College of Health Sciences (COHES)Medical Laboratory; Agriculture & environmental Biotecthology; Biochemistry; Molecular Medicine, Applied Epidemiology; Medicinal PhytochemistryPublic Health;http://localhost/xmlui/handle/123456789/12792024-03-28T11:00:16Z2024-03-28T11:00:16ZMechanical Pain Patterns and Risk Factors Associated with its Chronification among Patients with Non-Specific Low Back Pain at Nakuru Teaching and Referral HospitalMuisyo, Jonah Muasyahttp://localhost/xmlui/handle/123456789/62442024-02-12T09:58:52Z2024-02-12T00:00:00ZMechanical Pain Patterns and Risk Factors Associated with its Chronification among Patients with Non-Specific Low Back Pain at Nakuru Teaching and Referral Hospital
Muisyo, Jonah Muasya
The majority of patients with low back pain presents with the non-specific low back pain sub-type, research has shown that most of these patients often do not recover fully and risk transitioning to chronic pain. Causing extraordinary levels of disability, poor health-related quality of life and expensive medical cost due prolonged overutilization of healthcare services. In our setup, there is limited availability of information regarding how to address the aforementioned issue. The aim of this study was to identify the mechanical pain patterns associated with non-specific low back pain and assess the risk factors contributing to its chronification among individuals seeking treatment at the outpatient physiotherapy clinic in a tertiary facility located in Nakuru. Study Site: This study was done at Nakuru Teaching and Referral hospital in Nakuru County. Study design; An analytical cross-sectional; sample size of 70 participants were selected from physiotherapy out -patient department clinic. Methods; Participants were categorized into four Mechanical Pain Pattern (P1, P2, P3 &P4) through Saskatchewan Spine Pathway Assessment and Referral form and level of chronicity was established using Orebro Musculoskeletal pain screening questionnaire (OMPSQ). Descriptive and inferential statistics was generated using SPSS version26.Results; Among the participants Pattern1(n=32:45.7%, Pattern 2(n=11:15.7%), Pattern 3(n=15;21.5%) and Pattern 4(n=12;17.1%) were identified. The majority of participants were categorized as follows: 37.1% at moderate risk, 17.2% at high risk, and 45.7% at low risk. Concerning risk of chronification, Pain location was significantly correlated with Pattern 3 (p<0.012), whilst absenteeism was significant with leg symptoms(p<0.020) and severe disability index index/severe disability index (p<0.046) demonstrated a significant association. Absenteeism was found to be significant correlated with pain duration. Physical activity makes pain worse was positive correlated with extent of depression, risk of persistence and pain episodes. Significant predictors for risk of chronification were level of education, Pattern 3, and Pattern 4.Conclusion; this study established majority of patients of NSLBP categorized as P1 and 54%were flagged as moderate risk to high risk for chronification. Furthermore, those with subtype P3 mechanical pain pattern, leg symptoms, severe disability index; these clinical characteristics were associated with risk of chronification. That Orebro-musculoskeletal may implemented to identify patients at of risk of chronification.
Master of Science in Physiotherapy (Orthopedics)
2024-02-12T00:00:00ZComparative Histo-morphological and Histo-stereological Teratogenic Effects of In-utero Exposure to Lamotrigine and Levetiracetam on the Fetal Kidneys in Albino Rats (Rattus novegicus)Kweri, Cyrus Kamauhttp://localhost/xmlui/handle/123456789/62412024-02-07T10:28:31Z2024-02-07T00:00:00ZComparative Histo-morphological and Histo-stereological Teratogenic Effects of In-utero Exposure to Lamotrigine and Levetiracetam on the Fetal Kidneys in Albino Rats (Rattus novegicus)
Kweri, Cyrus Kamau
Lamotrigine and levetiracetam are second-generation antiepileptic medicines that are
currently being used widely in the management of maternal epilepsy and other
neuralgic disorders during pregnancy. However, their comparative histo-
morphological and histo-stereological teratogenic risks on the developing fetal
kidneys remains unclear. The broad objective of this study therefore was to
comparatively evaluate their histo-morphological and histo-stereological nephron-
teratogenic effects on the developing fetal kidney when exposed in varied doses and
at different gestational periods. In carrying out this study, a posttest experimental
study design with a control group was adopted. All animal experimentation
procedures that included breeding of the animals, feeding, drug administration up to
harvesting of fetuses was done in Nairobi university (UON) while tissue processing
for histology and stereological analysis was done in the department of Human
anatomy in JKUAT. A sample size of 30 albino rat dams was used for each of
lamotrigine and the levetiracetam treatment groups. These 30 albino rat dams for
each of the two study categories were first randomly assigned into two broad study
groups of 3 rats control and 27 rats experimental. The 27 rats in each of the
experimental category were further randomly assigned into three subgroups of 9 rats
each according to the three dose groups of low, medium and high dose as follows, 9
rats low dose lamotrigine/ levetiracetam treatment group, 9 rats for the medium dose
lamotrigine/ levetiracetam treatment group and 9 rats for the high dose lamotrigine/
levetiracetam treatment groups. To further evaluate the effects of the time of
exposure, the 9 rats in each of the three dose categories were further randomly sub-
divided into three sub-groups of 3 rats each as follows; 3 rats for trimester I, the next
3rats for trimester II; and the last 3 rats for Trimester III. The study findings showed
that in both lamotrigine and levetiracetam treatment groups, there was a statistical
significance increase (p<0.05) in medullary thickness while the cortical thickness
reduced in a proportionate manner. Stereologically there was marked reduction in
glomerular numbers per field of view as well as in their volume densities resulting to
their observed sparse distribution. There was an observed remarkable condensation
of glomerular tufts capillaries with significantly hypertrophied bowman spaces. The
critical nephron-teratogenic period was noted to be when both the drugs were
administered in trimester one and trimester two with critical teratogenic doses being
both the high dose of the two medicines. Lamotrigine was established to be more
teratogenic compared to levetiracetam across all dose groups and across all the
trimesters of exposure. In conclusion, both lamotrigine and levetiracetam are
teratogenic to the developing fetal kidney and their teratogenic effects depicted
patterns of both time-dose dependency. The study recommends caution when using
high doses of both drugs by pregnant mothers particularly during trimester one and
trimester two. It also recommends further studies on higher primates with close
relations to humans.
Master of Science in Human Anatomy
2024-02-07T00:00:00ZApplication and Influence of Fire Risk Reduction Rules on Fire Safety at Petroleum Dispensing Stations in Kisumu County, KenyaKebut, Carolyne Jepchirchirhttp://localhost/xmlui/handle/123456789/62402024-02-07T10:05:32Z2024-02-07T00:00:00ZApplication and Influence of Fire Risk Reduction Rules on Fire Safety at Petroleum Dispensing Stations in Kisumu County, Kenya
Kebut, Carolyne Jepchirchir
Fire safety is an essential aspect in each workplace, its efforts are geared to preservation of life and protection of property. Petroleum dispensing stations handle highly flammable and combustible substances that ignite at any given time at a conducive condition. The government of Kenya has instituted various laws and legislation to alleviate the fire safety status of such workplaces which should be adhered to. This thesis presents a qualitative and descriptive study on assessment of the application and influence of Fire Risk Reduction Rules (FRRR) on the status of fire safety in petroleum dispensing stations in Kisumu County. Questionnaires, interviews, and observation methods were used in this study to collect the data. Forty-seven (47) petroleum dispensing stations (PDS) were sampled of which sixteen (16) were independent PDS (IPDS) and the other thirty-one (31) being the branded PDS (BPDS). One hundred and seventy-six respondents were interviewed. The study found out that 83% of the respondents were aware of the safe storage of highly flammable substances;16.8% of the PDS carried out audits. Measurement of presence explosive vapors at the PDS’s using an explosimeter indicated an average of 3.0% and 2.4% at day and night respectively at the fueling pump site and fuel offloading storage site. 425 near misses and unsafe acts were reported collectively at the PDS’s. The study concluded that none of the PDS had fully implemented the FRRR, there wasn’t guarantee on status of fire safety at the PDS’s. However, BPDS had a better performance in awareness, implementation of FRRR and status of fire safety. This study recommends; regular Audits, workplace inspections and awareness creation on fire risk reduction rules should be done by the occupier and enforcing authorities.
Master of Science in Occupational Safety and Health
2024-02-07T00:00:00ZComparative Morphological and Histo-stereological Teratogenic Effects of Phenobarbital and Phenytoin on the Developing Fetal Kidneys in Albino Rats (Rattus norvegicus)Segut, Jennifer Chepkemoihttp://localhost/xmlui/handle/123456789/62392024-02-05T12:19:17Z2024-02-05T00:00:00ZComparative Morphological and Histo-stereological Teratogenic Effects of Phenobarbital and Phenytoin on the Developing Fetal Kidneys in Albino Rats (Rattus norvegicus)
Segut, Jennifer Chepkemoi
The prenatal teratogenicity exposures to phenobarbital and phenytoin on the morphology and the histo-stereological structures of the developing fetal kidneys remains largely unclear. At the same time, it is also not clear whether or not the teratogenic effects of the two medicines are dose and time dependent. In carrying out this study, post-test only control experimental study design was adopted. A resource equation for one-way analysis of variance (ANOVA) was used to arrive at a sample size of 30 albino rats (Rattus norvegicus) for each of the two-treatment groups. The rats were nine weeks old and weighed between 150-250 mg. These 30 albino rats in each of the study categories of phenobarbital and phenytoin were first randomly assigned into two broad study groups of three rats control and the 27 rats treatment category. To first evaluate the intrauterine effects of varied doses, the 27 rats in each of the treatment category were further subdivided in to three sub-groups of nine rats each as follows: nine rats for low dose, nine rats for medium and nine for high dose groups. To further evaluate the effects on the time of exposure, the nine rats in each of the three doses categories of low, medium and high was were further sub-divided into three sub-groups of three rats according to the trimesters of exposures as follows; three rats for Trimester I (TM1); three rats for trimester II (TM2) and three rats for trimester III (TM3). At gestation day 20, all the rats were humanely sacrificed, three fetuses from each rat were selected and their kidneys harvested for histo-morphological and stereological analysis. The data was collected using a structured check list, then coded and entered into the computer using an excel spreadsheet for windows version 10, it was then exported to the Statistical package for the Social Scientist (SPSS) version 25 for statistical analysis. The inferential statistical significance levels were determined by use ANOVA and MANOVA and all values whose P<0.05 were considered significant. This study established that the prenatal exposure of both phenobarbital and phenytoin in all doses had a statistical significant reduction (p<0.05) to all the maternal and fetal growth parameters that included placental weights, maternal weight gain, birth weights, bi-parietal diameters as well as crown lamp lengths, when exposed at TM1 and TM2. At trimester three (TM3), only the high doses were seen to negatively influence the outcomes. The histo-stereological finding revealed that in-utero exposure to either of the two medicine has a deleterious effect on the developing fetal kidneys including significant decrease (p<0.05) in the kidney volumes and volume densities. Widening of the bowman’s spaces, renal tubules and the increase in cellular densities per glomeruli was also observed in a dose and time dependent manner. In conclusion all doses of both phenytoin and phenobarbital are teratogenic to the developing fetal kidneys at TM1 and TM2 and whenever possible the mothers should then be advised not to use these two medicines in their early pregnancy.
Master of Science in Human Anatomy
2024-02-05T00:00:00Z