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Biomedical subjects

W Lore

Publications and source records attributed to W Lore.

At least 19 recordsLinked to original sources
PubMed1994

Authorship in the East African Medical Journal.

Between 1978 and 1987, Kenyan authors contributed an average of 47% of papers published in the East African Medical Journal (EAMJ), in comparison to 24% originating from Nigeria and 29% from other countries, mainly those in the eastern and central African region. From January 1988 to December 1993, 44.1% of the papers published in EAMJ originated from Kenyan authors as compared to 26.7% from Nigerian authors and 29.2% from authors in other countries. During this six year period, there has been a steady increase in authorship from Saudi Arabia, Sudan, Zimbabwe, Ethiopia and Tanzania, whereas authorship from Uganda and Zambia has declined. Many authors from Saudi Arabia are individuals originally from Nigeria now working in Saudi Arabia. These data indicate that Kenyan authorship has dropped by 3% over the last six years compared to the 1978-1987 period, while that of Nigeria has increased by at least 3% over the same period. During the period under review, EAMJ has attracted papers from as far as China, Turkey, Malaysia, Canada, USA, France, Sweden and Hungary. Similarly, papers have been received from other African countries not previously contributing to the journal; these include: Gabon, Mozambique, RSA, Burkina Faso, Botswana, Burundi, Namibia, Liberia, Egypt, Somalia and Zaire. Possible factors influencing authorship in the EAMJ are discussed.

Africa, Eastern↗
PubMed1994

Management of malaria before and after introduction of a treatment protocol at the Eldoret District Hospital.

A prospective study on the management of suspected malaria using a protocol on a general medical ward during the months of February and March, 1992 was done and the results compared with those of a retrospective study covering the months of November and December, 1991. The retrospective analysis showed that 78 (65%) from a total of 120 patients received antimalarial drugs despite negative or absent blood smears for malarial parasites. In 41 (34%) of the 120 patients, the first line treatment given was quinine. In the prospective study the overall quinine use dropped sharply to 19% from 54% in the retrospective study. 94 (49%) from a total of 193 patients with suspected malaria had negative blood smears of whom only 8 (4%) received quinine while 63 (33%) did not receive any antimalarial therapy and 38 of these 63 patients ended up with different final diagnoses; the remaining 25 were observed on no antimalarial treatment and discharged home feeling well. These results emphasize the need for proper diagnosis of malaria and suggest that chloroquine is still acceptable and effective as a first line drug for proven cases of malaria in adult patients in Eldoret. Unnecessary quinine use is discouraged as the drug is more expensive with more toxic effects compared to chloroquine.

Adult↗
PubMed1993

Epidemiology of cardiovascular diseases in Africa with special reference to Kenya: an overview.

At the beginning of this century, high blood pressure was virtually non-existent among the indigenous Kenyans. This phenomenon of normotension continued until the Second World War following which the Kenyan African began to exhibit progressive rise in blood pressure which was age-related. Similar changes were observed in Uganda at the same time. From about 25 years ago, high blood pressure became established in Kenya and the neighbouring countries, in particular Uganda. These trends have been observed in West Africa notably Ghana, Nigeria, Cote d'Ivoire and also in Cameroon and Zaire in the Central African region. Consumption of sodium salt and alcohol, psychological stress, obesity, physical inactivity and other dietary factors are thought to play important aetiologic role in the genesis of primary hypertension in the susceptible individuals. Low blood pressure communities still exist scattered all over the world, where blood pressure does not seem to rise with age. In Africa these have been observed in Kenya, Nigeria, Zaire and Kalahari Desert. They also exist in Pacific island, Australia, South America and elsewhere. Rural-urban migration coupled with acculturation and modernization trends have some relationship with the development of high blood pressure as observed in Kenyan and Ghanian epidemiologic studies.

Africa↗
PubMed1993

Cardiovascular features in adolescents and adults with sickle cell anaemia.

Fifty five sickle cell anaemia (SCA) patients at the Kenyatta National Hospital were studied with a view to elucidating their cardiovascular status. Their age range was 13 to 27 years (median 18.9 years). They comprised 27 males and 28 females and their mean haemoglobin concentration was 8.5 +/- 1.4 g/dl. Haemoglobin level of 8.0-9.9 g/dl seen in 30 patients was noted to confer the lowest incidence of exertional dyspnoea and palpitation. Similarly, patients with this haemoglobin level had the lowest mean heart rate. The mean blood pressure was 114.9 +/- 9.9 mmHg systolic and 64.6 +/- 10 mmHg diastolic. Blood pressures, ejection fraction (EF) and differential fibre shortening (%D) were found to be directly related to haemoglobin level, whereas cardio-thoracic index (CTI) and left ventricular dimensions were inversely related to haemoglobin level. Mean echocardiographic measurements were within normal limits and left ventricular functions were found to be normal in 80.9% of the patients indicating that the majority of SCA patients at the Kenyatta National Hospital have good cardiac function.

Adolescent↗
PubMed1992

Clinical studies on isradipine in the management of adult hypertensive patients at Moi University Teaching Hospital, Eldoret, Kenya.

In a 16 weeks open label therapeutic trial, studies were performed on isradipine (Lomir) to evaluate its haematological and biochemical safety and hypotensive capacity in the management of adult black hypertensive patients. The mean sitting diastolic blood pressure decreased from 105.5 +/- 9.66 mm hg at the end of the washout period to 92.1 +/- 7.59 mm hg at the end of the study, p less than 0.0001; while the mean standing diastolic blood pressure was 108.0 +/- 7.10 mm hg and 93.9 +/- 8.4 mm hg at the end of the washout phase and at the completion of the therapy respectively, p less than 0.0001. The corresponding mean sitting systolic blood pressures were 155.4 +/- 9.91 mm hg and 140.6 +/- 9.47 mm hg, p less than 0.001 while the corresponding mean standing systolic blood pressures were 156.6 +/- 12.50 mm hg and 142.6 +/- 9.15 mm hg, p less than 0.001. There were negligible changes in the mean heart rate; from 79.5 +/- 9.23 beats per minute (bpm) at the end of the placebo phase to 78.2 +/- 9.15 bpm at the end of the study in the sitting position, p greater than 0.1. The corresponding mean standing values of heart rate were 82.5 +/- 11.33 and 78.6 +/- 8.76, p greater than 0.5. The haematological, biochemical and electrocardiographic parameters remained within normal limits during the study. Side effects were mild, transitory, improved with therapy and consisted of dizziness, palpitations, headache, nocturia, tiredness and fainting attacks. The study achieved 96% good-to-excellent results with respect to both efficacy and tolerability. Isradipine (Lomir) is therefore an efficacious and safe antihypertensive agent in the management of black adult patients with mild to moderate primary arterial hypertension when administered in the dose of upto 2.5 mg twice daily alone or in combination with a beta-blocker.

Adult↗
PubMed1992

The efficacy and tolerability of enalapril--hydrochlorothiazide combination as a first line therapy in black patients with mild to moderate arterial hypertension: a clinical study in Kenya.

The study aimed at evaluating tolerability and efficacy of the combination enalapril 20 mg with hydrochlorothiazide 12.5 mg (co-renitec) as first line therapy in black patients with mild to moderate primary hypertension. Fifty patients completed a twelve weeks of open clinical study preceded by two weeks of washout period. They were evaluated every four weeks and haematological, biochemical urine microscopy and electrocardiographic tests were undertaken before the start and after the completion of study. Pre-treatment values of mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 172.16 mm hg (+/- 20.41) and 104.38 mm hg (+/- 7.339) respectively. The usual daily dosage was one tablet which was increased to two after eight weeks in case the DBP was not normalized, i.e. less than or equal to 95 mm hg. In 44 (88%) patients, the DBP was normalised at the end of the study period; three patients (6%) were resistant to treatment and another three (6%) exhibited labile response to the treatment. Clinical tolerance was considered to be very good with only five episodes of headache, backache and anxiety, probably not related to the test drug. Biological tolerance was excellent: there was no change in the haematologic parameters; there was a decrease of 5% in mean blood urea, of 9% in the mean serum creatinine and of 4% in the mean serum uric acid and a 5% increase in plasma potassium from 3.99 to 4.28 mmol/l.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Illness and efficiency of health services delivery in a district hospital.

Demographic data, medical problems and diagnosis, and efficiency of laboratory investigations and drug administration were evaluated in all patients admitted to an adult medical ward over a one month period at a district hospital in Kenya. The results show that the medical ward serves a poor, cosmopolitan population in the economically productive age range. Mental disorders (16%), symptoms and ill-defined conditions (16%), and infective and parasitic disease (15%) were the most common diagnoses. Out of 999 orders and/or results, 357 were delayed, interrupted, never done, or never received. Factors that affect medical education and efficiency of health services delivery at a district hospital are identified and discussed.

Adult↗
PubMed1991

A prospective study of electrocardiographic features in adult black hypertensive patients at the Kenyatta National Hospital, Nairobi.

A prospective study of electrocardiograms (ECG's) was carried out on 102 adult hypertensive African patients at the Kenyatta National Hospital. Their mean age was 45.2 years. All the patients had normal sinus rhythm. Forty seven percent of the patients had sinus bradycardia, although this could be attributable to the drugs they were taking. The duration of the P wave increased with the severity of hypertension. Twenty five percent of the patients had evidence of first degree A-V block. This was an expected finding as most of the patients were on treatment with B-adrenoreceptor blocking agents. Two patients had LBBB and none had RBBB. There were 13 patients with evidence of left axis deviation (LAD) and the incidence increased with the severity of hypertension. S-T, T changes were noted in 12.8% and 29% of patients respectively. Q-Tc duration did not increase with severity of hypertension. Left ventricular hypertrophy was noted in 27.5% of the patients using the criteria devised by Romhilt et al.

Adolescent↗
PubMed1990

Stroke at Kenyatta National Hospital.

Seventy two patients presenting with stroke to Kenyatta National Hospital were studied between January 1986 and January 1987. The majority were from the rural areas. There were about equal numbers between left and right sided hemipareses. The majority of the patients were in their 6th and 7th decades. 22 of the patients were hypertensive. Diabetes mellitus, cigarette smoking, alcohol consumption, and valvular heart disease were some of the other factors associated with strokes. 46% of the patients died while the remainder had residual neurological deficits.

Adolescent↗