Journal of Medical and Health Sciences

Prevalence of psychological insulin resistance among adults with type 2 diabetes mellitus at PCEA Chogoria Hospital, Kenya

Lilian Kamita — 2026-08-21

The aim of this study was to estimate the prevalence of psychological insulin resistance (PIR) among patients with Type 2 Diabetes Mellitus (T2DM) aged 18 – 80 years attending PCEA Chogoria Hospital, Kenya. Psychological insulin resistance represents a major challenge in the effective management of T2DM, as it often delays or prevents patients from initiating and sustaining insulin therapy. This descriptive cross-sectional study employed consecutive sampling to recruit 121 patients with T2DM attending the outpatient clinic. Data were collected using validated instruments, including the Insulin Treatment Appraisal Scale (ITAS) to assess PIR, the Generalised Anxiety Disorder-7 (GAD-7) for anxiety screening, and the Patient Health Questionnaire-9 (PHQ-9) for depression assessment. Data analysis involved chisquare tests and Fisher’s exact tests to examine associations between variables. PIR was identified in (62.8%) of participants, primarily attributed to feelings of personal failure regarding disease progression reported by (77%) and fear of injections reported by (58%), indicating significant emotional and practical barriers to insulin acceptance. The RE highlight the critical role of psychological factors, particularly self-blame and needle anxiety, in insulin resistance. Integrating mental health support and tailored educational interventions into diabetes management programs may reduce PIR, improve insulin uptake, and enhance overall treatment outcomes for individuals with T2DM in rural Kenya.

Academic stress in undergraduate nursing education: An integrative review

Rose Kariuki — 2026-08-21

This integrative review examines the nature, prevalence, and implications of academic stress among undergraduate nursing students, drawing on peer-reviewed evidence published between 2021 and 2025. Academic stress levels in nursing students are consistently among the highest in higher education, attributed to intensive theoretical coursework, emotionally demanding clinical placements, financial pressures, and insufficient institutional support. A narrative review methodology was employed, utilising research from major health sciences databases. Inclusion criteria encompassed peer-reviewed empirical studies and systematic reviews published within the specified timeframe, focusing on undergraduate nursing students globally. The findings indicate that 65 to 80 per cent of nursing students experience moderate to high stress, with significant rates of anxiety, depression, and burnout reported annually. Inadequate stress management is associated with lower academic achievement, increased program attrition, poor physical health, and diminished professional readiness, with downstream effects on early nursing practice and patient safety. Common adaptive coping behaviours include mindfulness, social support, and time management, while maladaptive strategies such as emotional suppression and substance use are also prevalent. Institutional interventions such as curriculum redesign, faculty development, proactive psychological care, and high-quality clinical supervision demonstrate measurable effectiveness. Nursing education systems are urged to prioritise preventative approaches to student wellbeing, positioning resilience-building as a central component of professional preparation.

Fatal cardiovascular injuries in homicidal chest trauma: A prospective autopsy study of pattern, mechanism, and demographic distribution in Nairobi, Kenya

Peter Wangai Kiama — 2026-08-21

The purpose of this article was to determine the distribution, mechanisms, and demographic characteristics of cardiovascular injuries in homicidal chest trauma in Nairobi, Kenya. Cardiovascular injuries are the most lethal component of thoracic trauma, yet detailed structure-specific forensic data from sub-Saharan Africa remain limited. A prospective descriptive autopsy study was conducted at Nairobi City Mortuary between July 2009 and June 2010. A total of 915 violent chest trauma cases were examined within 72 hours post-mortem using a census of all eligible cases. Data were analysed using descriptive statistics and chi-square tests. Of the 915 cases, 544 (59.5%) were classified as homicide, with cardiovascular structures involved in 290 (53.3%) cases. Relative to all homicidal chest trauma cases, injuries to the heart accounted for 21.1 per cent, followed by the aortic arch (12.7%) and thoracic aorta (9.6%). Within the subgroup of cardiovascular injuries, these corresponded to (39.7%, 23.8%, and 17.9%), respectively. Males constituted 87.7 per cent of cases, while young adults aged 15 – 44 years accounted for 79.6 per cent, with the highest incidence occurring among those aged 25 – 34 years (35.2%). Penetrating trauma accounted for 59.0 per cent of homicidal cardiovascular injuries, compared with 41.0 per cent caused by blunt trauma. Cardiovascular injuries were significantly more frequent in homicide than in accidental deaths (χ^² = 18.4, p < 0.001). The findings demonstrate that injuries to the heart and aorta are the leading cause of mortality in homicidal chest trauma in Nairobi, disproportionately affecting young adult males and arising mainly from penetrating trauma. These findings support targeted violence prevention strategies and strengthened trauma care systems.

Madelung deformity: A case report of a young Nigerian man

Taofeek Abiodun Ajadi — 2026-08-21

The purpose of this article is to emphasise the influence of cultural orientation as a factor that could lead to delays in the diagnosis of some wrist deformities. This is important in improving the need for detailed clinical evaluation and judicious radiological investigation of wrist deformities so as to prevent undue physical, economic, and artistic losses among patients with such conditions. Madelung deformity involves the arrest of growth at the medial distal end of the radius, resulting in abnormal wrist alignment and angulation. It occurs more frequently in women than in men, and cases remain underreported despite the possibility of diagnosis using conventional radiography. A 27-year-old male patient presented with recurrent wrist pain and inability to use the right wrist. Clinical examination indicated the presence of a deformity affecting the right wrist. A right forearm X-ray, including the elbow and wrist joints in anteroposterior and lateral views, demonstrated lateral bowing of the radial shaft, widening of the interosseous space, a radial inclination angle of 34.68°, and positive ulnar variance. These findings were consistent with Madelung deformity. This case report highlights the value of obtaining a comprehensive clinical history, including relevant cultural considerations, alongside a thorough physical examination when diagnosing Madelung deformity. It also highlights the value of the early and judicious use of X-ray imaging as a diagnostic tool, even in low-resource settings. Early diagnosis facilitates timely conservative or surgical management, which is likely to result in better clinical outcomes while minimising economic and artistic losses for the patient. Furthermore, this report adds to the existing body of knowledge and contributes to promoting the early diagnosis and specialist management of Madelung deformity in low-resource settings through the effective use of conventional radiography.

Physicochemical, Sensory, Chemical Stability and Cost Evaluation of Beef Sausages Produced with Substitution of Fat with Bovine Blood

Pius M. Mathi — 2026-08-26

The purpose of this study was to develop a nutrient-rich and shelf-stable beef sausage by partially replacing animal fat with bovine blood. Fat is a fundamental ingredient in sausage formulation; however, animal fat is increasingly being implicated in ill health worldwide, prompting processors to rethink sausage formulations and explore low-fat alternatives. Various fat substitutes have been tested, with varied results, while bovine blood is widely accepted as a food ingredient in Kenya. A completely randomised design was used with fat-to-blood ratios of 20:0, 15:5, 10:10, 5:15, and 0:20. The sausages were evaluated for sensory properties and analysed for proximate composition, texture, cooking loss, water-holding capacity, iron content, fat oxidation using peroxide value for keeping-quality determination, and cost. One-way ANOVA was used to analyse the data, while Duncan’s multiple range test was applied to determine differences among the means. Twenty untrained panellists with familiarity with sausages participated in the sensory evaluation. The findings showed that fat substitution with blood above 10% was not considered acceptable by the panellists. However, substitution significantly increased the protein, iron, and water contents of the sausages (p < 0.05), while reducing water-holding capacity and increasing cooking loss. Reducing the fat content of the sausages led to reduced peroxidation, with a 5 per cent fat level yielding a peroxide value as low as 6.4 meq/kg. The study concluded that it is possible to produce an acceptable fresh beef sausage by partially substituting up to 10 per cent of the fat with bovine blood, while also reducing production costs.