5 results on '"Lessan J"'
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2. Paediatric Bladder Stones in Kenya. A Single Institution Study
- Author
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Jumbi T and Lessan J
- Subjects
medicine.medical_specialty ,business.industry ,General surgery ,medicine ,General Medicine ,Bladder stones ,Single institution ,business ,medicine.disease - Published
- 2021
- Full Text
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3. Disorders of sexual differentiation as seen at Kenyatta National Hospital
- Author
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Kihiko, KD, Njiru, J, Hamdun, S, Lessan, J, Kyambi, J, Osawa, F, Muturi, NJ, Kambuni, F, and Mwirichia, M
- Abstract
Background: Disorders of sexual differentiation (DSD) are a group of congenital anomalies characterised by discordance between genetic, gonadal and phenotypic sex. There has been remarkable evolution in management over the last decade, including nomenclature, diagnosis and management. There has also been increased awareness and interest from patients and the public, including legal opinion. There has however been no local study to document and evaluate management in Kenya.Objective: To describe management of patients presenting with DSD at Kenyatta National Hospital (KNH) over a 10 year period.Design: Retrospective descriptive study.Setting: Kenyatta National Hospital.Subjects: Patients diagnosed with DSD.Results: A total of 30 patients whose charts were available were reviewed. Age ranged from birth to 19 years (median 5 months) at diagnosis. Presumed gender was assigned at birth in 28 patients. Karyotyping was available in 23(76%) patients. Other common tests included blood tests (23, 76%), ultrasound scan (14, 47%), contrast studies (3, 10%) and exploratory laparoscopy or laparotomy. 46XX and 46XY DSD were the most common conditions encountered (13, 43% and 7, 23% respectively). The commonest operations were correction of hypospadias and orchidopexy (55%), followed by feminising genitoplasty (16%). Only two patients had gender reassignment. Fifteen patients were asked how they feel about their current gender, and 11 expressed satisfaction.Conclusion: DSD is a relatively rare condition. There are also no strict protocols being followed. Management at KNH is acceptable although there is a lack of facilities to carry out many requisite investigations.
- Published
- 2016
4. Magnitude of post-urethroplasty urinary tract infections in children with hypospadias at a tertiary hospital in Kenya.
- Author
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Irene M, Osawa F, Kuria K, and Lessan J
- Subjects
- Child, Cross-Sectional Studies, Escherichia coli, Humans, Infant, Kenya epidemiology, Male, Prospective Studies, Tertiary Care Centers, Treatment Outcome, Urologic Surgical Procedures, Male adverse effects, Hypospadias epidemiology, Hypospadias surgery, Urethral Stricture, Urinary Tract Infections epidemiology, Urinary Tract Infections etiology
- Abstract
Introduction: Children who have undergone urethroplasty procedure for hypospadias are at a higher risk of getting urinary tract infections (UTI). This may be due to urethral scarring following urethroplasty that acts as a nidus for UTI. The risk is also attributed to urine stasis due to complications of urethroplasty such as urethral diverticulum, urethral stricture, meatal stenosis or breakdown of urethroplasty. Hypospadias is associated with mullerian duct remnants such as mullerian duct cysts and enlarged prostatic duct utricle which may lead to recurrent UTI., Objective: To determine the magnitude of urinary tract infections after urethroplasty for hypospadias in children at Kenyatta National Hospital (KNH), a tertiary hospital in Kenya., Design: This was a prospective descriptive cross-sectional study of male children with hypospadias who had undergone urethroplasty between January 2014 to December 2018 (5years) at KNH with age range from 6 months to 18 years. Appropriate urine collection method was used to obtain the urine specimen for microscopy, culture and sensitivity tests. Data collected was analyzed using STATA 15. Significance of the results was considered at 95% confidence interval., Results: The total number of patients seen and urine samples collected was 83 boys. The prevalence of UTI following urethroplasty for children with hypospadias was 6% (5/83). They all had UTI symptoms. Of the patients who had UTI, 60% was due to Enterobacter coli, 20% Pseudomonas aeruginosa and 20% Enterobacter cloaca complex. E.coli was 100% sensitive to nitrofurantoin, amoxicillin/clavulanic acid and cefazolin while 33% resistant to ciprofloxacin and Trimethoprim/sulfamethoxazole. Majority of the patients with UTI (80%) had penoscrotal hypospadias and 60% of them developed complications post-operatively., Conclusion: Urinary tract infections is not a common finding in children who have undergone urethroplasty for hypospadias at KNH. Patients with penoscrotal hypospadias appears to be at a higher risk of developing UTI in our institution with E. Coli being the commonest bacteria implicated. Antibiotic protocol should be based on local culture and sensitivity pattern., Competing Interests: Conflicts of interest The following authors have no financial disclosures (MI, FO, KK, JL.), (Copyright © 2021 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2021
- Full Text
- View/download PDF
5. Wilms tumor survival in Kenya.
- Author
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Axt J, Abdallah F, Axt M, Githanga J, Hansen E, Lessan J, Li M, Musimbi J, Mwachiro M, Newton M, Ndung'u J, Njuguna F, Nzioka A, Oruko O, Patel K, Tenge R, Ukoli F, White R, O'Neill JA Jr, and Lovvorn HN 3rd
- Subjects
- Adolescent, Adrenalectomy, Chemotherapy, Adjuvant, Child, Child, Preschool, Combined Modality Therapy, Disease-Free Survival, Female, Follow-Up Studies, Humans, Infant, Infant, Newborn, Internet, Kenya epidemiology, Kidney Neoplasms pathology, Kidney Neoplasms therapy, Male, Neoadjuvant Therapy, Neoplasm Staging, Radiotherapy, Adjuvant, Retrospective Studies, Survival Analysis, Treatment Outcome, Wilms Tumor pathology, Wilms Tumor therapy, Kidney Neoplasms mortality, Registries, Wilms Tumor mortality
- Abstract
Purpose: Survival from Wilms Tumor (WT) exceeds 90% at 5 years in developed nations, whereas at last report, 2-year event-free survival (EFS) in Kenya reached only 35%. To clarify factors linked to these poor outcomes in Kenya, we established a comprehensive web-based WT registry, comprised of patients from the four primary hospitals treating childhood cancers., Materials and Methods: WT patients diagnosed between January 2008 and January 2012 were identified. Files were abstracted for demographic characteristics, treatment regimens, and enrollment in the Kenyan National Hospital Insurance Fund (NHIF). Children under 15 years of age having both a primary kidney tumor on imaging and concordant histology consistent with WT were included., Results: Two-year event-free survival (EFS) was 52.7% for all patients (n=133), although loss to follow up (LTFU) was 50%. For the 33 patients who completed all scheduled standard therapy, 2-year EFS was 94%. Patients enrolled in NHIF tended to complete more standard therapy and had a lower hazard of death (Cox 0.192, p < 0.001)., Conclusion: Survival of Kenyan WT patients has increased slightly since last report. Notably, WT patients completing all phases of standard therapy experienced 2-year survival approaching the benchmarks of developed nations. Efforts in Kenya should be made to enhance compliance with WT treatment through NHIF enrollment., (Copyright © 2013 Elsevier Inc. All rights reserved.)
- Published
- 2013
- Full Text
- View/download PDF
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