Lucy W Muchiri - Academia.edu (original) (raw)

Papers by Lucy W Muchiri

Research paper thumbnail of Risk factors for human papillomavirus and cervical precancerous lesions, and the role of concurrent HIV-1 infection

International journal of gynaecology and obstetrics, May 1, 1999

4 3-0. 4.5; 95% CI, 0.8᎐27.4. Conclusions: Our results indicate that HSIL and even invasive cance... more 4 3-0. 4.5; 95% CI, 0.8᎐27.4. Conclusions: Our results indicate that HSIL and even invasive cancer are highly prevalent in this setting of women on reproductive age considered to be at low risk for STDs, suggesting that routine Pap smear screening may save lives. ᮊ 1999 International Federation of Gynecology and Obstetrics.

Research paper thumbnail of Fine needle aspiration cytological findings in patients presenting with accessible head and neck masses at Kenyatta National Hospital

East African Medical Journal, 2019

The cytologic features of five cases of epithelial-myoepithelial carcinoma arising in major saliv... more The cytologic features of five cases of epithelial-myoepithelial carcinoma arising in major salivary glands (four parotid and one submandibular gland) are presented. All cases were initially diagnosed as low-grade malignancies. The smears were generally cellular, with no specific architectural pattern. Single cells and naked nuclei were prominent in all cases. A biphasic epithelial (small-cell) and myoepithelial (large/clear-cell) pattern was identified readily in two cases and with difficulty in one case. The biphasic pattern may be subtle or absent since the clear cells have a fragile cytoplasm and often appear as naked nuclei. The differential diagnosis includes adenoid cystic carcinoma, polymorphous low-grade adenocarcinoma, and cellular pleomorphic adenoma.

Research paper thumbnail of Quantitative assessment of oestrogen and progesterone receptors on fine-needle aspirates and cryostat sections of breast carcinomas: how does this compare with biochemical assays?

PubMed, May 1, 1993

In this study monoclonal antibodies to oestrogen receptors in the ER-ICA kit (Abbott) and to prog... more In this study monoclonal antibodies to oestrogen receptors in the ER-ICA kit (Abbott) and to progesterone receptors (Biogenex) were used to determine the presence of those receptors in fine needle aspirates and cryostat sections. The degree of positivity is semi-quantitated and the results compared to biochemical assays (Dextran-Coated Charcoal Method) performed on the same specimens. Out of 14 cases that were positive on the biochemical assay, 11 (77%) were positive on ER-ICA performed on the FNA material, and there was a 100% agreement on the cryostat sections (11/11). PR-ICA on the cytospin smears and cryostat sections agreed in 63% and 90% respectively.

Research paper thumbnail of Role of fine-needle aspiration biopsy in the diagnosis of breast lumps at the Kenyatta National Hospital

PubMed, Apr 1, 1993

During 1990-1991, all patients seen at the surgical out-patient clinic at the Kenyatta National H... more During 1990-1991, all patients seen at the surgical out-patient clinic at the Kenyatta National Hospital (KNH) with breast lumps had a fine-needle aspiration biopsy for diagnosis prior to open biopsy. Out of 105 that had corresponding surgical biopsies, 82 aspirates were considered satisfactory. Of these, the correct diagnosis was made in 59 (71%), another 12 (21%) were called benign but the correct histologic diagnosis was not made, 7 (8.5%) were correctly called negatives. The diagnostic accuracy of this method in differentiating benign from malignant was 95% in this study.

Research paper thumbnail of Cryotherapy Following Visual Inspection with Acetic Acid and Lugol's Iodine (Via/Vili) in Khwisero, Western Kenya: Lesson from the Field Affecting Policy and Practice

PubMed, Oct 1, 2013

Background: Cervical cancer can be prevented and mortality/morbidity reduced by early detection a... more Background: Cervical cancer can be prevented and mortality/morbidity reduced by early detection and referral. Developing countries are likely to benefit from more cost effective methods of screening and treatment. Visual inspection with acetic acid and Lugol's iodine (VIA/VILI) offers a see and treat solution thus an affordable and efficient way to identify pre-malignant lesions. Immediate treatment with cryotherapy can be offered if pre-malignant lesions are found on visual inspection. Cryotherapyis a simple procedure that is curative for dysplasia; it is likely to benefit cervical dysplasia cases picked early in resource poor settings, however there are several factors that hinder patients' access to this noble technique. Objective: Determine hindrances to cryotherapy for patients following positive results of VIA/VILI after referral. Design: Cross sectional Study Setting: Khwisero, Western Kenya. Subjects: Women attending a medical camp, willing to get screened for cervical cancer. Results: One hundred and nine patients were screened; seventy three (66.97%) were negative for VIA/VILI, twenty one (19.26%) were positive and referred for cryotherapy. Reasons for lack of follow up were financial constraints, lack of medical personnel at referral centres and poor access to the referral facilities.19.26% of women identified with positive lesions required intervention. No patient received cryotherapy following referral. Conclusion: There is urgent need for availability of cryotherapy machines and training of personnel who can perform cryotherapy at the primary care level. Regional studies on knowledge attitudes and practices about VIA/VILI and cryotherapy are required to provide reasons for the poor uptake of this procedure.

Research paper thumbnail of Triaging women with positive visual inspection with Acetic Acid (via) results with Liquid Based Cytology (LBC) at Cimas Medical Laboratories, Zimbabwe

East African Medical Journal, 2020

Research paper thumbnail of Fine needle aspiration cytology of thyroid nodules at Kenyatta National Hospital, Nairobi

East African Medical Journal, Mar 26, 2008

Objective: To determine the pattern of thyroidal nodules diagnosed by (FNA) cytology. Design: A c... more Objective: To determine the pattern of thyroidal nodules diagnosed by (FNA) cytology. Design: A cross-sectional study. Setting: Kenyatta National Hospital (KNH)-a University of Nairobi affiliated hospital. Subjects: Forty two patients seen at FNA clinic at KNH between June and August 2001. Results: The female to male ratio was 7:1, with the majority in the age group 31-50 years. Overall 88.1% patients had benign FNA cytologic diagnostic results, 2.4% had a malignant, and a suspicious result respectively and 7.1% were non-diagnostic. Cytological results were as follows, nodular goiter comprised 83.3%, non-diagnostic samples 7.1%, papillary carcinoma 2.4%, atypia 2.4%, thyroglossal cyst 2.4%, and thyroiditis 2.4%. Conclusion: The findings are comparable in terms of sex, age and FNA cytologic diagnostic results to other studies. FNA cytology offered clinicians the possibility of early diagnosis of benign (>70%) and malignant (<5%) lesions. The test was an outpatient procedure, safe, time saving, cost effective and helped determine the course of therapy in the management of patients with thyroid nodules.

Research paper thumbnail of BRCA1 and BRCA2 mutations and their clinical relevance in selected women diagnosed with triple-negative breast cancer in Kenya: a descriptive cross-sectional study

Pan African Medical Journal

Research paper thumbnail of Cytomorphological patterns of breast lesions among women with palpable breast lumps attending select teaching and referral hospitals in Kenya: a descriptive cross-sectional study

Pan African Medical Journal

Research paper thumbnail of High Risk Human Papillomavirus (Hr-HPV) Prevalence and Genotypes Detected in Women ≥ 30 Years Old who have Never been Screened for Cervical Cancer in Harare, Zimbabwe

Asian Research Journal of Gynaecology and Obstetrics, Jun 3, 2021

Research paper thumbnail of Comparison of visual inspection with acetic (VIA) results and cervical leep biopsy histological results in a population stratified by HIV status in Harare, Zimbabwe

East African Medical Journal, Jun 17, 2021

Research paper thumbnail of Utility of high-risk HPV (HR-HPV) and Liquid Based Cytology (LBC) for cervical cancer screening of unscreened women over 29 years old in Harare, Zimbabwe

East African Medical Journal, May 21, 2021

Research paper thumbnail of The Supermarket for Women's Reproductive Health: A Demonstration Intervention Project in Nairobi, Kenya

Research paper thumbnail of Complication of radiotherapy in the management

Journal of obstetrics & gynaecology of Eastern and Central Africa, 2012

Background: Cervical cancer is one of the most common female malignancies worldwide. Since the in... more Background: Cervical cancer is one of the most common female malignancies worldwide. Since the introduction of conventional Papanicolaou smear mortality from cervical cancer has reduced considerably. Despite its success, it has a sensitivity of only 51% and false negative rate of 5-10%. Approved Liquid Based Cytology (LBC) products by FDA claim a 65% increased detection rate of High Grade Squamous Intraepithelial Lesions (HGSIL) compared with conventional smears, as well as decreased unsatisfactory sample rates. Evidence shows that Liquid Based Preparation is more sensitive and accurate for the detection of both squamous and glandular lesions of the cervix. Studies of the accuracy of liquid based preparations reports sensitivity of 61-66% and specificity of 82-91%. Objective : To compare the performance of conventional Pap smear cytology, liquid based cytology and colposcopy clinical impression with colposcopic biopsy as the gold standard among women eligible for colposcopy in Ken...

Research paper thumbnail of Oestradiol And Progesterone Receptor Concentrations And The Metabolism Of Oestrogen In Uterine Leiomyomata

Research paper thumbnail of Patterns of lymphomas in Kenya

Journal of Hematopathology, 2008

Research paper thumbnail of Role of Fine Needle Aspiration 1N the Diagnosis of Neoplasms

Research paper thumbnail of Immunohistochemistry

Pathology, 2014

Background: Hematoxylin and eosin (H&E) stained cervical tissue sections are subject to subst... more Background: Hematoxylin and eosin (H&E) stained cervical tissue sections are subject to substantial rates of discordance among pathologists. p16INK4a immunohistochemistry has shown valuable additional information in the interpretation of cervical histology and reduced inter-observer disagreement of conventional histology. Objective: To determine the utility of p16ink4a expression in cervical biopsies reported negative and positive for dysplasia. Method: A total of 91 cases of colposcopic biopsies diagnosed as negative for dysplasia and cervical intraepithelial neoplasia, from 2011 to 2013, were reviewed on H&E stain and immunostained with p16INK4a. Results: Primary reports: negative for dysplasia 16, CIN1 23, CIN2 37 and CIN3 15. Age range: 21–65 years; mean age: 40.2 years. On review, negative for dysplasia were 32, CIN1 19, CIN2 16 and CINIII 24 (p < 0.001, with kappa value of agreement: 0.568). p16INK4A expression: All negative for dysplasia cases were non-immunoreactive; 19/23 and 18/19 cases of CIN1, primary and review results respectively, were negative (p < 0.001); 48.6% and 69% of CINII, primary and review results, respectively, were positive; and finally 80% and 96% of CIN3, primary and review results respectively, stained positive (p < 0.001). Conclusion: There is significant inter-observer variation in interpretation of cervical biopsies on H&E. p16INK4a expression correlates well with high grade lesions.

Research paper thumbnail of Risk factors for human papillomavirus and cervical precancerous lesions, and the role of concurrent HIV-1 infection

International Journal of Gynecology & Obstetrics, 1999

4 3-0. 4.5; 95% CI, 0.8᎐27.4. Conclusions: Our results indicate that HSIL and even invasive cance... more 4 3-0. 4.5; 95% CI, 0.8᎐27.4. Conclusions: Our results indicate that HSIL and even invasive cancer are highly prevalent in this setting of women on reproductive age considered to be at low risk for STDs, suggesting that routine Pap smear screening may save lives. ᮊ 1999 International Federation of Gynecology and Obstetrics.

Research paper thumbnail of Digital Archiving and Preservation of Cancer Records: Case of KNH/UoN Department of Pathology

International Journal of Computer Applications Technology and Research

Cancer is considered to be 3rd leading killer and 2nd among non-communicable diseases in Kenya Mu... more Cancer is considered to be 3rd leading killer and 2nd among non-communicable diseases in Kenya Mutinda J. (2019). Ferlay, et al (2013) noted there are about 37,000 new cases of cancer annually and annual mortality rate of 28,000. This indicates cancer records rapidly accumulate over time and more resources are needed to collect and manage cancer-related data. KNH/UoN Department of Pathology have for a long time kept their records using a paper-based system. Objective of the study was to review current record keeping system including the process of preserving, storing and retrieving cancer records and the challenges faced, develop a model to guide the archival of locally available cancer paper-records and a web based prototype to preserve and avails this information to a wide range of stakeholders. The study used descriptive research design involving 22 participants. Random sampling technique was used to select respondents among the sampled population. The intervention prototype was ...

Research paper thumbnail of Risk factors for human papillomavirus and cervical precancerous lesions, and the role of concurrent HIV-1 infection

International journal of gynaecology and obstetrics, May 1, 1999

4 3-0. 4.5; 95% CI, 0.8᎐27.4. Conclusions: Our results indicate that HSIL and even invasive cance... more 4 3-0. 4.5; 95% CI, 0.8᎐27.4. Conclusions: Our results indicate that HSIL and even invasive cancer are highly prevalent in this setting of women on reproductive age considered to be at low risk for STDs, suggesting that routine Pap smear screening may save lives. ᮊ 1999 International Federation of Gynecology and Obstetrics.

Research paper thumbnail of Fine needle aspiration cytological findings in patients presenting with accessible head and neck masses at Kenyatta National Hospital

East African Medical Journal, 2019

The cytologic features of five cases of epithelial-myoepithelial carcinoma arising in major saliv... more The cytologic features of five cases of epithelial-myoepithelial carcinoma arising in major salivary glands (four parotid and one submandibular gland) are presented. All cases were initially diagnosed as low-grade malignancies. The smears were generally cellular, with no specific architectural pattern. Single cells and naked nuclei were prominent in all cases. A biphasic epithelial (small-cell) and myoepithelial (large/clear-cell) pattern was identified readily in two cases and with difficulty in one case. The biphasic pattern may be subtle or absent since the clear cells have a fragile cytoplasm and often appear as naked nuclei. The differential diagnosis includes adenoid cystic carcinoma, polymorphous low-grade adenocarcinoma, and cellular pleomorphic adenoma.

Research paper thumbnail of Quantitative assessment of oestrogen and progesterone receptors on fine-needle aspirates and cryostat sections of breast carcinomas: how does this compare with biochemical assays?

PubMed, May 1, 1993

In this study monoclonal antibodies to oestrogen receptors in the ER-ICA kit (Abbott) and to prog... more In this study monoclonal antibodies to oestrogen receptors in the ER-ICA kit (Abbott) and to progesterone receptors (Biogenex) were used to determine the presence of those receptors in fine needle aspirates and cryostat sections. The degree of positivity is semi-quantitated and the results compared to biochemical assays (Dextran-Coated Charcoal Method) performed on the same specimens. Out of 14 cases that were positive on the biochemical assay, 11 (77%) were positive on ER-ICA performed on the FNA material, and there was a 100% agreement on the cryostat sections (11/11). PR-ICA on the cytospin smears and cryostat sections agreed in 63% and 90% respectively.

Research paper thumbnail of Role of fine-needle aspiration biopsy in the diagnosis of breast lumps at the Kenyatta National Hospital

PubMed, Apr 1, 1993

During 1990-1991, all patients seen at the surgical out-patient clinic at the Kenyatta National H... more During 1990-1991, all patients seen at the surgical out-patient clinic at the Kenyatta National Hospital (KNH) with breast lumps had a fine-needle aspiration biopsy for diagnosis prior to open biopsy. Out of 105 that had corresponding surgical biopsies, 82 aspirates were considered satisfactory. Of these, the correct diagnosis was made in 59 (71%), another 12 (21%) were called benign but the correct histologic diagnosis was not made, 7 (8.5%) were correctly called negatives. The diagnostic accuracy of this method in differentiating benign from malignant was 95% in this study.

Research paper thumbnail of Cryotherapy Following Visual Inspection with Acetic Acid and Lugol's Iodine (Via/Vili) in Khwisero, Western Kenya: Lesson from the Field Affecting Policy and Practice

PubMed, Oct 1, 2013

Background: Cervical cancer can be prevented and mortality/morbidity reduced by early detection a... more Background: Cervical cancer can be prevented and mortality/morbidity reduced by early detection and referral. Developing countries are likely to benefit from more cost effective methods of screening and treatment. Visual inspection with acetic acid and Lugol's iodine (VIA/VILI) offers a see and treat solution thus an affordable and efficient way to identify pre-malignant lesions. Immediate treatment with cryotherapy can be offered if pre-malignant lesions are found on visual inspection. Cryotherapyis a simple procedure that is curative for dysplasia; it is likely to benefit cervical dysplasia cases picked early in resource poor settings, however there are several factors that hinder patients' access to this noble technique. Objective: Determine hindrances to cryotherapy for patients following positive results of VIA/VILI after referral. Design: Cross sectional Study Setting: Khwisero, Western Kenya. Subjects: Women attending a medical camp, willing to get screened for cervical cancer. Results: One hundred and nine patients were screened; seventy three (66.97%) were negative for VIA/VILI, twenty one (19.26%) were positive and referred for cryotherapy. Reasons for lack of follow up were financial constraints, lack of medical personnel at referral centres and poor access to the referral facilities.19.26% of women identified with positive lesions required intervention. No patient received cryotherapy following referral. Conclusion: There is urgent need for availability of cryotherapy machines and training of personnel who can perform cryotherapy at the primary care level. Regional studies on knowledge attitudes and practices about VIA/VILI and cryotherapy are required to provide reasons for the poor uptake of this procedure.

Research paper thumbnail of Triaging women with positive visual inspection with Acetic Acid (via) results with Liquid Based Cytology (LBC) at Cimas Medical Laboratories, Zimbabwe

East African Medical Journal, 2020

Research paper thumbnail of Fine needle aspiration cytology of thyroid nodules at Kenyatta National Hospital, Nairobi

East African Medical Journal, Mar 26, 2008

Objective: To determine the pattern of thyroidal nodules diagnosed by (FNA) cytology. Design: A c... more Objective: To determine the pattern of thyroidal nodules diagnosed by (FNA) cytology. Design: A cross-sectional study. Setting: Kenyatta National Hospital (KNH)-a University of Nairobi affiliated hospital. Subjects: Forty two patients seen at FNA clinic at KNH between June and August 2001. Results: The female to male ratio was 7:1, with the majority in the age group 31-50 years. Overall 88.1% patients had benign FNA cytologic diagnostic results, 2.4% had a malignant, and a suspicious result respectively and 7.1% were non-diagnostic. Cytological results were as follows, nodular goiter comprised 83.3%, non-diagnostic samples 7.1%, papillary carcinoma 2.4%, atypia 2.4%, thyroglossal cyst 2.4%, and thyroiditis 2.4%. Conclusion: The findings are comparable in terms of sex, age and FNA cytologic diagnostic results to other studies. FNA cytology offered clinicians the possibility of early diagnosis of benign (>70%) and malignant (<5%) lesions. The test was an outpatient procedure, safe, time saving, cost effective and helped determine the course of therapy in the management of patients with thyroid nodules.

Research paper thumbnail of BRCA1 and BRCA2 mutations and their clinical relevance in selected women diagnosed with triple-negative breast cancer in Kenya: a descriptive cross-sectional study

Pan African Medical Journal

Research paper thumbnail of Cytomorphological patterns of breast lesions among women with palpable breast lumps attending select teaching and referral hospitals in Kenya: a descriptive cross-sectional study

Pan African Medical Journal

Research paper thumbnail of High Risk Human Papillomavirus (Hr-HPV) Prevalence and Genotypes Detected in Women ≥ 30 Years Old who have Never been Screened for Cervical Cancer in Harare, Zimbabwe

Asian Research Journal of Gynaecology and Obstetrics, Jun 3, 2021

Research paper thumbnail of Comparison of visual inspection with acetic (VIA) results and cervical leep biopsy histological results in a population stratified by HIV status in Harare, Zimbabwe

East African Medical Journal, Jun 17, 2021

Research paper thumbnail of Utility of high-risk HPV (HR-HPV) and Liquid Based Cytology (LBC) for cervical cancer screening of unscreened women over 29 years old in Harare, Zimbabwe

East African Medical Journal, May 21, 2021

Research paper thumbnail of The Supermarket for Women's Reproductive Health: A Demonstration Intervention Project in Nairobi, Kenya

Research paper thumbnail of Complication of radiotherapy in the management

Journal of obstetrics & gynaecology of Eastern and Central Africa, 2012

Background: Cervical cancer is one of the most common female malignancies worldwide. Since the in... more Background: Cervical cancer is one of the most common female malignancies worldwide. Since the introduction of conventional Papanicolaou smear mortality from cervical cancer has reduced considerably. Despite its success, it has a sensitivity of only 51% and false negative rate of 5-10%. Approved Liquid Based Cytology (LBC) products by FDA claim a 65% increased detection rate of High Grade Squamous Intraepithelial Lesions (HGSIL) compared with conventional smears, as well as decreased unsatisfactory sample rates. Evidence shows that Liquid Based Preparation is more sensitive and accurate for the detection of both squamous and glandular lesions of the cervix. Studies of the accuracy of liquid based preparations reports sensitivity of 61-66% and specificity of 82-91%. Objective : To compare the performance of conventional Pap smear cytology, liquid based cytology and colposcopy clinical impression with colposcopic biopsy as the gold standard among women eligible for colposcopy in Ken...

Research paper thumbnail of Oestradiol And Progesterone Receptor Concentrations And The Metabolism Of Oestrogen In Uterine Leiomyomata

Research paper thumbnail of Patterns of lymphomas in Kenya

Journal of Hematopathology, 2008

Research paper thumbnail of Role of Fine Needle Aspiration 1N the Diagnosis of Neoplasms

Research paper thumbnail of Immunohistochemistry

Pathology, 2014

Background: Hematoxylin and eosin (H&E) stained cervical tissue sections are subject to subst... more Background: Hematoxylin and eosin (H&E) stained cervical tissue sections are subject to substantial rates of discordance among pathologists. p16INK4a immunohistochemistry has shown valuable additional information in the interpretation of cervical histology and reduced inter-observer disagreement of conventional histology. Objective: To determine the utility of p16ink4a expression in cervical biopsies reported negative and positive for dysplasia. Method: A total of 91 cases of colposcopic biopsies diagnosed as negative for dysplasia and cervical intraepithelial neoplasia, from 2011 to 2013, were reviewed on H&E stain and immunostained with p16INK4a. Results: Primary reports: negative for dysplasia 16, CIN1 23, CIN2 37 and CIN3 15. Age range: 21–65 years; mean age: 40.2 years. On review, negative for dysplasia were 32, CIN1 19, CIN2 16 and CINIII 24 (p < 0.001, with kappa value of agreement: 0.568). p16INK4A expression: All negative for dysplasia cases were non-immunoreactive; 19/23 and 18/19 cases of CIN1, primary and review results respectively, were negative (p < 0.001); 48.6% and 69% of CINII, primary and review results, respectively, were positive; and finally 80% and 96% of CIN3, primary and review results respectively, stained positive (p < 0.001). Conclusion: There is significant inter-observer variation in interpretation of cervical biopsies on H&E. p16INK4a expression correlates well with high grade lesions.

Research paper thumbnail of Risk factors for human papillomavirus and cervical precancerous lesions, and the role of concurrent HIV-1 infection

International Journal of Gynecology & Obstetrics, 1999

4 3-0. 4.5; 95% CI, 0.8᎐27.4. Conclusions: Our results indicate that HSIL and even invasive cance... more 4 3-0. 4.5; 95% CI, 0.8᎐27.4. Conclusions: Our results indicate that HSIL and even invasive cancer are highly prevalent in this setting of women on reproductive age considered to be at low risk for STDs, suggesting that routine Pap smear screening may save lives. ᮊ 1999 International Federation of Gynecology and Obstetrics.

Research paper thumbnail of Digital Archiving and Preservation of Cancer Records: Case of KNH/UoN Department of Pathology

International Journal of Computer Applications Technology and Research

Cancer is considered to be 3rd leading killer and 2nd among non-communicable diseases in Kenya Mu... more Cancer is considered to be 3rd leading killer and 2nd among non-communicable diseases in Kenya Mutinda J. (2019). Ferlay, et al (2013) noted there are about 37,000 new cases of cancer annually and annual mortality rate of 28,000. This indicates cancer records rapidly accumulate over time and more resources are needed to collect and manage cancer-related data. KNH/UoN Department of Pathology have for a long time kept their records using a paper-based system. Objective of the study was to review current record keeping system including the process of preserving, storing and retrieving cancer records and the challenges faced, develop a model to guide the archival of locally available cancer paper-records and a web based prototype to preserve and avails this information to a wide range of stakeholders. The study used descriptive research design involving 22 participants. Random sampling technique was used to select respondents among the sampled population. The intervention prototype was ...