubMed1990

Cholelithiasis in the Kenyan African.

A prospective and retrospective review of 20 cases of cholelithiasis diagnosed at Kenyatta National Hospital (KNH) between June 1987 and June 1989 was done. Females were more often affected (6 times) than their male counterparts. 94% of the females were parous with a mean parity of 5.6. Most patients were in the 4th decade at the time of diagnosis. Qualitative analysis for gall-stones showed evidence of cholesterol in all stones analysed with calcium being detected in only one female patient.

Adult↗
PubMed1990

The prevalence of hepatitis B surface antigen (HBsAg), anti-hepatitis B surface (anti-HBs) and anti-hepatitis B core (anti-HBc) in patients with acquired immuno-deficiency syndrome (AIDS).

Forty one consecutive patients (24 males and 17 females) with AIDS had their blood assayed for HBsAg, anti-HBs and anti-HBc by Reversed Passive Haemagglutination (RPHA), Passive Haemagglutination (PHA) and Enzyme Linked Immunosorbent Assay (ELISA) techniques respectively. 5 (12.2%) were found positive for HBsAg. 10 (24.4%) for anti-HBs and 31 (75.6%) for anti-HBc. 32 (78%) out of 41 patients with AIDS had serological evidence of exposure to hepatitis B virus (HBV). The prevalence of HBsAg found in this study is not different from what has been found in the Kenyan community without AIDS, while that of anti-HBs is much lower than what has been reported in the general community.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Some aspects of obstructive jaundice at Kenyatta National Hospital.

A prospective study was carried out at Kenyatta National Hospital (KNH) between June 1987 and September 1988 to look at some aspects of obstructive jaundice in patients above 12 years of age. Screening for cases was done by use of abdominal ultrasonography. A total of 20 cases (11 females, 9 males) were diagnosed. Carcinoma of the head of pancreas accounted for 55% of cases of the obstruction, followed by gallstones (10%), hepatocellular carcinoma (10%) and gall bladder tumour (10%).

Adult↗
PubMed1989

Serum pepsinogen I in relation to some clinical features and complications of duodenal ulcer disease.

Fasting serum pepsinogen 1 was assayed in 60 patients seen at the Kenyatta National Hospital with endoscopy - confirmed active duodenal ulceration. Pepsinogen 1 values were also correlated with some clinical features and complications of this disorder. 54 (90%) of the patients had significantly elevated values when compared with age and sex matched controls. Although elevated values were found in patients with chronic dyspepsia, family history of ulcer dyspepsia, history of gastro-duodenal blood loss and in patients with virulent ulcers, this did not show statistical significance. The possibility of using serum pepsinogen I to identify duodenal ulcer patients and to predict the clinical course and complications of this disorder is discussed.

Adult↗
PubMed1989

HBV markers (HBsAg, HBSAb, HBCAb in 160 medical students at Kenyatta National Hospital.

In an exercise to study the immunogenicity and reactogenicity of the Engerix B vaccine, 160 medical students were screened for Hepatitis B Markers (HBsAg, HBsAb and HBcAb) with a view to vaccinating those that were negative. 18% were HBsAg + ve, 33% were HBsAb + ve and 38% were positive for the HBcAb. These figures were extremely high and obviated the need to vaccinate the students as they begin their clinical years.

Carrier State↗
PubMed1989

The pattern of chronic gastric ulcer at Kenyatta National Hospital (K.N.H.).

Thirty consecutive patients with gastric ulcer diagnosed during upper gastrointestinal fibreoptic panendoscopy at both Kenya Medical Research Institute and Kenyatta National Hospital endoscopy rooms were studied. The male/female ratio was 5:1 with a peak prevalence in the 6th decade. 76.6% of the patients were from the Kikuyu ethnic group. Smoking habit was found in only 50% of patients with gastric ulcers. There were a total of 32 gastric ulcers in 30 patients. 84.4% of these were at the incisura angularis. All the incisural ulcers were benign. Two (6.25%) of the 32 ulcers were malignant (one at the cardia and the other at the antrum). Gastric ulcers whose diameter were greater than 30 mm had a higher tendency of being malignant. Five patients (16.7%) had both gastric (4 benign and 1 malignant) and duodenal ulcers while 4 (13.3%) patients had both gastric and pyloric ring ulcers. Apparent healing of a gastric ulcer while on an H2-antagonist does not totally exclude malignancy. Upper gastrointestinal bleed which was present in 53.3% of cases was the most frequent complication.

Adult↗
PubMed1989

The clinical pattern of duodenogastric bile reflux in the Kenyan Africans.

Forty consecutive African patients found to have duodenogastric bile reflux at endoscopy were studied. Bile reflux was found more commonly among males than females, giving a male/female ratio of 2.3:1, with a peak age at 41-60 years. ABO blood groups had no significant influence on duodenogastric bile reflux. Flatulence and borborygmi were the most consistent symptoms other than the classical dyspeptic pain pattern. Bilious vomiting was a rare finding. Duodenogastric bile reflux was more commonly associated with endoscopic gastritis (67.5%), gastric ulcer (35%) and oesophagitis (30%) than with duodenal ulcer (22.5%), deformed pyloric ring (5%) or distorted duodenal bulb (2.5%). The dysfunction in the pyloric sphincter in people with duodenogastric bile reflux appears to be more of a physiological defect than structural.

Adult↗