Automatic methods for the interpretation of gravity and magnetic field anomalies and their application to marine geophysical surveys

Direct methods for the interpretation of gravity and magnetic field anomalies have been developed and applied to interpret marine geophysical surveys of the Caribbean eastern margin and the Sierra Leone continental shelf. The gravity interpretation programs compute, under certain constraints to remove inherent ambiguity, the space form of the body producing a specified gravity anomaly. The computed body is built up from a set of two-dimensional trapesia thus producing a geologically realistic model. The programs can interpret interfering anomalies, caused by adjacent bodies and anomalies due. to bodies v/ith a known lateral variation in density. The method is based on an equivalent layer technique, the non-linear problem being solved by repeated solution of a linear integral equation, which is approximated by a finite set of linear algebraic equations. The technique has been extended to three dimensional analysis, the source body being built up from a set of rectangular prisms. The magnetic interpretation method is basically similar to the gravity method, but it is necessary to compute the dip of the body magnetisation vector before a solution can be obtained for the body space form. The programs have been used, to interpret a marine gravity survey of the south eastern Caribbean margin. The gravity data is used to determine the possible crustal structure, between points here the structure is known from seismic refraction data. Conclusions are drawn on the generalised crustal structure of the region and on the southward extension of the Lesser Antilles Island arc and the Barbados Ridge. A marine gravity survey of the Sierra Leone Continental Shelf has been interpreted using the programs developed. The space form of the Freetown Complex, a layered gabbroic intrusion, and its extension onto the continental shelf are determined

Prevalence of constipation among children referred to gastroenterology clinic with chronic abdominal pain at Kenyatta National Hospital

Background: Chronic abdominal pain is one of the most common presenting complaints to primary care providers and paediatricians. Studies in developed countries have shown that constipation is one of the most common diagnoses in children presenting with chronic abdominal pain.Objectives: To determine the prevalence of constipation in children 4-13 years presenting with chronic abdominal pain and to describe the pharmacological and non-pharmacological management of children with constipation at Kenyatta National Hospital.Design: A cross-sectional hospital based study.Setting: Paediatric Gastroenterology Clinic, Kenyatta National Hospital.Subjects: children aged 4 to 13 years attending the paediatric gastroenterology clinic at Kenyatta National Hospital between July to December 2014.Results: A total of 84 children with chronic abdominal pain were seen, 47 (55.95%) were girls and the median age was nine years. The prevalence of constipation in children with chronic abdominal pain with two or more Rome III criteria was 69 out of 84 (82%, 95%CI: 72%95%), out of which there were 37(53.62%) females and 32(46.3%) males. The difference among the boys and girls was not statistically significant. Pharmacological management was more commonly used than non-pharmacological management. The most common medication given to children with constipation was lactulose given to 63 (91.3%) of the children. The non-pharmacological management of constipation was education and dietary advice 53(76.8%), while behaviour change advice was given to 28 (40.6 %).Conclusion: The prevalence of constipation in children with chronic abdominal pain was 82%. Pharmacological management was more commonly used than non pharmacological

Attitude and practice of health care providers towards autopsies in children under five years at Kenyatta National Hospital

Background: Attitude and practice of health care professionals toward autopsy are important as they will give information regarding factors that contribute to the low rate of autopsies in children under five years.Objective: To evaluate the attitude and practice of health care providers towards autopsies in children under five years.Design: Cross-sectional hospital based descriptive survey.Setting: General paediatrics wards and newborn unit at Kenyatta National Hospital, Nairobi, Kenya.Subjects: Health care providers working at the Kenyatta National Hospital paediatric wards and newborn unit.Results: The study enrolled 95 health care providers. Majority (69.5%) of health care providers showed a positive attitude towards autopsy. Consultants and paeadiatric residents had a more positive attitude compared to interns (p< 0.001) and nurses (p=O.Oll). Clinical experience of> 15 years was associated with a more positive attitude. The main barriers to obtaining consent were lack of formal training in obtaining consent and failure of autopsy results to be availed in a timely manner.Conclusions: Health care providers had a positive attitude to autopsy which was significantly associated with their cadre and years of experience. The main reasons given for not obtaining consent for autopsy were lack of formal training in obtaining consent and failure to obtain autopsy results in timely manner

Prevalence of non-alcoholic fatty liver disease in overweight and obese children seeking ambulatory healthcare in Nairobi, Kenya

Background While linked to obesity and associated with an increased cardiovascular morbidity, non-alcoholic fatty liver disease (NAFLD) is an often-asymptomatic cause of chronic liver disease in children. Early detection provides opportunity for interventions to curb progression. Childhood obesity is on the rise in low/middle-income countries, but cause-specific mortality data associated with liver disease are scanty. Establishing the prevalence of NAFLD in overweight and obese Kenyan children would guide in public health policies aimed at early screening and intervention. Objectives To investigate prevalence of NAFLD in overweight and obese children aged 6–18 years using liver ultrasonography. Methodology This was a cross-sectional survey. After obtaining informed consent, a questionnaire was administered, and blood pressure (BP) measured. Liver ultrasonography was performed to assess fatty changes. Categorical variables were analysed using frequency and percentages. χ2 test and multiple logistic regression model were used to determine relationship between exposure and outcome variables. Results Prevalence of NAFLD was 26.2% (27/103, 95% CI=18.0% to 35.8%). There was no association between sex and NAFLD (OR1.13, p=0.82; 95% CI=0.4 to 3.2). Obese children were four times more likely to have NAFLD compared with overweight children (OR=4.52, p=0.02; 95% CI=1.4 to 19.0). About 40.8% (n=41) had elevated BP, but there was no association with NAFLD (OR=2.06; p=0.27; 95% CI=0.6 to 7.6). Older children (13–18 years) were more likely to have NAFLD (OR 4.42; p=0.03; 95% CI=1.2 to 17.9). Conclusion Prevalence of NAFLD was high in overweight and obese school children in Nairobi. Further studies are needed to identify modifiable risk factors to arrest progression and prevent sequelae

The association between OCD and shame : A systematic review and meta-analysis

Background Due to rumination and self-criticism over unwanted obsessions and repetitive rituals, shame is a common emotion experienced by individuals with obsessive–compulsive disorder (OCD). Shame is also theorized to have relevance to unacceptable thoughts in OCD. However, empirical research looking at the relationship between OCD and shame is still emerging and findings have been mixed. Objectives Our review systematically examines the association of shame with OCD and unacceptable thoughts. Methods The last updated search was conducted across five databases between 27 and 29 February 2022. The final selection included 20 papers, 18 of which were used in the primary meta-analysis to calculate pooled effect sizes between OCD and shame measures using a random effects model. In a separate analysis, three papers were used to calculate pooled effect sizes between shame and OCD symptom dimensions also using a random effects model. Results The meta-analyses identified a significant, moderate and positive correlation between total OCD and shame scores r = .352, 95% CI [0.260, 0.438]. In addition, significant, weak and positive relationships were found between shame and three OCD symptom dimensions: unacceptable thoughts r = .252, 95% CI [−0.467, 0.9708], harm obsessions r = .224, CI [−0.190, 0.638] and symmetry concerns r = .200, CI [−0.108, 0.509]. Limitations Shame measures in the reviewed studies were not specific to OCD, and between-study variance in the analyses examining unacceptable thoughts was significant. Conclusions Our findings support a medium positive relationship between shame and OCD. As shame in OCD can be a barrier to seeking treatment and impair quality of life, it is imperative to address this emotion through psychoeducation, assessment and treatment

Hemobilia secondary to choledochal cyst

Non variceal upper gastrointestinal hemorrhage in children is rare. A 5-year-old presented with hematemesis and melena. Pre-referral imaging and exploratory laparotomy did not reveal the source of bleeding. Hemobilia was detected on endoscopy MRI showed a choledochal cyst. The patient underwent successful resection of the cyst and hepaticojejunostomy

Effectiveness of sequential v. standard triple therapy for treatment of Helicobacter pylori infection in children in Nairobi, Kenya

Background: Once the diagnosis of Helicobacter pylori is confirmed, treatment requires at least two antibiotics and an acid inhibitor for a minimum of seven days. Unfortunately, treatment failures are being frequently reported. Treatment regimens that include sequential administration of antibiotics with acid inhibitors have been developed to try and increase the rate of eradication. Objective: To determine the effectiveness of a novel 10-day sequential therapy compared with the standard 10-day triple therapy for treatment of H. pylori infection in children. Methods: A double-blinded, randomised, controlled trial was conducted. Children under the age of 16 years with recurrent abdominal pain associated with dyspepsia and diagnosed with H. pylori by histology were randomly allocated either to a 10-day sequential treatment regimen or to a 10-day conventional triple therapy. Analysis of the outcome of this study was based on clinical improvement and confirmed H. pylori eradication based on stool H. pylori antigen detection and/or repeat endoscopy. Results: Of the 71 patients included in the analysis, 45 (63.4%) were given the 10-day conventional treatment while 26 (36.6%) received the 10-day sequential treatment. There was no difference in clinical improvement after treatment in the two therapies. However, there was a significant difference in the eradication of H. pylori between the conventional v. sequential regimens (48.8% v. 84.6%, respectively; p=0.02, odds ratio 0.19). Conclusion: The sequential treatment had a significantly higher H. pylori eradication rate than the conventional treatment

Depression and its associated factors: perceived stress, social support, substance use and related sociodemographic risk factors in medical school residents in Nairobi, Kenya

Abstract: Background: Little data exists regarding depression and its associated factors in medical residents and doctors in Sub-Saharan Africa. Residents are at high risk of developing depression owing to the stressful nature of their medical practice and academic training. Depression in medical residents leads to decreased clinical efficiency, and poor academic performance; it can also lead to substance abuse and suicide. Our primary aim was to measure depression prevalence among medical residents in Kenya’s largest national teaching and referral hospital. Secondary aims were to describe how depression was associated with perceived stress, perceived social support, substance use, and educational environment. Methods: We sampled 338 residents belonging to 8 different specialties using self administered questionnaires in this cross-sectional survey between October 2019 and February 2020. Questionnaires included: sociodemographics, the Centres for Epidemiology Depression Scale - Revised, Perceived Stress Scale, Multidimensional Scale of Perceived Social Support, Alcohol, Smoking and Substance Involvement Screening Test, and Postgraduate Hospital Educational Environment Measure. Bivariate and multivariate linear regression were used to assess for risk factors for depression. Results: Mean participant age was 31.8 years and 53.4% were males. Most residents (70.4%) reported no to mild depressive symptoms, 12.7% had moderate, and 16.9% had severe depressive symptoms. Most residents had high social support (71.8%) and moderate stress (61.6%). The educational environment was rated as more positive than negative by 46.3% of residents. Bivariate analyses revealed significant correlations between depressive symptoms, perceived stress, substance use, perceived social support, and educational environment. Multivariate analysis showed that depression was strongly associated with: fewer hours of sleep (β = − 0.683, p = 0.002), high perceived stress (β = 0.709, p \u3c 0.001) and low perceived social support (β = − 2.19, p \u3c 0.001)