Black Kenyans Research Articles

The Unusual High Origin Radial Artery in a Black Kenyan Population: A Cadaveric Study.

The anatomy of the radial artery draws great interests among anatomists for its frequent involvement in variations. Equally, these variations have gained significant attention from clinicians because of the preference to use the radial artery for catheterization. The commonest of radial artery variations involve its site of origin. In published literature, data on this variations exist, but the prevalence of such variations in a Kenyan population has hitherto been unknown. Sixty-two upper limbs from 50 formalin-fixed cadavers were studied during dissection in the Department of Human Anatomy, University of Nairobi. Fifty-four (87.1%) radial arteries arose within the cubital fossa, while eight (12.9%) had a high origin. Out of the eight high arteries, two (3.2%) branched off from the axillary artery, another two (3.2%) were branches of the proximal third of the brachial artery and four (6.5%) arose from the middle third of the brachial artery. The high origin radial arteries were more common on the right upper limbs (5 out of the 8 cases). Both axillary and brachial origins were seen bilaterally. The present study details important variations in the anatomy of the radial artery in a Kenyan population. With the radial artery being utilized during clinical, surgical and radiological interventions so frequently, an increased understanding and anticipation of such topographic variances is paramount.

The Journey of the Lingual Artery from the Neck to the Oral Cavity: A Cadaveric Study.

Descriptive cross-sectional. The origin of the lingual artery (LA) has been well studied due to its implication in neck dissection, but the course thereafter to the oral cavity is less described. This cadaveric study traced the journey of the LA from the external carotid artery to its terminal branches in the tongue. Following bilateral neck dissections in 35 black Kenyan cadavers, the incidence of Beclard's, Lesser's and Pirogoff's triangles, the types of LA origin with its length, relationship to the hyoglossus muscle and anastomosis with other vessels were documented. Beclard's triangle was found in 64 dissections (91.42%), Lesser's in 46 dissections (65.71%) and Pirogoff's in 39 dissections (55.71%). The LA presented either as a solitary branch (67.15%) or as a branch of either the linguofacial (LFT-24.29%), thyrolingual (TLT-2.72%) or thyrolinguofacial (TLFT-2.86%) trunk. The solitary LA was the longest at 6.93 mm, followed by the TLT branch (6.58 mm), LFT branch (6.12 mm) and TLFT branch (5.65 mm). The majority of solitary LA and LA branches of LFT and TLFT passed through the hyoglossus, while all LA branches of the TLT coursed medial to the muscle. All variants of LA have been found to anastomose with the submental artery (SMA) at frequencies that ranged from 11.10% to 100%. The LA was found in all cadavers and all Beclards' triangles. There is a significant incidence of LFT and TLFT variants in the Kenyan population. The LA passed either through or medial to the hyoglossus with no lateral relationship being observed.

Beta cell function, insulin resistance and vitamin D status among type 2 diabetes patients in Western Kenya

Serum vitamin D status exerts effects on glucose-insulin-homeostatic states underlying Diabetes-Mellitus, Type 2 (T2DM). This has been described in white and Asian population where low Vitamin D levels predicted future impairments in beta cell function and worsening of insulin resistance. This study aimed to examine the relationship between serum vitamin D, insulin resistance and beta cell function in a sub population of black Kenyan T2DM patients. The primary objective was to determine the levels of serum 25 hydroxy (25-OH) vitamin D, and estimate the insulin resistance, and beta cell function among T2DM patients at Moi Teaching and Referral Hospital (MTRH). This was a cross sectional study. 124 T2DM patients attending the MTRH Diabetes clinic between February and May 2016 were enrolled. Patients on insulin therapy and/or thiazolidinediones were excluded. Anthropometric, clinical and demographic data was obtained. Samples were drawn for estimation of serum 25-OH vitamin D, fasting insulin levels and fasting blood glucose levels. HOMA (Homeostatic model of assessment) model was used to estimate Beta cell secretion (HOMA-B) and insulin resistance (HOMA-IR); while the Disposition index {(DI) hyperbola product of insulin sensitivity (1/HOMA-IR) and beta cell secretion} was used to estimate the beta cell function. The relationships between serum vitamin D, insulin resistance and beta cell function were explored using a linear regression model. The study participants had a mean age of 56.2 (± 9.2) years, and a mean BMI of 26.9 kg/m2 (4.3). Forty nine percent (n = 61) were males. Vitamin D deficiency was present in 71.1% (n = 88) of the respondents. Relatively low levels of insulin resistance and higher levels of beta cell dysfunction were observed {median HOMA-IR of 2.3 (0.7, 6.5) and Disposition Index (DI) of 25.5 (14.3, 47.2)}. Vitamin D levels exhibited a low positive correlation with DI [r = 0.22 (95% CI: 0.03, 0.37)], but was not significantly correlated with HOMA-IR [r = 0.07(95% CI: − 0.11, 0.25)]. These results indicate that beta cell dysfunction rather than insulin resistance as the predominant defect among black T2DM patients seeking care at the MTRH diabetes clinic. Vitamin D deficiency is also prevalent among them and exhibits a low positive correlation with beta cell dysfunction. There was no correlation observed between Vitamin D deficiency and insulin resistance.

Variation in Levels of Flavonols Myricetin, Quercetin and Kaempferol—In Kenyan Tea (<i>Camellia sinensis L.</i>) with Processed Tea Types and Geographic Location

The aim of this study was to determine the levels of myricetin, quercetin, and kaempferol in green and black Kenyan types in relation to geographic location of production. Tea samples were extracted before chromatographic separations with a Shimadzu 20A HPLC coupled with PDA. Flavonol levels were quercetin > kaempferol > myricetin. Teas from east of rift, had quercetin 1.25-1.83 mg/g and 1.29-1.71 mg/g for green and black types, respectively. Kaempferol levels were between 1.28-1.72 mg/g in green and 1.36-1.76 mg/g in black tea. Myricetin ranged at 0.40-0.79 mg/g green and 0.12-0.38 mg/g black tea types. Total flavonols in green tea were highest at 4.28 mg/g while black tea was 3.83 mg/g. These trends agree well with those observed in teas west of the rift. For tea types, myricetin and kaempferol showed a significant difference (P ≤ 0.05) between green and black teas. Total flavonols showed no significant difference. Kenyan teas are a potential dietary source of flavonols myricetin, quercetin, and kaempferol as evidenced by the significant quantities recorded in this study.

Unusually low arcuate artery in a Kenyan cadaver

The arcuate artery is one of the two major branches of the dorsalis pedis artery that supply the dorsum of the foot including interdigital spaces. The artery’s origin varies but in almost all cases it branches in the proximal third of the dorsum of the foot. During routine dissection of the right foot in a black Kenyan, we encountered a case where the artery was located and branched in the distal third of the dorsum of the foot, at the level of the metatarsophalangeal joint. This is much more distal than previously reported in prevailing literature. This artery did not give off any dorsal metatarsal arteries but gave the digital arteries directly. The dorsalis pedis artery, lateral and medial tarsal arteries had normal course in this foot. Keywords: Translational research; Dorsalis pedis artery; Integration; Arcuate artery

Anatomy of the Middle Cerebral Artery and some related arteries on 256 MSCT

Abstracts: Introduction: studying the percentage of display and dimensions of the middle cerebral artery and some related arteries on on 256 MSCT data. Methods: A cross-sectional study, with sample size of 261. Results: The percentage of display of middle cerebral artery is 100%; the posterior artery is 76.4; Internal Carotid Artery is 100%. The average diameter, average length are (mm) M1T respectively: 3.25 ± 0.43 and 19.98 ± 6.10; M1 P: 3.26 ± 0.46 and 19.68 ± 6.28; M2T left 2.10 ± 0.48 and 22.85 ± 13.18; M2T right 2.09 ± 0.49 and 23.42 ± 11.89; M2D left 2.48 ± 0.49 and 31.73-16.36; M2D right 2.55 ± 0.49 and 29.11 ± 15.31. PCoA T 1.29 ± 0.63 and 11.87 ± 4.87; PCoA P 1.26 ± 0.66 and 14.02 ± 9.13; Conclusions: The size of the middle cerebral artery and some related arteries were accurately evaluated in the study, the image of vascular anatomy was display clearly.
 Keywords
 Middle cerebral artery, cerebral angiography, multi-slices computed tomography ...
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Anatomical Pattern of Dorsal Metatarsal Arteries in a Black Kenyan Population

Introduction Knowledge of anatomical variations in the origin and in the course of the dorsal metatarsal arteries (DMTAs) is valuable for many procedures, including reconstructive surgeries and flap selection. However, there is a paucity of data on these arteries among black Africans. Materials and Methods The present study studied the origin and the location of DMTAs in 30 formalin-fixed cadaveric feet of adult black Kenyans at the Department of Human Anatomy of the University of Nairobi, Nairobi, Kenya. Results Dorsal metatarsal arteries were present in all of the cases. Of the right dorsalis pedis artery (DPA), in the majority of the cases, the 1st DMTA arose as the continuation of the DPA, while the 2nd to 4th DMTAs were given off as branches from the arcuate artery (AA). On the left feet, in the majority of the cases, the 1st DMTA arose as the continuation of the DPA, while the rest were given off as branches from the AA. In relation to the dorsal interossei muscles, all of the the arteries were either within the muscle fibers (53%) or beneath them (47%), on the right side. On the left side, the 1st DMTA was above the muscles in 40% of the cases; within the muscles in 53%; and beneath the muscles in 7%. The 2nd and 3rd DMTAs were above the muscles in 57% and in 53% of the cases, respectively. Conclusion These results reveal that the DMTAs show variation in their origin and position relative to the dorsal interossei muscles. These variations display bilateral asymmetry.

Geometric Features of Vertebrobasilar Arterial System in Adult Black Kenyans

Geometric Features of Vertebrobasilar Arterial System in Adult Black Kenyans

Unpacking the landscape of female sex tourism in Kenya: a film analysis of Paradise: Love

This article examines Paradise: Love (2012, Dir. Ulrich Seidl), a compelling filmic account of the problematics of race, ethnicity, gender, and nation that organize contemporary accounts of female sex tourism. The storyline and visual imagery of the film positions Kenya – and a Eurocentric, homogenized, and reductive (mis)understanding of parts of ‘Africa’ – as an imagined site of racial and sexual adventure for older white Western women seeking intimate relationships with a category of local black men, many of whom enter into these sexual relationships in order to supplement personal and family economic shortfalls. This economy of intimate exchange is positioned as a trade of these black Kenyan men’s desire for money, local status, and the potential to travel to the West, for white Western women’s desire for sexual fulfillment from young black men’s bodies and their assumed sexual prowess. Deconstructing the discourses of female sex tourism through Paradise: Love centres the visual and representational components of processes of racialization and sexualization, wherein beach boys and white Western women gaze upon and ‘Other’ each other through essentialist and fetishized understandings of racial and sexual difference. In focusing on the power dynamics of female sex tourism in particular, the film plays up the shock value of women sexually exploiting men, pushing viewers to question: who counts as a sex tourist? Ultimately, this article seeks to enrich and extend scholarship that troubles intersecting power structures that shape and inform transnational inter-racial intimacies within economies of eroticized exchange.

Joubert\u2019s syndrome and related disorders and home-based peritoneal dialysis in East Africa: a case report

BackgroundJoubert’s syndrome is a rare condition affecting an estimated 1:80,000–1:100,000 individuals. There is underdevelopment of the cerebellar vermis resulting in a characteristic molar tooth sign on cross sectional axial magnetic resonance imaging. It can occur in association with multi-organ involvement; in such cases it is classified as Joubert’s syndrome and related disorders. To date, there are no cases of Joubert’s syndrome and related disorders from sub-Saharan Africa described in the literature.Case presentationAn 8 year old black Kenyan female child was diagnosed in Joubert’s syndrome in her first year of life. She was noted to have dysmorphic facies and hypotonia in the neonatal period and cranial MRI showed dysplasia of the cerebellar vermis and typical molar tooth malformation. She was subsequently lost to follow up for several years and later presented with anaemia. Further investigation revealed bilateral multicystic kidneys and significant renal impairment consistent with a diagnosis of end stage renal failure and polycystic kidney disease. She underwent home peritoneal dialysis for 7 months.ConclusionsJoubert’s syndrome and related disorders is a rare condition. This case report demonstrates that home peritoneal dialysis is feasible in a low resource setting. Although it is scarcely provided in African countries, it is an effective renal replacement strategy for patients with end stage renal disease.

Prevalence and anatomical pattern of the median artery among adult black Kenyans

Knowledge of the anatomy of median arteries is important in the diagnosis and management of carpal tunnel and pronator teres syndromes, reconstructive surgery in the forearm, minimizing inadvertent vascular injury as well as in limiting operative complications due to unexpected bleeding. The anatomical pattern displays ethnic differences but there are few studies on black Africans. This study therefore sought to describe the anatomy of median arteries in an adult black Kenyan population. A total of sixty two (62) upper limbs from thirty one (31) formalin-fixed cadavers were studied at the Department of Human Anatomy, University of Nairobi, Kenya. The prevalence, origin, types, relationship with median nerves and termination were determined. Median arteries were observed in 37 (59.7%) cases. Of these, the palmar type comprised 12 (32.4%) and antebrachial type 25 (67.6%) cases. It occurred bilaterally in 14 (45.2%) cases. The most common origin was the common interosseous artery (21; 56.8%) followed by anterior interosseous (13; 35.1%) and ulnar 3 (8.1%) arteries. The artery pierced the median nerve in 7 (18.9%) cases. The palmar type terminated by uniting with the ulnar artery to form a median-ulnar type of superficial palmar arterial arch in 8 (21.6%) cases and directly gave rise to the first, second and third common digital arteries in 4 (10.8%). In conclusion, the median artery occurs in nearly 60% of the population, much higher than in prevailing literature reports. Prevalence of the palmar type of median arteries and that of median arteries piercing median nerves are also higher than in other populations. Accordingly, presence of median artery and consequently other vascular and median nerve variations should be considered in the differential diagnosis of forearm entrapment neuropathies and due caution taken during forearm surgical procedures. We recommend preoperative ultrasound evaluation of the forearm and hand vascular system.Keywords: Median artery, origin, prevalence, median nerve, Kenyan

Histomorphological features of atherosclerosis in the left anterior descending coronary arteries among black Kenyans

The pattern of coronary artery atherosclerosis is valuable in informing mitigation strategies for coronary heart disease. Histomorphological data on this disease among Africans living in Sub Saharan Africa are, however, scarce. The left anterior descending is one of the most commonly afflicted arteries. This study, therefore, examined the left anterior descending artery of 213 black Kenyans [Mean age 36.8 years, range 5 – 82 years] who had died of non cardiovascular causes for features of atherosclerosis. The individuals were divided into male and female, then into 10-yr age groups. Specimens were obtained from the proximal segment of the artery during autopsy at the Department of Human Anatomy University of Nairobi, Kenya. They were processed routinely for paraffin embedding andsectioning. Five micron sections were stained with Haematoxylin/Eosin and Mason’s trichrome and examined with light microscope. Micrographs of representative features were taken using a high resolution digital camera. At least one feature of atherosclerosis was present in 54 (25.4%) of the individuals. The features observed included severe intimal hyperplasia (34; 63%), disintegration of the internal elastic lamina [30; 55.6%]; atherosclerotic plaque (20; 37%), adventitial thicknening (14; 26%) and mural neovascularization (10; 18.5%). The mean age of those with features of atherosclerosis was 38.4 years, range 6 – 62 years with 25 (46.3%) being aged 40 years and below. Of these, the male: female ratio was 1.7:1. In conclusion, features of atherosclerosis are present in over 25% of the population studied. The disease affects young people, including women. Proactive preventive measures including follow – up should commence early, and involve both men and womenKeywords: Atherosclerosis, coronary, young, men, women, Kenya

Features of atherosclerosis of common carotid arteries among black Kenyans

Abstract Introduction: Data on the features of atherosclerosis of common carotid artery are important for informing strategies against ischaemic stroke in Subsaharan Africa, but are scarce. Materials and Methods: This study therefore investigated, by light microscopy, the presence of features of atherosclerosis in the left common carotid artery among 108 black Kenyans [76 males; 32 females; Mean age 36.4, range 22-82 years] who suffered violent death. Specimens from the distal segment of the artery were prepared for routine paraffin embedding, and 5μ sections stained with Mason's Trichome. Results: At least one feature of atherosclerosis was observed in 22 (20.4%) cases. Intimal hyperplasia alone was present in all the 22 cases followed by Intimal hyperplasia and degeneration ofinternal elastic lamina 19 (17.6%); Intimal hyperplasia combined with disintegration ofinternal elastic lamina and medial degeneration 17 (15.7%). Thickening of tunica adventitia with neovascularization were present in 8 (7.4%) of cases. All the features were more frequent in males than females (1.4:1) and those over 40 years old. Eight of the cases (36.4%) were in individuals aged below 40 years. Conclusion: Multiple features of atherosclerosis in common carotid artery are present in over 20% of the asymptomatic black Kenyans studied. They occur more frequently in males, and affect individuals younger than 40 years. These features appear in all three layers of the vessel wall, suggesting that the disease has attained several stages of severity in this population. We recommend early screening for the disease in individuals at risk.

Sex differences in diameter of the coronary sinus ostium: Correlation with weight of the heart

Diameter of the coronary sinus ostium is important in the designing of cannulation devices used in cardiac resynchronization therapy and percutaneous mitral valve annuloplasty. Population variation of the diameter may account for the failure rate of these procedures. Studies of the coronary sinus ostium from African populations are scarce and altogether absent for Kenya. Therefore, this study aimed at determining sex differences in the diameter of coronary sinus ostium and its correlation with the weight of the heart. Seventy-four hearts of adult black Kenyans [43 male, 31 females; age range 20 – 70 years] obtained during autopsy at the Department of Human Anatomy, University of Nairobi, Kenya were weighed. The coronary sinus ostium was identified and its transverse and supero-inferior diameters measured in millimeters. The measurements were analyzed using SPSS version 17. Sex comparison was established using student’s t test. Association between diameter and heart weight was established using Pearson’s correlation test and considered significant at a p-value of ≤0.05. Data were presented using scatter plots. Transverse and supero-inferior diameters of the ostium were 11.04±1.88mm and 9.50±1.80mm respectively. The mean diameter was 10.27 mm. These correlated positively with weight of the heart. When corrected for weight of the hearts, the transverse and supero-inferior diameters were larger in females (0.042 and 0.036 respectively) than in males (0.034 and 0.03 respectively). The diameter of coronary sinus ostium is larger in females and shows positive correlation with weight of the heart. These data should be considered during design and use of cardiac devices introduced through the coronary sinus.Key words: Coronary sinus, ostium, diameter, sex difference.

Chemical and microbiological studies on Kenyan and Gabali Egyptian tea

The present study was designed to compare the quality of Gabali Egyptian tea and Kenyan tea locally cultivated in Egypt. Gabali, black and green Kenyan teas were laboratory processed, then analyzed chemically and microbiologically for their quality evaluation. Representative results show that all samples of the 3 types were contaminated with aerobic mesophilic plate counts of the tea types varied from 6.1x103 to 2.2x108 cfu/g, spore-forming bacteria 1.1x102 to 1.6x104 cfu/g, coliforms (MPN) 0.36- 1.5 x101 cell/g, molds 2.3x102 to 3.0x104 and yeasts 1.2x102 to 5.8x103 cfu/g, in which gabali tea was the highest and black Kenyan tea was the lowest microbial count. Pathogenic bacteria were not in detectable level. The black Kenyan tea had the highest antibacterial activity followed by the green Kenyan tea with all solvents, but extraction of Gabali tea had antibacterial activity only by distilled water and water reflux. Total aflatoxin in concentration range of 6.1, 9.8 and >50 μg/kg in black and green Kenyan tea and Gabali tea, respectively. Phytochemical analysis of the tea samples revealed the presence of tannin in high level in black Kenyan tea (14.33%). Considering the results obtained, only black and green Kenyan tea had acceptable levels for all microbial factors in comparison with the Egyptian standards. It was concluded that Gabali tea may be high risk product and therefore, more studies are necessary to find methods of decontamination.

Reflections on land policy and the independence settlement in Kenya

ABSTRACTThis essay reflects on a personal participation in policy-making in relation to Kenya, almost 50 years ago. The policies that the British colonial authorities pursued in respect of the transfer of land to black Kenyans were crucial in the design of the decolonisation framework which managed the transition from colonial to self-rule. The outcome of the land policy was the creation of a black middle class of prosperous farmers, the preservation of the position of white farming, a transition to capitalism and the creation of a black capitalist class eagerly embraced by Kenyatta and his successors, but not solving the problems of land hunger and accompanying rural poverty which continue today.

Length of coronary sinus in a black Kenyan population: Correlation with heart length

Length of coronary sinus is important in the design of cannulation devices used in cardiac resynchronization therapy and percutaneous mitral valve annuloplasty. It displays gender and population variations that may account for the failure rate of these procedures. Cardiac conditions requiring these procedures are common in black African populations. Studies of the coronary sinus from African populations, however, are scarce and altogether absent for Kenya. The aim of the current study was to determine the length of coronary sinus among black Kenyans. Coronary sinuses of seventy-four hearts (43 males and 31 females) of adult age range (20-70years) black Kenyans obtained during autopsy were studied at the Department of Human Anatomy, University of Nairobi, Kenya. Heart samples were classified into male and female and weighed. Lengths of the heart, left atrio-ventricular groove and coronary sinus were measured in millimeters. The mean coronary sinus length was 39.55±5.32 mm while that of heart was 139.73±13.86 mm. The length of left atrio-ventricular groove length was 66.12±9.97 mm. The sinus occupied 60% of the groove and correlated positively with the length of the groove. The coronary sinus of the study population is shorter than those reported for Caucasian populations. The length correlated with that of the atrioventricular groove and the heart. Key words : Length, Coronary sinus, heart, black African.

Intima – Media Thickness of Left Anterior Descending Coronary Artery in a Black Kenyan Population: Correlation with Morphological Features

Background: Intima-Media thickness is an acknowledged surrogate marker for predicting and profiling of atherosclerotic cardiovascular disease. It displays geographical and ethnic variation but is seldom reported among black populations of Africa. The left anterior descending coronary artery is one of the most frequently afflicted arteries by atherosclerosis. This study, therefore, aimed at correlating its intima – media thickness with morphological features of left coronary artery in a black Kenyan population. Materials and methods: Materials for this study were 126 hearts obtained during autopsy at the Department of Human Anatomy, University of Nairobi Kenya from black adult Kenyans [72 males, 54 females] who died of noncardiovascular causes. The left coronary artery was identified, its termination pattern recorded and its length and bifurcation angle measured. Specartery and procesimens for light microscopy were taken from the proximal segment of the left anterior descending sed for paraffin embedding and sectioning. Five micron sections were stained with Masson’s trichrome and examined at magnification x35. The results were analyzed using SPSS version 17.0. Student t-test was performed at 95% confidence interval where p ≤ 0.05 was taken to be statistically significant. They are presented in micrographs and tables. Results: The mean intima – media thickness was 0.332 mm. It was higher in males (0.357 ± 0.06 mm) than in females (0.25 ± 0.03 mm), increased with number of branches of left coronary artery, from 0.336 ± 0.014 mm in bifurcation to 0.506 ± 0.01 mm in pentafurcation; and was also higher in left coronary arteries that were shorter than 5 mm and those with bifurcation angles >800. Conclusion: The intima – media thickness of left anterior descending artery is influenced by length, bifurcation angle and terminal branching pattern of left coronary artery, and is higher in males than in females. This suggests that these morphological features of left coronary artery constitute anatomical risk factors for atherosclerosis. Individuals with these features should be screened for atherosclerosis, to inform early intervention.

Ischemic Cortical Stroke in a Kenyan Referral Hospital

Background: The pattern of stroke displays ethnic and geographical variations. In Sub-Saharan Africa there is scarcity of data from Eastern and Central Africa. Objective: To describe the characteristics of patients with ischemic cortical stroke in a Kenyan referral hospital. Study design and set up: Retrospective study at Kenyatta National Hospital, Nairobi Kenya. Patients and methods: Records of adult black Kenyan patients seen with ischemic cortical stroke at Kenyatta National Hospital, Nairobi, Kenya between January 2007 and December 2011 were examined for age, sex, site, comorbidities and outcome. Only files with complete data were included. Data were analyzed by SPSS version 17.0 for Windows and presented in tables and bar charts. Results: Three hundred and seven cases of ischemic cortical stroke were analyzed. Mean age was 54.7 years, with 20.6% of cases occurring below 40 years. The male: female ratio was 1:1.2 with female predominance in all age groups. Brain regions most commonly affected were fronto-parietal (32.8%) and parietal (31.6%), while 11.6% involved extensive regions of the cerebral cortex. Predominant single comorbidities were hypertension (64.1%), smoking (19.2%), alcohol (13.4%), HIV infection (6.8%) and bacterial infections (6.8%). Multiple risk factors were implicated in 42.4% cases. Two hundred (65.1%) suffered paralysis; 70 (22.8%) clinically recovered and 37 (12.1%) died within 90 days. Conclusion: Ischemic cortical stroke occurs in young individuals in over 20% of the study population and is female predominant. Hypertension, cigarette smoking and infections including HIV are the leading comorbidities, and it causes high morbidity. Control measures comprising regulation of blood pressure, reduction of smoking and prudent management of infections should be instituted from early in life.

Vertebral Artery Hypoplasia in a Black Kenyan Population.

This study examined the characteristics of vertebral artery hypoplasia in 346 arteries of adult black Kenyans. The circumference was measured on haematoxylin/eosin stained microscopic sections of the distal one-third of the intracranial vertebral arteries using scion image analyser. Internal diameter was calculated in millimetre. Data were analysed using SPSS version 16.0. Vertebral artery hypoplasia (diameter < 2.0 mm) occurred in 100 (28.9%) arteries. Sixty of these (17.3%) were on the left and 40 (11.6%) on the right. Sixty (17.3%) were in females while 40 (11.6%) were in males. The side and gender differences were statistically significant at confidence interval of 95%. Frequency of vertebral artery hypoplasia was higher than in most other populations studied. The condition differs from that in other populations because it is more common on the left side and in females. We recommend ultrasound, angio-CT, or angio-MRI evaluation of vertebral arterial system before diagnostic or interventional procedures on posterior circulation.