H Saidi

University of Nairobi, Nairoba, Nairobi Area, Kenya

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Publications (20)5.18 Total impact

  • W Kaisha, A Wobenjo, H Saidi
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    ABSTRACT: Injury to the recurrent laryngeal nerve (RLN) is an important but avoidable complication of thyroidectomy. This complication may be avoided by the identification of the nerve facilitated by important landmarks found along its course. The setting for this work is the Human Anatomy Laboratory of the University of Nairobi. The aim of this work is to determine the topographic relationship of the RLN with the inferior thyroid artery (ITA), the tubercle of Zuckerkandl (TZ), and the ligament of Berry (LB) in a Kenyan population. The relationship between the nerve and the above landmarks was determined during dissection of 146 right and left thyroid lobes. One right side of the neck had a nonrecurrent nerve. Of the specimens where relationship was determined, the nerve was anterior to the ITA in 37% of cases and posterior in 51.4%. In relation to the LB, 45.3% were superficial (dorsolateral). The TZ was clearly delineated in 86 of the 146 specimens. No nerve traversed the tubercle. The RLN exhibited variations similar to those in other populations. The TZ when present was a reliable landmark to the nerve.
    Clinical Anatomy 10/2011; 24(7):853-7. DOI:10.1002/ca.21192 · 1.16 Impact Factor
  • 06/2011; 7:42-49. DOI:10.4314/aas.v7i1.67029
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    ABSTRACT: Background Configuration and branching pattern of the posterior communicating artery influence occurrence and approaches to management of aneurysms. Distribution of the various configurations and branching patterns shows population variations but reports from Africa are scanty. Objective To determine the prevalence of various configurations and branching pattern of the posterior communication artery in a Kenyan population. Materials and Methods Eighty four posterior communicating arteries obtained from Department of Human Anatomy were studied. The configuration and number of branches in each third and length of the longest perforator free zone of the posterior communicating artery were evaluated. Results Adult configuration was observed in 56%, hypoplastic in 25%, fetal in 12% and transitional in 7%. Mean number of branches given off was 7.2 ± 1.9 (range: 3-12), highest in proximal and lowest in the distal third of the artery. Perforator free zone ranged between 1mm to 8mm with a mean of 4.01 ± 1.54mm and was longest in the hypoplastic configuration. Conclusion Configurations observed in the Kenyan population are comparable to those reported in the Caucasian populations. From an anatomical standpoint, the two are equally predisposed to development of aneurysms. Posterior third of PomA had the least number of branches suggesting that the pterional approach to basilar tip aneurysm among Kenyans may be a safer procedure. The Annals of African Surgery, Volume 6, 2010
    01/2011; 6(1). DOI:10.4314/aas.v6i1.63236
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    ABSTRACT: Background: The functional significance of myocardial bridging remains controversial. The bridge morphology and structure of the tunneled vessels may modify its ultimate clinical effects. Objective: To describe the morphological characteristics of myocardial bridges and their influence on coronary histology. Design: A descriptive cross-sectional study. Methods: One hundred and nine formalin-fixed adult hearts were evaluated by dissection for these data: prevalence, site, lengths and depths of myocardial. Bridges. Vessel segments proximal and distal to the bridged portion were also processed for histology and stained to elaborate smooth muscle, collagen and elastic fibers. Stereology was also employed to compare the relative sizes of the tunica intima and the vessel wall to lumen ratios. Results: Myocardial bridges were found in 40.4% of the hearts, most commonly in the left anterior descending artery (LAD). The average length of the bridges was 22.66 +11.94 mm while the depth was 1.83+ 0.98mm, with only 11 % being long (34.87mm- 50mm) and 9% of them being deep (3.46mm - 5.Oomm). The tunica intima was thickest proximal to and thinnest under the myocardial bridge. The intima of the proximal segment was also more elastic. An elaborate perivascular `cushion′ of adipose tissue intervened between the intramural coronary and the surrounding myocardium. Conclusions: Most myocardial bridges are superficial and short. Tunica intima under myocardial bridges is spared from ". The thick perivascular space around the bridged segment may protect it from extreme compression.
    African health sciences 09/2010; · 0.66 Impact Factor
  • M Abdihakin, H Saidi
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    ABSTRACT: The evolution of systemic inflammatory response syndrome (SIRS) to septic shock is a continuum that can be stemmed using dedicated and early goal directed interventions. In the setting of necrotizing soft tissue infection, mortality approaches 100% when debridement is delayed or altogether omitted. Volume depletion, vasodilatation, myocardial depression, high metabolism and attendant global hypoxia that precede multi- organ dysfunction syndrome (MODS) and mortality need to be addressed early, avoiding delays in the emergency department, hospital ward, or the intensive care unit. Early goal directed therapy denotes the use of interventions such as administration of crystalloid solutions, vaso-active agents, blood transfusion and inotropic agents to achieve specific targets, namely, a central venous pressure of 8 – 12 mmHg, a mean arterial pressure of 65 – 90 mmHg, a urine output of > 0.5mls/kg/hr, a hematocrit of >30% and a central venous oxygen saturation of > 70% in a patient who is intubated, sedated and paralysed.We present an illustrative case of the management of severe Fournier’s gangrene and how a series of misadventures at home, the A & E and the wards contributed to the inevitable demise.
    04/2010; 5(1). DOI:10.4314/aas.v5i1.53718
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    International Journal of Morphology 12/2009; 27(4):1217-1222. · 0.20 Impact Factor
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    ABSTRACT: Objective: To describe the pattern and prevalence of variations that occur in the supraclavicular part of the brachial plexus in a Kenyan population. Study design: Descriptive cross-sectional study. Materials and methods: Ninety-four brachial plexuses from forty-seven formalin fixed cadavers were displayed by gross dissection. Results: The presence of at least one variation from the classical anatomy was observed in 73 (77.7%) of the 94 plexuses. The roots and trunks were involved in 32 (34%) of the plexuses . Preand postfixed roots were present in 23 (24.7%) and 3 (3.2%), respectively. The presence of four trunks, and trunks passing between the scalene medius and posterior were also noted. The long thoracic nerve was variant in 51 (54.3%) of the plexuses. Unusual relations of the phrenic nerve to scalene muscles and the subclavian vein were encountered. Conclusion: The presence of four trunks and an accessory phrenic nerve passing through the subclavian vein are probably described and reported for the first time. However, most of the variations of the BP among Kenyans are similar to those reported in the other populations.
    09/2009; 2(1). DOI:10.4314/aas.v2i1.46236
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    ABSTRACT: BACKGROUND: The onset of colorectal cancer appears to be two to three decades earlier in developing countries. Data on whether colorectal cancer in the young has worse prognosis than in older patients is conflicting. METHOD: Clinical charts of 70 patients ≤40 years old were reviewed to determine clinical and pathological patterns and treatment outcomes. Their data were compared with a larger group of older patients treated between 1993-2005 at Kenyatta National Hospital in Nairobi, Kenya. RESULTS: The data retrieval was highest for sub-site distribution and lowest for pathology information. Patients ≤ 40 years of age comprised 27.3% of all colorectal cancer cases treated over the study period. There were 41 males (58.6%) and 29 (41.4%) females patients. The most common symptoms were abdominal pain (76.9%), change in bowel habit (71.4%) and rectal bleeding (54.3%). The mean duration of symptoms was 24.6 ± 30 months. The rate of advanced colorectal disease (Duke C and D) was 73.5%. Mean follow-up time was 5.8 months with median survival of only 6.9 months. The Duke staging, histology, symptom duration, locations of tumours, follow-up and the complication rates were similar for young and older patients. CONCLUSION: Younger patients form a significant proportion of colorectal cancer burden. Both the clinico-pathological characteristics and treatment outcome correspond to older individuals. It is suggested that the concluded colorectal symptoms in younger patients should also be aggressively evaluated including early endoscopy. A prospective follow-up study of patients with the disease will unravel the true survival picture.
    09/2009; 1(1). DOI:10.4314/aas.v1i1.45790
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    ABSTRACT: BACKGROUND: The sigmoid colon in Africans is commonly affected by volvulus formation. Anatomical characteristics of this part of the colon could provide some of the contributory explanations for male gender predisposition. METHOD: Ninety five sigmoid colons (fifty male subjects) were harvested at autopsy. The following measurements were made: length of the sigmoid colon, length of the mesocolon root, height of the mesocolon. The sigmoid length. mesocolic root length ratio and sigmoid length: mesocolic height ratios were also calculated. All means and ratios were compared for gender using the Student t-test. P < 0.05 was considered statistically significant. RESULTS: The mean sigmoid colon length was higher in males (36.9cm) than in females (32.6cm) (p=0.007). Most (41.7%) of the sigmoid colons measured 30-34.9cm long. Males had shorter mesocolon roots and longer mesocolon heights. CONCLUSION: The greater colon length and smaller mesocolic root lengths in males may be the anatomical basis for the higher incidence of sigmoid volvulus in males.
    09/2009; 1(1). DOI:10.4314/aas.v1i1.45798
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    ABSTRACT: Ventral hernia formation is a common complication of rectus abdominis musculocutaneous flap harvest. The site and extent of harvest of the flap are known contributing factors. Therefore, an accurate location of the arcuate line of Douglas, which marks the lower extent of the posterior wall of the rectus sheath, may be relevant before harvesting the flap. This study is aimed at determining the position of the arcuate line in relation to anatomical landmarks of the anterior abdominal wall. Arcuate lines were examined in 80 (44 male, 36 female) subjects, aged between 18 and 70 years, during autopsies and dissection. The position of the arcuate line was determined in relation to the umbilicus, pubic symphysis, and intersections of rectus abdominis muscle. Sixty four (80.4%) cases had the arcuate line. In most cases (52), this line was located in the upper half of a line between the umbilicus and the pubic symphysis. Most males (93%) had the arcuate line, while more than a third of females did not have it. In all these cases, the line occurred bilaterally as a single arcade, constantly at the most distal intersection of the rectus abdominis muscle. Consequently, the arcuate line is most reliably marked superficially by the distal tendinous intersection of the rectus abdominis muscle. Harvesting of the muscle cranial to this point will minimize defects in the anterior abdominal wall that may lead to hernia formation.
    Clinical Anatomy 01/2009; 23(1):84-6. DOI:10.1002/ca.20877 · 1.16 Impact Factor
  • International Journal of Morphology 01/2009; 27(4). DOI:10.4067/S0717-95022009000400041 · 0.20 Impact Factor
  • H Saidi, K O Awori, P Odula
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    ABSTRACT: To describe the pattern of gender-associated violence amongst adult survivors. Descriptive case analysis of prospectively collected data. The gender violence and recovery centre (GVRC), a shelter and violence treatment facility for the gender-associated violence at the Nairobi Women's hospital (NWH). Data on 663 consecutive adult patients who presented to GVRC between February 2003 and April 2004 were evaluated. The patients age ranged from 18 to 74 years (mean 27.7 years). Four hundred and eight patients (61.5%) presented following sexual assault. Most of assaults were perpetrated at night. A stranger was the assault perpetrator in 75.1% and 2% of sexual and non-sexual assault respectively. An intimate partner was the perpetrator in majority (86.5%) of nonsexual violence. Most physical injuries were minor bruises and swellings. The rate of positive spermatozoa from high vaginal swabs was only 15.9% in cases of sexual assault. Sexual assault was significantly associated with single status of the victim and assault by more than one assailant. Violence against women is a common public health problem in the city of Nairobi. Women are vulnerable both in and out of the home. More efforts, including massive public education, are needed to protect this vulnerable population.
    East African medical journal 08/2008; 85(7):347-54. DOI:10.4314/eamj.v85i7.9647
  • H S Saidi, D Karuri, E O Nyaim
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    ABSTRACT: To evaluate the colorectal cancer clinical data with respect to the anatomical location and stage of disease. Retrospective observational study. Kenyatta National Hospital (KNH), Nairobi, Kenya. Two hundred and fifty three tumours were categorised as right colonic (RCC), left colonic (LCC) and rectal (RC) lesions. The distribution of symptoms (rectal bleeding, tenesmus, change in bowel habits, abdominal pain, intestinal obstruction, rectal mass), anaemia, transfusion requirement, and the Dukes' stages were compared for right colon, left colon and rectal tumours. There were 54 RCC, 59 LCC, 140 RC lesions. Patient delay from onset of symptom(s) to presentation was a mean of 26.6 +/- 43, 20 +/- 25 and 33.7 +/- 42 weeks for right, left and rectal lesions respectively (p = 0.092). The proportion of patients presenting with rectal bleeding was 21%, 44% and 79% for RCC, LCC and RC lesions, respectively. The prevalence of intestinal obstruction was 14.8%, 27.1% and 43.6% in right, left and rectal lesions, respectively. The haemoglobin levels were significantly lower for right sided lesions (p = 0.05 for right colon/rectum pair; p = 0.059 for right colon/left colon pair). The sites of the lesions had no relationship to the stage of disease at presentation. In patients with colorectal cancer, the duration of symptoms was prolonged irrespective of the anatomical sub-sites. Symptoms were evenly distributed across the anatomical regions except for bleeding and obstruction which predominated in rectal and left colon cancers respectively. This underlines the need for early investigations in patients with rectal bleeding, change of bowel habit, intestinal obstruction and anaemia.
    East African medical journal 07/2008; 85(6):259-62. DOI:10.4314/eamj.v85i6.9622
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    ABSTRACT: To describe the topography and anatomical variations of the carotid arteries among Kenyans. A descriptive cross-sectional study. Department of Human Anatomy, University of Nairobi. Eighty carotid arteries of forty cadavers were dissected. The bifurcation of the commonest carotid artery was high (above the reference points) in 63.8% of vessels and the external carotid was antero-lateral to the internal carotid artery in 30% of the vessels. A linguo-facial trunk was the most common variation of the external carotid artery. The origin of the right common carotid artery was high and low in 10% and 2.6% of vessels respectively. The carotid arteries show important variability and thus emphasise caution for clinicians during surgical procedures in the neck.
    East African medical journal 06/2008; 85(5):244-7. DOI:10.4314/eamj.v85i5.9619
  • European Journal of Anatomy 01/2008; 12(1):89-95.
  • European journal of medical research 01/2008; 13(2). · 1.40 Impact Factor
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    International Journal of Morphology 12/2007; 25(4):851-854. · 0.20 Impact Factor
  • International Journal of Morphology 01/2007; 25(4). DOI:10.4067/S0717-95022007000400027 · 0.20 Impact Factor