Factors influencing Choice of Paediatrics as a Career among Medical Students at the University of Nairobi; Kenya

Objective. We aimed to determine factors influencing choice of a career in paediatrics by medical students in Kenya. Methods. A cross-sectional survey of 450 medical students from the University of Nairobi; Kenya; was undertaken using aquestionnaire designed to assess their preferences with regard to future specialisation; and timing of and factors influencing this choice. The data were analysed using the Statistical Package for Social Sciences. Results. The response rate was 385/450 (85.6). Paediatrics was the second most preferred specialty after surgery; and was chosen by 50 students (13.0). Female students were five times more likely than males to select paediatrics. Choice of paediatrics as a career was mainly determined by perceived intellectual challenge; presence of a role model; and ease of combining a careerwith raising a family. Those who had completed a clerkship in the specialty reported that they were encouraged by the teaching and clinical staff (p=0.006); but found the specialty less prestigious than others (p=0.030). None of the male students but 12 of the female students (30) considered gender distribution to be a factor influencing their career choice (p=0.046). Conclusion. This study indicates that paediatrics is popular among female students and that several factors influence choice of this specialty. Understanding these factors may help medical school administrators and faculty plan future recruitment strategies

Variations in the pattern of formation of the abdominis rectus muscle sheath among Kenyans / Variaciones en el patrón de formación de la vaina del músculo recto abdominal en kenianos

The pattern of formation of the human rectus sheath exhibits variations, it is not clear if these variations are population specific. This study aimed at describing the pattern of formation of the rectus sheath in a select Kenyan population. Formation of the rectus sheath was analyzed in eighty subjects (47 male, 33 female) during autopsies and cadaveric dissection. The anterior wall of the rectus sheath in all cases was aponeurotic and firmly attached to rectus abdominis muscle. The posterior wall of the rectus sheath was aponeurotic in 71 (88.5 percent) cases, the rest were musculoaponeurotic and only seen in males. In all cases the aponeurosis of internal oblique abdominis split into two lamina; a deep lamina that fused with the aponeurosis of transverses abdominis at the lateral border of rectus abdominis and a superficial lamina that fused with aponeurosis of external oblique abdominis mid-way between the medial and lateral borders of rectus abdominis muscle. The pattern of formation of the rectus sheath among Kenyans shows some variations which have not been reported by previous workers. Knowledge of these variations is important in surgery as this sheath is always incised when making most aabdominal incisions.

El patrón de formación de la vaina del músculo recto abdominal humano muestra variaciones, no está claro si estas variaciones son población-específicas. Este estudio tiene como objetivo describir el patrón de formación de la vaina del músculo recto del abdomen en una población seleccionada de Kenia. La formación de la vaina del músculo recto del abdomen se analizó en 80 sujetos (47 hombres, 33 mujeres) durante autopsias y disección de cadáveres. La pared anterior de la vaina del músculo recto en todos los casos era aponeurótica y firmemente unida al músculo recto abdominal. La pared posterior de la vaina del músculo recto era aponeurótica en 71 (88,5 por ciento) casos, las paredes restantes eran musculoaponeuróticas y sólo se observaron en varones. En todos los casos, la aponeurosis del músculo oblicuo interno del abdomen se dividió en dos láminas, una lámina profunda que se fusionaba con la aponeurosis del músculo transverso del abdomen en el borde lateral del músculo recto del abdomen y una lámina superficial que se fusionaba con la aponeurosis del músculo oblicuo externo del abdomen a mitad del recorrido entre los bordes medial y lateral del músculo recto del abdomen. El patrón de formación de la vaina del músculo recto del abdomen, entre los kenianos muestra algunas variaciones que no han sido reportadas en trabajos anteriores. El conocimiento de estas variaciones es importante en cirugía ya que esta vaina es seccionada en abordajes abdominales.

Anatomic position of the pterion among Kenyans for lateral skull approaches

The pterion is a point of sutural confluence seen in the norma lateralis of the skull where frontal, parietal, temporal and sphenoid bones meet. The position of the pterion exhibits population-based variations. Location of this point is important in surgical approaches to the anterior and middle cranial fossae. Specific measurements were taken on both sides of 90 (51 male, 39 female) Kenyan human skulls. The distances from the center of pterion to the frontozygomatic suture were 38.88+3.49 mm on the right side and 38.24+3.47 mm on the left side. The pterion was 30.35+3.40 mm and 30.34+4.34 mm above the mid point of the zygomatic arch on the right and left sides, respectively. Males had statistically significant higher pteria compared to females being 39.31+3.28 mm and 37.35+2.97 mm above the midpoint of the zygoma, respectively. Frontozygomatic suture and mid point of the zygoma can reliably be used in locating the pterion. This information may be useful in planning prior to surgery especially where neuronavigation devices equipments are scarce.

La pterion es un punto de confluencia sutural visto en la norma lateral del cráneo, donde se unen los huesos frontal, parietal, temporal y esfenoides. La posición del pterion exhibe variaciones en la población. La ubicación de este punto es importante en abordajes quirúrgicos a las fosas craneales anterior y la media. Mediciones específicas se han realizado en ambos lados de 90 cráneos humanos Kenyanos (51 varones, 39 mujeres). Las distancias desde el centro de pterion a la sutura frontocigomática fue de 38,88+3,49 mm en el lado derecho y 38,24+3,47 mm en el lado izquierdo. El pterion fue ubicado 30,35+3,40 mm y 30,34+4,34 mm por encima del punto medio del arco cigomático en los lados derecho e izquierdo, respectivamente. Los hombres presentaron un pterion estadísticamente significativo superior en comparación con las mujeres, siendo de 39,31+3,28 mm y 37,35+2,97 mm por encima del punto medio del cigoma, respectivamente. La sutura frontocigomática y el punto medio del cigoma pueden ser utilizados como referencia fiables para localizar a el pterion. Esta información puede ser útil en la planificación previa a la cirugía, sobre todo cuando los equipos dispositivos de neuronavegación son escasos.