The decision to pay out earnings or retain dividends has been a subject of debate for many scholars. The effect of dividend on the firm value and cost of capital have been covered in attempt to resolve the dividend puzzle. This research paper tests the applicability of constant dividend model by companies listed at the Nairobi stock exchange. Data was collected from annual reports and share price schedules obtained from Nairobi stock exchange and Capital market Authority for a population of 20 companies that paid dividends consistently from 2002 to 2008. The data was then analyzed by re-computing the dividends that should have been paid if the dividend constant model was applied. This recomputed figure was later compared to the dividend as paid out by the companies thought the years of study. Paired sample t-test statistic was also performed to determine whether there is a significant difference between the two dividend figures. The findings of the research established that the dividend model was not employed by the companies listed at the Nairobi stock exchange. Most firms instead adopted stable and predictable policy where a specific amount of dividend per share each year was paid periodically. In some years there was a slight adjustment of the dividend paid after an increase in earnings, but only by a sustainable amount. The study shows that the relationship between the stock market prices and the dividend paid from the constant dividend model is uneven from one year to another and where there was a relationship it was insignificant. Though a share would be highly priced, a high dividend per share was not always declared.

Vertex epidural haematomas (VEDH) are rare and difficulties are encountered in diagnosis and management. This is a case report of a patient with a vertex epidural haematoma who presented with signs of severe head injury with upper limb decerebrate posture. We discuss the challenges of radiological investigation and neurosurgical management of VEDH.

The book is written for graduates and undergraduates. It contains advices on how to improve grades in Universities and Colleges.It advises on how to prepare, effectively learn and retain im memory all required materials, and how to gain examination skills.

This paper describes the methodology and presents preliminary results of an economic appraisal of a community based health care project in Kenya. Community health workers, trained for 12 weeks and deployed in two locations in Kenya's Western Province, act as first contact providers of basic health care and promoters of selected health, sanitation and nutrition practices. A Cost Benefit Analysis has been undertaken using the Willingness to Pay approach to compare the costs of the project and its benefits. The benefits are in the form of more easily accessible basic health care and are measured as consumer surplus accruing to the community. Gain in consumer surplus is consequent on the fall of average user costs and rise in utilisation of the project established points of first contact with primary health care. The argument for the economic viability of the project is validated by the large Net Present Value and Benefit Cost Ratio obtained for the whole of the project area and for the two locations separately. Although the evaluation technique used faces the problem of valuation of community time, aggregation of health care services at all points of first contact and the partial nature of cost benefit analysis evaluations, the results are strongly in favour of decentralisation of primary health care on similar lines in the rest of the country.

A case of dystocia resulting in rupture of he middle uterine artery and subsequent death in a cow is reported

The decision to pay out earnings or retain dividends has been a subject of debate for many scholars. The effect of dividend on the firm value and cost of capital have been covered in attempt to resolve the dividend puzzle. This research paper tests the applicability of constant dividend model by companies listed at the Nairobi stock exchange. Data was collected from annual reports and share price schedules obtained from Nairobi stock exchange and Capital market Authority for a population of 20 companies that paid dividends consistently from 2002 to 2008. The data was then analyzed by re-computing the dividends that should have been paid if the dividend constant model was applied. This recomputed figure was later compared to the dividend as paid out by the companies thought the years of study. Paired sample t-test statistic was also performed to determine whether there is a significant difference between the two dividend figures. The findings of the research established that the dividend model was not employed by the companies listed at the Nairobi stock exchange. Most firms instead adopted stable and predictable policy where a specific amount of dividend per share each year was paid periodically. In some years there was a slight adjustment of the dividend paid after an increase in earnings, but only by a sustainable amount. The study shows that the relationship between the stock market prices and the dividend paid from the constant dividend model is uneven from one year to another and where there was a relationship it was insignificant. Though a share would be highly priced, a high dividend per share was not always declared.

The decision to pay out earnings or retain dividends has been a subject of debate for many scholars. The effect of dividend on the firm value and cost of capital have been covered in attempt to resolve the dividend puzzle. This research paper tests the applicability of constant dividend model by companies listed at the Nairobi stock exchange. Data was collected from annual reports and share price schedules obtained from Nairobi stock exchange and Capital market Authority for a population of 20 companies that paid dividends consistently from 2002 to 2008. The data was then analyzed by re-computing the dividends that should have been paid if the dividend constant model was applied. This recomputed figure was later compared to the dividend as paid out by the companies thought the years of study. Paired sample t-test statistic was also performed to determine whether there is a significant difference between the two dividend figures. The findings of the research established that the dividend model was not employed by the companies listed at the Nairobi stock exchange. Most firms instead adopted stable and predictable policy where a specific amount of dividend per share each year was paid periodically. In some years there was a slight adjustment of the dividend paid after an increase in earnings, but only by a sustainable amount. The study shows that the relationship between the stock market prices and the dividend paid from the constant dividend model is uneven from one year to another and where there was a relationship it was insignificant. Though a share would be highly priced, a high dividend per share was not always declared.

A case of dystocia resulting in rupture of he middle uterine artery and subsequent death in a cow is reported

The decision to pay out earnings or retain dividends has been a subject of debate for many scholars. The effect of dividend on the firm value and cost of capital have been covered in attempt to resolve the dividend puzzle. This research paper tests the applicability of constant dividend model by companies listed at the Nairobi stock exchange. Data was collected from annual reports and share price schedules obtained from Nairobi stock exchange and Capital market Authority for a population of 20 companies that paid dividends consistently from 2002 to 2008. The data was then analyzed by re-computing the dividends that should have been paid if the dividend constant model was applied. This recomputed figure was later compared to the dividend as paid out by the companies thought the years of study. Paired sample t-test statistic was also performed to determine whether there is a significant difference between the two dividend figures. The findings of the research established that the dividend model was not employed by the companies listed at the Nairobi stock exchange. Most firms instead adopted stable and predictable policy where a specific amount of dividend per share each year was paid periodically. In some years there was a slight adjustment of the dividend paid after an increase in earnings, but only by a sustainable amount. The study shows that the relationship between the stock market prices and the dividend paid from the constant dividend model is uneven from one year to another and where there was a relationship it was insignificant. Though a share would be highly priced, a high dividend per share was not always declared.

The decision to pay out earnings or retain dividends has been a subject of debate for many scholars. The effect of dividend on the firm value and cost of capital have been covered in attempt to resolve the dividend puzzle. This research paper tests the applicability of constant dividend model by companies listed at the Nairobi stock exchange. Data was collected from annual reports and share price schedules obtained from Nairobi stock exchange and Capital market Authority for a population of 20 companies that paid dividends consistently from 2002 to 2008. The data was then analyzed by re-computing the dividends that should have been paid if the dividend constant model was applied. This recomputed figure was later compared to the dividend as paid out by the companies thought the years of study. Paired sample t-test statistic was also performed to determine whether there is a significant difference between the two dividend figures. The findings of the research established that the dividend model was not employed by the companies listed at the Nairobi stock exchange. Most firms instead adopted stable and predictable policy where a specific amount of dividend per share each year was paid periodically. In some years there was a slight adjustment of the dividend paid after an increase in earnings, but only by a sustainable amount. The study shows that the relationship between the stock market prices and the dividend paid from the constant dividend model is uneven from one year to another and where there was a relationship it was insignificant. Though a share would be highly priced, a high dividend per share was not always declared.

Forty-two pigs in a herd of 117 displayed various clinical signs of progressive atrophic rhinitis. The main signs included sneezing, coughing, lachrymation, serous to mucopurulent nasal discharge, and nasal bleeding in 1 pig. Three pigs had lateral deviation of the snout, while 4 had brachygnathia superior with obvious deformation of the face. Four acutely affected weaner pigs appeared weak, while the 7 chronically-affected pigs appeared smaller than their apparently unaffected penmates of the same age. Treatment of the acutely affected pigs with long-acting oxytetracycline at 20 mg/kg body weight intramuscularly, repeated once after 7 days, reduced the severity but did not clear the sneezing from all the pigs. Fifteen pigs were slaughtered 2 months after the clinical diagnosis was made. The carcasses of the chronically affected pigs were about 15% lighter than those of the apparently normal pigs of the same age and from the same pen, which translated to a loss of 921.00 Kenya shillings per pig (US$13.7). Diagnosis of progressive atrophic rhinitis was confirmed by sectioning the snouts of randomly selected slaughtered pigs with obvious deformation of the snout. Sections were made at the level of the 1st/2nd upper premolar tooth. Varying degrees of turbinate atrophy, from mild to complete, were noted. Histopathology of the turbinates revealed metaplasia of nasal epithelium and fibrosis in the lamina propria

Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman","serif";} Products of gene modification have vast implications. Creating public awareness and disseminating information on the subject seeks to demystify some of the widely held falsehoods regarding genetically modified products. This is an informative, thorough and easy to understand guidebook that aims to enlighten and debunk some of the commonly held misconceptions on products of gene modification and to give the reader a better understanding of the role genetic modification will play. The review sheds light on the safety, and application of these products in medicine, the food industry and other areas, especially those where genetic modification may represent a cheap, faster, credible, viable alternative in achieving sustainable development among resource-poor communities.

The book is a biography of the author. He begins with fundamenbtal question whether we can determine our destiny or we are just fulfiling what has already been ordained. He then explains how he has grown over the yeas experiencing changes.  

The decision to pay out earnings or retain dividends has been a subject of debate for many scholars. The effect of dividend on the firm value and cost of capital have been covered in attempt to resolve the dividend puzzle. This research paper tests the applicability of constant dividend model by companies listed at the Nairobi stock exchange. Data was collected from annual reports and share price schedules obtained from Nairobi stock exchange and Capital market Authority for a population of 20 companies that paid dividends consistently from 2002 to 2008. The data was then analyzed by re-computing the dividends that should have been paid if the dividend constant model was applied. This recomputed figure was later compared to the dividend as paid out by the companies thought the years of study. Paired sample t-test statistic was also performed to determine whether there is a significant difference between the two dividend figures. The findings of the research established that the dividend model was not employed by the companies listed at the Nairobi stock exchange. Most firms instead adopted stable and predictable policy where a specific amount of dividend per share each year was paid periodically. In some years there was a slight adjustment of the dividend paid after an increase in earnings, but only by a sustainable amount. The study shows that the relationship between the stock market prices and the dividend paid from the constant dividend model is uneven from one year to another and where there was a relationship it was insignificant. Though a share would be highly priced, a high dividend per share was not always declared.

The book is a biography of the author. He begins with fundamenbtal question whether we can determine our destiny or we are just fulfiling what has already been ordained. He then explains how he has grown over the yeas experiencing changes.  

The decision to pay out earnings or retain dividends has been a subject of debate for many scholars. The effect of dividend on the firm value and cost of capital have been covered in attempt to resolve the dividend puzzle. This research paper tests the applicability of constant dividend model by companies listed at the Nairobi stock exchange. Data was collected from annual reports and share price schedules obtained from Nairobi stock exchange and Capital market Authority for a population of 20 companies that paid dividends consistently from 2002 to 2008. The data was then analyzed by re-computing the dividends that should have been paid if the dividend constant model was applied. This recomputed figure was later compared to the dividend as paid out by the companies thought the years of study. Paired sample t-test statistic was also performed to determine whether there is a significant difference between the two dividend figures. The findings of the research established that the dividend model was not employed by the companies listed at the Nairobi stock exchange. Most firms instead adopted stable and predictable policy where a specific amount of dividend per share each year was paid periodically. In some years there was a slight adjustment of the dividend paid after an increase in earnings, but only by a sustainable amount. The study shows that the relationship between the stock market prices and the dividend paid from the constant dividend model is uneven from one year to another and where there was a relationship it was insignificant. Though a share would be highly priced, a high dividend per share was not always declared.

Vertex epidural haematomas (VEDH) are rare and difficulties are encountered in diagnosis and management. This is a case report of a patient with a vertex epidural haematoma who presented with signs of severe head injury with upper limb decerebrate posture. We discuss the challenges of radiological investigation and neurosurgical management of VEDH.

Data collected in the years 2001--2003 from an antenatal clinic in Nairobi, Kenya, were used to assess the benefit of couple counselling and test it as a way of increasing the uptake of interventions in the prevention of mother-to-child transmission of HIV-1. Among 2833 women enrolled, 311 (11%) received couple pretest counselling and 2100 (74%) accepted HIV-1 testing. Among those tested 314 (15%) were HIV-1 seropositive. We incorporated these and other data from the cohort study into a spreadsheet-based model and costs associated with couple counselling were compared with individual counselling in a theoretical cohort of 10,000 women. Voluntary couple counselling and testing (VCT), although more expensive, averted a greater number of infant infections when compared with individual VCT. Cost per disability-adjusted life year was similar to that of individual VCT. Sensitivity analyses found that couple VCT was more cost-effective in scenarios with increased uptake of couple counselling and higher HIV-1 prevalence.

Gives guidelines on how to prepare and conduct research and write MBA project in time for graduation. It gives sugestions on how to sucessfuly present oral defense and how to answer question during such sessions.

The decision to pay out earnings or retain dividends has been a subject of debate for many scholars. The effect of dividend on the firm value and cost of capital have been covered in attempt to resolve the dividend puzzle. This research paper tests the applicability of constant dividend model by companies listed at the Nairobi stock exchange. Data was collected from annual reports and share price schedules obtained from Nairobi stock exchange and Capital market Authority for a population of 20 companies that paid dividends consistently from 2002 to 2008. The data was then analyzed by re-computing the dividends that should have been paid if the dividend constant model was applied. This recomputed figure was later compared to the dividend as paid out by the companies thought the years of study. Paired sample t-test statistic was also performed to determine whether there is a significant difference between the two dividend figures. The findings of the research established that the dividend model was not employed by the companies listed at the Nairobi stock exchange. Most firms instead adopted stable and predictable policy where a specific amount of dividend per share each year was paid periodically. In some years there was a slight adjustment of the dividend paid after an increase in earnings, but only by a sustainable amount. The study shows that the relationship between the stock market prices and the dividend paid from the constant dividend model is uneven from one year to another and where there was a relationship it was insignificant. Though a share would be highly priced, a high dividend per share was not always declared.

Vertex epidural haematomas (VEDH) are rare and difficulties are encountered in diagnosis and management. This is a case report of a patient with a vertex epidural haematoma who presented with signs of severe head injury with upper limb decerebrate posture. We discuss the challenges of radiological investigation and neurosurgical management of VEDH.

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This paper describes the methodology and presents preliminary results of an economic appraisal of a community based health care project in Kenya. Community health workers, trained for 12 weeks and deployed in two locations in Kenya's Western Province, act as first contact providers of basic health care and promoters of selected health, sanitation and nutrition practices. A Cost Benefit Analysis has been undertaken using the Willingness to Pay approach to compare the costs of the project and its benefits. The benefits are in the form of more easily accessible basic health care and are measured as consumer surplus accruing to the community. Gain in consumer surplus is consequent on the fall of average user costs and rise in utilisation of the project established points of first contact with primary health care. The argument for the economic viability of the project is validated by the large Net Present Value and Benefit Cost Ratio obtained for the whole of the project area and for the two locations separately. Although the evaluation technique used faces the problem of valuation of community time, aggregation of health care services at all points of first contact and the partial nature of cost benefit analysis evaluations, the results are strongly in favour of decentralisation of primary health care on similar lines in the rest of the country.

A case of dystocia resulting in rupture of he middle uterine artery and subsequent death in a cow is reported

A case of dystocia resulting in rupture of he middle uterine artery and subsequent death in a cow is reported

The decision to pay out earnings or retain dividends has been a subject of debate for many scholars. The effect of dividend on the firm value and cost of capital have been covered in attempt to resolve the dividend puzzle. This research paper tests the applicability of constant dividend model by companies listed at the Nairobi stock exchange. Data was collected from annual reports and share price schedules obtained from Nairobi stock exchange and Capital market Authority for a population of 20 companies that paid dividends consistently from 2002 to 2008. The data was then analyzed by re-computing the dividends that should have been paid if the dividend constant model was applied. This recomputed figure was later compared to the dividend as paid out by the companies thought the years of study. Paired sample t-test statistic was also performed to determine whether there is a significant difference between the two dividend figures. The findings of the research established that the dividend model was not employed by the companies listed at the Nairobi stock exchange. Most firms instead adopted stable and predictable policy where a specific amount of dividend per share each year was paid periodically. In some years there was a slight adjustment of the dividend paid after an increase in earnings, but only by a sustainable amount. The study shows that the relationship between the stock market prices and the dividend paid from the constant dividend model is uneven from one year to another and where there was a relationship it was insignificant. Though a share would be highly priced, a high dividend per share was not always declared.

The decision to pay out earnings or retain dividends has been a subject of debate for many scholars. The effect of dividend on the firm value and cost of capital have been covered in attempt to resolve the dividend puzzle. This research paper tests the applicability of constant dividend model by companies listed at the Nairobi stock exchange. Data was collected from annual reports and share price schedules obtained from Nairobi stock exchange and Capital market Authority for a population of 20 companies that paid dividends consistently from 2002 to 2008. The data was then analyzed by re-computing the dividends that should have been paid if the dividend constant model was applied. This recomputed figure was later compared to the dividend as paid out by the companies thought the years of study. Paired sample t-test statistic was also performed to determine whether there is a significant difference between the two dividend figures. The findings of the research established that the dividend model was not employed by the companies listed at the Nairobi stock exchange. Most firms instead adopted stable and predictable policy where a specific amount of dividend per share each year was paid periodically. In some years there was a slight adjustment of the dividend paid after an increase in earnings, but only by a sustainable amount. The study shows that the relationship between the stock market prices and the dividend paid from the constant dividend model is uneven from one year to another and where there was a relationship it was insignificant. Though a share would be highly priced, a high dividend per share was not always declared.

The book is a biography of the author. He begins with fundamenbtal question whether we can determine our destiny or we are just fulfiling what has already been ordained. He then explains how he has grown over the yeas experiencing changes.  

The decision to pay out earnings or retain dividends has been a subject of debate for many scholars. The effect of dividend on the firm value and cost of capital have been covered in attempt to resolve the dividend puzzle. This research paper tests the applicability of constant dividend model by companies listed at the Nairobi stock exchange. Data was collected from annual reports and share price schedules obtained from Nairobi stock exchange and Capital market Authority for a population of 20 companies that paid dividends consistently from 2002 to 2008. The data was then analyzed by re-computing the dividends that should have been paid if the dividend constant model was applied. This recomputed figure was later compared to the dividend as paid out by the companies thought the years of study. Paired sample t-test statistic was also performed to determine whether there is a significant difference between the two dividend figures. The findings of the research established that the dividend model was not employed by the companies listed at the Nairobi stock exchange. Most firms instead adopted stable and predictable policy where a specific amount of dividend per share each year was paid periodically. In some years there was a slight adjustment of the dividend paid after an increase in earnings, but only by a sustainable amount. The study shows that the relationship between the stock market prices and the dividend paid from the constant dividend model is uneven from one year to another and where there was a relationship it was insignificant. Though a share would be highly priced, a high dividend per share was not always declared.

The book is a biography of the author. He begins with fundamenbtal question whether we can determine our destiny or we are just fulfiling what has already been ordained. He then explains how he has grown over the yeas experiencing changes.  

The decision to pay out earnings or retain dividends has been a subject of debate for many scholars. The effect of dividend on the firm value and cost of capital have been covered in attempt to resolve the dividend puzzle. This research paper tests the applicability of constant dividend model by companies listed at the Nairobi stock exchange. Data was collected from annual reports and share price schedules obtained from Nairobi stock exchange and Capital market Authority for a population of 20 companies that paid dividends consistently from 2002 to 2008. The data was then analyzed by re-computing the dividends that should have been paid if the dividend constant model was applied. This recomputed figure was later compared to the dividend as paid out by the companies thought the years of study. Paired sample t-test statistic was also performed to determine whether there is a significant difference between the two dividend figures. The findings of the research established that the dividend model was not employed by the companies listed at the Nairobi stock exchange. Most firms instead adopted stable and predictable policy where a specific amount of dividend per share each year was paid periodically. In some years there was a slight adjustment of the dividend paid after an increase in earnings, but only by a sustainable amount. The study shows that the relationship between the stock market prices and the dividend paid from the constant dividend model is uneven from one year to another and where there was a relationship it was insignificant. Though a share would be highly priced, a high dividend per share was not always declared.

A text book of Strategic Management for both undergraduate and graduate students. Case studies are drawn from East African Countries.

The decision to pay out earnings or retain dividends has been a subject of debate for many scholars. The effect of dividend on the firm value and cost of capital have been covered in attempt to resolve the dividend puzzle. This research paper tests the applicability of constant dividend model by companies listed at the Nairobi stock exchange. Data was collected from annual reports and share price schedules obtained from Nairobi stock exchange and Capital market Authority for a population of 20 companies that paid dividends consistently from 2002 to 2008. The data was then analyzed by re-computing the dividends that should have been paid if the dividend constant model was applied. This recomputed figure was later compared to the dividend as paid out by the companies thought the years of study. Paired sample t-test statistic was also performed to determine whether there is a significant difference between the two dividend figures. The findings of the research established that the dividend model was not employed by the companies listed at the Nairobi stock exchange. Most firms instead adopted stable and predictable policy where a specific amount of dividend per share each year was paid periodically. In some years there was a slight adjustment of the dividend paid after an increase in earnings, but only by a sustainable amount. The study shows that the relationship between the stock market prices and the dividend paid from the constant dividend model is uneven from one year to another and where there was a relationship it was insignificant. Though a share would be highly priced, a high dividend per share was not always declared.

Vertex epidural haematomas (VEDH) are rare and difficulties are encountered in diagnosis and management. This is a case report of a patient with a vertex epidural haematoma who presented with signs of severe head injury with upper limb decerebrate posture. We discuss the challenges of radiological investigation and neurosurgical management of VEDH.

   

This paper describes the methodology and presents preliminary results of an economic appraisal of a community based health care project in Kenya. Community health workers, trained for 12 weeks and deployed in two locations in Kenya's Western Province, act as first contact providers of basic health care and promoters of selected health, sanitation and nutrition practices. A Cost Benefit Analysis has been undertaken using the Willingness to Pay approach to compare the costs of the project and its benefits. The benefits are in the form of more easily accessible basic health care and are measured as consumer surplus accruing to the community. Gain in consumer surplus is consequent on the fall of average user costs and rise in utilisation of the project established points of first contact with primary health care. The argument for the economic viability of the project is validated by the large Net Present Value and Benefit Cost Ratio obtained for the whole of the project area and for the two locations separately. Although the evaluation technique used faces the problem of valuation of community time, aggregation of health care services at all points of first contact and the partial nature of cost benefit analysis evaluations, the results are strongly in favour of decentralisation of primary health care on similar lines in the rest of the country.

A case of dystocia resulting in rupture of he middle uterine artery and subsequent death in a cow is reported

The CCR5 chemokine receptor acts as a coreceptor with CD4 to permit infection by primary macrophage-tropic human immunodeficiency virus type 1 (HIV-1) strains. The CCR5Δ32 mutation, which is associated with resistance to infection in homozygous individuals and delayed disease progression in heterozygous individuals, is rare in Africa, where the HIV-1 epidemic is growing rapidly. Several polymorphisms in the promoter region of CCR5 have been identified, the clinical and functional relevance of which remain poorly defined. We evaluated the effect of 4 CCR5 promoter mutations on systemic and mucosal HIV-1 replication, disease progression, and perinatal transmission in a cohort of 276 HIV-1–seropositive women in Nairobi, Kenya. Mutations at positions 59353, 59402, and 59029 were not associated with effects on mortality, virus load, genital shedding, or transmission in this cohort. However, women with the 59356 C/T genotype had a 3.1-fold increased risk of death during the 2-year follow-up period (95% confidence interval [CI], 1.0–9.5) and a significant increase in vaginal shedding of HIV-1–infected cells (odds ratio, 2.1; 95% CI, 1.0–4.3), compared with women with the 59356 C/C genotype.

A case of dystocia resulting in rupture of he middle uterine artery and subsequent death in a cow is reported

The decision to pay out earnings or retain dividends has been a subject of debate for many scholars. The effect of dividend on the firm value and cost of capital have been covered in attempt to resolve the dividend puzzle. This research paper tests the applicability of constant dividend model by companies listed at the Nairobi stock exchange. Data was collected from annual reports and share price schedules obtained from Nairobi stock exchange and Capital market Authority for a population of 20 companies that paid dividends consistently from 2002 to 2008. The data was then analyzed by re-computing the dividends that should have been paid if the dividend constant model was applied. This recomputed figure was later compared to the dividend as paid out by the companies thought the years of study. Paired sample t-test statistic was also performed to determine whether there is a significant difference between the two dividend figures. The findings of the research established that the dividend model was not employed by the companies listed at the Nairobi stock exchange. Most firms instead adopted stable and predictable policy where a specific amount of dividend per share each year was paid periodically. In some years there was a slight adjustment of the dividend paid after an increase in earnings, but only by a sustainable amount. The study shows that the relationship between the stock market prices and the dividend paid from the constant dividend model is uneven from one year to another and where there was a relationship it was insignificant. Though a share would be highly priced, a high dividend per share was not always declared.

The decision to pay out earnings or retain dividends has been a subject of debate for many scholars. The effect of dividend on the firm value and cost of capital have been covered in attempt to resolve the dividend puzzle. This research paper tests the applicability of constant dividend model by companies listed at the Nairobi stock exchange. Data was collected from annual reports and share price schedules obtained from Nairobi stock exchange and Capital market Authority for a population of 20 companies that paid dividends consistently from 2002 to 2008. The data was then analyzed by re-computing the dividends that should have been paid if the dividend constant model was applied. This recomputed figure was later compared to the dividend as paid out by the companies thought the years of study. Paired sample t-test statistic was also performed to determine whether there is a significant difference between the two dividend figures. The findings of the research established that the dividend model was not employed by the companies listed at the Nairobi stock exchange. Most firms instead adopted stable and predictable policy where a specific amount of dividend per share each year was paid periodically. In some years there was a slight adjustment of the dividend paid after an increase in earnings, but only by a sustainable amount. The study shows that the relationship between the stock market prices and the dividend paid from the constant dividend model is uneven from one year to another and where there was a relationship it was insignificant. Though a share would be highly priced, a high dividend per share was not always declared.

to estimate HIV-1 incidence and cofactors for HIV-1 incidence during pregnancy and postpartum.

Abstract
Background: We set out to determine the relative roles of stigma versus health systems in non-uptake of
prevention of mother to child transmission (PMTCT) of HIV-1 interventions: we conducted cross-sectional
assessment of all consenting mothers accompanying infants for six-week immunizations.
Methods: Between September 2008 and March 2009, mothers at six maternal and child health clinics in Kenya’s
Nairobi and Nyanza provinces were interviewed regarding PMTCT intervention uptake during recent pregnancy.
Stigma was ascertained using a previously published standardized questionnaire and infant HIV-1 status
determined by HIV-1 polymerase chain reaction.
Results: Among 2663 mothers, 2453 (92.1%) reported antenatal HIV-1 testing. Untested mothers were more likely
to have less than secondary education (85.2% vs. 74.9%, p = 0.001), be from Nyanza (47.1% vs. 32.2%, p < 0.001)
and have lower socio-economic status. Among 318 HIV-1-infected mothers, 90% reported use of maternal or infant
antiretrovirals. Facility delivery was less common among HIV-1-infected mothers (69% vs. 76%, p = 0.009) and was
associated with antiretroviral use (p < 0.001). Although internal or external stigma indicators were reported by
between 12% and 59% of women, stigma was not associated with lower HIV-1 testing or infant HIV-1 infection
rates; internal stigma was associated with modestly decreased antiretroviral uptake. Health system factors
contributed to about 60% of non-testing among mothers who attended antenatal clinics and to missed
opportunities in offering antiretrovirals and utilization of facility delivery. Eight percent of six-week-old HIV-1-
exposed infants were HIV-1 infected.
Conclusions: Antenatal HIV-1 testing and antiretroviral uptake was high (both more than 90%) and infant HIV-1
infection risk was low, reflecting high PMTCT coverage. Investment in health systems to deliver HIV-1 testing and
antiretrovirals can effectively prevent infant HIV-1 infection despite substantial HIV-1 stigma.
Keywords: mother-to-child HIV transmission, HIV/AIDS, Health system, testing, antiretrovirals, facility delivery

We set out to determine the relative roles of stigma versus health systems in non-uptake of prevention of mother to child transmission (PMTCT) of HIV-1 interventions: we conducted cross-sectional assessment of all consenting mothers accompanying infants for six-week immunizations.

Abstract
Objectives—To estimate HIV-1 incidence and cofactors for HIV-1 incidence during pregnancy
and postpartum.
Design—Retrospective study among women who were HIV seronegative during pregnancy.
Methods—Mothers accompanying their infants for routine 6-week immunizations at 6 maternal
child health clinics in Nairobi and Western Kenya were tested for HIV-1 after completing a
questionnaire that included assessment of sociodemographics, obstetric history and HIV-1 risk
perception.
Results—Of 2,135 mothers who had tested HIV-1 seronegative antenatally, 2,035 (95.3%)
accepted HIV-1 re-testing at 6 weeks postpartum. Of these, 53 (2.6%) were HIV-1 seropositive
yielding an estimated HIV-1 incidence of 6.8 (95% CI: 5.1-8.8) per 100 woman-years). Mothers
who seroconverted were more likely to be employed (45.3% vs 29.0%, p=0.01), married (96.2 vs
86.6%, p=0.04) and from a higher HIV-1 prevalence region (60.4% in Western Kenya vs 28.8% in
Nairobi, p<0.001). Among married women, those in polygamous relationship were significantly
more likely to seroconvert (19.6% vs 6.7%, p<0.001). In multivariate analysis, region and
employment independently predicted seroconversion.
Conclusions—Repeat HIV-1 testing in early postpartum was highly acceptable and resulted in
detection of substantial HIV-1 incidence during pregnancy and postpartum period. Within
prevention of mother-to-child HIV-1 transmission programs strategic approaches to prevent
maternal HIV-1 acquisition during pregnancy are urgently needed.

We set out to determine the relative roles of stigma versus health systems in non-uptake of prevention of mother to child transmission (PMTCT) of HIV-1 interventions: we conducted cross-sectional assessment of all consenting mothers accompanying infants for six-week immunizations.

The characteristics of markets for free-range pigs in Busia District, Kenya were determined using retrospective analysis of veterinary records, key informant interviews and questionnaire survey. A total of 8,377 pigs were slaughtered between 2001 and 2005, which accounted for 27% of all the livestock slaughtered and inspected by the government officers. Loss of fetuses was recorded for 13% of slaughtered pigs and the loss was attributed to ignorance on pregnancy diagnosis. Although most of the money (82%) generated by the veterinary department arose from meat inspection fees, constraints including limited personnel and lack of enough vehicles were observed. The marketing system comprised of farmers, middlemen, slaughter-slab owners and butchers, while the government played the role of meat inspection. Majority of the butchers were males (94%) with a mean age of 39 (range: 21-74) years. The majority (63%) had a primary school level of education. The average net income per annum for each butcher was 887 USD and the profit earned per pig was 3.8 USD. The major constraints which affected the butchery business included conflicts with regulatory authorities, high government levies, erratic number of slaughter pigs mainly due to African Swine Fever (ASF) and poor mode of transportation. There is a need to address these constraints especially the control of ASF, reduction in levies and provision of incentives to improve pig trade in Busia District.

Fusarium head blight (FHB) is an important disease of small grain cereals. This study
assessed the incidence and severity of FHB of wheat at hard dough stage, and levels of
deoxynivalenol and T2-toxin at harvest by direct competitive enzyme linked immuno-sorbent
assay. Wheat ears were randomly sampled from 51 farms in Narok County and 51 farms in
Nakuru County at hard dough stage while wheat kernels were sampled at harvest.
Prevalence of FHB in both Counties was 100%. The mean incidence of FHB was 28.4 …

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Breastfeeding is the ideal infant food—it provides both optimal nutrition and numerous factors that contribute to infant immunity, growth, cognition, and health. It also enhances maternal–infant bonding and child-spacing and may provide long-term benefits to mothers. An estimated 7.7 million children under 5 years of age die annually, with >30% dying of infectious diseases [1, 2]. Breastfeeding has been identified as the most effective intervention to prevent under-5 mortality [3]. It was therefore a huge public health and policy challenge to discern the best infant feeding strategy when it was discovered that HIV-1 could be transmitted through breastfeeding. While nonbreastfeeding could entirely prevent transmission of a rapidly fatal infection, implementation of artificial feeding could be associated with increased infant mortality and morbidity. Over the past two decades, mothers, clinicians, and policy makers have wrestled with balancing infant risk of HIV-1 acquisition against risk of infant mortality in the context of concurrently changing interventions that decrease transmission of HIV-1.

Disclosure to HIV-infected children regarding their diagnosis is important as expanding numbers of HIV-infected children attain adolescence and may become sexually active. In order to define correlates of pediatric disclosure and facilitate development of models for disclosure, we conducted a cross-sectional survey of primary caregivers of HIV-1 infected children aged 6-16 years attending a pediatric HIV treatment program in Nairobi, Kenya. We conducted focus group discussions with a subset of caregivers to further refine perceptions of disclosure. Among 271 caregiver/child dyads in the cross-sectional survey, median child age was 9 years (interquartile range: 7-12 years). Although 79% of caregivers believed children should know their HIV status, the prevalence of disclosure to the child was only 19%. Disclosure had been done primarily by health workers (52%) and caregivers (33%). Caregivers reported that 5 of the 52 (10%) who knew their status were accidentally disclosed to. Caregivers of older children (13 vs. 8 years; p<0.001), who were HIV-infected and had disclosed their own HIV status to the child (36% vs. 4%; p=0.003), or who traveled frequently (29% vs. 16%, p=0.03) were more likely to have disclosed. Children who had been recently hospitalized (25% vs. 44%, p=0.03) were less likely to know their status, and caregivers with HIV were less likely to have disclosed (p=0.03). Reasons for disclosure included medication adherence, curiosity or illness while reasons for nondisclosure included age and fear of inadvertent disclosure. Our study found that disclosure rates in this Kenyan setting are lower than observed rates in the USA and Europe but consistent with rates from other resource-limited settings. Given these low rates of disclosure and the potential benefits of disclosure, strategies promoting health worker trainings and caregiver support systems for disclosure may benefit children with HIV.

Disclosure to HIV-infected children regarding their diagnosis is important as expanding numbers of HIV-infected children attain adolescence and may become sexually active. In order to define correlates of pediatric disclosure and facilitate development of models for disclosure, we conducted a cross-sectional survey of primary caregivers of HIV-1 infected children aged 6-16 years attending a pediatric HIV treatment program in Nairobi, Kenya. We conducted focus group discussions with a subset of caregivers to further refine perceptions of disclosure. Among 271 caregiver/child dyads in the cross-sectional survey, median child age was 9 years (interquartile range: 7-12 years). Although 79% of caregivers believed children should know their HIV status, the prevalence of disclosure to the child was only 19%. Disclosure had been done primarily by health workers (52%) and caregivers (33%). Caregivers reported that 5 of the 52 (10%) who knew their status were accidentally disclosed to. Caregivers of older children (13 vs. 8 years; p<0.001), who were HIV-infected and had disclosed their own HIV status to the child (36% vs. 4%; p=0.003), or who traveled frequently (29% vs. 16%, p=0.03) were more likely to have disclosed. Children who had been recently hospitalized (25% vs. 44%, p=0.03) were less likely to know their status, and caregivers with HIV were less likely to have disclosed (p=0.03). Reasons for disclosure included medication adherence, curiosity or illness while reasons for nondisclosure included age and fear of inadvertent disclosure. Our study found that disclosure rates in this Kenyan setting are lower than observed rates in the USA and Europe but consistent with rates from other resource-limited settings. Given these low rates of disclosure and the potential benefits of disclosure, strategies promoting health worker trainings and caregiver support systems for disclosure may benefit children with HIV.

Abstract
Abstract Disclosure to HIV-infected children regarding their diagnosis is important as expanding numbers of HIV-infected children attain adolescence and may become sexually active. In order to define correlates of pediatric disclosure and facilitate development of models for disclosure, we conducted a cross-sectional survey of primary caregivers of HIV-1 infected children aged 6-16 years attending a pediatric HIV treatment program in Nairobi, Kenya. We conducted focus group discussions with a subset of caregivers to further refine perceptions of disclosure. Among 271 caregiver/child dyads in the cross-sectional survey, median child age was 9 years (interquartile range: 7-12 years). Although 79% of caregivers believed children should know their HIV status, the prevalence of disclosure to the child was only 19%. Disclosure had been done primarily by health workers (52%) and caregivers (33%). Caregivers reported that 5 of the 52 (10%) who knew their status were accidentally disclosed to. Caregivers of older children (13 vs. 8 years; p<0.001), who were HIV-infected and had disclosed their own HIV status to the child (36% vs. 4%; p=0.003), or who traveled frequently (29% vs. 16%, p=0.03) were more likely to have disclosed. Children who had been recently hospitalized (25% vs. 44%, p=0.03) were less likely to know their status, and caregivers with HIV were less likely to have disclosed (p=0.03). Reasons for disclosure included medication adherence, curiosity or illness while reasons for nondisclosure included age and fear of inadvertent disclosure. Our study found that disclosure rates in this Kenyan setting are lower than observed rates in the USA and Europe but consistent with rates from other resource-limited settings. Given these low rates of disclosure and the potential benefits of disclosure, strategies promoting health worker trainings and caregiver support systems for disclosure may benefit children with HIV.

Abstract
Abstract Disclosure to HIV-infected children regarding their diagnosis is important as expanding numbers of HIV-infected children attain adolescence and may become sexually active. In order to define correlates of pediatric disclosure and facilitate development of models for disclosure, we conducted a cross-sectional survey of primary caregivers of HIV-1 infected children aged 6-16 years attending a pediatric HIV treatment program in Nairobi, Kenya. We conducted focus group discussions with a subset of caregivers to further refine perceptions of disclosure. Among 271 caregiver/child dyads in the cross-sectional survey, median child age was 9 years (interquartile range: 7-12 years). Although 79% of caregivers believed children should know their HIV status, the prevalence of disclosure to the child was only 19%. Disclosure had been done primarily by health workers (52%) and caregivers (33%). Caregivers reported that 5 of the 52 (10%) who knew their status were accidentally disclosed to. Caregivers of older children (13 vs. 8 years; p<0.001), who were HIV-infected and had disclosed their own HIV status to the child (36% vs. 4%; p=0.003), or who traveled frequently (29% vs. 16%, p=0.03) were more likely to have disclosed. Children who had been recently hospitalized (25% vs. 44%, p=0.03) were less likely to know their status, and caregivers with HIV were less likely to have disclosed (p=0.03). Reasons for disclosure included medication adherence, curiosity or illness while reasons for nondisclosure included age and fear of inadvertent disclosure. Our study found that disclosure rates in this Kenyan setting are lower than observed rates in the USA and Europe but consistent with rates from other resource-limited settings. Given these low rates of disclosure and the potential benefits of disclosure, strategies promoting health worker trainings and caregiver support systems for disclosure may benefit children with HIV.

A cornerstone of effective disease surveillance programs comprises the early identification of infectious threats and the subsequent rapid response to prevent further spread. Effectively identifying, tracking and responding to these threats is often difficult and requires international cooperation due to the rapidity with which diseases cross national borders and spread throughout the global community as a result of travel and migration by humans and animals. From Oct.1, 2008 to Sept. 30, 2009, the United States Department of Defense's (DoD) Armed Forces Health Surveillance Center Global Emerging Infections Surveillance and Response System (AFHSC-GEIS) identified 76 outbreaks in 53 countries. Emerging infectious disease outbreaks were identified by the global network and included a wide spectrum of support activities in collaboration with host country partners, several of which were in direct support of the World Health Organization's (WHO) International Health Regulations (IHR) (2005). The network also supported military forces around the world affected by the novel influenza A/H1N1 pandemic of 2009. With IHR (2005) as the guiding framework for action, the AFHSC-GEIS network of international partners and overseas research laboratories continues to develop into a far-reaching system for identifying, analyzing and responding to emerging disease threats.

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Abstract
This paper presents results from eight field studies in Asia and Africa on the emissions performance of 16 stove/fuel combinations measured during normal cooking events in homes. Characterizing real-world emissions performance is important for understanding the climate and health implications of technologies being promoted as alternatives to displace baseline cooking stoves and fuels. Almost all of the stove interventions were measured to have substantial reductions in PM2.5 and CO emissions compared to their respective baseline technologies (reductions of 24–87% and 25–80%, for PM2.5 and CO emission rates, respectively), though comparison with performance guidance from the World Health Organization (WHO) and the International Organization for Standardization (ISO) suggests that further improvement for biomass stoves would help realize more health benefits. The emissions of LPG stoves were generally below the WHO interim PM2.5 emissions target (1.75 mg/min) though it was not clear how close they were to the most aspirational ISO (0.2 mg/min) or WHO (0.23 mg/min) targets as our limit of detection was 1.1 mg/min. Elemental and organic carbon emission factors and elemental-to-total carbon ratios (medians ranging from 0.11 to 0.42) were in line with previously reported field-based estimates for similar stove/fuel combinations. Two of the better performing forced draft stoves used with pellets—the Oorja (median ET/TC = 0.12) and Eco-Chula (median ET/TC = 0.42)—were at opposite ends of the range, indicating that important differences in combustion conditions can arise even between similar stove/fuel combinations. Field-based tests of stove performance also provide important feedback for laboratory test protocols. Comparison of these results to previously published water boiling test data from the laboratory reinforce the trend that stove performance is generally better during controlled laboratory conditions, with modified combustion efficiency (MCE) being consistently lower in the field for respective stove/fuel categories. New testing approaches, which operate stoves through a broader range of conditions, indicate potential for better MCE agreement than previous versions of water boiling tests. This improved agreement suggests that stove performance estimates from a new ISO laboratory testing protocol, including testing stoves across low, medium, and high firepower, may provide more representative estimates of real-world performance than previously used tests. More representative results from standardized laboratory testing should help push stove designs toward better real-world performance as well as provide a better indication of how the tested technologies will perform for the user. View Full-Text
Keywords: household energy; solid fuel; biomass; stove performance; emission factors; black carbon

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Mental health refers to a wider range of activities directly or indirectly related to the mental well-being. Mentally ill patients in Kenya are increasingly becoming prone to a high risk of polypharmacy, complex therapeutic regimen and frequent modification of therapy. The objective of this study was to assess the prevalence and severity of potential drug-drug interactions among mentally ill patients admitted at Mathari Mental Hospital in Nairobi County, Kenya. The study was designed in a retrospective descriptive cross-sectional study of medical records data of patients who had undergone mental treatment and were admitted at Mathari Mental Hospital between July and December 2013. This study focused on a population comprising of all mentally ill patients who were admitted and put on medication during the study period of either gender and ageing between 13 to 75 years. One hundred and seventy five patient files were sampled, married and unemployed patients had a statistically significant (p<0.05) association with a prevalence and severity of potentially serious drug interactions. Participants with bipolar mood disorder had a statistically significant association with potentially serious drug interactions [OR 4.39 CI (1.09, 17.46) p = 0.04].
There was a statistically significant association of potentially serious drug interactions with fluphenazine [OR 10.38 CI (4.66, 23.10) p<0.01) haloperidol [OR 4.39 CI (2.29, 8.41) p<0.01] and amitriptyline [OR 3.39 CI (1.36, 8.41) p=0.01]. Married, unemployed and patients on fluphenazine, haloperidol, amitriptyline and chlorpromazine were at a higher risk of having potentially serious drug-drug interactions. These drugs exhibited both pharmacodynamic and pharmacokinetic drug interaction mechanisms. We recommend continuous electrocardiogram for patients on specific antipsychotics like haloperidol.

KEY WORDS : Mental Health, Drug Interaction, Prescriptions

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Background. We evaluated the prognostic usefulness of interferon g release assays (IGRAs) for active tuberculosis
and mortality in Kenyan human immunodeficiency virus type 1 (HIV-1)–infected women and their infants.
Methods. Prevalence and correlates of Mycobacterium tuberculosis–specific T-SPOT.TB IGRA positivity were
determined during pregnancy in a historical cohort of HIV-1–infected women. Hazard ratios, adjusted for baseline
maternal CD4 cell count (aHRCD4), were calculated for associations between IGRA positivity and risk of active
tuberculosis and mortality over 2-year postpartum follow-up among women and their infants.
Results. Of 333 women tested, 52 (15.6%) had indeterminate IGRA results. Of the remaining 281 women,
120 (42.7%) had positive IGRA results, which were associated with a 4.5-fold increased risk of active tuberculosis
(aHRCD4, 4.5; 95% confidence interval [CI], 1.1–18.0; Pp.030). For immunosuppressed women (CD4 cell count,
!250 cells/mL), positive IGRA results were associated with increased risk of maternal mortality (aHRCD4, 3.5; 95%
CI, 1.02–12.1; ), maternal active tuberculosis or mortality (aHRCD4Pp.045 , 5.2; 95% CI, 1.7–15.6; Pp.004), and
infant active tuberculosis or mortality overall (aHRCD4, 3.0; 95% CI, 1.0–8.9; Pp.05) and among HIV-1–exposed
uninfected infants (aHRCD4, 7.3; 95% CI, 1.6–33.5; Pp.01).
Conclusions. Positive IGRA results for HIV-1–infected pregnant women were associated with postpartum
active tuberculosis and mortality among mothers and their infants.

Prevention of maternal-to-child transmission program at a tertiary care hospital in Nairobi, Kenya. The risk of acquiring Mycobacterium tuberculosis infection among peripartum human immunodeficiency virus (HIV) infected women is poorly defined.

Abstract
BACKGROUND:
We evaluated the prognostic usefulness of interferon γ release assays (IGRAs) for active tuberculosis and mortality in Kenyan human immunodeficiency virus type 1 (HIV-1)-infected women and their infants.
METHODS:
Prevalence and correlates of Mycobacterium tuberculosis-specific T-SPOT.TB IGRA positivity were determined during pregnancy in a historical cohort of HIV-1-infected women. Hazard ratios, adjusted for baseline maternal CD4 cell count (aHR(CD4)), were calculated for associations between IGRA positivity and risk of active tuberculosis and mortality over 2-year postpartum follow-up among women and their infants.
RESULTS:
Of 333 women tested, 52 (15.6%) had indeterminate IGRA results. Of the remaining 281 women, 120 (42.7%) had positive IGRA results, which were associated with a 4.5-fold increased risk of active tuberculosis (aHR(CD4), 4.5; 95% confidence interval [CI], 1.1-18.0; P = .030). For immunosuppressed women (CD4 cell count, <250 cells/μL), positive IGRA results were associated with increased risk of maternal mortality (aHR(CD4), 3.5; 95% CI, 1.02-12.1;), maternal active tuberculosis or mortality (aHR(CD4), 5.2; 95% CI, 1.7-15.6; P = .004), and infant active tuberculosis or mortality overall (aHR(CD4), 3.0; 95% CI, 1.0-8.9; P = .05) and among HIV-1-exposed uninfected infants (aHR(CD4), 7.3; 95% CI, 1.6-33.5; P = .01).
CONCLUSIONS:
Positive IGRA results for HIV-1-infected pregnant women were associated with postpartum active tuberculosis and mortality among mothers and their infants.

We consider a rift valley fever model with treatment in human and livestock populations and trapping in the vector (mosquito) population. The basic reproduction number R 0 is established and used to determine whether the disease dies out or is established in the three populations. When R 0 ≤ 1, the disease-free equilibrium is shown to be globally asymptotically stable and the disease does not spread and when R 0 > 1, a unique endemic equilibrium exists which is globally stable and the disease will spread. The mathematical model is analyzed analytically and numerically to obtain insight of the impact of intervention in reducing the burden of rift valley fever disease’s spread or epidemic and also to determine factors influencing the outcome of the epidemic. Sensitivity analysis for key parameters is also done.

Ampicillin products, 20 capsules, 2 tablets and 23 dry suspensions were evaluated for quality by liquid chromatography at theDrug Analysis Unit University of Nairobi. Four capsule formulations failed limits on content. The Ampicillin content in 5 suspensions dropped below 80% on storage, but had no correlation to decrease in chemical content
 
Ampicillin is semi-synthetic penicillin used in the management of infections caused by sensitive microorganisms. Microbial resistance against ampicillin is well documented and cross-resistance is a common problem among the penicillins. Development of resistance is always associated with exposure of microorganisms to sub-lethal levels of drugs. The quality administered and especially low content of ampicillin in dosage form could therefore contribute to the development of resistance.
 
Work on the quality of drugs in the period 1982 to 1992 has shown presence of poor quality penicillin products in the market [1-4]. This observation was recently reinforced by the findings on quality of phenoxymethylpenicillin syrups [5]. The extensive use of ampicillin in kenya as one of the drugs on the essential drugs list of Ministry of Health [6] led to observed increase in resistance. It was recently replaced by amoxicillin.
 
The communication presents findings on the quality of ampicillian capsules and tablets and dry syrups found on the Kenyan market using liquid chromatography (LC). The preparations were from private and public sources including those submitted to the ministry of Health drug regulatory authority. The latter are intended for marketing in Kenya after registration, and for the purpose of this paper are treated as being on the market.

Ampicillin products, 20 capsules, 2 tablets and 23 dry suspensions were evaluated for quality by liquid chromatography at theDrug Analysis Unit University of Nairobi. Four capsule formulations failed limits on content. The Ampicillin content in 5 suspensions dropped below 80% on storage, but had no correlation to decrease in chemical content
 
Ampicillin is semi-synthetic penicillin used in the management of infections caused by sensitive microorganisms. Microbial resistance against ampicillin is well documented and cross-resistance is a common problem among the penicillins. Development of resistance is always associated with exposure of microorganisms to sub-lethal levels of drugs. The quality administered and especially low content of ampicillin in dosage form could therefore contribute to the development of resistance.
 
Work on the quality of drugs in the period 1982 to 1992 has shown presence of poor quality penicillin products in the market [1-4]. This observation was recently reinforced by the findings on quality of phenoxymethylpenicillin syrups [5]. The extensive use of ampicillin in kenya as one of the drugs on the essential drugs list of Ministry of Health [6] led to observed increase in resistance. It was recently replaced by amoxicillin.
 
The communication presents findings on the quality of ampicillian capsules and tablets and dry syrups found on the Kenyan market using liquid chromatography (LC). The preparations were from private and public sources including those submitted to the ministry of Health drug regulatory authority. The latter are intended for marketing in Kenya after registration, and for the purpose of this paper are treated as being on the market.

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Ampicillin products, 20 capsules, 2 tablets and 23 dry suspensions were evaluated for quality by liquid chromatography at theDrug Analysis Unit University of Nairobi. Four capsule formulations failed limits on content. The Ampicillin content in 5 suspensions dropped below 80% on storage, but had no correlation to decrease in chemical content
 
Ampicillin is semi-synthetic penicillin used in the management of infections caused by sensitive microorganisms. Microbial resistance against ampicillin is well documented and cross-resistance is a common problem among the penicillins. Development of resistance is always associated with exposure of microorganisms to sub-lethal levels of drugs. The quality administered and especially low content of ampicillin in dosage form could therefore contribute to the development of resistance.
 
Work on the quality of drugs in the period 1982 to 1992 has shown presence of poor quality penicillin products in the market [1-4]. This observation was recently reinforced by the findings on quality of phenoxymethylpenicillin syrups [5]. The extensive use of ampicillin in kenya as one of the drugs on the essential drugs list of Ministry of Health [6] led to observed increase in resistance. It was recently replaced by amoxicillin.
 
The communication presents findings on the quality of ampicillian capsules and tablets and dry syrups found on the Kenyan market using liquid chromatography (LC). The preparations were from private and public sources including those submitted to the ministry of Health drug regulatory authority. The latter are intended for marketing in Kenya after registration, and for the purpose of this paper are treated as being on the market.

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Ampicillin products, 20 capsules, 2 tablets and 23 dry suspensions were evaluated for quality by liquid chromatography at theDrug Analysis Unit University of Nairobi. Four capsule formulations failed limits on content. The Ampicillin content in 5 suspensions dropped below 80% on storage, but had no correlation to decrease in chemical content
 
Ampicillin is semi-synthetic penicillin used in the management of infections caused by sensitive microorganisms. Microbial resistance against ampicillin is well documented and cross-resistance is a common problem among the penicillins. Development of resistance is always associated with exposure of microorganisms to sub-lethal levels of drugs. The quality administered and especially low content of ampicillin in dosage form could therefore contribute to the development of resistance.
 
Work on the quality of drugs in the period 1982 to 1992 has shown presence of poor quality penicillin products in the market [1-4]. This observation was recently reinforced by the findings on quality of phenoxymethylpenicillin syrups [5]. The extensive use of ampicillin in kenya as one of the drugs on the essential drugs list of Ministry of Health [6] led to observed increase in resistance. It was recently replaced by amoxicillin.
 
The communication presents findings on the quality of ampicillian capsules and tablets and dry syrups found on the Kenyan market using liquid chromatography (LC). The preparations were from private and public sources including those submitted to the ministry of Health drug regulatory authority. The latter are intended for marketing in Kenya after registration, and for the purpose of this paper are treated as being on the market.

Ampicillin products, 20 capsules, 2 tablets and 23 dry suspensions were evaluated for quality by liquid chromatography at theDrug Analysis Unit University of Nairobi. Four capsule formulations failed limits on content. The Ampicillin content in 5 suspensions dropped below 80% on storage, but had no correlation to decrease in chemical content
 
Ampicillin is semi-synthetic penicillin used in the management of infections caused by sensitive microorganisms. Microbial resistance against ampicillin is well documented and cross-resistance is a common problem among the penicillins. Development of resistance is always associated with exposure of microorganisms to sub-lethal levels of drugs. The quality administered and especially low content of ampicillin in dosage form could therefore contribute to the development of resistance.
 
Work on the quality of drugs in the period 1982 to 1992 has shown presence of poor quality penicillin products in the market [1-4]. This observation was recently reinforced by the findings on quality of phenoxymethylpenicillin syrups [5]. The extensive use of ampicillin in kenya as one of the drugs on the essential drugs list of Ministry of Health [6] led to observed increase in resistance. It was recently replaced by amoxicillin.
 
The communication presents findings on the quality of ampicillian capsules and tablets and dry syrups found on the Kenyan market using liquid chromatography (LC). The preparations were from private and public sources including those submitted to the ministry of Health drug regulatory authority. The latter are intended for marketing in Kenya after registration, and for the purpose of this paper are treated as being on the market.

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Two groups of 6 rats each received subcutaneous injections of 2.3 mg/kg or 5.0 mg/kg of quinuronium, respectively, on two consecutive days, while 5 rats injected with physiological saline served as controls. Clinical signs of muscular tremors, jumps, enlarged and hyperemic eyeballs, lacrimation, depression and anorexia were observed following administration of quinuronium. One rat receiving 5 mg/kg died before termination of the study. When killed 48 h after the first injection, the quinuronium-treated rats had a higher liver weight/body weight ratio compared to the controls. Quinuronium resulted in hepatic centrilobular fatty degeneration, but no depletion of hepatic glutathione (GSH). The present findings suggest that glutathione depletion does not seem to be involved in quinuronium hepatotoxicity

Objective: To remove or modify fluorotic enamel stains using a combined chemical micro-abrasion and bleaching technique. Design: An in-vivo study was carried out. A sample of 21 participants was randomly selected from patients presenting with brown staining due to flourosis as the chief complaint. Eighty nine teeth were selected based on the Thylstrup-Fejerskov Index [TFI] with a score of 4 as the acceptable maximum. Only upper anterior teeth were included in the study. Setting: The study was undertaken at the University Of Nairobi Dental Hospital, Kenya. Subjects: Patients with an expressed need for treatment of their discoloured teeth who consented to a clearly demonstrated treatment procedure constituted the sample. Results: Enamel discolouration was removed or modified yielding a uniform colour and lustre depending on the initial depth of the stain. All patients appreciated the colour change. Conclusion: A combined chemical micro-abrasion and bleaching technique is a feasible treatment modality in selected cases of enamel fluorosis.

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Two groups of 6 rats each received subcutaneous injections of 2.3 mg/kg or 5.0 mg/kg of quinuronium, respectively, on two consecutive days, while 5 rats injected with physiological saline served as controls. Clinical signs of muscular tremors, jumps, enlarged and hyperemic eyeballs, lacrimation, depression and anorexia were observed following administration of quinuronium. One rat receiving 5 mg/kg died before termination of the study. When killed 48 h after the first injection, the quinuronium-treated rats had a higher liver weight/body weight ratio compared to the controls. Quinuronium resulted in hepatic centrilobular fatty degeneration, but no depletion of hepatic glutathione (GSH). The present findings suggest that glutathione depletion does not seem to be involved in quinuronium hepatotoxicity

Objectives: To describe the psychiatric services offered at Kenyatta National Hospital and the types
of patients and cases seen at Kenyatta National Hospital.
Design: A retrospective study based on case notes and other hospital records.
Settings: Kenyatta National Hospital, Nairobi, Kenya.
Subjects : All patients seen in the various psychiatric clinics and those who attended the Patient
Support Centre Unit in the hospital in the year 2002.
Results : In the year 2002, 598,119 patients were treated at KNH out of which 6,878 (1.15%) were
seen in the psychiatric clinics: 1,709 adults and 1,412 children were referred to the various psychiatric
clinics. At the hospital's Patient Support Centre (PSC) 3,454 patients were seen, mostly for pre and
post-HIV test counselling. Consultations from the wards accounted for 332 (9.6%) of the cases referred
to PSC. The main diagnoses among the latter in order of frequency were alcohol related psychiatric
disorders, acute and transient psychoses, depressive disorders, dissociative and conversion disorders
and dementia.
Conclusion : In view of the high load of acute and transient psychotic states, as well as substance
related disorders, it is recommended that the hospital should establish acute wards for the
comprehensive management of such patients. An alcohol and drug detoxification and rehabilitation
centre should also be developed at the hospital. Services to those with HIV related disorders should also
be improved.

Two groups of 6 rats each received subcutaneous injections of 2.3 mg/kg or 5.0 mg/kg of quinuronium, respectively, on two consecutive days, while 5 rats injected with physiological saline served as controls. Clinical signs of muscular tremors, jumps, enlarged and hyperemic eyeballs, lacrimation, depression and anorexia were observed following administration of quinuronium. One rat receiving 5 mg/kg died before termination of the study. When killed 48 h after the first injection, the quinuronium-treated rats had a higher liver weight/body weight ratio compared to the controls. Quinuronium resulted in hepatic centrilobular fatty degeneration, but no depletion of hepatic glutathione (GSH). The present findings suggest that glutathione depletion does not seem to be involved in quinuronium hepatotoxicity

Normal 0 false false false EN-GB X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin-top:0cm; mso-para-margin-right:0cm; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0cm; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} This study aimed to explore the understanding of and factors in adherence to ARV treatment in people living with HIV and AIDS (PLWHA) who are engaged in harmful alcohol use and to intervene on prioritised factors to improve adherence, using participatory research and action (PRA) methods. We sought to determine the perceptions of and understanding of alcohol abuse and ARV treatment among PLWHA, their peers, family members and health workers. We aimed to increase collaboration between the mental health workers from clinic and hospital level and the community to respond to identified barriers to improve adherence to ARV treatment in PLWHA who use alcohol in a socio-economically deprived urban area in Nairobi (Kariobangi). The work was implemented within an EQUINET programme that aimed to build capacities in participatory action research to explore dimensions of (and impediments to delivery of) Primary Health Care responses to HIV and AIDS. The majority of the PLWHA included in the study were socially disadvantaged, unemployed, and with low education. Social support was equally poor since a large number were widowed, separated or divorced. Most of the PLWHA who participated were single or divorced women, some of them admitted that they sometimes engaged in commercial sex to cater for their basic needs. These factors, together with poor health, limited their economic opportunities and security. In this context, alcohol use, noted by PLWHA, community members and health workers to be prevalent in the community, is not only encouraged by poor living and social conditions, but also by cost (it is relatively cheap) and by the social pressure to use alcohol to escape the mental stress caused by poverty. This is exacerbated by social attitudes that do not discourage alcohol use, and misconceptions that in fact encourage alcohol use, such as that alcohol can kill the HIV virus. This study suggests that the problem of alcohol abuse is poorly recognised for both communities and health workers: It was generally under reported to services, with low numbers of people on ARVs reported to have alcohol related problems, so that health workers see only a small share of the problem. A survey of the local health centres providing ARVs showed that screening for alcohol use was not routinely done and protocols for managing alcohol related disorders were not available. For PLWHA on ARVs, there are already challenges in dealing with the timing, frequency of medication and appointments and the availability and cost of food to support treatment. For PLWHA who use alcohol these difficulties are compounded. There are a range of services in the community that could potentially address these barriers that are involved in nutrition, psychosocial, medical care, PHC, HIV prevention and treatment services, counselling, social, legal, information and referral support for PLWHA. However these do not explicitly deal with the treatment of alcohol and drug related problems in the community or the needs of PLWHA on ARVs who use alcohol, and their adherence to treatment. Reflecting on these problems, the participants implemented a programme of counselling and education. The health workers were taught how to use the AUDIT in identifying problem drinkers and how to recognise and manage alcohol related disorders such as withdrawal fits. The PLWHA and their family members were encouraged to support one another and to identify symptoms of harmful alcohol use among themselves. The process was perceived by those involved to have reduced the harmful use of alcohol in those involved; to have made some improvements in community and health service support; in management of mental health and communication with families and in reducing stigma around alcohol use and HIV. The scores of the PLWHA on the repeat AUDIT questionnaire were however significantly lower than the baseline level.

Two groups of 6 rats each received subcutaneous injections of 2.3 mg/kg or 5.0 mg/kg of quinuronium, respectively, on two consecutive days, while 5 rats injected with physiological saline served as controls. Clinical signs of muscular tremors, jumps, enlarged and hyperemic eyeballs, lacrimation, depression and anorexia were observed following administration of quinuronium. One rat receiving 5 mg/kg died before termination of the study. When killed 48 h after the first injection, the quinuronium-treated rats had a higher liver weight/body weight ratio compared to the controls. Quinuronium resulted in hepatic centrilobular fatty degeneration, but no depletion of hepatic glutathione (GSH). The present findings suggest that glutathione depletion does not seem to be involved in quinuronium hepatotoxicity

The objective of our study is to assess the influence of organizational culture and market orientation on
performance. The population of the study comprise microfinance institutions that are members of the Association of Microfinance Institutions (AMFI) in Kenya. We used descriptive cross-sectional survey design. We collected primary data using structured questionnaire. We test our hypotheses through regression analysis. Our results demonstrate that organizational culture significantly and positively influence variations in performance. The partial mediation effect of market orientation on the relationship between organizational culture and performance was confirmed. The complimentary effect of organizational culture on market orientation implies that organizations need to spend more resources in nurturing market orientation to create sustainable competitive advantage through delivery of superior customer experience. We conclude that the influence of organizational culture and market orientation on performance is more plausible for mature industries regarded as diverse in terms of customer needs.
Keywords: organizational culture, market orientation, performance, microfinance

Two groups of 6 rats each received subcutaneous injections of 2.3 mg/kg or 5.0 mg/kg of quinuronium, respectively, on two consecutive days, while 5 rats injected with physiological saline served as controls. Clinical signs of muscular tremors, jumps, enlarged and hyperemic eyeballs, lacrimation, depression and anorexia were observed following administration of quinuronium. One rat receiving 5 mg/kg died before termination of the study. When killed 48 h after the first injection, the quinuronium-treated rats had a higher liver weight/body weight ratio compared to the controls. Quinuronium resulted in hepatic centrilobular fatty degeneration, but no depletion of hepatic glutathione (GSH). The present findings suggest that glutathione depletion does not seem to be involved in quinuronium hepatotoxicity

Transcultural psychiatry, whose scientific founder Emil Kraepelin is considered as, in its 100 years of tradition has not only developed a varied range of methods but has also brought about a change in the respective scientific questions as well as in related research and clinical applications. Whereas transcultural research on the psychopathology of depression contributed to the further development of psychiatric nosology, transcultural psychiatry has recently been increasingly faced with issues concerning phenomena of social change and globalization. One region, where such conditions can be observed in particular is Africa, where the dissolving of traditional standards and support systems and growing economic insecurity causes a considerable burden especially on women. As an example, results from a cross-sectional study on East African women using a two step design as well as qualitative and quantitative, standardized psychiatric methods are discussed concerning the association of social change, psycho-social risk factors and the development of depressive disorders. Efficient clinical methods towards diagnosis and treatment of new risk groups will have to be developed, of which an important aspect will be crisis intervention.

Sixty-four patients atteending the Kenyatta National Hospital psychiatric clinic with minor p.yychiatric disorders were assessed using the Enugu Somatization Scale with a view of eliciting the nature and types of somatic complaints they had. A control group of 66, 5th year medical student, was used. The average scores for the head and body symptoms were 10.9 and 22.1 for the neurotics and 0.9 and 1.5 for the controls respectively. Overall the commonest complaints among the patients were vague, the highest positive scores in order a/frequency being. 'What worries me is not steady." . 3.7%), "parts of my body are out of order" (87.3%), "my whole body is not all right" (87.3%), ':feeling various parts of the body shiver" (85. 7%) and ':feeling dizzy" (84. 1 %). The complaints were not related to age, sex, education, occupation or p,\ychiatric diagno,yis. The average scores for the Kenyan neurotic, were higher than that obtained from the Nigerian (head: 8.14; body: 15.2) and Indian neurotics (head: 8.75: body: 11.78) in previous .ytudies. On the other hand the Kenyan controls had lower scores compared to the other 2 groups. The implication of these findings is discussed.

Two groups of 6 rats each received subcutaneous injections of 2.3 mg/kg or 5.0 mg/kg of quinuronium, respectively, on two consecutive days, while 5 rats injected with physiological saline served as controls. Clinical signs of muscular tremors, jumps, enlarged and hyperemic eyeballs, lacrimation, depression and anorexia were observed following administration of quinuronium. One rat receiving 5 mg/kg died before termination of the study. When killed 48 h after the first injection, the quinuronium-treated rats had a higher liver weight/body weight ratio compared to the controls. Quinuronium resulted in hepatic centrilobular fatty degeneration, but no depletion of hepatic glutathione (GSH). The present findings suggest that glutathione depletion does not seem to be involved in quinuronium hepatotoxicity

Due to the widespread calls for the construction industry to adopt sustainable approaches, the various stakeholders are now engaging in the sustainability agenda more than before. This study investigated how the Kenyan construction industry is engaging the sustainability agenda. Specifically, this study sought to establish sustainable construction (SC) literacy levels, key sustainability considerations and SC literacy avenues in the interior design market segment of the Kenyan construction industry. Key project stakeholders in the interior design market segment of the Kenyan construction industry were the target population. A total of 60 (12 architects/interior designers, 12 electrical engineers, 12 mechanical engineers,12 quantity surveyors and 12 contractors) structured questionnaires were distributed, out of which 46 (10 architects/interior designers, 9 electrical engineers, 9 mechanical engineers, 8 quantity surveyors and 10 contractors) were received back. Collected data was analysed using frequencies, percentages, mean item scores (MIS) and standard deviations (SD). The study revealed an average level of sustainability literacy with a composite mean score of 3.7102 and mismatch between SC literacy levels and key sustainability considerations in interior design projects. Additionally, the respondents rated standard SC approaches, legislation, policies and construction trade associations as the least effective contributors to their current SC literacy levels. On the other hand, informal learning, construction professional associations influence, collaboration amongst firms, and formal learning were largely attributed to the respondent’s SC literacy levels. The implication of the findings was that there is need to fine-tune SC literacy drives to the peculiarities of the various industry market segments to ensure their effectiveness in informing practice. Additionally, there is the need to leverage standard SC approaches, legislation, policies and construction trade associations as avenues to improve the overall sustainability literacy levels.

Two groups of 6 rats each received subcutaneous injections of 2.3 mg/kg or 5.0 mg/kg of quinuronium, respectively, on two consecutive days, while 5 rats injected with physiological saline served as controls. Clinical signs of muscular tremors, jumps, enlarged and hyperemic eyeballs, lacrimation, depression and anorexia were observed following administration of quinuronium. One rat receiving 5 mg/kg died before termination of the study. When killed 48 h after the first injection, the quinuronium-treated rats had a higher liver weight/body weight ratio compared to the controls. Quinuronium resulted in hepatic centrilobular fatty degeneration, but no depletion of hepatic glutathione (GSH). The present findings suggest that glutathione depletion does not seem to be involved in quinuronium hepatotoxicity

Two groups of 6 rats each received subcutaneous injections of 2.3 mg/kg or 5.0 mg/kg of quinuronium, respectively, on two consecutive days, while 5 rats injected with physiological saline served as controls. Clinical signs of muscular tremors, jumps, enlarged and hyperemic eyeballs, lacrimation, depression and anorexia were observed following administration of quinuronium. One rat receiving 5 mg/kg died before termination of the study. When killed 48 h after the first injection, the quinuronium-treated rats had a higher liver weight/body weight ratio compared to the controls. Quinuronium resulted in hepatic centrilobular fatty degeneration, but no depletion of hepatic glutathione (GSH). The present findings suggest that glutathione depletion does not seem to be involved in quinuronium hepatotoxicity

Objective: To remove or modify fluorotic enamel stains using a combined chemical micro-abrasion and bleaching technique. Design: An in-vivo study was carried out. A sample of 21 participants was randomly selected from patients presenting with brown staining due to flourosis as the chief complaint. Eighty nine teeth were selected based on the Thylstrup-Fejerskov Index [TFI] with a score of 4 as the acceptable maximum. Only upper anterior teeth were included in the study. Setting: The study was undertaken at the University Of Nairobi Dental Hospital, Kenya. Subjects: Patients with an expressed need for treatment of their discoloured teeth who consented to a clearly demonstrated treatment procedure constituted the sample. Results: Enamel discolouration was removed or modified yielding a uniform colour and lustre depending on the initial depth of the stain. All patients appreciated the colour change. Conclusion: A combined chemical micro-abrasion and bleaching technique is a feasible treatment modality in selected cases of enamel fluorosis.

Objective: To remove or modify fluorotic enamel stains using a combined chemical micro-abrasion and bleaching technique. Design: An in-vivo study was carried out. A sample of 21 participants was randomly selected from patients presenting with brown staining due to flourosis as the chief complaint. Eighty nine teeth were selected based on the Thylstrup-Fejerskov Index [TFI] with a score of 4 as the acceptable maximum. Only upper anterior teeth were included in the study. Setting: The study was undertaken at the University Of Nairobi Dental Hospital, Kenya. Subjects: Patients with an expressed need for treatment of their discoloured teeth who consented to a clearly demonstrated treatment procedure constituted the sample. Results: Enamel discolouration was removed or modified yielding a uniform colour and lustre depending on the initial depth of the stain. All patients appreciated the colour change. Conclusion: A combined chemical micro-abrasion and bleaching technique is a feasible treatment modality in selected cases of enamel fluorosis.

n/a

Two groups of 6 rats each received subcutaneous injections of 2.3 mg/kg or 5.0 mg/kg of quinuronium, respectively, on two consecutive days, while 5 rats injected with physiological saline served as controls. Clinical signs of muscular tremors, jumps, enlarged and hyperemic eyeballs, lacrimation, depression and anorexia were observed following administration of quinuronium. One rat receiving 5 mg/kg died before termination of the study. When killed 48 h after the first injection, the quinuronium-treated rats had a higher liver weight/body weight ratio compared to the controls. Quinuronium resulted in hepatic centrilobular fatty degeneration, but no depletion of hepatic glutathione (GSH). The present findings suggest that glutathione depletion does not seem to be involved in quinuronium hepatotoxicity

This chapter captures the origins and current status of mental health research in Africa and emphasizes the challenges, current and past, pointing out ways in which they might be overcome. It also gives brief hints to think further on the potential of mental health research in Africa. Of course, the chapter is not intended to be a comprehensive overview or a complete guide to research.

Two groups of 6 rats each received subcutaneous injections of 2.3 mg/kg or 5.0 mg/kg of quinuronium, respectively, on two consecutive days, while 5 rats injected with physiological saline served as controls. Clinical signs of muscular tremors, jumps, enlarged and hyperemic eyeballs, lacrimation, depression and anorexia were observed following administration of quinuronium. One rat receiving 5 mg/kg died before termination of the study. When killed 48 h after the first injection, the quinuronium-treated rats had a higher liver weight/body weight ratio compared to the controls. Quinuronium resulted in hepatic centrilobular fatty degeneration, but no depletion of hepatic glutathione (GSH). The present findings suggest that glutathione depletion does not seem to be involved in quinuronium hepatotoxicity

To explore structure and process factors which influence patients' perception of quality inpatient psychiatric nursing care at Mathari hospital. This was a cross-sectional study of 236 inpatients selected by stratified random sampling. Competence to give consent was determined by a minimum score of 24 on Mini Mental State Examination. Patients were interviewed using a semi-structured questionnaire. Differences in proportions of variables were determined by calculating confidence interval and summary chi-squared statistics. P-values of < or =0.05 were considered significant. Majority of patients (87%) were aged 20-49 years with 43% having stayed in the ward for over a month. Structure factors related to patients' perception of care included physical environment, being happy with the way the ward looked was significantly related to satisfaction with care (chi(2) = 5.506, P = 0002). Process factors significantly related to patients' satisfaction with care included nurses providing patients with information on prescribed medicines (chi(2) = 10.50, P = 00012). Satisfaction with care was positively related to ability to recommend someone for admission in the same ward (chi(2) = 20.2, P = 00001). Structure and process factors identified as influencing patients' perception of care were physical environment and nurses' qualities that fit within the characteristics of Peplau's Interpersonal Relations Theory.

Two groups of 6 rats each received subcutaneous injections of 2.3 mg/kg or 5.0 mg/kg of quinuronium, respectively, on two consecutive days, while 5 rats injected with physiological saline served as controls. Clinical signs of muscular tremors, jumps, enlarged and hyperemic eyeballs, lacrimation, depression and anorexia were observed following administration of quinuronium. One rat receiving 5 mg/kg died before termination of the study. When killed 48 h after the first injection, the quinuronium-treated rats had a higher liver weight/body weight ratio compared to the controls. Quinuronium resulted in hepatic centrilobular fatty degeneration, but no depletion of hepatic glutathione (GSH). The present findings suggest that glutathione depletion does not seem to be involved in quinuronium hepatotoxicity

The objective of our study is to assess the influence of organizational culture and market orientation on
performance. The population of the study comprise microfinance institutions that are members of the Association of Microfinance Institutions (AMFI) in Kenya. We used descriptive cross-sectional survey design. We collected primary data using structured questionnaire. We test our hypotheses through regression analysis. Our results demonstrate that organizational culture significantly and positively influence variations in performance. The partial mediation effect of market orientation on the relationship between organizational culture and performance was confirmed. The complimentary effect of organizational culture on market orientation implies that organizations need to spend more resources in nurturing market orientation to create sustainable competitive advantage through delivery of superior customer experience. We conclude that the influence of organizational culture and market orientation on performance is more plausible for mature industries regarded as diverse in terms of customer needs.
Keywords: organizational culture, market orientation, performance, microfinance

Two groups of 6 rats each received subcutaneous injections of 2.3 mg/kg or 5.0 mg/kg of quinuronium, respectively, on two consecutive days, while 5 rats injected with physiological saline served as controls. Clinical signs of muscular tremors, jumps, enlarged and hyperemic eyeballs, lacrimation, depression and anorexia were observed following administration of quinuronium. One rat receiving 5 mg/kg died before termination of the study. When killed 48 h after the first injection, the quinuronium-treated rats had a higher liver weight/body weight ratio compared to the controls. Quinuronium resulted in hepatic centrilobular fatty degeneration, but no depletion of hepatic glutathione (GSH). The present findings suggest that glutathione depletion does not seem to be involved in quinuronium hepatotoxicity

Sixty-four patients atteending the Kenyatta National Hospital psychiatric clinic with minor p.yychiatric disorders were assessed using the Enugu Somatization Scale with a view of eliciting the nature and types of somatic complaints they had. A control group of 66, 5th year medical student, was used. The average scores for the head and body symptoms were 10.9 and 22.1 for the neurotics and 0.9 and 1.5 for the controls respectively. Overall the commonest complaints among the patients were vague, the highest positive scores in order a/frequency being. 'What worries me is not steady." . 3.7%), "parts of my body are out of order" (87.3%), "my whole body is not all right" (87.3%), ':feeling various parts of the body shiver" (85. 7%) and ':feeling dizzy" (84. 1 %). The complaints were not related to age, sex, education, occupation or p,\ychiatric diagno,yis. The average scores for the Kenyan neurotic, were higher than that obtained from the Nigerian (head: 8.14; body: 15.2) and Indian neurotics (head: 8.75: body: 11.78) in previous .ytudies. On the other hand the Kenyan controls had lower scores compared to the other 2 groups. The implication of these findings is discussed.

Two groups of 6 rats each received subcutaneous injections of 2.3 mg/kg or 5.0 mg/kg of quinuronium, respectively, on two consecutive days, while 5 rats injected with physiological saline served as controls. Clinical signs of muscular tremors, jumps, enlarged and hyperemic eyeballs, lacrimation, depression and anorexia were observed following administration of quinuronium. One rat receiving 5 mg/kg died before termination of the study. When killed 48 h after the first injection, the quinuronium-treated rats had a higher liver weight/body weight ratio compared to the controls. Quinuronium resulted in hepatic centrilobular fatty degeneration, but no depletion of hepatic glutathione (GSH). The present findings suggest that glutathione depletion does not seem to be involved in quinuronium hepatotoxicity

Construction industry has been identified as key to the sustainability agenda. Efforts towards improved sustainability compliance in the construction industry involve a socio-technical transformation. Such transitions are said to be purposive, of a wider perspective, multi-dimensional in nature and are influenced by numerous factors. This paper focused on establishing sustainable construction (SC) uptake levels, including identification of key SC drivers and barriers with specific reference to the interior design market segment of the Kenyan construction industry. The study employed a quantitative research approach. For quantitative attributes, the study employed structured questionnaires to collect data from actively practicing architects/interior designers, electrical engineers, mechanical engineers, quantity surveyors and contractors drawn from the interior design market segment of Kenyan construction industry in Nairobi City County. Data analysis employed the descriptive statistics of distribution (frequencies), proportions (percentages), central tendency (mean) and dispersion (standard deviation). Generally, the respondents ranked the overall uptake of the three dimensions of sustainability (economic, environmental and social) as average- ranking as social, environment and economic in a decreasing order of uptake levels. The study findings ranked sustainability driver categories as organization related drivers, stakeholder related drivers, economic related drivers and management related drivers; in order of decreasing influence. Lastly, barrier categories were ranked as economic related barriers, professional/capacity related barriers, technology related barriers and societal/cultural related barriers, in order of decreasing influence. With the average sustainable construction practices uptake in the Kenyan construction industry, there is an implied call to action to leverage known sustainability drivers, while at the same time suppressing the known barriers. This implies significant room for improvement and an appropriate starting point for key construction project stakeholders as above identified.

Two groups of 6 rats each received subcutaneous injections of 2.3 mg/kg or 5.0 mg/kg of quinuronium, respectively, on two consecutive days, while 5 rats injected with physiological saline served as controls. Clinical signs of muscular tremors, jumps, enlarged and hyperemic eyeballs, lacrimation, depression and anorexia were observed following administration of quinuronium. One rat receiving 5 mg/kg died before termination of the study. When killed 48 h after the first injection, the quinuronium-treated rats had a higher liver weight/body weight ratio compared to the controls. Quinuronium resulted in hepatic centrilobular fatty degeneration, but no depletion of hepatic glutathione (GSH). The present findings suggest that glutathione depletion does not seem to be involved in quinuronium hepatotoxicity

Two groups of 6 rats each received subcutaneous injections of 2.3 mg/kg or 5.0 mg/kg of quinuronium, respectively, on two consecutive days, while 5 rats injected with physiological saline served as controls. Clinical signs of muscular tremors, jumps, enlarged and hyperemic eyeballs, lacrimation, depression and anorexia were observed following administration of quinuronium. One rat receiving 5 mg/kg died before termination of the study. When killed 48 h after the first injection, the quinuronium-treated rats had a higher liver weight/body weight ratio compared to the controls. Quinuronium resulted in hepatic centrilobular fatty degeneration, but no depletion of hepatic glutathione (GSH). The present findings suggest that glutathione depletion does not seem to be involved in quinuronium hepatotoxicity

Objective: To remove or modify fluorotic enamel stains using a combined chemical micro-abrasion and bleaching technique. Design: An in-vivo study was carried out. A sample of 21 participants was randomly selected from patients presenting with brown staining due to flourosis as the chief complaint. Eighty nine teeth were selected based on the Thylstrup-Fejerskov Index [TFI] with a score of 4 as the acceptable maximum. Only upper anterior teeth were included in the study. Setting: The study was undertaken at the University Of Nairobi Dental Hospital, Kenya. Subjects: Patients with an expressed need for treatment of their discoloured teeth who consented to a clearly demonstrated treatment procedure constituted the sample. Results: Enamel discolouration was removed or modified yielding a uniform colour and lustre depending on the initial depth of the stain. All patients appreciated the colour change. Conclusion: A combined chemical micro-abrasion and bleaching technique is a feasible treatment modality in selected cases of enamel fluorosis.

Two groups of 6 rats each received subcutaneous injections of 2.3 mg/kg or 5.0 mg/kg of quinuronium, respectively, on two consecutive days, while 5 rats injected with physiological saline served as controls. Clinical signs of muscular tremors, jumps, enlarged and hyperemic eyeballs, lacrimation, depression and anorexia were observed following administration of quinuronium. One rat receiving 5 mg/kg died before termination of the study. When killed 48 h after the first injection, the quinuronium-treated rats had a higher liver weight/body weight ratio compared to the controls. Quinuronium resulted in hepatic centrilobular fatty degeneration, but no depletion of hepatic glutathione (GSH). The present findings suggest that glutathione depletion does not seem to be involved in quinuronium hepatotoxicity

Following the death of 67 boys in a fire tragedy at Kyanguli School in rural Kenya, the level of traumatic grief was assessed in a sample of 164 parents and guardians whose sons died in the fire. The study was cross-sectional. Counseling services were offered to all the bereaved parents soon after the tragedy. The subjects were interviewed using the Traumatic Grief Scale. A group of 92 parents/guardians was interviewed 2 months after the event, while the other group of 72 was assessed 7 days later. The second group of bereaved parents also completed the Self Rating Questionnaire (SRQ) and the Ndetei-Othieno-Kathuku scale (NOK). Over 90% of parents from both groups had a yearning for the departed and found themselves searching for him quite often. There was no much difference in terms of symptoms profile or intensity between the two groups. It appears that the counseling offered had minimal impact on the levels of distress.

Two groups of 6 rats each received subcutaneous injections of 2.3 mg/kg or 5.0 mg/kg of quinuronium, respectively, on two consecutive days, while 5 rats injected with physiological saline served as controls. Clinical signs of muscular tremors, jumps, enlarged and hyperemic eyeballs, lacrimation, depression and anorexia were observed following administration of quinuronium. One rat receiving 5 mg/kg died before termination of the study. When killed 48 h after the first injection, the quinuronium-treated rats had a higher liver weight/body weight ratio compared to the controls. Quinuronium resulted in hepatic centrilobular fatty degeneration, but no depletion of hepatic glutathione (GSH). The present findings suggest that glutathione depletion does not seem to be involved in quinuronium hepatotoxicity

Objective: To remove or modify fluorotic enamel stains using a combined chemical micro-abrasion and bleaching technique. Design: An in-vivo study was carried out. A sample of 21 participants was randomly selected from patients presenting with brown staining due to flourosis as the chief complaint. Eighty nine teeth were selected based on the Thylstrup-Fejerskov Index [TFI] with a score of 4 as the acceptable maximum. Only upper anterior teeth were included in the study. Setting: The study was undertaken at the University Of Nairobi Dental Hospital, Kenya. Subjects: Patients with an expressed need for treatment of their discoloured teeth who consented to a clearly demonstrated treatment procedure constituted the sample. Results: Enamel discolouration was removed or modified yielding a uniform colour and lustre depending on the initial depth of the stain. All patients appreciated the colour change. Conclusion: A combined chemical micro-abrasion and bleaching technique is a feasible treatment modality in selected cases of enamel fluorosis.

Two groups of 6 rats each received subcutaneous injections of 2.3 mg/kg or 5.0 mg/kg of quinuronium, respectively, on two consecutive days, while 5 rats injected with physiological saline served as controls. Clinical signs of muscular tremors, jumps, enlarged and hyperemic eyeballs, lacrimation, depression and anorexia were observed following administration of quinuronium. One rat receiving 5 mg/kg died before termination of the study. When killed 48 h after the first injection, the quinuronium-treated rats had a higher liver weight/body weight ratio compared to the controls. Quinuronium resulted in hepatic centrilobular fatty degeneration, but no depletion of hepatic glutathione (GSH). The present findings suggest that glutathione depletion does not seem to be involved in quinuronium hepatotoxicity

This study investigated sustainability compliance in the Kenyan construction industry focusing on the interior design market segment. This focus was informed by the need to have all market segments involved in sustainable construction endeavours. From past literature, independent variables were identified as sustainability literacy, uptake and assessment with the moderating and dependent variables as market segment peculiarities and sustainable construction compliance respectively. The study had hypothesized, in the alternative, the impact of independent variables individually and jointly on dependent variable in the Kenyan construction industry was above average. The phrase above average was based on threshold which for this study was set at a mean of three [Average]. Additionally, the study sought to assess the extent of independent variables, individually and jointly, as key contributors to sustainable construction compliance in Nairobi City County. The targeted population were key practitioners in the Kenyan construction industry. These were identified as architects/interior designers, electrical engineers, mechanical engineers, quantity surveyors and contractors being the typical core team required for a professionally executed interior design project in Kenya. They have the potential to influence project lifecycle towards improved sustainable construction compliance. Sampling frame was defined as actively practicing key professionals as above identified in Nairobi City County. The Yamane (1967) formula was used to compute sample size which was adjusted for non-response resulting in 60 respondents. For the research instruments, structured questionnaires, appropriate measures were taken to ensure their validity and reliability. Lastly, appropriate research ethics considerations were observed. The unit of analysis and observation was the individual key professional. For data analysis, descriptive statistics were mainly through computation of means and standard deviations and inferential statistics through t-statistic p-value score calculations. Resulting data was presented in form of charts, tables and graphs. Out of the 60 targeted respondents, valid responses were 46 representing a 77% response rate. On hypotheses testing, individually and jointly, sustainable construction literacy, transition/uptake and assessment/evaluation had an above average impact on sustainable construction compliance in the Kenyan construction industry. The findings also established the impact of independent variables on dependent variable in the Kenyan construction industry individually and jointly as above average in Nairobi City County. Additionally, the study highlighted improvement measures for the three independent variables as a means of achieving improved sustainability compliance in the Kenyan construction industry both at policy and practice levels. Recommendations for future research based on the findings of this study were also outlined.

Two groups of 6 rats each received subcutaneous injections of 2.3 mg/kg or 5.0 mg/kg of quinuronium, respectively, on two consecutive days, while 5 rats injected with physiological saline served as controls. Clinical signs of muscular tremors, jumps, enlarged and hyperemic eyeballs, lacrimation, depression and anorexia were observed following administration of quinuronium. One rat receiving 5 mg/kg died before termination of the study. When killed 48 h after the first injection, the quinuronium-treated rats had a higher liver weight/body weight ratio compared to the controls. Quinuronium resulted in hepatic centrilobular fatty degeneration, but no depletion of hepatic glutathione (GSH). The present findings suggest that glutathione depletion does not seem to be involved in quinuronium hepatotoxicity

Transcultural psychiatry, whose scientific founder Emil Kraepelin is considered as, in its 100 years of tradition has not only developed a varied range of methods but has also brought about a change in the respective scientific questions as well as in related research and clinical applications. Whereas transcultural research on the psychopathology of depression contributed to the further development of psychiatric nosology, transcultural psychiatry has recently been increasingly faced with issues concerning phenomena of social change and globalization. One region, where such conditions can be observed in particular is Africa, where the dissolving of traditional standards and support systems and growing economic insecurity causes a considerable burden especially on women. As an example, results from a cross-sectional study on East African women using a two step design as well as qualitative and quantitative, standardized psychiatric methods are discussed concerning the association of social change, psycho-social risk factors and the development of depressive disorders. Efficient clinical methods towards diagnosis and treatment of new risk groups will have to be developed, of which an important aspect will be crisis intervention.

Two groups of 6 rats each received subcutaneous injections of 2.3 mg/kg or 5.0 mg/kg of quinuronium, respectively, on two consecutive days, while 5 rats injected with physiological saline served as controls. Clinical signs of muscular tremors, jumps, enlarged and hyperemic eyeballs, lacrimation, depression and anorexia were observed following administration of quinuronium. One rat receiving 5 mg/kg died before termination of the study. When killed 48 h after the first injection, the quinuronium-treated rats had a higher liver weight/body weight ratio compared to the controls. Quinuronium resulted in hepatic centrilobular fatty degeneration, but no depletion of hepatic glutathione (GSH). The present findings suggest that glutathione depletion does not seem to be involved in quinuronium hepatotoxicity

Two groups of 6 rats each received subcutaneous injections of 2.3 mg/kg or 5.0 mg/kg of quinuronium, respectively, on two consecutive days, while 5 rats injected with physiological saline served as controls. Clinical signs of muscular tremors, jumps, enlarged and hyperemic eyeballs, lacrimation, depression and anorexia were observed following administration of quinuronium. One rat receiving 5 mg/kg died before termination of the study. When killed 48 h after the first injection, the quinuronium-treated rats had a higher liver weight/body weight ratio compared to the controls. Quinuronium resulted in hepatic centrilobular fatty degeneration, but no depletion of hepatic glutathione (GSH). The present findings suggest that glutathione depletion does not seem to be involved in quinuronium hepatotoxicity

Two groups of 6 rats each received subcutaneous injections of 2.3 mg/kg or 5.0 mg/kg of quinuronium, respectively, on two consecutive days, while 5 rats injected with physiological saline served as controls. Clinical signs of muscular tremors, jumps, enlarged and hyperemic eyeballs, lacrimation, depression and anorexia were observed following administration of quinuronium. One rat receiving 5 mg/kg died before termination of the study. When killed 48 h after the first injection, the quinuronium-treated rats had a higher liver weight/body weight ratio compared to the controls. Quinuronium resulted in hepatic centrilobular fatty degeneration, but no depletion of hepatic glutathione (GSH). The present findings suggest that glutathione depletion does not seem to be involved in quinuronium hepatotoxicity

Objectives: To determine the psychological problems the non-psychiatric doctors commonly encounter, the treatment offered and/or referrals made and to determine any obstacles met in providing psychiatric treatment or making referrals. Design: Cross- sectional survey. Setting: Kenyatta National Hospital, Nairobi, Kenya. Subjects: Doctors working at Kenyatta National Hospital. Results: One hundred and thirty (94 males and 36 females) doctors subm .t .J usable questionnaires. Seventy eight per cent of the respondents were below 35 years and 57 had less than five years experience. The commonest psychiatric disorders seen by doctors were anxiety, depression, psychosomatic disorders and organic psychoses similar to findings in previous prevalence studies. Drugs therapy with anxiolytics antidepressants and antipsychotics were commonly utilised. Brief counselling was the verbal form of treatment most commonly used. Referral to mental health workers was less often done. Obstacles cited by the doctors were the patients' resistance to referral, lack of coordination and insufficient knowledge to treat the disorders. Conclusion: The doctors recognise that psychiatric disorders are common among their patients but they have major obstacles in managing them. These findings are discussed and remedial measures suggested.

Kenya’s agricultural sector accounts for 20–30% of the gross domestic product (GDP). Of this, the livestock sector alone makes a contribution of about 50%. Thus, livestock contributes heavily to the GDP and food security of its population. It also provides the necessary thrust for other forms of development in the country. Recent statistics indicate that currently over 50% of the country’s livestock population is based in the arid and semi-arid lands (ASALs), which form about 80% of the country’s land area. However, comparative international statistics show that livestock contributes 88% of the total agricultural output in Botswana even though the country has half Kenya’s livestock population and is of less agricultural potential. Thus, there is a huge potential contribution that livestock can make to the Kenyan national economy. Unfortunately, this sector receives only 10% of the government’s agricultural expenditure and less than one per cent of total spending, yet it is estimated that Kenya’s potential to export livestock products if adequately exploited would earn more than the earnings from tea and coffee combined. This then calls for new thinking about livestock development strategies to harness the arid landsThe livestock sector accounts for 90% of employment and more than 95% of household incomes in the ASALs. Most of the livestock slaughtered in major urban centres originates in these areas, with an annual slaughter of about 1.6 million Tropical Livestock Units. Kenya’s livestock from the ASALs is worth Kshs 60 billion (US$800 million). The internal livestock trade in trade in thepastoral areas alone nets in about 6 billion shillings (US$80 million )a yearIn the arid areas of the ASALs, arable crop production is not possible without some form of irrigation; while in semi-arid areas rainfall may be sufficient for certain types of crops, requiring special management techniques. Therefore, except for the areaunder cropping, the rest of the arid areas is used for livestock.......

Background

Urbanisation has been described as a key driver of the evolving non-communicable disease (NCD) epidemic. In Africa, hypertension is the commonest cardiovascular problem. We determined the prevalence and risk factor correlates of hypertension in the largest Nairobi slum.
Methods

In 2010 we conducted a population-based household survey in Kibera, a large informal settlement in Nairobi City; utilising cluster sampling with probability proportional to size. Households were selected using a random walk method. The WHO instrument for stepwise surveillance (STEPS) of chronic disease risk factors was administered by trained medical assistants, who also recorded blood pressure (BP) and anthropometric measures. BP was recorded using a mercury sphygmomanometer utilising the American Heart Association guidelines. Hypertension was defined as per the 7th Report of the Joint National Committee or use of prescribed antihypertensive medication. Those with hypertension or with random capillary blood sugar (RCBS) >11.1 mmol/l had an 8 hours fasting venous blood sugar sample drawn. Age standardised prevalence was computed and multivariate analysis to assess associations.
Results

We screened 2200 and enrolled 2061 adults; 50.9% were males; mean age was 33.4 years and 87% had primary level education. The age-standardised prevalence of hypertension (95% CI) was 22.8% (20.7, 24.9). 20% (53/258) were aware of their hypertensive status; 59.3% had pre-hypertension; 80% reported high levels of physical activity and 52% were classified as harmful alcohol drinkers; 10% were current smokers and 5% had diabetes. Majority of males had normal BMI and waist circumference, whereas a third of females were obese or overweight and 40% had central obesity. Older age, higher general and central obesity were independently associated with hypertension and higher SBP and DBP readings.
Conclusions

Our findings of high prevalence of hypertension, in association with excess body weight in this poor urban slum community, point to the need for greater awareness and implementation of primary preventive strategies.
Keywords
Hypertension prevalence Urban health Poverty areas Africa South of the Sahara Non-communicable diseases

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One common feature of most neurodegenerative diseases, including Alzheimer's disease (AD) and stroke, is the death of neuronal cells. Neuronal cell death is associated with apoptosis, generation of reactive oxygen species and oxidative stress. Neuronal cell death pathways can be reversed by endothelin B receptor agonist, IRL-1620, which was found to enhance neuroprotection by promoting vascular and neuronal growth in a rodent stroke model. Previous studies conducted at our institution indicated that the treatment with IRL-1620 significantly improved neurological and motor function while reducing oxidative stress and overall infarct area. IRL-1620 is a hydrophilic, 15 amino acid peptide and has a molecular weight of 1820Da. In this study, we have encapsulated IRL-1620 in PEGylated liposomes in order to enhance its efficacy. Each batch of liposomes encapsulating IRL-1620 was evaluated for particle size, polydispersity index, and charge (zeta potential) over a period of time to determine their stability. A dose-response bar graph was plotted based on the effect of neuroprotection by free IRL-1620 on differentiated neuronal PC-12 cells. The 1nM concentration was found to have the highest cell viability. The liposomes loaded with IRL-1620 were tested on differentiated neuronal PC-12 cells for their neuroprotective ability against apoptosis caused by removal of nerve growth factor (NGF) against free (non-encapsulated) IRL-1620. The liposomal IRL-1620 was found to proliferate the growth of serum-deprived differentiated PC-12 cells significantly (p<0.0001). In the western blot analysis, the expression of the anti-apoptotic marker, BCL-2 was found to be increased, and that of pro-apoptotic marker, BAX was found to be decreased with liposomal IRL-1620. The effects were found to be independent of the NGF levels. Finally the free IRL-1620 was found to cause neuronal outgrowth equivalent to the 75ng/ml NGF treatment.

Between February and July 1987, some 40 consecutive patients with established chronic renal failure, on either maintenance dialysis or conservative management, were studied to determine the nature and incidence of upper gastrointestinal tract mucosal disease. Serum assays for gastrin, bombesin and gastric inhibitory polypeptide were also done.

Endoscopic gastritis was evident in 27.5%, duodenitis in 20%, bile reflux in 17.5%, distorted duodenal bulb in 17.5% oesophangitis in 5% and duodenal ulcer in 5%. In 32.5% of the patients there was no endoscopic abnormality noted. No patient had active gastrointestinal bleeding. Gastrin and gastric inhibitory polypeptide were significantly elevated in all study cases when compared to the controls. None of the cases had conditions, other than chronic renal failure to account for fasting hypergastrinemia. Fasting serum gastrin levels did not correlate significantly with endoscopic diagnosis, serum creatinine or creatinine clearance. A statistically significant correlation was found between serum gastrin and bombesin levels.

The results indicate a high prevalance of inflammatory and hypertrophic mucosal changes in chronic renal failure but not peptic ulcer disease, and suggest that these changes may be a consequence of hypergastrinemia.

It is r~ded that all chronic renal failure patients with significantupper gastrointestinal symptomatology and all pre­ renal transplant patients undergo upper gastrointestinal endoscopicassessement.

Background. The host immune response against mucosally-acquired pathogens may be influenced by the mucosal immune milieu during acquisition. Since Neisseria gonorrhoeae can impair dendritic cell and T cell immune function, we hypothesized that co-infection during HIV acquisition would impair subsequent systemic T-cell responses.   Methods. Monthly screening for sexually transmitted infections (STIs) was performed in high risk, HIV seronegative Kenyan female sex workers as part of an HIV prevention trial. Early HIV-specific CD8+ T cell responses and subsequent HIV viral load set point were assayed in participants acquiring HIV, and were correlated with the presence of prior genital infections during HIV acquisition.   Results. Thirty-five participants acquired HIV during follow up, and 16/35 (46%) had a classical STI at the time of acquisition. N. gonorrhoeae co-infection was present during HIV acquisition in 6/35 (17%), and was associated with an increased breadth and magnitude of systemic HIV-specific CD8+ T-cell responses, using both interferon- (IFNg) and MIP-1 beta (MIP1b) as an output. No other genital infections were associated with differences in HIV-specific CD8+ T cell response, and neither N. gonorrhoeae nor other genital infections were associated with differences in HIV plasma viral load at set point.   Conclusion. Unexpectedly, genital N. gonorrhoeae infection during heterosexual HIV acquisition was associated with substantially enhanced HIV-specific CD8+ T-cell responses, although not with differences in HIV viral load set point. This may have implications for the development of mucosal HIV vaccines and adjuvants.