The role of co-infections on cervical intraepithelial neoplasia prevalence in western Kenya.

Background: Screening for co-infections with HIV, HSV-2 and among high-risk human papilloma virus (hr-HPV) positive women remains essential in alleviating high morbidity of cervical cancer (CC). The aim of this study was to determine the prevalence of cervical intraepithelial neoplasia (CIN) among women referred for CC screening at a referral hospital in Kisumu County, Kenya; and to establish the role of co-infection on CIN.

Method: In a cross-sectional study, we collected HPV, HIV, HSV-2 and CT data, cervical cytology results, and demographic information from 517 referrals.

The role of vitamin D status on treatment outcome among HIV- infected children receiving care in Kisumu County, Kenya.

Background: Kenya has a paediatric HIV burden of nearly 140,000 children, of which only 48% of those on antiretroviral therapy (ART) have achieved the desired viral suppression possibly due to vitamin D deficiency. We explored the influence of vitamin D levels on treatment outcome.

Method: We performed a cross-sectional study of 196 participants aged 3 - 14 years; among them 98 HIV infected who received treatment between 2019 - 2020 in Jaramogi Oginga Odinga Teaching and Referral Hospital, Kenya.

Immunization of Rabbits with a Quadrivalent Bioconjugate Vaccine Induces Functional Antibodies Reactive with Isolates from Kenya.

Diarrheal diseases are a leading cause of global morbidity and mortality, disproportionately affecting children in resource-limited settings. Although improvements in hygiene and access to clean water are helpful, vaccines are considered essential due to the low infectious dose of species and increasing antibiotic resistance. Building on achievements with conjugate vaccines, a safe and immunogenic novel bioconjugate vaccine linking O-antigen to Pseudomonas aeruginosa exoprotein A has been developed to induce immunity against Shigella flexneri 2a, 3a, and 6 and S.

Phenotypic and Genotypic Characteristics of Uropathogenic Isolates from Kenya.

Uropathogenic (UPECs) are a significant cause of urinary tract infections (UTIs). In Kenya, UTIs are typically treated with β-lactam antibiotics without antibiotic susceptibility testing, which could accelerate antibiotic resistance among UPEC strains. This study determined the occurrence of UPEC producing extended-spectrum β-lactamases (ESBLs), the genes conferring resistance to β-lactams, and the phylogenetic groups associated with ESBLs in Kenyan UPECs.

Characterization and engineering of two new GH9 and GH48 cellulases from a Bacillus pumilus isolated from Lake Bogoria.

Objectives: To search for new alkaliphilic cellulases and to improve their efficiency on crystalline cellulose through molecular engineering RESULTS: Two novel cellulases, BpGH9 and BpGH48, from a Bacillus pumilus strain were identified, cloned and biochemically characterized. BpGH9 is a modular endocellulase belonging to the glycoside hydrolase 9 family (GH9), which contains a catalytic module (GH) and a carbohydrate-binding module belonging to class 3 and subclass c (CBM3c). This enzyme is extremely tolerant to high alkali pH and remains significantly active at pH 10.

Novel biomarkers with promising benefits for diagnosis of cervical neoplasia: a systematic review.

Background: Cervical cancer screening is slowly transitioning from Pappanicolaou cytologic screening to primary Visual Inspection with Acetic Acid (VIA) or HPV testing as an effort to enhance early detection and treatment. However, an effective triage tests needed to decide who among the VIA or HPV positive women should receive further diagnostic evaluation to avoid unnecessary colposcopy referrals is still lacking. Evidence from experimental studies have shown potential usefulness of Squamous Cell Carcinoma Antigen (SCC Ag), Macrophage Colony Stimulating Factor (M-CSF), Vascular Endothelial Growth Factor (VEGF), MicroRNA, p16INKa / ki-67, HPV E6/E7/mRNA, and DNA methylation biomarkers in detecting premalignant cervical neoplasia.

A conservative approach to dislocation following total hip arthroplasty: a review of 8606 hips.

Patients And Methods: We present the data on 8606 total hip arthroplasty (THA) procedures carried out in 7818 patients through a posterior approach between 1998 and 2017.

Results: 218 hips (2.5%) suffered at least 1 dislocation with dislocation rates declining from 6.

Diagnostic dose determination and efficacy of chlorfenapyr and clothianidin insecticides against Anopheles malaria vector populations of western Kenya.

Background: Malaria vector control is dependent on chemical insecticides applied to walls by indoor residual spraying or on long-lasting insecticidal nets. The emergence and spread of insecticide resistance in major malaria vectors may compromise malaria control and elimination efforts. The aim of this study was to estimate a diagnostic dose for chlorfenapyr (class: pyrrole) and clothianidin (class: neonicotinoid) and assess the baseline susceptibility of three major Anopheles malaria vectors of western Kenya to these two insecticides.

Antibiotic Prophylaxis Protocols and Surgical Site Infection Rates in Trauma Surgery: A Prospective Regional Study of 26,849 Procedures.

Introduction: Prophylactic antibiotics have been shown to reduce the rate of surgical site infection (SSI) 1, however there is little evidence supporting the effectiveness of one antibiotic over another. We have studied SSI rates and antibiotic prophylaxis protocols in Northern Ireland trauma surgery over a 10-year period to Identify the most effective antibiotic protocol associated with lowest rate of SSI.

Method: Antibiotic prophylaxis protocols from 2004-2014 were sought from each of the region's 4 trauma hospitals and their dates of introduction recorded.

Distribution of Snails in Associated Vegetations and Schistosome Infection Prevalence Along the Shores of Lake Victoria in Mbita, Kenya: A Cross-Sectional Study.

Background: Schistosomiasis due to remains a major public health problem and cause of morbidity and mortality in sub-Saharan Africa despite the implementation of control programmes. More than 6 million Kenyans are at risk of infection. Regarding control measures, snail species, which are the obligatory intermediate hosts for transmission of have been neglected.

Correction to: Seroprevalence and determinants of transfusion transmissible infections among voluntary blood donors in Homabay, Kisumu and Siaya counties in western Kenya.

Following publication of the original article [1], the authors reported that for two of the authors, Felix Humwa and Vallarie Opollo, an incorrect affiliation has been given. In this Correction the incorrect and correct affiliations are listed.

Seroprevalence and determinants of transfusion transmissible infections among voluntary blood donors in Homabay, Kisumu and Siaya counties in western Kenya.

Objective: Since the implementation of a series of blood donation safety improvements in Kenya, information about seroprevalence and determinants of transfusion transmissible infections among voluntary blood donors especially in high HIV burden regions of Homabay, Kisumu and Siaya counties remain scanty. A cross-sectional study examining HIV, syphilis, hepatitis B and C virus sero-markers and associated determinants was conducted among voluntary blood donors. Their demographic characteristics and previous risk exposure were recorded in a pre-donation questionnaire, while blood samples collected were screened for hepatitis B, hepatitis C, human immunodeficiency viruses by ELISA and RPR (syphilis), then confirmed using CMIA.

Minimal Incision Total Hip Arthroplasty: A Concise Follow-up Report on Functional and Radiographic Outcomes at 10 Years.

Unlabelled: In 2005, we conducted a prospective randomized controlled trial that demonstrated that, compared with a standard incision, a minimal incision technique did not improve early outcomes of total hip arthroplasty (THA). There was concern that reduced exposure could compromise long-term outcome. For the current study, all surviving participants were invited to return for 10-year radiographic and clinical evaluation.

Aspirin for thromboprophylaxis after primary lower limb arthroplasty: early thromboembolic events and 90 day mortality in 11,459 patients.

Aims: The aim of this study was to present data on 11 459 patients who underwent total hip (THA), total knee (TKA) or unicompartmental knee arthroplasty (UKA) between November 2002 and April 2014 with aspirin as the primary agent for pharmacological thromboprophylaxis.

Patients And Methods: We analysed the incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE) then compared the 90-day all-cause mortality with the corresponding data in the National Joint Registry for England and Wales (NJR).

Results: The incidence of PE was 0.

Polymorphisms in the Fc gamma receptor IIIA and Toll-like receptor 9 are associated with protection against severe malarial anemia and changes in circulating gamma interferon levels.

An understanding of the immunogenetic basis of naturally acquired immunity to Plasmodium falciparum infection would aid in the designing of a rationally based malaria vaccine. Variants within the Fc gamma receptors (FcγRs) mediate immunity through engagement of immunoglobulin G and other immune mediators, such as gamma interferon (IFN-γ), resulting in erythrophagocytosis and production of inflammatory cytokines in severe malarial anemia (SMA). The Toll-like receptors (TLRs) trigger transcription of proinflammatory cytokines and induce adaptive immune responses.

Reliability of the radiological assessments of radiolucency and loosening in total hip arthroplasty using PACS.

We evaluated the reliability of three commonly used radiological assessments of total hip arthroplasty (THA) using the electronic picture archiving and communications system (PACS). Thirty-three patients were selected at random at a mean of 7.2 years after THA.

LCS mobile bearing total knee arthroplasty without patellar resurfacing. Does the unresurfaced patella affect outcome? Survivorship at a minimum 10-year follow-up.

Background: Patellar resurfacing during total knee arthroplasty (TKA) remains controversial. The aim of this study was to evaluate the long-term outcomes of a mobile-bearing TKA without patellar resurfacing.

Methods: We assessed the outcomes in 503 patients (600 knees) who had cemented LCS (low contact stress) mobile bearing TKA without patellar resurfacing at a minimum follow-up of 10 years.

The levels of CD16/Fc gamma receptor IIIA on CD14+ CD16+ monocytes are higher in children with severe Plasmodium falciparum anemia than in children with cerebral or uncomplicated malaria.

Fc gamma receptor IIIA (CD16/Fc gamma RIIIA) on monocytes/macrophages may play an important role in the pathogenesis of severe malarial anemia (SMA) by promoting phagocytosis of IgG-coated uninfected red cells and by allowing the production of tumor necrosis factor alpha (TNF-alpha) upon cross-linking by immune complexes (ICs). However, not much is known about the differential expression of this receptor on monocytes of children with severe malaria and uncomplicated malaria. Therefore, we investigated the expression of CD16/Fc gamma RIIIA on monocytes of children with SMA, cerebral malaria (CM), and their age-matched uncomplicated malaria controls by flow cytometry.

Age as a predictive factor for in-patient admission following day-case shoulder arthroscopic sub-acromial decompression - a district general hospital audit.

Introduction: Admission following day-case surgery can be problematic for both the patient and the health service. The purpose of this study was to identify any factors predictive of admission following arthroscopic sub-acromial decompression (ASAD) of the shoulder planned as day-case procedures.

Patients And Methods: A postal questionnaire provided data for 27 patients undergoing ASAD as a day-case procedure between June 2002 and June 2004.

Comparison of immediate postoperative walking ability in patients receiving minimally invasive and standard-incision hip arthroplasty: a prospective blinded study.

Minimally invasive hip arthroplasty is thought to result in less soft tissue damage, earlier ambulation, and improved rehabilitation. This prospective blinded cohort study objectively analyzed early functional walking ability by stride analysis 2 days postoperatively. Ninety-five patients were analyzed, 43 of who received the minimal incision and 52 the traditional incision.

Comparison of topical fibrin spray and tranexamic acid on blood loss after total knee replacement: a prospective, randomised controlled trial.

We performed a randomised, controlled trial involving 150 patients with a pre-operative level of haemoglobin of 13.0 g/dl or less, to compare the effect of either topical fibrin spray or intravenous tranexamic acid on blood loss after total knee replacement. A total of 50 patients in the topical fibrin spray group had 10 ml of the reconstituted product applied intra-operatively to the operation site.

The transverse acetabular ligament: an aid to orientation of the acetabular component during primary total hip replacement: a preliminary study of 1000 cases investigating postoperative stability.

Ensuring the accuracy of the intra-operative orientation of the acetabular component during a total hip replacement can be difficult. In this paper we introduce a reproducible technique using the transverse acetabular ligament to determine the anteversion of the acetabular component. We have found that this ligament can be identified in virtually every hip undergoing primary surgery.

Comparison of early postoperative functional levels following total hip replacement using minimally invasive versus standard incisions. A prospective randomized blinded trial.

Objective: To compare the results of single-incision minimally invasive total hip replacement (< or = 10 cm) to standard-incision (16 cm) total hip replacement in the early postoperative period with respect to functional and mobilizing ability (transfers, mobilizing, walking and stair assessment).

Setting: Orthopaedic wards of a regional orthopaedic centre.

Subjects: Two hundred and nineteen total hip replacement patients were tested between December 2003 and June 2004.

Comparison of gait kinematics in patients receiving minimally invasive and traditional hip replacement surgery: a prospective blinded study.

Minimally invasive (MI) total hip replacement (THR) supposedly provides improved ambulation in the immediate post-operative period. This study used a prospective blinded design to analyse early post-operative walking ability using gait analysis. Seventeen patients were available for full analysis with nine having had the MI technique and eight having the standard incision (SI) technique.