Medicine
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Despite the anticipated growth in the global burden of obesity especially in low-income countries, limited data exist on the contribution of obesity to cardiometabolic diseases in Africa. We examined population-based samples of Kenyan adults who participated in the 2015 national chronic disease risk factor surveillance survey. Weight and height were measured, and body mass index (BMI) was calculated and used as a measure for general obesity. ⋯ Compared with adults of normal weight, individuals with a BMI of ≥30 kg/m2 had an odds ratio of 2.39 (95% confidence interval [CI], 1.82-3.12) for hypertension and 2.24 (95% CI, 1.70-2.96) for dyslipidemia. Obesity prevalence is high in Kenya and is associated with hypertension and dyslipidemia but not diabetes. Our findings indicate an urgent need to develop public health interventions to address obesity and prevent the development of comorbid conditions.
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Observational Study
Clinical significance of overweight in patients with hypertrophic cardiomyopathy: A retrospective cohort study.
Hypertrophic cardiomyopathy (HCM) is a common genetic heart disease with varying clinical outcomes and it is important to identify new predictors of adverse events and survival in HCM patients. Overweight may independently predict the clinical outcomes of HCM patients. This was a retrospective study. ⋯ Overweight was an independent determinant of MACCE in HCM patients (heart rate = 3.40, 95% confidence interval: 1.79-6.61, P < .001), mainly attributed to HF rehospitalization (heart rate = 3.44, 95% confidence interval: 1.64-6.72, P < .001). However, a prognostic effect of overweight on overall survival was not observed by Kaplan-Meier analysis (P = .23). These results provide the evidence that overweight could predict the presence of MACCE, especially HF rehospitalization, in HCM patients.
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Case Reports
Novel WTX nonsense mutation in a family diagnosed with osteopathia striata with cranial sclerosis: Case report.
Rationale: Osteopathia striata with cranial sclerosis is characterized by linear striations in the metaphysis of the long bones and pelvis with cranial sclerosis. It is an X-linked dominant sclerosing bone dysplasia and affected males show fetal or neonatal lethality. Mutations in the gene encoding Wilms tumor on the X chromosome (WTX) was identified as the cause of X-linked osteopathia striata with cranial sclerosis. About 30 pathogenic mutations in WTX have been reported recently. We have identified a novel nonsense mutation in the family diagnosed as osteopathia striata with cranial sclerosis. ⋯ We found a novel nonsense mutation in a family diagnosed as osteopathia striata with cranial sclerosis. The relationship between various clinical features and genetic mutations can be clarified by accumulation of genetic database.
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An estimated 1.5 million Kenyans are HIV-seropositive, with 1.1 million on antiretroviral therapy (ART), with the majority of them unaware of their drug resistance status. In this study, we assessed the prevalence of drug resistance to nucleoside reverse transcriptase inhibitors (NRTIs), nucleoside reverse transcriptase inhibitors (NNRTIs), and protease inhibitors, and the variables associated with drug resistance in patients failing treatment in Nairobi, Kenya. This cross-sectional study utilized 128 HIV-positive plasma samples obtained from patients enrolled for routine viral monitoring in Nairobi clinics between 2015 and 2017. ⋯ HIV-1 subtype, age, or ART-regimen were not associated with resistance mutation counts. Drug resistance mutations were found in alarmingly high numbers, and they were associated with viral load and treatment time. This finding emphasizes the importance of targeted resistance monitoring as a tool for addressing the problem.
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Reconstruction of complex craniofacial defects in fronto-orbital region has been reported to be extremely few. In this study, we report 2 cases with fronto-orbital defects of different etiologies in one-stage surgical reconstruction with polyetheretherketone (PEEK) prosthesis using computer-assisted design and computer-assisted manufactured (CAD-CAM) techniques. ⋯ The CAD-CAM PEEK implants could be a preferred option for reconstruction of patients with various complex fronto-orbital defects.