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Biomedical subjects

M L Chindia

Publications and source records attributed to M L Chindia.

At least 19 recordsLinked to original sources
PubMed2006

Oral health status among Kenyans in a rural arid setting: dental caries experience and knowledge on its causes.

OBJECTIVE: To determine the dental caries experience and knowledge on the causes and preventive measures for dental diseases. DESIGN: A community based cross-sectional descriptive study. SETTING: Elwak sub-district hospital, North Eastern Province, Kenya. SUBJECTS: One hundred and forty one adults who presented themselves during a dental check up at a sub-district hospital and gave written consent. MAIN OUTCOME MEASURES: Dental caries status and knowledge on its causes and preventive measures. The importance of outreach programmes in obtaining information as well as helping to alleviate the pain and suffering caused by dental diseases among communities living in remote areas is also revealed. RESULTS: Of the one hundred and forty one individuals, who were included in the study, 63.1% were women and 36.9% were men. Their ages ranged between 18 and over 65 years. 41.1% were in the 18-24-year age bracket. Regarding the oral health knowledge, 43% did not know any causes of dental diseases while 36%, 17% and 12% knew that diet, "dirt" on teeth and bacteria were possible causes, respectively. Fifty percent did not know any preventive measures for dental diseases while the rest indicated abstention from the consumption of sugary foods; and only 0.8% mentioned use of fluoridated toothpaste as a preventive measure for dental caries. 56.7% of the subjects were caries free. The mean DMFT for all ages was 3.4. Of those with caries 72.1% were women. CONCLUSION: There is a low level of oral health awareness and a moderately high level of dental caries experience in this community with women apparently carrying the biggest burden of dental caries.

Adolescent↗
PubMed2006

Socio-economic effects of khat chewing in north eastern Kenya.

BACKGROUND: The khat habit is a widespread phenomenon which has in the past two decades spread to parts of Western Europe and North America from Eastern Africa and the Arabian Peninsula. Although khat has been identified as one of the most commonly abused substances in Kenya, restrictions on cultivation, trade and usage have been non-existent since its legalisation in 1977. OBJECTIVE: To describe the socio-economic effects of khat chewing in Ijara District in the North Eastern Province of Kenya. DESIGN: Cross sectional study. SETTING: Ijara District, North Eastern Kenya. SUBJECTS: Fifty respondents were interviewed. RESULTS: Eighty eight percent of the respondents were khat chewers, and the majority (80%) had family members who engaged in the khat habit. There was a general lack of education on the negative effects of khat chewing. Due to reported mood changes and withdrawal symptoms when not chewing khat, many respondents used more than half of their domestic budgets on khat, but few (28%) perceived this as a waste of resources. Fifty four percent of khat chewers typically started the habit during the day, implying a waste of time for productive work. However, only 40% of the persons interviewed admitted that the drug affected work performance negatively. The khat habit was associated with strain on family relationships, anti-social behaviour and health effects such as insomnia. CONCLUSION: In spite of the negative socio-economic impact of khat in Ijara District, khat consumption remains a widespread habit.

Adolescent↗
PubMed2005

Dental injuries in 0-15 year olds at the Kenyatta National Hospital, Nairobi.

OBJECTIVE: To determine the pattern of occurrence of dental injuries in the 0-15 year-olds. DESIGN: A retrospective study. SETTING: Kenyatta National Hospital, Nairobi. SUBJECTS: Five hundred and five patient records with dental injuries were retrieved and analysed. RESULTS: A total of 505 patient records with dental injuries were retrieved and analysed. Most of the injuries were recorded in the year 1999 (22.2%). Boys were more affected (63.0%) than girls (37.0%). The main presenting complaint recorded was pain (75.8%). The majority of the patients (69.5%) presented for treatment during the same day or the day after trauma. Falls were the leading cause of injuries (73.5%). Most injuries involved two teeth (47.1%) and the maxillary central incisors were the most affected teeth both in the primary (67.5%) and permanent (64.0%) dentitions. Luxation injuries were the most common type of dental trauma with 47.5% occurring in the permanent teeth and 77.3% in the primary teeth. The main radiographic investigation performed was intraoral periapical views (52.9%) following which dental extraction (34.4%) was the main treatment modality offered. CONCLUSION: Prospective cross-sectional studies to determine the prevalence of dental injuries are needed. Furthermore improving the knowledge of dental practitioners through continuing dental education programmes would help in updating them on current trends in managing these injuries.

Adolescent↗
PubMed2005

Post-operative re-construction of dentoalveolar tissue and the mandible and maxillae using prosthetic therapy.

OBJECTIVE: To determine the range of ablative surgery and rehabilitative procedures performed on maxillofacial structures. DESIGN: A retrospective descriptive study. SETTING: University of Nairobi Dental Teaching Hospital. SUBJECTS: Patients operated on at the institutions theatre, and followed up at the University of Nairobi Dental Teaching Hospital Oral Surgery Outpatient Clinic during the period February 1996, August 1998. RESULTS: Forty four patients underwent ablative surgery during the study period. Complete records were available for 38 patients, 27 females and 11 males aged 10 to 79 years (mean 32.6 years). Surgical procedures performed included: partial mandibulectomy, marginal mandibular resection, subtotal maxillectomy, sequestrectomy and enucleation. Six (15.8%) patients who underwent mandibular resection had rigid bone plating. Five (13.2%) patients who had maxillary involvement were given surgical obturators post-operatively with one receiving a complete denture after full recovery. A total of 22 (57.9%) patients who would have reaped benefits from prostheses therapy received none. Individual patient follow-up periods ranged from seven days for two patients who had cyst enucleation to two years for three cases with ameloblastoma, and two cases with squamous cell carcinoma. CONCLUSION: It is concluded that prosthetic rehabilitation of patients undergoing extensive surgery at the University of Nairobi Dental Teaching Hospital is largely inadequate.

Adolescent↗
PubMed2005

Ameloblastic fibroma at the University of Nairobi Dental Hospital.

OBJECTIVE: To document the occurrence of cases of ameloblastic fibroma. DESIGN: A retrospective study. SETTING: The Division of Oral Pathology and Oral Medicine histopathology laboratory at the Faculty of Dental Sciences, University of Nairobi, January 1991 to December 2000. RESULTS: Seven complete records of histopathologically confirmed cases of ameloblastic fibroma were identified. There were four male and three female cases with an age range of 10 to 22 years (mean=14 years). Remarkably, six of the cases had lesions in the molar regions of the mandible with a single case with a maxillary molar area lesion. One of the cases had the neoplasm associated with an unerupted tooth. From the clinical notes all the patients were managed by meticulous enucleation and curettage of the lesions. After follow up periods ranging from several months to eight years no recurrences had been recorded. CONCLUSION: Evidently ameloblastic fibroma is an uncommon neoplasm as noted in the earlier literature. Although the lesions can be quite extensive at the time of diagnosis, the recurrence rate appears to be relatively low if the neoplasms are meticulously extirpated.

Adolescent↗
PubMed2002

Extra-abdominal fibromatosis invading the mandible: case report.

Extra-abdominal fibromatosis (desmoid tumour) is a rare aggressive neoplasm with a tendency to infiltrate local structures but rarely metastasises or undergoes spontaneous malignant transformation. The treatment of choice is surgery, however, recurrences have been reported even after wide-field resection. This article presents a case of extra-abdominal fibromatosis that had extensively invaded the mandible.

Adult↗
PubMed2001

Osteosarcoma of the jaw bones.

Currently, it has been established that osteosarcoma (OS) of bone is not a stereotyped disease, and several varieties have been identified by clinical findings, radiographic and histopathologic appearances. Generally, it is the most common primary malignant bone neoplasm that accounts for at least 30% of all primary tumours of bone. In the jaw bones, OS accounts for about 4% of all the primary malignant neoplasms. In the general skeleton, the highest incidence is observed in the second decade of life; the neoplasm is said to be unusual before the age of 5 years and very rare after age 50 years. The aetiology and precise pathogenesis of this disease remain unknown. A diagnosis of clinically and radiologically suspicious OS requires meticulous histologic examination. However, histologic diagnosis may also be difficult since the different varieties of OS may have different morphological patterns in different sample sites. Currently, the two therapeutic modalities used in the primary treatment of OS include radical surgery and cytotoxic chemotherapy. In the general skeleton, the use of surgery alone results in a 90% rate of recurrence of OS. Notably, the advent of adjuvant and neoadjuvant cytotoxic chemotherapy as an adjunct to radical surgery has greatly improved the prognosis of many cases of OS of the jaw bones.

Humans↗
PubMed2001

Multiple myeloma presenting as a painful mandibular swelling: a case report.

Multiple myeloma is a disease characterized by monoclonal proliferation of plasma cells, the most differentiated stage of B-cells. Primary manifestation of multiple myeloma in the jawbones is rare. In the case reported here, a 29-year-old woman who presented with a right mandibular swelling after extraction of a mobile painful tooth turned out to have multiple myeloma. Current diagnostic criteria and management strategies of the disease are discussed.

Adult↗
PubMed2001

Oral manifestations of HIV/AIDS in a Kenyan provincial hospital.

BACKGROUND: In Kenya many patients exposed to the HIV infection present with orofacial lesions as the primary manifestations of the disease and only a few studies have been performed to document this observation. OBJECTIVE: To clinically evaluate and document the range and pattern of oral lesions in a group of hospitalised patients with HIV-infection. DESIGN: A prospective study. SETTING: Coast Province General Hospital in Mombasa, Kenya, which is the main referral institution serving a population of approximately two million people. METHODS: Examination of all the cases included in the study was performed according to the WHO criteria. Both male and female patients aged 16 years and above were selected. The criterion of recruitment was based on a suspicion of immunosuppression, the presence of oral manifestations and the willingness to participate in the study. Prior to the examination each patient had undergone counselling followed by two consecutive screening tests using the ELISA technique. Where indicated incisional biopsy was performed to confirm the clinical diagnosis of the relevant lesions. In collaboration with the medical team, treatment was administered as per the needs of the patient in terms of anti-fungals, antivirals or topical cortisteroids. RESULTS: Of the 61 cases, 25(41%) were males and 36(59%) females with an age range of 19 to 65 years (mean = 34.7 years). While all the cases had periodontal disease, over 80% had candidiasis of the hyperplastic, erythematous and pseudomembraneous types. Lymphadenopathy and angular cheilitis were each diagnosed in 27.9% of the cases; while oral Kaposi's sarcoma was seen in 13% of the patients. Other conditions seen included persistent oral ulceration (11.5%), oral hairy leukopLakia and herpes zoster each constituting 4.9%; herpes simplex, mucosal hyperpigmentation, parotomegaly and facial palsy each comprised six per cent and oral warts seen in one case. In accordance with the pattern and prevalence of oral manifestations in our study, the results were largely consistent with those documented elsewhere. CONCLUSION: For the alleviation of the morbidity arising from the commonly occurring lesions, early detection is mandatory. Furthermore, documentation of the varied regional patterns of occurrence of these lesions may aid in the rational application of the emerging treatments.

AIDS-Related Opportunistic Infections↗
PubMed2000

Neural tumours of the head and neck.

OBJECTIVE: To document the pattern of occurrence of all primary neural tumours arising in the neck and craniofacial region over the period 1982 to 1991. DESIGN: A retrospective study. SETTING: Cancer Registry, Nairobi, Kenya. RESULTS: Out of the 289 cases who were identified to have had whole body neural tumours, 225 (77.8%) had the lesions distributed in the neck and craniofacial area. While 80% of the neoplasms located in this region were retinoblastomas (mainly occurring in the age group 0 to 4 years), other lesion types occurred in small numbers thus: neurofibromas comprised 12.4%, Schwannomas four per cent, neuroblastomas and neuromas each 0.4%; and extracranial gliomas 2.7%. Overall, the male to female ratio was 1:1 and the site distribution revealed that over 90% of the lesions afflicted the upper face. CONCLUSION: Neural tumours of the neck and craniofacial region appear generally rare in this population as has been shown elsewhere.

Adolescent↗
PubMed2000

Sarcomas of the head and neck at Kenyatta National Hospital.

OBJECTIVE: To determine the pattern of occurrence of sarcomas afflicting the neck and craniofacial region. DESIGN: A retrospective study (1982-1991). SETTING: Cancer Registry, Kenyatta National Hospital, Nairobi, Kenya. METHOD: Examination was performed of the cancer records in the registry over the period 1982 to 1991 inclusive. Histopathological types of the sarcomas were then analysed to indicate the numbers that occurred per year; and also the pattern of occurrence according to age groups, gender and site. RESULTS: Of the 10,897 whole body neoplasms, 985 were sarcomas. Among these sarcomas, 160 (16%) were located in the neck and craniofacial region. The histopathological types of the neoplasms included Kaposi's sarcoma (39%), osteosarcoma (23%), rhabdomyosarcoma (21%), fibrosarcoma (13%), chondrosarcoma (two per cent), malignant fibrous histiocytoma (one per cent) and dermatofibrosarcoma protuberans (one per cent). CONCLUSION: The results of this investigation, in concordance with those of other series worldwide, indicate that the various sarcomas afflicting the neck and craniofacial area are generally rare.

Adolescent↗
PubMed2000

Pierre Robin Syndrome: case report.

A case of a female neonate with Pierre Robin Syndrome with frequent cyanotic episodes and feeding difficulties which could not be adequately managed by positioning and oral airway placement is presented. Tongue-anterior mandible fusion procedure was performed with satisfactory results.

Female↗