Some anatomical and morphometric observations in the transverse foramina of the atlas among Kenyans

The transverse foramen, which transmits the vertebral vessels, is the result of special formation of the cervical transverse processes. It is formed by a vestigial costal element fused to the body of the originally true transverse process of the vertebra. In the atlas, where the vertebral artery exits the transverse foramen to enter the cranium, many bony variations have been described, and some are attributable to tortuosity of the vessel, as well as stress forces on the neck. The transverse foramen of the atlas has not been studied in terms of shape, morphometry, presence or absence and bilateral differences. This may shed light on the side differences in neck and vertebra-basilar pathology. A hundred and two atlases obtained from the Osteology Department of National Museums of Kenya were observed for presence, shape and variations of the transverse foramen. Accessory transverse foramina were noted, as well as missing foramina. Anteroposterior and mediolateral diameters of the foramina were taken and the area calculated. Out of the 102 vertebra studied (204 foramina transversaria), 8 incomplete foramina were observed, 6 on the right side and 2 bilateral. There were 4 double transverse foramina observed, 1 on the left and 3 on the right side. All atlases had foramina transversaria. The foramina categorized into types 1 to 5 using a recognized criterion. On the right side, type 4 was predominant (40.2%), while on the left, types 2 and 5 were predominant (39.2% each). Morphometrically, the right and left transverse foramina had mean cross-sectional area of 36.30mm2 and 37.20mm2 respectively. The presence of variations in the foramen transversaria is predominant on the right side. Further, the right foramina have a smaller cross-sectional area. These should be taken into account during posterior cervical approaches, as well as during evaluation of cervicogenic syndromes.Keywords: Atlas vertebrae, transverse foramina, morphometr

Risk Factor Profile of Motorcycle Crash Victims in Rural Kenya

Background: Road traffic injuries involving motorcycles are increasing  especially in rural Kenya resulting in both human and economic loss. This study was done to identify the risk factors and the host characteristics associated with motorcycle injury victims in rural setting so as to instituteappropriate interventions for prevention of these incidents.Methods: A descriptive cross-sectional study conducted at Kangundo District Hospital between 1st July and 31st December 2011.Results:167 crash victims (136 (81.4%) males, 31 (18.6%) females) were seen. Mean age was 29 years; most victims (94.2%) being aged 16-40  years. Cyclists comprised 61 (36.5%) while 79 (47.3%) were passengers. All cyclists were men; more women were passengers (p, 0.03), while  pedestrians were mostly children below 10 years. Most victims (74.3%) didnot wear helmets while 72.1% did not wear jackets with reflectors. Alcohol use was recorded in 22.8% of cyclists. About 71.9% of cyclists lacked valid driving licenses. Overloading was common, with 74.8% of the cyclists carrying two or more passengers.Conclusion: Poor driving skills, reluctance to use protective gear, alcohol use and overloading of passengers were the main risk factors observed.  Our observations call for more stringent regulations and aggressive road safety campaigns. Injury prevention and safety promotion campaigns should focus more on the risk factors for motorcycle accidents.Key Words: Motorcycles, Crash, Risk factors, Rura

Prediction of Ideas Number During a Brainstorming Session

International audienceIn this paper, we present an approach allowing the prediction of ideas number during a brainstorming session. This prediction is based on two dynamic models of brainstorming, the non-cognitive and the cognitive models proposed by Brown and Paulus (Small Group Res 27(1):91–114, 1996). These models describe for each participant, the evolution of ideas number over time, and are formalized by differential equations. Through solution functions of these models, we propose to calculate the number of ideas of each participant on any time intervals and thus in the future (called prediction). To be able to compute solution functions, it is necessary to determine the parameters of these models. In our approach, we use optimization model for model parameters calculation in which solution functions are approximated by numerical methods. We developed two generic optimization models, one based on Euler’s and the other on the fourth order Runge–Kutta’s numerical methods for the solving of differential equations, and we apply them to the non-cognitive and respectively to the cognitive models. Through some feasibility tests, we show the adequacy of the proposed approach to our prediction context

Use of Cervical Cerclage as a Treatment Option for Cervical Incompetence: Patient Characteristics, Presentation and Management over a 9 Year Period in a Kenyan Centre

Treatment of cervical incompetence by cerclage and other methods has yet to be standardized, as its diagnosis is not uniformly accepted. Its diagnosis, particularly in the African setting, is mostly based on past obstetric history of pregnancy losses, while in developed centres; ultrasound diagnosis is increasingly being used. The mainstay of treatment in developing countries is cervical cerclage, although the indications and contraindications of this mode of treatment are not documented. Our aim was to appraise this practice in terms of patient characteristics, the diagnostic process and management at the Kenyatta National Hospital, Nairobi, Kenya. This was a descriptive retrospective study over 9 years. Predesigned questionnaires were employed to collect data on patient’s socio-demographic profile, presentation, risk factors, diagnosis and management of cervical incompetence. Chisquared test and student’s t-test were used to correlate variables. A total of 199 patients were treated for cervical incompetence, with the patient mean age being 27.97. 87.4% of the patients (p=0.02) were in the 20 to 35 years category. Most of the patients (60.1%) were of low socio-economic status. Cervical cerclage was employed in all the patients, although ultrasound investigation was not employed in 65.8% of them. Diagnosis of cervical incompetence still relies on history of previous pregnancy losses, with the standard transvaginal ultrasound relatively unemployed. There is need to intensify investigations for this condition, standardize the indications for cerclage, and diversify management to other newer modalities.RésuméLe traitement de l’insuffisance cervicale par le cerclage n'a pas encore été standardisé, étant donné que son diagnostic n'est pas uniformément accepté. Son diagnostic en Afrique, est principalement basé sur les antécédents obstétricaux de pertes de grossesse, alors que dans les centres développés, le diagnostic échographique est utilisé. Notre objectif était d'évaluer cette pratique en termes de caractéristiques des patientes, le processus de diagnostic et de gestion à l'Hôpital National Kenyatta, à Nairobi, au Kenya. Il s'agissait d'une étude rétrospective descriptive qui a duré 9 ans. Les questionnaires préconçus ont été utilisés pour recueillir des données sur la situation sociodémographique des patientes, la présentation, les facteurs de risque, le diagnostic et la gestion d'insuffisance cervicale. Le Test du chi carré et le test de t de l’étudiant ont été utilisés pour corréler les variables. Un total de 199 patientes ont été traitées pour l’insuffisance cervicale, l'âge moyen des patientes étant de 27,97. 87,4% des patientes (p = 0,02) se trouvaient dans la catégorie des 20 à 35 ans. La plupart des patientes (60,1%) étaient de faible statut socioéconomique. Le cerclage du col utérin a été utilisé chez toutes les patientes, bien qu’on n’ait pas mené une enquête échographique auprès des 65,8% d'entre elles. Le diagnostic d'insuffisance cervicale repose toujours sur les antécédents de perte de grossesses précédentes, là où on n’a presque pas utilisé l'échographie trans-vaginale normale. Il est nécessaire d'intensifier les recherches pour cette situation, de standardiser les indications du cerclage, et de diversifier la gestion vers d'autres modalités nouvelles.Keywords: Cervical incompetence, cerclage, diagnosis, managemen

Responsiveness to HIV Education and VCT Services among Kenyan Rural Women: A Community-Based Survey

Uptake of VCT and other HIV prevention strategies among rural African women is affected by various socio-cultural and economic factors which need elucidation. Our aim was to establish the responsiveness to HIV education among rural women attending three dispensaries in Kenya. This study was designed to assess gender and psycho-social factors that influence HIV dynamics in rural Kenya. This was a cross-sectional questionnaire based study of 1347 women, conducted in October 2009. Socio-economic status as well as knowledge on methods of HIV transmission was assessed. Testing status, knowledge on existing VCT services and willingness to share HIV information with their children was assessed. Majority of the women have heard about VCT services, but significantly few of them have been tested. Those with secondary school education and above are more knowledgeable on methods of HIV transmission, while those with inadequate education are more likely to cite shaking hands, sharing utensils, mosquito bites and hugging as means of transmission (p=0.001). 90% of educated women are willing to share HIV information with their children, compared to 40% of uneducated women. Marital status is seen to positively influence testing status, but has no significant effect on dissemination of information to children. We conclude that despite the aggressive HIV education and proliferation of VCT services in Kenya, women are not heeding the call to get tested. Education has a positive impact on dissemination of HIV information. Focus needs to shift into increasing acceptability of testing by women in rural Kenya (Afr. J. Reprod. Health 2010; 14[3]: 165-169).Key words: Responsiveness, VCT- voluntary counseling and testing, HIV, wome

Foramen arcuale: a rare morphological variation located in atlas vertebrae

To investigate the incidence of foramen arcuale in dry atlas vertebrae which may cause clinical problems