THE PULSE - ISSUE 38

THE PULSE
Issue 38

HYPERTENSION AND What's Inside?
KIDNEY DISEASE
APPLICATION OF
By:  Dr. Khalida Soki NEURONAVIGATION
SYSTEM IN
Hypertension or commonly referred to as High NEUROSURGERY AT TNH
Blood Pressure is globally considered among the
primary causes of Kidney Disease and Kidney TNH host Neuronavigation Symposium
Failure.
VALENTINES AT TNH
What is Hypertension?
TNH spreads the love with staff and
It is the force exerted by your blood on the blood patients
vessels as it flows around your body. During your
hospital visits, it is among the first tests taken at
triage before you see a doctor. A blood pressure
cuff and the automated machine is used to
measure your blood pressure.

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When taking your blood pressure, the continues to damage your heart and blood
reading on the automated machine will vessels. This increases the risk of Stroke,
consist of 2 numbers at the top and the Heart Attacks, visual loss, and Kidney
bottom. The number at the top is called the Failure. Conversely, High Blood Pressure
Systolic Blood Pressure, it represents the could also be a symptom of kidney disease.
pressure generated by the heart when it
pumps. The lower number called the How does high blood pressure affect the
Diastolic Blood Pressure represents the kidneys?
pressure generated by the heart when it's
relaxed. Normal blood pressure ranges Each kidney contains more than a million
between 110 – 129 / 60 – 79 mmHg. The filtering units called nephrons. The
pre-hypertension stage is between 130 – 139 nephrons are made up of tiny blood vessels.
/ 80 - 89 mmHg. If your blood pressure When these blood vessels become damaged
reads above 140 / 90 mmHg, you are by hypertension, they are progressively
considered to be Hypertensive. unable to filter toxins and excess water out
of the body. Gradually, the percentage of
Normal blood pressure ranges between 110 – 129 / 60 – kidney function reduces and this leads to
79 mmHg. The pre-hypertension stage is between 130 – kidney failure. This can happen suddenly,
139 / 80 - 89 mmHg. If your blood pressure reads above termed as Acute Kidney Failure; or for many
140 / 90 mmHg, you are considered to be Hypertensive years, called Chronic Kidney Disease (CKD);
eventually leading to Chronic Kidney
Why is it important to monitor your Failure.
blood pressure?
How can the kidneys cause High Blood
Measuring your high blood pressure may be Pressure?
assumed as basic and unnecessary. On the
contrary, Hypertension is considered of CKD can be caused by High Blood Pressure
concern overtime if uncontrolled. It but it may also be caused by other diseases
such as Diabetes, Heart Failure, infections
and inflammatory diseases of the kidneys
(Glomerulonephritis).

More than half of people with CKD have
high blood pressure. This is because the
kidneys play a major role in regulating blood
pressure in your body, through the
production of various hormones. As the
kidney function declines, so does its ability
to regulate blood pressure, causing
hypertension. Hypertension then damages

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the kidneys further, as well as the heart and As the kidney function declines, so does its ability to
other blood vessels around the body. regulate blood pressure, causing hypertension

How can I prevent kidney disease caused How often do I need to get my kidney
by high blood pressure? function checked?
Early kidney disease can only be detected
    using a simple blood Kidney Function test.
Check your blood pressure regularly Get your kidney checked at least once a year
If you are already hypertensive, control if you have:
your blood pressure. Take your      
medications as prescribed by the doctor
Adopt a healthy diet. Eat less sodium, High blood pressure
such as that found in processed foods, Diabetes
and less fat. Speak with a dietician if Heart disease
required      A family history of kidney disease
Control your blood sugar if you It is important to note that Kidney Disease
have diabetes does not have to lead to Kidney Failure.
Quit smoking or using tobacco
Limit your alcohol intake
Keep your body at a healthy weight. This
is by maintaining a Body Mass Index
(BMI) range of 18.5 – 24.9
Be active most days of the week
Limit stress

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APPLICATION OF Due to imaging modalities being more
NEURONAVIGATION refined, available and cost-effective,
SYSTEM IN Stereotactic Surgery commonly known as
NEUROSURGERY AT TNH Neuronavigation has been made possible.
This technology uses computer-assisted
By:  Dr. Michael Magoha technology to perform minimally invasive
Anatomical knowledge is the cornerstone of surgeries within the skull confines.
surgical management of disease pathology.
An experienced surgeon can testify to the Neuronavigation gets its name from Neuro-
nuances and variations in similar diseases radiologists that helped transfer imaging
presenting in two different people due to inCfhoarrlmes aKtaiuomna (l(aK(biHnoAraMtotrehym)isbweirt)hcMasre. A.FM.B.ROIg)ott to the
inherent anatomical variation. To this end, operative field in real-time. Thereby
surgeons use a myriad of tools and assisting in real-time positioning of the
investigations to better prepare themselves surgeon whilst intra-op allowing directional
for situations they may encounter guidance for what may not be visible to the
intraoperatively. naked eye. Neuronavigation simultaneously
represents a complex, multimodal,
The use of imaging modalities such as information-based, widely adaptable
ultrasounds, X-rays, CT Scan and MRI is the technique, method, or device using
standard practice in pre-operative frameless stereotaxy (previously large
management. Using data from pre-operative expensive unwieldy frames were needed) for
imaging enables the surgeon to use a three- precise intraoperative guidance, orientation,
dimensional coordinate system to carry out and localization, with consequently greater
a minimally invasive surgical intervention surgical precision and possibilities for
known as Stereotactic Surgery. preoperative virtual simulation and
postoperative analysis of the surgical
Neuronavigation in action illustrating set up and its procedure.
use in assisting brain surgery
Despite its name, this “GPS for surgery” has
utilities in multiple surgical specialties such
as maxillofacial, Orthopedic, ENT as well as
none surgical fields for indications such as
ablation, biopsy direct organ space injection,
etc. This coupled with other assistive
technologies such as operating microscopes
has drastically increased the standard of
patient care worldwide.

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In June 2018 The Nairobi Hospital L-R; Dr. R. Ombachi, Mr. M. M. Qureshi & Mr. D.
purchased state-of-the-art electromagnetic Oluoch Olunya during a panel session
technology for the Stealth Station
Navigation system. This system is the second Symposium attendees during a session
of its kind in Kenya. This complements the
existing framework of assistive devices e.g.
operative microscopes, endoscopes,
fluoroscopy, etc.

To date, approximately 38 patients have
benefited from the use of Neuronavigation in
a wide range of procedures. They include
craniotomies for brain tumors, spine
surgeries, endoscopic sinus surgeries,
maxillofacial surgeries, multidisciplinary
cases, and biopsies.

In conjunction with Medtronic, The Nairobi
hospital conducted a Surgical Navigation
Symposium and Live Surgery Seminar from
the 5th to the 8th of February 2020. The aim
was to sensitize and train surgeons and
patients to ensure the continuous quality
improvement of services to our patients.

Mr. Baraza (MAC Chairman) opening the forum Dr. M. Magoha explaining the history of
Neuronavigation

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THE NAIROBI HOSPITAL Upon visiting the Hospital as advised, an
GIVES HOPE TO BABY ultrasound was done but wasn’t clear what
BEVERLY’S FAMILY the problem was and hence needed an MRI
to get a diagnosis. MRI's are usually quite
By: Beth Njoroge – M&CS costly. Benjamin is the sole breadwinner for
this family and relies mostly on seasonal
Baby Beverly was only 3 months old when construction work to provide. Hence, it was
her parents, Benjamin and Caroline Mitungi, quite challenging for this family to raise
noticed that she wouldn’t maintain balance approximately Kshs. 20,000 for an MRI.
when assuming a sitting position. Beverly is a They didn’t know what to do.
curious baby, and when she saw her parents
sit, she would want to sit too.  “When The piece of land in which they live in is
Beverly sat, she would look as though she owned by a lady who allowed them to build a
was leaning too much on her right side”, home. Upon her usual visits, Benjamin
Caroline explained. “We didn’t pay much opened up about the problem they are facing
attention to it. She was still young to sit with their child. She was kind enough to
properly without leaning on one side or refer them to her friend, Dr. Kambuni
without falling”. (Pediatric Surgeon) for his assistance.
Through his assistance, they were able to do
As she grew older, the problem became an MRI which was able to reveal Beverly’s
persistent. It is expected that by the time problem. Dr. Kambuni explained that Baby
your child gets to the age of 8 months, Beverly had a Lipoma that was sitting on the
he/she can sit for a few minutes without Sciatic Nerve.
support.  At around the same time, you
should  be able to  help  him/her to  stand  up A Lipoma is a slow-growing, fatty lump
by gently pulling him/her up and then giving that's most often situated between the skin
him/her support. Also, your child should be and the underlying muscle layer. Generally,
adding weight gradually. Unfortunately, this it is harmless and non-cancerous.
was not the case for Baby Beverly. She was Nonetheless, it can be painful if it grows near
still unable to sit on her own. Her left leg was a nerve. In Beverly's case, the Lipoma was
extremely weak and wouldn’t assume a lying on the Sciatic Nerve. This is the longest
standing position even with support. During and widest nerve in the human body. It runs
a normal visit to a local clinic in Kitengela, from the lower back, through the buttocks,
the attending nurse noticed that Beverly’s and down the legs, ending just below the
left buttock was quite swollen and she had knee. This nerve controls several muscles in
also lost so much weight. The Nurse advised the lower legs and supplies sensation to the
that they should visit Machakos Level 5 skin of the foot and the majority of the lower
Hospital for further investigations. leg. This resulted in weakness on her left leg.
As a result, surgical treatment was necessary

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to remove the Lipoma. The thought of a Baby Beverly Kerubo
surgical procedure on their young child and Baby Beverly and her mother Caroline Mitungi
the cost implication that comes with it was
grueling.  They felt hopeless.

Dr. Kambuni went the extra mile and
approached The Nairobi Hospital (TNH) to
assist this young family as they had no means
to cater to Beverly's treatment. Upon
engaging TNH management, it was
concluded that this case was needy and the
Hospital's intervention was necessary.
Towards the end of 2019, Beverly went
through a successful surgery and discharged
3 days later. Baby Beverly is a year old now.
It’s been a few months post-surgery and she
is recovering well. She can now sit
comfortably, walk with support, and have
since started gaining weight gradually.

Through a letter written by Beverly’s
parents, they expressed their sincere
gratitude to TNH. Special thanks were to Dr.
Kambuni, the theatre team, and St. Mary's
Ward team. These teams gave their daughter
a second chance and made their stay at the
Hospital comfortable. “We shall always
continue praying for TNH. May you flourish
and continue giving hope to all”, they said.

We wish Beverly and her family well as she
grows up!

Baby Beverly with her parents Benjamin & Caroline
Mitungi

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VALENTINES DAY AT Stella Owaki (M&CS) & ChN. Betty-Jane Kung'u
TNH (Maternity) spreading the love with a client

By: Stella Owaki - M&CS L-R; Rose Musau,Leah Kamaliki, Lilian Nyatome &
Gladys Kibe from A&E
This year, Valentines Day fell on a Friday
and as is the norm, The Nairobi Hospital Staff who went an extra mile as per the day's theme
took this opportunity to spread the love. The
M&CS team indulged in some activities
throughout the day at the Main hospital and
all the satellite clinics.

The activities conducted includes:

Chocolate gifting’s to all our staff and
inpatients
Red Roses gifting to all our female staff
and patients
Teddy Bear gifting to all the babies born
on 14th February 2020
Gifting to all the best dressed ladies and
gentlemen in red. They were treated to a
Red carpet prize giving ceremony.

Some uniformed staff went to the extra mile
of custom making their uniforms to align
with the day’s theme while other none
uniformed staff went to the extra mile of
finding a theme adhering outfit from their
closets. Thank you for your support on this
day. Let’s keep the spirit of Valentines
throughout the year!

L-R; Ag. Head M&CS Maryanne Wahito, Martin
Nyoike (Security) & Angela Mburu (IT)

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VALENTINES SPECIAL From L-R; SrN. Agnes Ngatia (Psycho-Social) and Dr.
CANCER SUPPORT Dennis Mbuve (Pharmacy)
GROUP

By: Glorias Muchina - M&CS

The Nairobi hospital cancer support group
meeting is held every 2nd Tuesday of the
month. The 2nd meeting of the year was
held on 13th February at the Oncology
seminar room.

We had a special valentine's day treat for the
warriors, patients, and caregivers who
managed to come. The purpose of this
meeting is to provide patients with a
comfortable environment to share their
experiences and journey post-diagnosis. It
was well represented by the Oncologists,
dieticians, nursing team and other medical
professionals.

Dr. Mbuve gave a talk on HPV Vaccine and 
Cervical Cancer, while Judith Thumbi
(Hospital Counselor) had a presentation on
Keeping love alive.

Sr. Judith Thumbi propelling a discussion From L-R; Patricia Macharia (warrior), Rev. Phillip Owour
(Hospital Chaplain), John Kiprop ( Oncology), Miriam
Ndirangu (warrior) & Faith Rotich (Dietitian)

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TNH Q1 PRAYER DAY 2020

In pictures

TNH Choir entertaining the attendants

Rev. Cannon Dr. Rosemary Mbogo delivering a sermon Attending staff participating in Praise &Worship

LENT, A JOURNEY WITH Family Basilica to mark the World Day of
AND FOR CHRIST the Sick which was observed on 13th
February 2020. The main Celebrant was the
By: Bernard Omondi - Quality Hospital Chaplain, Rev Fr. Francis Maina
assisted by Rev Fr. Paul Kabito.
The Nairobi Hospital observed the
Solemnity of Ash Wednesday (26th March Many of us look at Lent as a season of
2020, celebrating Holy Mass at the Hospital's refraining from something or giving it up
Amphitheatre. This marked the beginning of altogether. Yes, that is true. But more
the Lenten Season in the Catholic Church. importantly, Lent is made of three very
This came less than two weeks after the distinct themes that are the essence of our
Hospital sent representatives to the Holy being. First is fasting or in another way,

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abstinence, the staying away from or giving not diminish or extinguish our own. On the
up that we mentioned earlier. Second is contrary, with more candles that we light,
prayer; the encounter with God, the the room (read, the world) becomes brighter.
conversation with our Father and taking
extra moments to read the Scripture and Mother Theresa said that if you cannot feed
finding a quiet corner to spend time with the world, feed just one person. To
God. Visiting the adoration chapel is also a paraphrase her, use this Lenten season to
blessing at this time and an additional make it about someone else. And on the
opportunity to pray for those who have same breath, St. Pope John Paul II reminds
asked us to pray for them, and even for those us that, "'Your Father who sees in secret will
who have not asked us but need our prayer. reward you" (Mt 6: 4, 6, 18). Jesus' words are
And the third is alms-giving. addressed to each one of us at the beginning
of our Lenten journey. We begin it with the
When you decide to fast, abstain or refrain imposition of ashes, an austere penitential
from something, let it come from a place of gesture very dear to Christian tradition. It
love, prayer, penance, and giving-of-self. emphasizes the awareness of sinners as they
And in life today, we are spoilt for choice; stand before the majesty and holiness of
drop the phone and pick up actual face to God. At the same time, it demonstrates
face conversation with someone that you readiness to accept and to transform into
concrete choices adherence to the Gospel."
TNH representatives at Holy Family Basilica during
the World Day of the Sick Therefore, if it is for us that service to the
sick is our calling, then perhaps this Lenten
love, drop the evening trip to the club and season is another opportunity to care just a
pick up an evening trip to the gym, drop the little more, go just a little further and sing
occasional drink and pick up a shopping just a little louder. We will be doing it for the
basket to the children's home, learn a new greater glory of God; God present in the
skill, teach a new skill, coach your son or little sick child we visit, in the old lady whose
daughter's swimming team. Let this remind wound we cleaned, and in the first time
us that lighting someone else's candle does mother you just taught how to breastfeed.

In the words of Pope John Paul II, "By
inviting us through the discipline of Lent to
tread the paths of love and hope marked out
by Christ, the Church makes us realize that
the Christian life involves detachment from
superfluous goods, and the acceptance of a
poverty which sets us free, and enables us to
discover God's presence and to welcome our

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brothers and sisters with an ever more active
solidarity and in an ever wider fellowship."

May you all have a blessed Lenten season.

Some TNH Staff during the mass

Father Francis Maina placing ash on SrN. Margaret
Nyangau forehead

Father Francis Maina placing ash on Innocent Mose's
forehead

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FEBRUARY 2020 ACTIVATIONS

Southfield Mall activation

Nancy Munnai (Southfield OPC) with a client Sylvia Ngunju (Southfield OPC) with a client

Toyotsu activation

Andrew Okanga (Capital OPC) with a client Daniel Kirocho (Capital OPC) with a client

PCEA Gateway Church activation

Sn. Milcah Olukhutsi giving a Breast Cancer PCEA Gateway Church health team & TNH team
Education talk share a photo moment

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44TH ANNUAL AEEDC DUBAI ORAL AND
CONFERENCE AOMSI IN MAXILLOFACIAL
BENGALURU SURGERY CONFERENCE

In pictures In pictures

Dr. Eric Kahugu (Maxillofacial Surgeon) during his Dr. Eric Kahugu (Maxillofacial Surgeon) during his
presentation on Craniofacial Injuries presentation

From second to left; Prof. Mon Kuriakose, Prof. Sanjiv From second to left; Prof. Alejaxnadro Martinez, Prof.
Nair, Prof. Greorio Anoceto &Dr. Eric Kahugu Juio Acero, Prof. Sat Parmar & Dr. Eric Kahugu

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ENDOSCOPIC ULTRASOUND (EUS) WORKSHOP

In pictures

Dr. Ankit Dalal leading Dr. Betty Musau & Prof. E. Ogutu leading a training session
Endoscopy Unit team during a hands on session

THE NAIROBI HOSPITAL STARS

Cancer Centre team appreciated by a Endoscopy team appreciated by Prof. PMC team appreciated by a happy client
patient Ogutu for their excellent participation

during the EUS Workshop

POSITIVE FEEDBACK

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THE NAIROBI HOSPITAL NEW STAFF

Welcome to The Nairobi Hospital; the leading healthcare provider in East and
Central Africa!

NAME JOB TITLE

Hawa Ahmed Suleiman Senior Radiotherapist
Ndambuki Phelomena Kavete Staff Nurse
Tambasi Vallary Abramis Staff Nurse
Karanja Irene Njeri Staff Nurse
Kadhi Rufeida Mohammed Staff Nurse
Muiruri Ann Wanjiru Staff Nurse
Mukuni Eric Shirandula Staff Nurse
Masese Ann Nyakerario Staff Nurse
Thiong'o Purity Wambui Staff Nurse
Njeri Susan Wambui Staff Nurse
Gitahi Teresia Njeri Staff Nurse
Mwangi Margaret Wanjiru Staff Nurse
Ndung'u Hilda Wanjiru Staff Nurse
Nyamai Francis Special Projects Manager
Mburu Jeremano Muiruri Performance Monitoring and
Evaluation Manager
Kiurire Rose Nyambura Laboratory Technologist II
Odida Oliver Omondi Driver
Muhingi Joshual Lumwaji Driver

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DEATH
NOTIFICATION

Unfortunately,  in  the  midst  of  all  the
activities  at  the  Hospital,  we  are  mourning
the demise of :

Mrs. Esther Kieti, mother to Susan
Kieti, Assistant Director Nursing
Services, who passed away on Sunday,
16th February 2020

January 2020 trivia question February 2020 trivia question

Who is the Chairman and Vice- Is Novel Corona Virus transmittable 
chairman of the KHA Board of through parcels from China?
Management?
Share your answer with
Chaiman - Dr. Wilfred Irungu Ndirangu [email protected]
Vice-Chaiman - Hon Dr.Chris M. The 1st correct participant will be awarded.
Bichage Good luck!

January 2020 trivia question winner

Joan Amunga
Nursing