Utility of Prostate Specific Antigen (PSA) in the Indigenous African Man

Objectives: To examine the great possibility that the indigenous black African man with prostate diseases requires a different diagnostic approach and strategies beyond the standard PSA reference levels generated in non-African study subjects.Design: A hospital based cross-sectional descriptive study.Setting: The Urology Outpatient Clinic and Surgical Ward of Moi Teaching and Referral Hospital, Eldoret, Kenya between 1st April 2012 to 31st March 2013.Subjects: Two hundred and nineteen patients aged 50 years and above with prostate diseases.Main Outcome Measures: The main outcome measure was the PSA levels in patients diagnosed with Acute Prostatitis, Benign Prostate Hyperplasia (BPH) and Prostate Cancer in MTRH. The secondary outcome measures were the correlates associated with elevated PSA.Results: Patients ranged in age from 50 to 96 years with a mean ±  standard deviation of 65.4 ± 10.2 years. Clinical diagnosis of Acute  Prostatitis, BPH and Prostate Cancer was made in 1.8, 63.9 and 34.3% of the study subjects respectively. Sixty-two patients (28.3%) had PSA in the laboratory reference range of 0-4ng/ml considered normal with an average of 1.8 ng/ml. The overall mean was 31.2 ng/ml and those with elevatedPSA levels had a mean of 42.3 ng/ml. There was a positive correlate between prostate enlargement, urine retention, dysuria and family history of prostate disease and elevated PSA (all with p<0.001).Conclusions: The indigenous black African man has high levels of PSA even in benign prostate diseases. This together with histological findings of malignancy in some clinically diagnosed BPH with normal range PSA levels make the use of PSA in this group a bigger challenge. Studies should be conducted to not only elucidate the best use of PSA in the indigenous black African man but also his place in the new biomarkers to supplement or replace PSA in diagnosis and care

Clinical Characteristics of African Men with Prostate Diseases in a Tertiary Centre in Western Kenya

No Abstract

Possible Biochemical Markers in Protein-Energy Malnutrition and Malaria in Children in Western Kenya

This study was carried out to determine possible biochemical markers in children suffering from Plasmodium falciparum malaria and Protein-Energy Malnutrition in a Hospital setting in Western Kenya. Spectrophotometric assays of selected biochemical parameters namely, albumin, total proteins, glucose, glutamate oxaloacetate transaminase, glutamate pyruvate transaminase and bilirubin, were determined. The assays were done on serum samples obtained from children < 5 years of age admitted to the paediatric ward as well as outpatient clinics at Webuye District Hospital and Moi Teaching and Referral Hospital in Western Kenya suffering from either or both of the two disease conditions. Plasma albumin levels showed 33% of the children to be below the normal range and 40% above normal; mean total protein concentration was 56.0 mg/l; mean glucose concentration was 65 mmol/l, glutamate oxaloacetate transaminase and glutamate pyruvate transaminase concentrations were 9.0 and 5.9 μl/l respectively. Total bilirubin was 0.3 mg/dl while mean concentration for creatinine was 0.75 mg/dl. The biochemical markers studied did not show any unusual values at the time of the assays, but serum glucose and albumin levels showed potential as diagnostic markers for the two disease conditions.Keywords: Biochemical markers, spectrophotometry, protein-energy malnutrition, Western KenyaEast and Central African Journal of Pharmaceutical Sciences Vol. 15 (2012) 18-2

Occurrence of Aspergillus species and aflatoxin contamination in raw and roasted peanuts from formal and informal markets in Eldoret and Kericho towns, Kenya

Published Online: August 2013.The population and diversity of fungal species and levels of aflatoxin contamination were investigated in 228 marketed peanut samples; 140 from formal and 88 from informal markets, in Kericho and Eldoret towns of Kenya. Ground pea- nut samples were cultured on Modified Dichloran Rose Bengal (MDRB) agar while aflatoxin level was quantified based on indirect competitive ELISA. Correlation between the incidence of major aflatoxin-producing fungal species and aflatoxin levels was also established. Fungal species commonly isolated from the peanut samples included Asper-gillus flavus L strain, A. flavus S strain, A. parasiticus, A. tamarii, A. caelatus, A. alliaceus (all of Aspergillus section Flavi) and A. niger. Fungi isolated in low frequency included Fusarium spp., Penicillium spp., Mucor spp. and Rhi- zopus spp. Aflatoxin levels in peanut products ranged from 0 to 2345 μg/kg in raw peanuts, 0 to 382 μg/kg in roasted coated peanuts, and 0 to 201 μg/kg in roasted de-coated peanuts. Overall, levels of total aflatoxin were higher in sam- ples from informal (mean = 97.1 μg/kg) than formal (mean = 55.5 μg/kg) market outlets. There was a positive and sig- nificant correlation (R2 = 0.63; p ≤ 0.05) between aflatoxin levels and the major aflatoxin producing fungi in raw pea- nuts from formal markets in Eldoret town. Additionally, total aflatoxin in raw peanut samples from informal markets in Kericho was positively and significantly correlated (R2 = 0.81; p ≤ 0.05) to the population of A. flavus (L and S strains). In roasted coated peanuts sampled from formal market outlets in Eldoret, aflatoxin levels correlated positively and sig- nificantly (R2 = 0.37; p ≤ 0.05) with A. flavus S strain. There is need to create awareness among peanut traders and con- sumers on proper handling of peanuts and health risks associated with consumption of unsafe peanut products

Occurrence of Aspergillus Species and Aflatoxin Contamination in Raw and Roasted Peanuts from Formal and Informal Markets in Eldoret and Kericho Towns, Kenya

The population and diversity of fungal species and levels of aflatoxin contamination were investigated in 228 marketed peanut samples; 140 from formal and 88 from informal markets, in Kericho and Eldoret towns of Kenya. Ground peanut samples were cultured on Modified Dichloran Rose Bengal (MDRB) agar while aflatoxin level was quantified based on indirect competitive ELISA. Correlation between the incidence of major aflatoxin-producing fungal species and aflatoxin levels was also established. Fungal species commonly isolated from the peanut samples included Aspergillus flavus L strain, A. flavus S strain, A. parasiticus, A. tamarii, A. caelatus, A. alliaceus (all of Aspergillus section Flavi) and A. niger. Fungi isolated in low frequency included Fusarium spp., Penicillium spp., Mucor spp. and Rhizopus spp. Aflatoxin levels in peanut products ranged from 0 to 2345 μg/kg in raw peanuts, 0 to 382 μg/kg in roasted coated peanuts, and 0 to 201 μg/kg in roasted de-coated peanuts. Overall, levels of total aflatoxin were higher in samples from informal (mean = 97.1 μg/kg) than formal (mean = 55.5 μg/kg) market outlets. There was a positive and significant correlation (R2 = 0.63; p ≤ 0.05) between aflatoxin levels and the major aflatoxin producing fungi in raw peanuts from formal markets in Eldoret town. Additionally, total aflatoxin in raw peanut samples from informal markets in Kericho was positively and significantly correlated (R2 = 0.81; p ≤ 0.05) to the population of A. flavus (L and S strains). In roasted coated peanuts sampled from formal market outlets in Eldoret, aflatoxin levels correlated positively and significantly (R2 = 0.37; p ≤ 0.05) with A. flavus S strain. There is need to create awareness among peanut traders and consumers on proper handling of peanuts and health risks associated with consumption of unsafe peanut products

Lessons learned from colorectal model of tumourigenesis

(East African Medical Journal: 2001 78(7) Supplement: 48-49

LESSONS LEARNED FROM COLORECTAL MODEL OF TUMOURIGENESIS

Genetic analytical techniques were carried out to identily mutations in adenomatouspolyposis coli (APC) gene and K-ras oncogene in colorectal tu mourigenesis. These two genesaresaid to be early mutation genes among other mutation genes that constitute the model forcolorectal tumourigenesis. To do this analysis, DNA was isolated from colorectal formalinfixed paraffin-embedded tumour tissue sections. The sections were deparaff~nised, digestedin proteinase-K, followed by DNA isolation. The DNA was a mplified by Polymerase ChainReaction (PCR), screened by using Denaturing Gradient C el Electrophoresis (DGGE) orSingle Strand Conformation Polymorphism (SSCP) and the] I sequenced. These results lendsupport to the fact that colorectal cancer and indeed cancel, in general develops through amulti-step process; also that accumulation of genetic mutatic Ins underlie the development ofneoplasia. We are in the process of extending this study to :ancer of oesophagus to see if asimilar or parallel model of carcinogenesis holds and in what sequence it is

Protein-Energy Malnutrition And Malaria Antibody Profiles In Pre-School Children In Western Kenya: A Potential Diagnostic Tool

Protein-energy malnutrition is a serious clinical condition with high prevalence in areas where Plasmodium falciparum is highly endemic such as western Kenya. There is a major need to determine the relationship between PEM and malaria antibody profiles especially in an area where malaria is endemic. The objective of this work, therefore, was to determine the association between PEM and specific malaria antibodies and the potential diagnostic value of the antibodies in children aged between 5 and 59 months. Cross- sectional surveys as well as analysis of sera for specific malaria antibodies were carried out at Asembo Division, Bondo District, Kisumu County, Nyanza Province. A total of sixty villages identified through random sampling with each household as the sampling unit were used for data collection. Two thousand, one hundred and twelve (2112) Children < 5 years of age were sampled in three successive cross- sectional surveys: The first survey included children < 3 years of age while the subsequent two surveys included children < 5 years of age. Anthropometric measurements were carried out followed by finger prick blood sample for assay of antibodies in sera of the study children. Statistical variables (Odds Ratio, at 95% CI) were determined using SPSS 11 and SAS computer packages. Both Multivariate and Bivariate analyses were carried out. Epi-info 2002 package was used to determine anthropometric variables. Demographic variables and malaria parasite counts were determined for all the children sampled. Circumsporozoite Surface Protein (CSP) IgG antibody was found to be significantly associated with stunting and underweight (p<0.05) but not with wasting. Liver Stage Antigen (LSA) IgG antibody was significantly associated with wasting only (p<0.05) while Merozoite Surface Protein (MSP) IgG antibody was not significantly associated with any malnutrition state. The mean concentration of CSP IgG was elevated in stunted, wasted and underweight in comparison to controls. Liverstage antigen 1 IgG was elevated in stunted children only as compared to controls, whereas MSP IgG was low in all PEM cases as compared to controls. Specific Plasmodium falciparum antibody profiles could accurately be used to determine the association between malaria and Protein-Energy Malnutrition