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Biomedical subjects

J Kyobe

Publications and source records attributed to J Kyobe.

At least 19 recordsLinked to original sources
PubMed1992

Estimation of plasma fibrinogen and its degradation products in uncomplicated cases of malaria with low parasitemia.

There are four hypotheses which have been advanced to explain the pathophysiology of severe and complicated malaria such as cerebral malaria. However, none of them adequately explains all the features of cerebral malaria in man. One such hypotheses is Disseminated Intravascular Coagulation (DIC). To determine whether this condition occurs in patients with uncomplicated malaria, the authors conducted a study on fibrinogen and its degradation products, euglobulin lysis time and parasite counts in 30 cases of uncomplicated malaria. By spectrophotometric method, plasma fibrinogen in patients with uncomplicated malaria was found to be normal as compared to normal healthy adults. There were no fibrinogen degradation production (FDP) detected in either patients or healthy controls, using latex agglutination tests at a dilution of 1:5. This method for FDP estimation is significant in that a serum agglutination with 1:5 dilution indicates a concentration of FDP in the original serum in excess of 10g/ml, designated as positive results of experiment. High values of euglobulin lysis time (ELT) were noted in patients with low parasitaemia. Analysis of these results showed that disseminated intravascular coagulation did not occur in uncomplicated cases of malaria. In this study on cases of uncomplicated malaria and low parasitaemia the biochemical parameters relating to to DIC have been essentially normal, although DIC is thought to be a primary stage in the development of cerebral malaria. According to Reid, DIC is an important intermediate mechanism in the pathophysiology of severe and complicated malaria such as cerebral malaria.

Disseminated Intravascular Coagulation↗
PubMed1990

Platelet function in nephrotic syndrome patients at the Kenyatta National Hospital.

Platelet function was assessed in 40 patients with nephrotic syndrome but without renal failure in order to establish whether or not there is any haemostatic disorder lending to hypercoagulable state. The findings were compared with those from 40 normal controls. There was no clinical evidence of thromboembolic phenomena in the patients. Values for the mean platelet counts and clot retraction were similar (P less than 0.05), whereas significant decrease of platelet adhesiveness (P less than 0.001) as well as prolonged platelet aggregation time (P less than 0.001) were noted. This is different from some reports in literature which have frequently reported enhanced platelet function. There may be a difference in the way platelets metabolise arachidonic acid to potent aggregating agents, in the African patients as compared to patients studied elsewhere. The hypercoagulable state in our nephrotic syndrome may be explained by alterations in other haemostatic parameters rather than in platelet function.

Adolescent↗
PubMed1989

Single dose metrifonate or praziquantel treatment in Kenyan children. I. Effects on Schistosoma haematobium, hookworm, hemoglobin levels, splenomegaly, and hepatomegaly.

The relationships between S. haematobium, hookworm, malaria, hemoglobin level, splenomegaly, and hepatomegaly before and 8 months after treatment with a single dose of metrifonate or praziquantel were studied in Kenyan primary schoolchildren in an area where anemia, S. haematobium, and hookworm are common and malaria is holoendemic. Children with light to moderate S. haematobium infection were examined (Exam 1), assigned at random to groups receiving placebo (PL, n = 104), metrifonate (MT, n = 103, dose 10 mg/kg body weight) or praziquantel (PR, n = 105, dose 40 mg/kg body weight), treated, and examined 8 months later (Exam 2). At Exam 2, 62% of the MT group still passed S. haematobium eggs vs. 13% in the PR group. Egg reduction rates were substantial in both groups, but greater in the PR group; geometric mean egg counts in both groups were very low. Prevalence and intensity in the PL group had not changed between exams. Hookworm egg counts were significantly reduced in the MT group (59% egg reduction rate); malarial infection had increased in all 3 groups, presumably due to the long rainy season between exams. Hookworm egg count was the most significant predictor of initial hemoglobin level, followed by S. haematobium egg count and presence of malarial infection. Treatment with a single dose of MT or PR can produce substantial decreases in S. haematobium infection 8 months later.

Adolescent↗
PubMed1988

Pattern of multiple myeloma in Kenyans.

A study of 75 myeloma patients diagnosed at the Kenyatta National Hospital, Nairobi, is presented. The male to female ratio was 1.7:1; the mean age +/- s.d. was 51.5 +/- 12.5 (range 16-80) years; the peak age incidence of 32% occurred in the sixth decade. A combination of: anaemia (81.3%), osteolytic lesions on X-ray skeletal survey (80%), bone pains (66.7%) and an ESR above 50mm/hr (77.3%) formed an important diagnostic tetrad. Other significant findings included: hypoalbuminaemia (76%), elevated leukocyte alkaline phosphatase (61.3%), uraemia (54.7%), upper respiratory tract infections (44%), elevated serum creatinine (34.7%), raised alkaline phosphatase (33.3%), pathological fractures (32%), hyperuricaemia (30.7%) and hypercalcaemia (29.3). The study confirms that the disease is not infrequent in indigenous Kenyan Africans as previous literature seemed to suggest. Poor prognosis was significantly (p less than 0.05) associated with hypoalbuminaemia, raised serum blood urea, hyperuricaemia and an elevated serum creatinine level.

Adolescent↗
PubMed1982

Chronic idiopathic thrombocytopenic purpura (ITP) in Kenyan Africans.

Forty-two African patients with chronic idiopathic thrombocytopenic purpura (ITP) seen at the Kenyatta National Hospital, Nairobi, Kenya between June 1975 and June 1981 were used in this study. The disease appears to behave no differently from that in Western populations with regard to clinical and haematological features. Specific problems related to the disease in an African setting and the clinical significance of recognizing the disorder especially in a tropical environment are briefly pointed out.

Adolescent↗