X-ray Services in Kenya
X-ray Services in Kenya, where there are fewer than 200 radiologists to serve 43 million people, the prospect of getting an X-ray may seem slim for most residents, especially those living in rural parts of the east African country. X-ray equipment is scarce and facilities that do have the technology are in bigger cities like Nairobi, leaving residents in far-flung areas with few options for getting radiographs. Public transportation—usually tiny, crowded buses—takes an entire day and can create financial hardships for residents who often can’t afford to miss a day’s work. The need for follow-up exams creates additional challenges.
X-ray Services in Kenya – X-radiation
X-radiation (composed of X-rays) is a form of electromagnetic radiation. Most X-rays have a wavelength ranging from 0.01 to 10 nanometers, corresponding to frequencies in the range 30 petahertz to 30 exahertz (3×1016 Hz to 3×1019 Hz) and energies in the range 100 eV to 100 keV. X-ray wavelengths are shorter than those of UV rays and typically longer than those of gamma rays. In many languages, X-radiation is referred to with terms meaning Röntgen radiation, after Wilhelm Röntgen, who is usually credited as its discoverer, and who had named it X-radiation to signify an unknown type of radiation. Spelling of X-ray(s) in the English language includes the variants x-ray(s), xray(s), and X ray(s).
X-rays with high photon energies (above 5–10 keV, below 0.2–0.1 nm wavelength) are called hard X-rays, while those with lower energy are called soft X-rays. Due to their penetrating ability, hard X-rays are widely used to image the inside of objects, e.g., in medical radiography and airport security. The term X-ray is metonymically used to refer to a radiographic image produced using this method, in addition to the method itself. Since the wavelengths of hard X-rays are similar to the size of atoms they are also useful for determining crystal structures by X-ray crystallography. By contrast, soft X-rays are easily absorbed in air; the attenuation length of 600 eV (~2 nm) X-rays in water is less than 1 micrometer.
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X-ray Services in Kenya – Mobile X-ray Truck
The origins of the mobile X-ray truck project can be traced to a 1997 partnership between IUSM and Kenya’s two teaching hospitals, Moi University School of Medicine and Moi Teaching and Referral Hospital in Eldoret. Both are part of AMPATH, the Academic Model Providing Access to Healthcare, a consortium devoted to treating Kenyans with HIV and AIDS.
In 2003, the IUSM Radiology Department began participating in bi-directional exchanges with those Kenya institutions, educating faculty and residents with the goal of eventually educating a new generation of technologists and radiologists. As an extension of that partnership, Dr. Kohli—who had visited Kenya as an IUSM radiology resident—launched the mobile X-ray truck project in 2010 with funds for the X-ray equipment provided by the National Library of Medicine.
X-ray Services in Kenya – X-ray fluorescence (XRF)
X-ray fluorescence (XRF) is the emission of characteristic “secondary” (or fluorescent) X-rays from a material that has been excited by bombarding with high-energy X-rays or gamma rays. The phenomenon is widely used for elemental analysis and chemical analysis, particularly in the investigation of metals, glass, ceramics and building materials, and for research in geochemistry, forensic science, archaeology and art objects such as paintings and murals.
X-ray Services in Kenya – Digital radiography
Digital radiography is a form of X-ray imaging, where digital X-ray sensors are used instead of traditional photographic film. Advantages include time efficiency through bypassing chemical processing and the ability to digitally transfer and enhance images. Also, less radiation can be used to produce an image of similar contrast to conventional radiography.
Instead of X-ray film, digital radiography uses a digital image capture device. This gives advantages of immediate image preview and availability; elimination of costly film processing steps; a wider dynamic range, which makes it more forgiving for over- and under-exposure; as well as the ability to apply special image processing techniques that enhance overall display quality of the image.
Digital radiographic systems
Digital dental radiography comes in two forms: direct, that connect directly to the computer via USB and provides immediate images, and indirect (photostimulable phosphor plates, or PSP) which uses plates that are radiated and then digitally scanned.
Direct digital sensors represent a significant initial investment, but in addition to the convenience of digital images, provide instant images that can reduce the time the patient spends in the dental chair. They also reduce the need for the constant purchase of film and the necessary development chemicals. Early systems used CCD sensor technology, but changed to Amorphous Silicon (aSi:H) sensors following their introduction in early 1998-9.
Indirect digital imaging (also termed Computed Radiography) utilizes a reusable plate in place of the film. After X-ray exposure the plate (sheet) is placed in a special scanner where the latent formed image is retrieved point by point and digitized, using laser light scanning. The digitized images are stored and displayed on the computer screen. This method is halfway between old film-based technology and current direct digital imaging technology.
It is similar to the film process because it involves the same image support handling but differs in that the chemical development process is replaced by scanning. This is not much faster than film processing and the resolution and sensitivity performances are contested. PSP has been described as having an advantage of fitting within any pre-existing equipment without modification because it replaces the existing film; however, it includes extra costs for the scanner and replacement of scratched plates.
X-ray Services in Kenya – Types and differences of X–Rays
This minimally invasive test involves injection of a contrast medium into a joint, followed by a standard x-ray, CAT scan or MRI (magnetic resonance imaging). Its uses include identification of tendon and ligament injuries, torn rotator cuff and loosening of joint replacements or other prostheses.
This test is often performed on patients who are considering back surgery or who have not responded well to conventional treatments for back pain caused by conditions such as degenerative disc disease or a herniated disc. The patient wears a metal–free hospital gown and lies on an imaging table. After the skin is numbed with anesthetic, a needle is inserted into the intervertebral disc using x-rays as guidance. Once in place, the needle injects contrast dye to outline any damaged areas and CAT scans are taken. Pain medicines may be administered if pain persists beyond the usual recovery time, typically about one hour.
This type of test uses x-rays to image internal body organs while they are in motion. A continuous x-ray beam is focused on the part of the patient being examined to create a detailed, moving image that appears on a monitor, much like a movie. Fluoroscopy can be used in pain management – for example, to guide corticosteroid injections inside a joint.
DEXA scan (dual-energy x-ray absorptiometry).
Also known as a bone density scan, DEXA is the standard method of measuring bone mineral density. DEXA scans are often used to screen for the bone-thinning disease osteoporosis, especially in women after menopause. Some DEXA units use ultrasound instead of x-rays.
This is an x-ray procedure in which contrast material is injected into one of the arteries of the heart. This allows the physician to detect if there is obstruction in coronary arteries. Angiography may be performed if the patient is experiencing chest pain.
These imaging tests use a chalky element called barium as the contrast medium. They include:
Upper GI (gastrointestinal) barium tests, such as barium swallow, barium meal and small-bowel series. Fluoroscopy or other x-ray techniques are performed after the patient consumes a liquid or solid containing barium. These tests can be used in diagnosing conditions that cause esophageal or abdominal pain, such as gastroparesis (delayed emptying of the stomach).
The patient is given an enema with a solution containing barium. The barium coats the insides of the intestines, allowing this area to be viewed in greater detail with an x-ray. This test may be used to determine causes of intestinal or pelvic pain, such as colon cancer.
Intravenous pyelography (IVP).
These x-rays of the urinary tract use a contrast medium to help detect conditions such as kidney stones, bladder cancer and prostate enlargement (benign prostatic hyperplasia).
Mammograms are specialized x-rays that create detailed images of the breasts. They are used to screen for and diagnose breast cancer and other breast conditions, such as cysts. The American Cancer Society recommends that women have annual mammograms starting at age 40.
X-ray Services in Kenya – Before the x-ray test
In general, no special preparation is needed before an x-ray is taken, unless a special dye called a contrast medium is going to be used. Contrast mediums outline a specific body area internally. They can be swallowed, injected into a vein or inserted rectally, and have a dull, opaque appearance on film.
If a contrast medium will be used, patients may be asked not to eat or drink after midnight before the test, and the physician may make minor changes in how the patient takes medication. The physician will ask about the patient’s history of allergies to screen for a potential allergic reaction to the dye.
A radiology technician or specially trained nurse generally takes x-ray films. At the time of the test, the examiner will ask the patient to remove any objects that may show up on the image (e.g., clothing, jewelry, wigs, watches or dentures). Splints or prosthetic limbs may also be removed in some cases.
Patients should inform the examiner if they have had an x-ray using a contrast dye or barium in the past few days. They should also make sure the examiner is aware of all medications that have been taken recently, including over–the–counter medications.
X-ray Services in Kenya – Female patients
They Should be sure to inform the examiner if they are or may be pregnant because x-rays can be harmful to fetuses in rare cases. In cases where the benefits of the x-ray outweigh the potential risks, pregnant women may wear a lead apron over their abdomen during the test.
A lead apron is also often worn by patients to help protect sex organs from x-rays. In high doses, women’s eggs and men’s sperm can be affected by radiation. However, the risk of this occurring as a result of an x-ray test is extremely low. Women should also inform the examiner if they have an IUD (a form of birth control) implanted.
X-ray Services in Kenya
A comprehensive list of all X-ray Services in Kenya, their addresses (postal and physical), contacts (telephone and e-mail) and a link to the clinics website.