Testicular artery arising from an aberrant right renal artery

Testicular arteries usually arise from the abdominal Aorta; however they may rarely arise from other arteries of posterior abdominal wall. Variations of the testicular arteries and renal vessels are common. Awareness of these variations is very important to surgeons to increase their surgical precision and therefore avoiding iatrogenic injuries as well as useful in diagnostic procedures. This case report we discovered the rare variation of the origin of the right testicular artery arising from the right aberrant renal artery with double renal artery irrigating both left and right kidneys. These variations in the testicular arteries and renal arteries have implication to surgical procedures such as orchidopexy repair for undescended testis, renal transplantation and nephrectomy. Thus with the introduction of novel surgical and invasive diagnostic procedures understanding of these rare variations becomes significantly important. Currently these procedures are of increasing in our settings as such the information on variations is of prime importance.Keywords: Testicular artery; renal artery, variation, abdominal aort

The determinants of health related quality of life of patients on maintenance haemodialysis at Kenyatta National Hospital, Kenya

Background: Health related quality of life (HRQOL) is increasingly being recognised as a primary outcome measure in the treatment of end stage renal disease. In addition to being an important surrogate marker of quality of care in patients on maintenance haemodialysis, HRQOL measures have being shown to be robust predictors of mortality and morbidity.Objective: To determine the health related quality of life and its determinants in patients on maintenance haemodialysis at the Kenyatta National Hospital.Design: A cross-sectional descriptive study.Setting: Renal unit, Kenyatta National HospitalSubjects: Adult patients with end stage renal disease on maintenance haemodialysis.Results: The mean physical composite summary and mental composite summary scores were 39.09±9.49 and 41.87±10.56 respectively. The burden of kidney disease sub-scale, symptom and problems sub-scale and effect of kidney disease on daily life sub-scale scores were 16.15±21.83, 73.46±18.06 and 67.63±23.45 respectively. No significant correlations were found between the health-related quality of life scores, socio-demographic and clinical factors assessed.Conclusion: The health-related quality of life of patients on maintenance haemodialysis is reduced. The physical quality of life is more affected than the mental quality of life. No independent determinants of health-related quality of life were identified

Responding to Major Burn Disasters in Resource-Limited Settings: Lessons Learned From an Oil Tanker Explosion in Nakuru, Kenya.

BACKGROUN

On Tensor Products and Elementary Operators

In This Paper We Describe Operator Systems And Elementary Operators Via Tensor Products. We Also Discuss Norms Of Elementary Operators

Health related quality of life of patients on maintenance haemodialysis at Kenyatta National Hospital

Background: Health related quality of life is increasingly being recognised as a primary outcome measure in treatment of end-stage renal disease. The health related quality of life of patients on maintenance haemodialysis is reduced. Several interventions directed at modifiable risk factors have been shown to improve quality of life of patients on haemodialysis.Objective: To assess the health-related quality of life of patients on maintenance haemodialysis at the Kenyatta National Hospital.Design: Cross sectional descriptive study.Setting: Kenyatta National Hospital, Renal Unit.Subjects: The study was conducted on 96 patients with end-stage renal disease on maintenance haemodialysis. Socio-demographic and clinical factors were recorded for all patients. Health-related quality of life was assessed using the Kidney Disease Quality of Life-36 questionnaire. Two summary scores and three subscale scores were calculated.Results: The mean physical composite summary and mental composite summary scores were 39.09±9.49 and 41.87±10.56 respectively. The burden of kidney disease subscale, symptom and problems subscale and effect of kidney disease on daily life subscale scores were 16.15±21.83, 73.46±18.061 and 67.63±23.45 respectively.Conclusion: Health-related quality of life of patients on maintenance haemodialysis is reduced. The physical quality of life is more affected than the mental quality of life. The burden of kidney disease subscale is the most affected subscale score

Regional Collective Action Wraps Up

After four years, the Regional Collective Action Programme has come to an end. In this final issue of Collective Action News, we report on how Regional Collective Action activities have supported the work of the Consortium and the CRPs. The Regional Collective Action Programme has been described by Carlos Seré, Director General of the International Livestock Research Institute (ILRI), which has hosted the Programme since its inception in 2007, as ‘a bold experiment that achieved considerable success in promoting collaborative action in eastern and southern Africa that has now been overtaken by the process of CGIAR reform’. Many of the activities started under the Programme have now been incorporated into the CGIAR Consortium and the CGIAR Research Programmes (CRPs)

Stratification of persons with diabetes into risk categories for foot ulceration

Background: Patients with diabetes mellitus are at a higher risk of lower extremity complications as compared to their non-diabetic counterparts.Objective: To study risk factors for diabetic foot ulcer disease and stratify patients with diabetes into risk categories for foot ulceration.Design: Cross-sectional descriptive study over five months period.Setting: Diabetic outpatient clinic, at the Kenyatta National Hospital.Subjects: Two hundred and eighteen ambulatory subjects with diabetes mellitus without active foot lesions.Results: The prevalence of previous foot ulceration was 16% while that of previous amputation was 8%. Neuropathy was present in 42% of the study subjects and was significantly associated with age, male gender, duration of diabetes, random blood sugar, systolic blood pressure and the presence of foot deformity. Peripheral arterial disease was present in 12% and showed significant association with male gender. Foot deformities were observed in 46% of study subjects and were significantly associated with age, male gender, and presence of neuropathy. Subsequently 57% were categorised into IWGDF group 0 - no neuropathy, 10% were placed in group 1- neuropathy alone, 16% were put in group 2 - neuropathy plus either peripheral arterial disease or foot deformity and 17% were placed in risk group 3 - previous foot ulceration/amputation.Conclusion: More than one third (33%) of diabetic patients were found to be at high risk for future foot ulceration (lWGDF groups 2 and 3). Published evidence exists that shows improved outcomes with interventions targeting individual patients with diabetes at high-risk of foot ulceration. Long term prospective studies to determine outcomes for the different risk categories should be carried out locally