http://repository.mut.ac.ke:8080/xmlui/handle/123456789/45 Sun, 05 Apr 2026 09:16:54 GMT 2026-04-05T09:16:54Z http://repository.mut.ac.ke:8080/xmlui/handle/123456789/6894 The Great Mimicker: Chronic Thromboembolic Pulmonary Hypertension Gichuki, Joseph Maina; Malik, A.N; Kanyugo, A.M Chronic thromboembolic pulmonary hypertension (CTEPH) is a sub-category of pulmonary hypertension that is unique from other forms of pulmonary hypertension with regards to its pathogenesis, patient characteristics and management. By definition, CTEPH is precapillary hypertension with a minimum of one segmental perfusion abnormality on scintigraphy or a CT pulmonary angiogram having typical findings of CTEPH. Despite advancement in awareness, diagnosis and treatment of CTEPH, its prevalence has remained a question of concern in the field of medicine majorly contributed by its clinical presentation that mimics common cardiorespiratory diseases. This has largely been contributed by misdiagnosis and under-reporting of the incidence. Available data suggest an incidence of 0.56% for early diagnosis and 3% for late diagnosis/survivors. The commonest risk factors associated with CTEPH include unprovoked pulmonary embolism, recurrent pulmonary embolism and antiphospholipid syndrome. In this case report, we present a 24yr old female who presented to our outpatient clinic with features of heart failure and deep venous thrombosis initially being followed up for heart failure. The only clue towards CTEPH was the chronic leg swelling that was more pronounced on the left side otherwise a systemic inquiry was non-contributory. A Doppler ultrasound of the left lower limb demonstrated chronic deep venous thrombosis involving the femoral system of veins. Consistent with CTEPH was an echocardiogram that showed tricuspid regurgitation and elevated pulmonary pressures whereas a CT Pulmonary angiogram showed a dilated pulmonary artery trunk, dilated right ventricle and atrium, and pulmonary oligaemia. Wed, 01 Jan 2025 00:00:00 GMT http://repository.mut.ac.ke:8080/xmlui/handle/123456789/6894 2025-01-01T00:00:00Z http://repository.mut.ac.ke:8080/xmlui/handle/123456789/6882 Efficacy of Plant-based Repellents Against Anopheles Mosquitoes: A Systematic Review Wangai, Laura Nyawira; Kamau, Kenny Kimani; Munyekenye, Godwil; Nderu, David; Maina, Eva; Gitau, William; Murigi, Mary; Kamau, Susan; Njuguna, Mercy; Gichuki, Joseph; Otieno, Fredrick Mosquitoes are usually targeted using insecticides, insect growth regulators, and microbial agents. Indoor residual spraying and insecticide-treated bed nets. However, these strategies have negative effects on human health, the environment and induce resistance in a number of species. Eco-friendly tools have been recently implemented against mosquito vectors, including plant-based insecticides. To date few studies have adopted World Health Organization (WHO) Pesticide Evaluation Scheme guidelines for repellent testing against mosquitoes. This review presents a summary of recent information on development, and efficacy of plant-based repellents against Anopheles mosquitoes as well as promising new advances in the field. All eligible studies published up to April 2020 were systematically searched in several databases, namely PubMed/Medline, Scopus and Google scholar. The outcomes of interest were percentage repellency, protection time and additional properties identified in repellent compounds. A total of 27 trials met the inclusion criteria. The highest repellency effect against mosquitoes was conferred by citronella, followed by Ligusticum sinense extract, pine, Dalbergia sissoo, and Rhizophora mucronata oils with 100% protection for 8 to 14 hours. Furthermore, essential oils from plants such as lavender, camphor, catnip, geranium, jasmine, broad-leaved eucalyptus, lemongrass, lemon-scented eucalyptus, amyris, narrow-leaved eucalyptus, carotin, cedarwood, chamomile, cinnamon oil, juniper, cajeput, soya bean, rosemary, niaouli, olive, tagetes, violet, sandalwood, litsea, galbanum, and C. longa also showed >90% repellency within 8 hours against different species of Anopheles. Therefore, the review showed, essential oils and extracts of some plants could be formulated for the development of eco-friendly repellents against Anopheles species. Plant oils may serve as suitable alternatives to synthetic repellents in the future as they are relatively safe, inexpensive, and are readily available in many parts of the world. Wed, 01 Jan 2020 00:00:00 GMT http://repository.mut.ac.ke:8080/xmlui/handle/123456789/6882 2020-01-01T00:00:00Z http://repository.mut.ac.ke:8080/xmlui/handle/123456789/6881 Phytochemicals Extraction in Craterostigma Plantagineum Hoscht: Aqueous and Ethanol Solvents Gichuki, Joseph Maina; Ngw’ena, Gideon Magak; Marera, Domnic; Kanyugo, Anne Murugi Phytochemicals are plant bioactive compounds that are produced for their protection with some having medicinal value. Craterostigma plantagineum hoscht is a plant that is purported to have medicinal value and is used for treatment of pain, liver and diarrheal ailments. Extensive researches on phytochemicals present in Craterostigma plantagineum hoscht are missing. The aim of this study was to determine qualitative phytochemicals yield in ethanol and aqueous extracts of Craterostigma plantagineum hoscht. Materials and methods: Craterostigma plantagineum hoscht was harvested and allowed to air dry for one month. Grinding into powder form later followed this. Solvents used included 70% ethanol and distilled water. 500mg of Craterostigma plantagineum ground powder was soaked in 70% ethanol for 48 hours, filtered and vaporized in rotary evaporator. Aqueous extraction involved soaking of 500mg of ground powder in 250 millilitre distilled water, set in a shaker for 2 days, filtered, deep frozen for 48 hours and finally freeze dried for 72 hour. Chemicals used to test phytochemicals included 1% gelatin, chloroform, ferric chloride, sulphuric acid, lead acetate solution, magnesium turnings, 10% sodium chloride, acetic anhydride, Mayer’s reagent, ammonia and hydrochloric acid. Results: The yield included flavonoids, Saponins, tannins, cardiac glycosides, phenols, anthraquinones, alkaloids, terpenoids and sterols. Tannins, anthraquinones, flavonoids, sterols, cardiac glycosides, Saponins, and phenols were highly extracted in ethanol while aqueous extract yielded more alkaloids and terpenoids. Conclusion and recommendations: Ethanol extraction yielded more phytochemicals than aqueous. Nonetheless, some phytochemicals were better extracted in ethanol while others in aqueous making the choice of extraction method dependent on the phytochemical of interest. Sun, 01 Jan 2023 00:00:00 GMT http://repository.mut.ac.ke:8080/xmlui/handle/123456789/6881 2023-01-01T00:00:00Z http://repository.mut.ac.ke:8080/xmlui/handle/123456789/6879 Malignant Small Round Cell Tumor: A Rare Aggressive Malignancy-Case Report Gichuki, Joseph Maina; Ndunge, Loise; Gikonyo, Anthony; Masese, Charles; Wachira, Timothy; Luvayo, Duncan; Ponoth, Premanand Background: Malignant Small round Cell Tumor (MSRCT) is very rare group of tumors. Malignant cells have similar histologic appearance making it difficult to distinguish one from another, and poses a diagnostic challenge with needs for a multimodal approach. Immunohistochemistry and immunophenotyping by flow cytometry, reverse transcriptase polymer chain reaction (RTPCR) and fluorescence in situ hybridization are needed to confirm. The appropriate and best treatment in early stages of MSRCT is early surgical excision with chemoradiotherapy based on patient specification. Inspite of all these, tumors have poor prognosis and chance of recurrence are high. Method: Case study of a 27-year-old male who presented with a non-productive cough for 4 weeks, with feverish feeling with weight loss and shortness of breath and a new onset precordial chest pain non radiating and worse on exertion. On examination his vitals were: BP 121/91 mm of hg, pulse rate 114bpm, temperature 36.3 degrees Celsius, respiratory rate 24/per min, SPO2 96%.On examination, Elevated Jugular Venous Pressure, hyperactive precordium, displaced apex beat to 6th intercostal space anterior axillary line, muffled heart sounds and bilateral lower limb edema. Respiratory exam was unremarkable. Sputum gene expert was negative for mycobacterium tuberculosis and covid 19 rapid test was negative. Chest X Ray showed cardiomegaly and a transthoracic echocardiography revealed moderate-large pericardial effusion, with mild collapse of right atrium in diastole. Pericardiocentesis done showed hemorrhagic effusion with lymphocytes cell component, patient was initiated on treatment for TB pericarditis empirically. Three months later a chest CT scan done revealed extensive mediastinal/pericardial mass with lung nodules. An ultrasound guided mediastinal/Pericardial biopsy was done, revealed a poorly differentiated small round cell carcinoma. Results: Patient expired 14 weeks from the initial onset of symptoms while awaiting immunohistochemistry studies for specific diagnosis of the tumor and oncology review. Discussion: This demonstrates the complexity of establishing differential diagnosis of MSRCT in a resource limited setting with subsequent delay in treatment initiation, heralds poor prognosis. This also confirms difficulties in establishing differential diagnosis in poorly differentiated tumor. Sun, 01 Jan 2023 00:00:00 GMT http://repository.mut.ac.ke:8080/xmlui/handle/123456789/6879 2023-01-01T00:00:00Z