Hassan Saidi

University of Nairobi, Nairoba, Nairobi Area, Kenya

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Publications (14)10.79 Total impact

  • Philip Mwachaka · Hassan Saidi · Paul Odula · Pamela Mandela
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    ABSTRACT: Monocular deprivation results in anatomical changes in the visual cortex in favor of the non-deprived eye. Although the retina forms part of the visual pathway, there is scarcity of data on the effect of monocular deprivation on its structure. The objective of this study was to describe the effects of monocular deprivation on the retinal ganglion cell dendritic features. The study design was quasi-experimental. 30 rabbits (18 experimental, 12 controls) were examined. Monocular deprivation was achieved through unilateral lid suture in the experimental animals. The rabbits were observed for three weeks. Each week, 6 experimental and 3 control animals were euthanized, their retina harvested and processed for light microscopy. Photomicrographs of the retina were taken using a digital camera then entered into FIJI software for analysis. The number of primary branches, terminal branches and dendritic field area among the non-deprived eyes increased by 66.7%(p=0.385), 400%(p=0.002), and 88.4%(p=0.523) respectively. Non-deprived eyes had 114.3% more terminal dendrites (p=0.002) compared to controls. Among deprived eyes, all variables measured had a gradual rise in the first two weeks followed by decline with further deprivation. There were no statistically significant differences noted between the deprived and control eyes. Monocular deprivation results in increase in synaptic contacts in the non-deprived eye, with reciprocal changes occurring in the deprived eye.
    International Journal of Morphology 12/2014; 32(4):1144-1151. DOI:10.4067/S0717-95022014000400004 · 0.20 Impact Factor
  • Joseph Nderitu · Fawzia Butt · Hassan Saidi
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    ABSTRACT: Comprehensive understanding of the anatomy of the inferior palpebral (IP) nerve is crucial to preservation of sensation in the inferior eyelid and conjunctiva. Iatrogenic injuries may occur during blepharoplasty, repair of orbitozygomatic fracture and other maxillofacial surgeries involving this region. Although several studies depict the anatomical variations of the main infraorbital nerve (ION), little information exclusive to the IP nerve exists. This study provides information on the additional variations of the ION with reference to the IP nerve. The study was performed on 84 IP nerves by dissection of 42 formalin-fixed cadavers from the laboratory of topographic anatomy, Department of Human Anatomy, University of Nairobi, Kenya. Each of the nerves were exposed at the emergence and followed to their termination. Variations encountered involved emergence, course, and even absence. Variant emergence was through an accessory infraorbital foramen, an infraorbital notch, and as a common trunk with the external nasal nerve. This nerve shows high anatomical variability that may account for the difficulties and complications encountered in clinical interventions. It is believed that this information will improve clinical management of conditions affecting the region of distribution of the IP nerve.
    Craniomaxillofacial Trauma and Reconstruction 09/2014; 7(3):233-6. DOI:10.1055/s-0034-1374062
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    Hassan Saidi · Ben Kasyoka Mutiso · Julius Ogengo
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    ABSTRACT: Africa has 4% of the global vehicles but accounts for about one tenth of global vehicular deaths. Major trauma in Kenya is associated with excess mortality in comparison with series from trauma centers. The determinants of this mortality have not been completely explored.Objectives: To determine the factors affecting mortality among road users in Nairobi, Kenya. Cross-sectional study of prospectively collected data of trauma admissions at the Kenyatta National Hospital over a calendar year (2009-2010). Information collected included age, gender, road user type, principal anatomical region of injury, admission status, admission blood pressure and GCS, disposition destination, Injury Severity Score (ISS), injuries sustained, treatment and mortality at two weeks. Major or severe injury was defined as injuries of ISS > 15. Groups based on in-hospital survival were compared using determinants of mortality using X2 or students t-test as appropriate. Logistic regression was used to assess the independence of predictive variables. One thousand six hundred forty seven (1647) patients were admitted for trauma during the study period. Traffic admissions were 1013 (61.7%) and males predominated (79.8%). The average age of patients admitted was 31.7 years. Pedestrians, vehicle occupants and motorcyclists represented 43.3%, 27.2% and 15.2% of the road users injured. The proportion of patients with ISS > 15 was 10.9%.The overall mortality was 7.7%. Mortality for ISS > 15 was 27.6%. The following factors significantly predicted mortality on univariate analysis: head injury, abdominal injury, transfer in status, blood transfusion, ICU admission, age > 60 years, Glasgow coma scale (GCS) and injury severity. GCS (p = 0.001) and ISS > 15 (p < 0.05) remained significant predictors on regression analysis. Trauma mortality rates in this study exceed those from mature trauma systems. Head injury and injury severity based on the ISS are independent predictors of mortality after traffic trauma. Improvements in neurosurgical and critical care services ingrained within wider primary and secondary prevention initiatives are logical targets.
    Journal of Trauma Management & Outcomes 02/2014; 8(1):4. DOI:10.1186/1752-2897-8-4
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    ABSTRACT: In the developing world, data about the burden of injury, injury outcomes, and complications of care are limited. Hospital-based trauma registries are a data source that can help define this burden. Under the trauma care component of the Bloomberg Global Road Safety Partnership, trauma registries have been implemented at three sites in Kenya. We describe the challenges and lessons learned from this effort. A paper-based trauma surveillance form was developed, in collaboration with local hospital partners, to collect data on all trauma patients presenting for care. The form includes demographic information, pre-hospital care given, and patient care and clinical information necessary to calculate estimated injury surveillance. The type of data collected was standardized across all three sites. Frequent reviews of the data collection process, quality, and completeness, in addition to regular meetings and conference calls, have allowed us to optimize the process to improve efficiency and make corrective actions where required. Trauma registries have been implemented in three hospitals in Kenya, with potential for expansion to other hospitals and facilities caring for injured patients. The process of establishing registries was associated with both general and site-specific challenges. Problems were identified in planning, data collection, entry processes, and analysis. Problems were addressed when identified, resulting in improved data quality. Trauma registries are a key data source for defining the burden of injury and developing quality improvement processes. Trauma registries were implemented at three sites in Kenya. Problems and challenges in data collection were identified and corrected. Through the registry data, gaps in care were identified and systemic changes made to improve the care of the injured.
    Injury 12/2013; 44 Suppl 4:S70-4. DOI:10.1016/S0020-1383(13)70216-X · 2.46 Impact Factor
  • H. Saidi · B. K. Mutisto
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    ABSTRACT: Background The rise in the use of motorcycles in Kenya in the last 10 years has been associated with increased injury rates. Between 2004 and 2009, motorcycle injuries increased at a rate of 29 % and, in some hospitals, motorcycle users have become the predominant road user category injured. Although most road traffic injuries occur in Nairobi, there has been no previous account of motorcycle injury and associated outcomes at its main hospital. Objective To describe the injury patterns and outcomes following motorcycle trauma at the Kenyatta National Hospital. Methods All motorcycle trauma admissions during one calendar year were analyzed. The data captured included demographics, injury patterns and outcomes, lengths of hospital stay, hospitalization cost, and early hospital mortality. Factors associated with outcomes were analyzed by univariate and multivariate means. The probability of survival was estimated using the Trauma and Injury Severity Score (TRISS) methodology for each patient. Results Two hundred and five patients were reviewed. Motorcycle trauma admissions formed 22.3 % of all road traffic injury admissions. Male riders predominated. The average age and modal age group was 30.78 and 21–30 years, respectively. Half of riders and 20 % of passengers used protective helmets. Injuries were mostly to the extremities (60.7 %) and head/neck (32.07 %), and the average Injury Severity Score (ISS) was 7.57 + 4.0 (median 9.0). At 2 weeks, 9.0 % of patients had died. The estimated probability of survival ranged from 0.86 to 0.97. Surgical interventions were needed for 51.7 % of patients. The mean length of stay in the hospital was 24.3 days, while the cost of treatment was 31,783 Kenya Shillings (Kshs). Injury severity (P < 0.001), admission to the intensive care unit (ICU) (P < 0.001), non-surgical treatment (P = 0.003), blood transfusion (P = 0.029), head injury (P < 0.001), and low Glasgow Coma Scale (GCS) score at admission were significantly associated with mortality. Conclusion Injuries to the lower limbs and the head predominate in motorcycle trauma. The high mortality rate, need for surgery in the majority of patients, and prolonged admission days call for motorcycle control and expedited care. Significant head injury mortality calls for efforts to embrace helmet laws for riders and passengers.
    European Journal of Trauma and Emergency Surgery 10/2013; 39(5). DOI:10.1007/s00068-013-0280-8 · 0.38 Impact Factor
  • Hassan Saidi · Johannes Oduor
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    ABSTRACT: Immediate trauma fatality is not amenable to trauma care and primary prevention is the key. The published profiles of deaths due to trauma differ in different regions. Injury mortality rates are higher in developing countries where injury data capture systems are unreliable for prevention purposes. To describe the pattern of pre-hospital injury (immediate) deaths at the Nairobi city mortuary and compare these with hospital (late) trauma deaths. Consecutive trauma autopsies performed over one year (November 2009 to December 2010) at the main mortuary of the Nairobi city council were analyzed for demographic (age, sex, occupation) characteristics, circumstances of the trauma and injury patterns. The patterns of injuries were compared to those of victims who survived and later died at the Kenyatta National Hospital over the same period. Two hundred and thirty seven trauma autopsies were analyzed. The average age of the victims was 29.8 years (range 1-67 years). Christians (93.7%) and males (89.5%) predominated. The place of injury was the road in 32.9% and home/neighborhood in 57.5% of cases. The main mechanisms of fatal injury were traffic (35.4%), gunshot wounds (25.7%) and assault (19.8%). Burns and suicides accounted for 5.9% and 6.3% of fatalities. Most fatalities were intentional (59.4%) Of vehicular injuries, pedestrians predominated (65.5%). For assault, blunt and penetrating injuries accounted for 68.7% and 31.11% of fatalities. Law enforcement officers were responsible for majority of gunshot deaths. Fatal injuries were sustained in single, two and multiple regions in 56.2%, 25.7% and 14.2% of cases. The body region most involved was the head/neck (40.5%). Twelve children under 15 years died. Compared to in-hospital deaths, pre-hospital deaths were associated with intentional injuries, night-time occurrence and preponderance of gun involvement. Injury was a significant cause of mortality among adults of working age in this urban African setting. Intentional injuries predominate in causation of immediate but not late deaths. Local prevention programs should incorporate mortuary data to unravel further aspects of trauma and address violence as a key determinant of prehospital mortality.
    Journal of Forensic and Legal Medicine 08/2013; 20(6):570-4. DOI:10.1016/j.jflm.2013.04.016 · 0.99 Impact Factor
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    ABSTRACT: Background. Branching pattern of inferior mesenteric artery (IMA) and pattern of vascular supply to the left colon and rectosigmoid areas, though important during colorectal surgery, display interethnic variations. Further, these regions have notable vascular “weak points” reported to be highly susceptible to ischemic colitis. This study aimed at evaluating the branching pattern of IMA in a black African population. Materials and Methods. Fifty-seven formalin-embalmed cadavers (28 Male, 27 Female) were studied. The length, branching pattern, and diameter of IMA at its origin were recorded. Results. IMA mean length and diameter at origin were mm and mm, respectively. IMA most frequently branched into left colic artery and a common sigmoid trunk in 23 cases while the classical branching pattern was observed in only 7 cases. Colic marginal artery was absent at the splenic flexure and sigmoid colon in 7 and 5 cases, respectively. Arc of Riolan was observed in 9 cases. Conclusion. Branching pattern of IMA shows variations from the previously reported cases which might help account for some of the untoward outcomes observed following colon surgery. An angiographic study to further delineate functionality of the arterial anastomoses in this region is recommended.
    12/2012; 2013. DOI:10.5402/2013/962904
  • Kevin Ongeti · Anne Pulei · Julius Ogeng'o · Hassan Saidi
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    ABSTRACT: Unilateral variations in the formation of the median nerve, with the presence of the third head of the biceps brachii entrapping the nerve are very rare. These variations were observed on the right side, of a 30-year-old male cadaver during routine dissection at the Department of Human Anatomy, University of Nairobi. The median nerve was formed by the union of three contributions; two from the lateral cord and one from the medial cord. An additional head of the biceps brachii looped over the formed median nerve. On the left side, the median nerve was formed classically by single contributions from the medial and the lateral cords. These variations are clinically important because symptoms of high median nerve compression arising from similar formations are often confused with more common causes such as radiculopathy and carpal tunnel syndrome. Clin. Anat., 2012. © 2012 Wiley-Liss, Inc.
    Clinical Anatomy 11/2012; 25(8). DOI:10.1002/ca.22028 · 1.16 Impact Factor
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    Moses M Obimbo · Julius A Ogeng'o · Hassan Saidi
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    ABSTRACT: Uterine artery undergoes structural modifications at different physiologic states. It is expected that due to its unique course, hemodynamic stresses in the vessel would vary resulting in differences in arterial dimensions. The objective of this study was to investigate regional morphometric changes in the human uterine artery. Twenty four uterine arteries (12 each from non-gravid uteri and gravid uteri) were obtained during autopsy after ethical approval from women aged between 21 to 47 years. Sections from proximal, middle and distal segments of the artery taken within 72 hours were processed for paraffin embedding, sectioned and stained with Mason's Trichrome. Micrographs of the slides were analyzed using Scion Image Multiscan software. Data were entered into and analyzed with Statistical Programme for Social Sciences. The pregnancy related increase in diameter and wall thickness are most pronounced in the proximal segment. In the distal segment, however, wall thickness reduces significantly (p < 0.05). Intimal thickness was lesser in pregnancy compared to non-gravid state in all the segments. Regional morphometric changes in the uterine artery during pregnancy may be designed to regulate blood flow to the uterus and placenta during pregnancy.
    10/2012; 13:30.
  • Moses M Obimbo · Julius A Ogeng'o · Hassan Saidi
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    ABSTRACT: To investigate the uterine artery's origin, branching patterns, and relation to the ureter in a Kenyan population. The uterine arteries of the bodies of 53 girls and women were dissected at the University of Nairobi Department of Human Anatomy to study these patterns. Data were analyzed for frequency and the patterns are presented via digital macrographs. The uterine artery consistently originated as a branch of the internal iliac artery. It formed the second or third branch of the anterior trunk in 70.8% of cases; it ascended as a single branch, or from a bifurcation, or from a trifurcation in 76.4%, 17.1%, and 6.7% of cases; and lay posterior to the ureter in 3.8% of cases. In all, 46.2% of the uterine arteries studied varied from the classic description. About half of the uterine arteries had a nonclassic origin, branching pattern, or relation to the ureter-as a posterior relation to the ureter had not been previously described. Surgeons operating in the pelvis should be aware of this variant anatomy to avoid injury to the ureter and other organs.
    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 10/2010; 111(1):49-52. DOI:10.1016/j.ijgo.2010.04.033 · 1.56 Impact Factor
  • Hassan Saidi · Paul Odula · Kirsten Awori
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    ABSTRACT: Kenyan media reports indicate escalating levels of child maltreatment, but the characteristics of the offence are undefined. At the Gender and Violence recovery Center of the Nairobi Women's Hospital, we analysed 342 consecutive children for age, gender, perpetrator characteristics, time and scene of assault and the nature of injuries between February 2003 and April 2004. The children comprised 43.5% of all assault survivors. The mean age was 10.0 years and about 20% of the children were < or =5 years. Most (71.5%) of the child sexual abuse (CSA) was perpetrated by people known to the victim. Intra-family CSA (incest) was highest among the one to five year olds. The proportion of assaults committed against boys reduced with the age of the child. Older children were more likely to be assaulted later in the day and by multiple perpetrators. Most recorded injuries were perineal. The majority of children are assaulted by people they had trusted. The epidemiological correlates of maltreatment differ for younger and older children. More effort is needed to further characterize child violence and protect this vulnerable section of the population.
    Tropical Doctor 04/2008; 38(2):87-9. DOI:10.1258/td.2007.060173 · 0.53 Impact Factor
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    ABSTRACT: CRC (CRC) rates are low but increasing in Africa. Data on detection, treatment, and outcome are scarce. The aim of this study was to evaluate the presentation, treatment, and outcome pattern of CRC and to compare the care processes for two time periods. The setting was Kenyatta National Hospital (KNH), a teaching and referral center. A total of 259 patients seen over two time periods (1993-1998 and 1999-2005) were analyzed for admission date, sex, subsite involvement, diagnostic process, treatment, follow-up, and outcome. The distribution of variables between the time periods were analyzed using Student's t-test and chi2 as appropriate. Survival trends were generated using Kaplan Meier method; p<0.05 was statistically significant. The average number of CRC diagnoses showed a 2.7-fold increase during the study periods. The mean age at presentation was 49.7 years. The mean duration of symptoms was 29.6 weeks; and the commonest subsite was the rectum (55.3%). The overall resection rate was 67.7%. For rectal tumors the abdominoperineal rate was 51.4%. Mortality was higher for poorly differentiated cancer, advanced disease, age>50 years, and emergency surgery. There was no change in the age, duration of symptoms, proportion of patients<40 years, or the colon/rectal ratios of the cancer site. The second time period saw more adjuncts for diagnosis, less in-hospital mortality, and better staging data. CRC peaks during the fifth decade of life in Kenyans. The disease is characterized by late presentation, rectal preponderance, and inadequate pathology data. Improved patient follow-up will unravel the true pattern of disease outcome.
    World Journal of Surgery 02/2008; 32(2):217-23. DOI:10.1007/s00268-007-9301-2 · 2.35 Impact Factor
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    Hassan Saidi · Tharao M Karanja · Julius A Ogengo
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    ABSTRACT: Knowledge of the variant vascular anatomy of the subhepatic region is important for hepatobiliary surgeons in limiting operative complications due to unexpected bleeding. The pattern of arterial blood supply of 102 gallbladders was studied by gross dissection. The cystic artery originated from the right hepatic artery in 92.2% of cases. The rest were aberrant and originated from the proper hepatic artery. Accessory arteries were observed to originate from proper hepatic artery (n = 5), left hepatic artery (n = 2), and right hepatic artery (n = 1). Most of the arteries approached the gallbladder in relation to the common hepatic duct (anterior 45.1%, posterior, 46.1%). The other vessels passed anterior to common bile duct (2.9%), posterior to common bile duct (3.9%), or were given off in Calot's triangle. Cystic arteries in this data set show wide variations in terms of relationship to the duct systems. In about one tenth of patients, an accessory cystic artery may need to be ligated or clipped during cholecystectomy.
    Clinical Anatomy 11/2007; 20(8):943-5. DOI:10.1002/ca.20550 · 1.16 Impact Factor
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    ABSTRACT: Background:The developing world continues to experience a disproportionate burden of injury. About one half of injury deaths are due to motor vehicle collisions. Road traffic fatalities per 10,000 vehicles are ten to 20 times higher in Africa compared to Europe.Patients and Methods:233 patients were consecutively analyzed. Injury acuity was determined by calculating Injury Severity Scores (ISS) for each patient. Information on the care and treatment outcome was obtained from patient interviews, case notes and discharge summaries. Data analysis was performed using the SPSS version 10.0 statistical software.Results:Injury accounted for 48.8% of all emergency hospitalizations into the surgical units. Injury due to traffic comprised a third (31%) of trauma admissions. Injuries to the limbs were predominant (54%). Acuity ranged from ISS 1 to 43. The mean ISS was 8.78. Major injury (ISS > 15) constituted 13% of all the admissions. Operating room resources were utilized in 52% of the patients (major operations were performed in 12% of this group). The overall complication rate was 12.0%. Although the overall mortality amounted to 6%, mortality was 35.6% amongst those with major injury. It was also higher with associated head injury, pedestrian injury and weekend injury.Conclusion:The overall trauma acuity was moderate injury. Mortality escalated to 35% for major injury. There is need to explore the factors contributing to this high mortality and a system of care that can optimize outcome.
    European Journal of Trauma 07/2005; 31(4):401-406. DOI:10.1007/s00068-005-1014-3