Kenya Association of Physicians Scientific Conference

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    Chemotherapy-Related Tumour Lysis Syndrome
    (Association of Kenya Physicians, 2007) Busakhala, N. W.; Association of Kenya Physicians Scientific Conference (11th : Mar. 2007 : Eldoret, Kenya)
    Two types of tumour lysis syndrome (TLS) ; 1. Laboratory TLS: 25% increase in potassium, phosphate and uric acid, or decline in calcium from baseline. Occur within 4 days of initiating chemotherapy. Patients on standard of care. Minimum of two out of four criteria. 2. Clinical tumour lysis syndrome: Laboratory TLS plus renal failure, cardiac arrhythmias or sudden death. A new definition has been suggested by Cairo and Bishop to include values above upper limit of normal. Study used Hande and Garrow definition.
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    The ACT Malaria Treatment Policy Change in Kenya
    (Association of Kenya Physicians, 2007) Akhwale, Willis S.; Association of Kenya Physicians Scientific Conference (11th : Mar. 2007 : Eldoret, Kenya)
    Objectives of the national Antimalarial treatment policy: •Enable population at risk access safe, good quality, effective, affordable & acceptable antimalarial drugs •Ensure rapid and long lasting clinical cure •Prevent progression to severe disease •Reduce the incidence of anaemia •Reduce consequences of placental malaria infection •Delay development of resistance to antimalarial drugs Key specific issues: •Limited data available on safety of ACTs in young infants (use of coartem <5kgs) •Lack of adequate safety and efficacy data on drug combinations in pregnant women (safety of lumefantrine in pregnancy) •Improving systems of forecasting of drug needs •Strengthening the management and drug supply system (procurement, distribution and use) according to the specificities of the new drugs (shorter shelf life and the course-of-therapy packs) •Complex treatment schedules poses challenge for ensuring compliance •Need for more friendly paediatric formulations
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    Slowing Disease Progression in Type 2 Diabetes: Latest Advances
    (Association of Kenya Physicians, 2007) Otieno, C. F.; Association of Kenya Physicians Scientific Conference (11th : Mar. 2007 : Eldoret, Kenya)
    Background: Largest head-to-head, double-blind study of metformin, glyburide and rosiglitazone (N = 4,360). Primary objective: To compare the durability of glycemic control using rosiglitazone versus metformin or glyburide as initial monotherapy in patients with recently diagnosed type 2 diabetes. Design: Double-blind, randomized, controlled trial. Inclusion criteria: Type 2 diabetes ≤ 3 years, drug-naive, male and female, aged 30–75 years, FPG 126–180 mg/dl (7–10 mmol/l). Exclusion criteria: Previous use of glucose-lowering therapy, women of child-bearing potential, significant hepatic disease, renal impairment, unstable or severe angina, known CHF (NYHA Class I–IV), uncontrolled hypertension. Treatment duration: Treatment period: 4 to 6 years. Median duration of treatment: 4 years (rosiglitazone and metformin); 3.3 years (glyburide). Interventions: Rosiglitazone, metformin, glyburide.
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    Renal Transplant at MTRH
    (Association of Kenya Physicians, 2007) Owiti, M. O. G.; Association of Kenya Physicians Scientific Conference (11th : Mar. 2007 : Eldoret, Kenya)
    J.A. 48 yrs male - Diabetic since July 1997, on insulin. Crf & high Bp-2004.urea=57.3, crt=1040. Lt kid-7.27x3.62, rt kid8.51x3.34cm, loss of cmd. Haemodialysis x2 wkly till last two wksx3. While on treatment Bp=150/100, pulse78/min. on Adalat 20mg b.d,lasix 80mg od, captopril 25mg b.d,ca-sandoz i.o.d, recormon 2000i.u x2wkly, venofer 100 wkly, ranitidine150 mgo.d. N.C. 17 yrs female - Facial puff, head ache,oliguria, epigastric and bil loin Painsx3/52. 03.08.2004. Post herbal use. Abortion –pph, 07.06.04, post abortal psychosis. Bp220/110mmhg, hb=7.6g/dl, Op=600mls, ip=1.5l.
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    Chemotherapy for HIV associated Kaposi's sarcoma
    (Association of Kenya Physicians, 2007) Busakhala, N.; Association of Kenya Physicians Scientific Conference (11th : Mar. 2007 : Eldoret, Kenya)
    HIV associated Kaposi’s sarcoma is a malignant, multifocal systemic disease that originates from the vascular endothelium. In contrast to the classical KS found in older men, in whom the tumors usually occur on the lower legs and feet, HIV-associated KS does not have a preferential pattern of localization.
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    DD of Arthritis
    (Association of Kenya Physicians, 2007) Association of Kenya Physicians Scientific Conference (11th : Mar. 2007 : Eldoret, Kenya)
    Patient with Musculo-skeletal Complaints -Summary 1.Soft Tissue Rheumatism or Arthritis 2.Arthritis –Monoarticular-Crystals, Gout-Infective –acute –G+ve –ve-Chronic –Koch'sPolyarticular-:-(Asymmetrical)SSA -Reiter's, Reactive AS Psoriasis(Symetrical):-RA, SLE, DM. PM, Scleroderma APS, Vasculitis 3.Extraarticular features… 4.Laboratory, Imaging workup : DIAGNOSIS
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    Combination of OHA Therapy in Type 2 Diabetes Mellitus
    (Association of Kenya Physicians, 2007) Shah, Siddharth; Association of Kenya Physicians Scientific Conference (11th : Mar. 2007 : Eldoret, Kenya)
    O.H.A. are the most common form of treatment of Type2 D.M. worldwide. When used judiciously they are important agents in the management of the most common form of diabetes. For economic, logistic and general effectiveness, oral agents are a dependable means of treating a large population of diabetics worldwide when used correctly.
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    Disparities of Health Care: Challenge to Physicians
    (Association of Kenya Physicians, 2007) Nyikal, James; Association of Kenya Physicians Scientific Conference (11th : Mar. 2007 : Eldoret, Kenya)
    Challenges to the health sector: Finance and financial flows. Rapid growth of infrastructure. Human resource. Emerging diseases. Coordination. Legal framework. Poverty. Challenges to the physician: Health reforms. Leadership role and head of team. Role model. Cost of care and poverty. Ethics in compromised social environment. CPD. Curative care/disease prevention and health promotion. Perpetual dilemma.
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    Disparities in Health Care: Challenges to Physicians
    (Association of Kenya Physicians, 2007) Okelo, G. B. A.; Otieno, L. S.; Association of Kenya Physicians Scientific Conference (11th : Mar. 2007 : Eldoret, Kenya)
    Many developing countries, including Kenya, face many challenges in health care some of which are outlined below: 1.1Relatively High fertility Rates 1.2 High mortality from preventable diseases 1.3Changing life style such as increasing tobacco consumption and increase in non-communicable diseases 1.4New and re-emerging diseases especially viral diseases 1.5Declining life expectancy 1.6Inadequate and poorly focused and/or targeted goals in disease control 1.7Civil unrest with its implications for health services 1.8Huge burdens of infectious diseases such as HIV/AIDS and tuberculosis 1.9Increasing burdens of non-communicable diseases such as Heart diseases, Cancer [such as prostate cancer, metabolic disorders like diabetes 10.0Slow pace in embracing new technology 11.0A steady rise in the socially disadvantaged groups i.e. women, children and the disabled populations whose access to reasonable health care is very limited. 12.0 Low immunization cover rate.
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    Management of Arthritis
    (Association of Kenya Physicians, 2007) Association of Kenya Physicians Scientific Conference (11th : Mar. 2007 : Eldoret, Kenya)