Premature ovarian failure in twins: case report

Premature ovarian failure (POF)is a serious life-changing condition that affects young women, remains an enigma and the researchers’ challenge. POF, premature ovarian insufficiency (POI), premature menopause, premature dysfunction (POD), or hypergonadotropic hypogonadism is one of the most perplexing disorders with aheterogeneous origin. Infertility, social and psychological stress are common consequences of this entity. This paper presents a rare condition where both twins had presented with POF

The Structured Operational Research and Training Initiative (SORT IT), second workshop using the national tuberculosis routinely collected program data

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Comparison of demographic and clinical characteristics between pulmonary and extra-pulmonary tuberculosis patients in Kiambu County, 2012-2015

Background: Tuberculosis (TB) continues to be a public health challenge globally. The most common organ to be involved is the lung although it can affect any organ in the body. The diagnosis of extra-pulmonary TB (EPTB) has faced many challenges mainly due to inadequate expertise to diagnose or lack of equipment for diagnosis.Objective: To compare the demographic and clinical characteristics between pulmonary and extrapulmonary tuberculosis in Kiambu CountyDesign: Retrospective cross-sectional studySetting: Kiambu County, KenyaSubjects: Tuberculosis patients notified in TIBU surveillance systemResults: Of the 15, 833 patients analyzed, 2,704 (17%) had extra-pulmonary tuberculosis. Male to female ratio was 1:1.7 in PTB and 1:1.3 in EPTB patients. There was declining trend of TB cases notified over the years for both PTB and EPTB. Pleural TB accounted for 38% with TB lymphadenitis accounting for 14% of the EPTB subtypes. TB-HIV co-infection was higher among EPTB (36%) compared to PTB (30%). The treatment success rate was 85% and 86% among PTB and EPTB cases respectively. The mortality was 10% among EPTB and 5% in PTB cases. The 5-14 age category were more likely to developing EPTB compared to PTB (AOR 4.67 95% CI (1.5-13.99). Kabete zone was most affected with EPTB (AOR 2.11(1.19-2.74) while a protective factor was observed among the HIV positive clients (AOR 0.58 (0.43 - 0.78)Conclusion: There was a general decline in cases for both EPTB and PTB. However, the age category most affected was 5-14 years. The co-infectivity rate was higher among the EPTB patients compared to the PTB patients. High index of suspicion and appropriate diagnostic tools are needed in evaluation particularly in EPTB which will assist in early management of the patients. ART uptake could play a big role in protecting HIV positive clients from getting EPTB

Validating physician-certified verbal autopsy and probabilistic modeling (InterVA) approaches to verbal autopsy interpretation using hospital causes of adult deaths

<p>Abstract</p> <p>Background</p> <p>The most common method for determining cause of death is certification by physicians based either on available medical records, or where such data are not available, through verbal autopsy (VA). The physician-certification approach is costly and inconvenient; however, recent work shows the potential of a computer-based probabilistic model (InterVA) to interpret verbal autopsy data in a more convenient, consistent, and rapid way. In this study we validate separately both physician-certified verbal autopsy (PCVA) and the InterVA probabilistic model against hospital cause of death (HCOD) in adults dying in a district hospital on the coast of Kenya.</p> <p>Methods</p> <p>Between March 2007 and June 2010, VA interviews were conducted for 145 adult deaths that occurred at Kilifi District Hospital. The VA data were reviewed by a physician and the cause of death established. A range of indicators (including age, gender, physical signs and symptoms, pregnancy status, medical history, and the circumstances of death) from the VA forms were included in the InterVA for interpretation. Cause-specific mortality fractions (CSMF), Cohen's kappa (κ) statistic, receiver operating characteristic (ROC) curves, sensitivity, specificity, and positive predictive values were applied to compare agreement between PCVA, InterVA, and HCOD.</p> <p>Results</p> <p>HCOD, InterVA, and PCVA yielded the same top five underlying causes of adult deaths. The InterVA overestimated tuberculosis as a cause of death compared to the HCOD. On the other hand, PCVA overestimated diabetes. Overall, CSMF for the five major cause groups by the InterVA, PCVA, and HCOD were 70%, 65%, and 60%, respectively. PCVA versus HCOD yielded a higher kappa value (κ = 0.52, 95% confidence interval [CI]: 0.48, 0.54) than the InterVA versus HCOD which yielded a kappa (κ) value of 0.32 (95% CI: 0.30, 0.38). Overall, (κ) agreement across the three methods was 0.41 (95% CI: 0.37, 0.48). The areas under the ROC curves were 0.82 for InterVA and 0.88 for PCVA. The observed sensitivities and specificities across the five major causes of death varied from 43% to 100% and 87% to 99%, respectively, for the InterVA/PCVA against the HCOD.</p> <p>Conclusion</p> <p>Both the InterVA and PCVA compared well with the HCOD at a population level and determined the top five underlying causes of death in the rural community of Kilifi. We hope that our study, albeit small, provides new and useful data that will stimulate further definitive work on methods of interpreting VA data.</p

Imperial Remains and Imperial Invitations : Centering Race within the Contemporary Large-Scale Infrastructures of East Africa

In this paper we combine infrastructure studies and black radical traditions to foreground how imperial remains deeply inform the logics that bring forth contemporary large-scale infrastructures in Africa. The objective, prompted by the ongoing avid promotion of such architectures on the continent, is to contribute to an analysis that centres race in these projects. Our argument is that these initiatives have to be understood in relation to inherited material and discursive scaffoldings that remain from the colonial period, through what we refer to as imperial remains and imperial invitations. These remains and invitations demonstrate how recent mega infrastructures inhere, in their planning, financing and implementation, a colonial racialism, despite rhetorical claims to the opposite. Empirically, we draw, principally, on China built and financed infrastructure projects from Kenya, and theoretically upon black radical traditions in order to foreground a longer genealogy of black pathologizing and resistance to it on the continent.QC 20200220Grounding and Worlding Urban Infrastructures (GROWL