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Ilovi CS, GN.Lule, Irimu H, Obel AO. Correlation of WHO clinical staging with CD4 counts in adult HIV/AIDS patients at KNH.; 2011. Abstract

OBJECTIVE: To determine the degree of correlation between the WHO clinical staging and CD4 T cell counts in HIV / AIDS adults at Kenyatta National Hospital, Nairobi. DESIGN: Cross-sectional study. SETIING: Kenyatta National Hospital, Nairobi. SUBJECTS: 152 newly diagnosed HIV patients were recruited prospectively. Patients were first staged using the 2005 WHO clinical staging and then blood drawn for CD4 count. RESULTS: The mean age in the study was 35 years, with females comprising 56.2% of the study group. The mean CD4 counts were 455, 420, 203 and 92 for WHO Stage 1, 2, 3 and 4 respectively. The sensitivity of the WHO clinical staging to predict CD4 counts of >350cells/lJl was 63% with a specificity of 82%. The commonest HIV clinical events were bacterial infections(33%), severe weight loss(28%) and tuberculosis(27%). CONCLUSIONS: There was correlation between the WHO clinical staging and expected CD4 T cell count. However, the sensitivity was low and missed over a third of the patients in need of HAART. Majority of the patients presented in severe disease in need of HAART at the onset of their HIV diagnosis with 107 (70.3%) of the patients with Stage 3 or 4 disease and 114 (75%) of patients with CD4 counts of <350 cells/pl. KEY WORDS: HIV, AIDS, CD4 counts, Kenyatta National Hospital, Nairobi

MR GITAU WILSON. Diagnosis and Predictability of Intraseasonal characteristics of wet and dry spells over Equatorial East Africa. PROF OGALLO LABAN, PROF CAMBERLIN PIERRE, DR OKOOLA RAPHAEL, eds. Nairobi: University of Nairobi; 2011.
Wayua FO. Evaporative Cooling and Solar Pasteurization technologies for value addition of Camel (Camelus dromedaries) Milk in Marsabit and Isiolo Counties of Northern Kenya. Okoth MW, Wangoh J, eds. University of Nairobi; 2011. Abstract

Abstract
The potential for evaporative cooling and solar pasteurisation technologies for value addition
of camel milk in Marsabit and Isiolo counties of northern Kenya was investigated. To find
out existing postharvest handling and preservation practices, a survey was conducted using a
semi-structured questionnaire and focus group discussion on 167 came l milk producers, 50
primary and 50 secondary milk traders. Results showed that the camel milk chain was
characterised by poor milk handling infrastructure, including poor roads and lack of cooling
facilities. Camel milk was marketed raw under unhygienic conditions with minimal value
addition, and spoilage was a major problem. Milk traders occasionally boiled milk using
firewood as a means of temporary preservation during times when transport was unavailable.
Provision of appropriate cooling facilities and utilisation of renewable energy technologies
such as solar energy for milk processing were identified as possible intervention strategies to
enhance marketing.
Therefore, a low-cost charcoal evaporative cooler was developed and tested for the storage
of camel milk. The cooler, 0.75 m3 in capacity, was made of galvanised angle iron (25 mm x
25 mm x 4 mm) frame with 10 cm wide charcoal walls which were moistened through a drip
system. Temperature of camel milk inside the cooler did not significantly (p>0.05) change
after storage for 10 hours. However, temperature of control milk at ambient conditions
significantly increased (p=0.05) over the same period, from 22.6 ± 0.08°C to 28.1 ± 0.08°C.
Milk inside the cooler was also significantly cooler (p=0.05) than control milk in the
evening, with a net temperature reduction of 27.0%. Total bacterial count changed from
31.4±2.1 x 104 colony forming units per ml (cfu.ml–1) to 43.1±1.9 x 104 and 1638±81 x 104
cfu.ml–1 for milk inside the cooler and that at ambient conditions, respectively, after storage
for 10 hours. The cooler’s performance was modelled using artificial neural networks
(ANN), with inputs being ambient dry bulb temperature, wet bulb temperature, wind speed
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and temperature of drip water. The outputs were cooled milk temperature and cooling
efficiency. The ANN predictions agreed well with experimental values with mean squared
error (MSE) of 10.2, mean relative error (MRE) of 4.02% and correlation coefficients (R2) in
the range of 0.86-0.93.
The development of the solar milk pasteuriser started with thermal performance testing of
four water heating flat plate solar collectors available in Kenya with the objective of
selecting a suitable one to be used to provide process heat for batch pasteurisation. The
collectors included three commercial solar collectors purchased from local shops in Nairobi,
Kenya and one prototype collector designed and fabricated by the author. The three
commercial solar collectors had effective areas of 1.67, 1.87 and 1.83 m2 while the self-made
collector had an effective area of 1.60 m2. Thermal performance of the collectors was
determined in terms of the Hottel-Whillier-Bliss equation. The FR(ta )e values, obtained
using the effective collector areas and the inlet water temperature, were 0.76, 0.75, 0.73, and
0.82, respectively, for the commercial collectors and the self -made collector. The FRUL
values were 8.33, 12.01, 9.80 and 13.77 W.m–2.°C–1, respectively. The solar collector with
the lowest FRUL value had a black chrome selective absorber surface and was the most cost
effective for delivering temperatures of about 80°C at an efficiency of 15%. It was used to
develop a low -cost batch solar milk pasteuriser consisting of the collector and a cylindrical
milk vat. The milk vat had a 50 mm-wide hot water jacket and an outer layer of 38 mm thick
fibre glass insulation. The water jacket held approximately 30 litres of water, whereas the
milk tank had a capacity of 80 litres. The hot water produced by the collector was used for
pasteurising milk. The optimum quantity of milk which could be pasteurised by this device
under the study conditions was 40 litres, which was pasteurised in approximately 1.3±0. 5
hours at an average insolation and ambient temperature of 22.5±0.9 MJ.m–2.day–1 and
29.8±0.1°C, respectively. The average temperature difference between hot water and milk
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being pasteurised was 8.1±0.6°C. Total bacterial counts in pasteurised milk were less than 10
cfu.ml–1 while coliform counts were negative.
The solar milk pasteuriser was modelled using ANN as described for the cooler. The inputs
of the model were ambient air temperature, solar radiation, wind speed, temperature of hot
water, and water flow rate through the collector, whereas the output was temperature of milk
being pasteurised. The ANN predictions agreed well with experimental values , with MSE,
MRE and R2 of 5.22°C, 3.71% and 0.89, respectively.
It has thus been established that there is both the need and potential for evaporative cooling
and solar pasteurisation along the camel milk value chain in Kenya. The two technologies
augment each other in increasing the quantity and quality of marketed camel milk from
scattered pastoral production sites in Kenya. The devices are of low cost and can be locally
fabricated by village artisans using locally available materials , and their performance can be
successfully modelled using ANNs, which helps to design an appropriate system for any
application.

Dr Gathece LW. Impact of health education on oral heal threlated Quality of life of people living with Hiv/aids in nairobi..; 2011. Abstract

background Oraldiseases and conditions affect every race worldwide. The prevalence of the
twomajor oral diseases namely periodontal diseases and dental caries has been
foundto vary from region to region among the general population. Studies have
found that the prevalence and severity of these diseases and other oral
conditionsis higher among People Living with the Acquired Immuno-Deficiency
Syndrome (PLWHA) than HIV (Human Immunodeficiency Virus) seronegative
persons.The PLWHA also tend to suffer from other types of oral diseases which
are either very rare or do not occur in the oral cavity among seronegative
individuals. Studies have found to a large extent, that oral diseases can be
effectively prevented by oral health education among the general population.
However, the impact of oral health education on oral diseases and conditions
amongPLWHA is unknown in Kenya.
Objective
To determine the impact of oral health education on the oral health status and
Oral Health-Related quality (OHRQoL) of life among PLWHA.
Study Design: This was a quasi-experimental study
Study sites: The study was conducted at the Kenyatta National Hospital (KNH)
(intervention group) and Mbagathi District Hospital (MDH) (non-intervention
group) Comprehensive Care Centers (CCC).

Agutu PO. THE IMPACT OF ISO 9000 CERTIFICATION ON INTERNATIONALIZATION OF THE UNIVERSITY OF NAIROBI. Nairobi: University of Nairobi; 2011. Abstract

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THE IMPACT OF ISO 9000 CERTIFICATION ON INTERNATIONALIZATION OF THE UNIVERSITY OF NAIROBI BY PATRICK OBONYO AGUTU A RESEARCH PROJECT SUBMITTED IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF BUSINESS ADMINISTRATION SCHOOL OF BUSINESS UNIVERSITY OF NAIROBI SEPTEMBER 2011
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ii DECLARATION This research project is my original work and has not been presented for examination in any other University Signature……………………………. Date……………………………….. PATRICK OBONYO AGUTU D61/75210/2009 This research project has been submitted for examination with my approval as University Supervisor. Signature……………………………. Date……………………………….. DR. JOHN YABS DEPARTMENT OF BUSINESS ADMINISTRATION SCHOOL OF BUSINESS UNIVERSITY OF NAIROBI
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iii ACKNOWLEDGEMENTS This Research Project has been made possible through the collective efforts of all my Lecturers at the University of Nairobi and my classmates with whom we have travelled in the continuing search for knowledge. I hereby acknowledge all their contributions. Special acknowledgement goes to my Supervisor Dr. John Yabs for his guidance and commitment for the completion of this project. I also acknowledge the Moderator Mr. E. Mududa and all the project Evaluators. I also acknowledge members of the University staff who provided valuable input to make the study possible. Special mention goes to Professor A. Mitema, Director, Centre for International Programs and Links, University of Nairobi.
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iv DEDICATION To my entire family for support and encouragement even when their social time had to be invested in this study.
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v ABSTRACT This study looks at the contribution of ISO 9000 in the Internalization process of the University of Nairobi. A case study approach was employed to gather data and provide the required information. ISO 9000 Certification continues to gain worldwide acceptance with over one million certifications to date. It has been described as representing a world consensus on standards with international participation of member bodies from countries all over the world. Implementation requires the commitment of resources in terms of personnel, finances and materials required to implement and sustain the quality management system. As resources are scarce with competing demands it is important to establish the accruing gains from implementing the system. The University of Nairobi obtained ISO Certification in the year 2008 and was subsequently recertified in July 2011 on completion of the initial three year certification period. As an institution that continues to undergo internationalization process as is the case with higher education institutions internationally, the contribution of quality standards to this process is important. In this study it was found that ISO 9000 is important especially with respect to Quality control, Corporate branding and image, International Grants funding, International programs and linkages and international student enrolment.

Andollo AA. Influence of Quality Management Systems on Service Provision in the University of Nairobi, Kenya. C.M. DR, ed. Nairobi: University of Nairobi; 2011.
Mulwa JK. Integrated geophysical study of Lake Bogoria basin, Kenya: Implications for geothermal energy prospecting. Mulwa JK, of Prof. Justus Barongo(University of Nairobi DG), of Prof. Jayanti Patel(University of Nairobi DP), Prof. Derek Fairhead(Leeds University and MD GETECH), of and Prof. Greg Houseman(Leeds University IGT), Dr Nicholas Mariita(Kenya Electricity Generating Company OGP), eds. Nairobi/Leeds: University of Nairobi/Leeds University; 2011. Abstract

The Lake Bogoria basin, herein referred to as ‘the study area’, is located in the greater Baringo-Bogoria basin (BBB), about 250 km from the city of Nairobi on the floor of Kenya Rift Valley (KRV). It is bound by latitudes 0o 00’ and 0o 30’N and longitudes 35o45’E and 36o15’E within the rift graben. The study area is characterised by geothermal surface manifestations which include hot springs, spouting geysers, fumaroles/steam jets and mud pools. The area is overlain by Miocene lavas mainly basalts and phonolites, and Pliocene to Recent sediments and pyroclastics such as tuffs, tuffaceous sediments, superficial deposits, volcanic soils, alluvium and lacustrine silts. The terrain is characterized by extensive faulting which forms numerous N-S ridges and fault scarps.

Gravity and magnetotelluric (MT) surveys were undertaken in the area in order to determine the heat source and evaluate the geothermal resource potential of the basin for generation of geothermal power. The gravity data used was from the University of Texas at El Paso and Leicester University gravity data bases. New gravity measurements’ comprising 260 data points was undertaken for the purpose of this study. In addition, magnetotelluric data comprising about fourty sites was also acquired in the study area.

Gravity survey results indicate Bouguer anomaly having an amplitude of ~40 mGals aligned in a north-south direction and this has been interpreted to be due to a series of dyke injections and hence the heat source in the basin. The dyke injections occur at depths of 3-6 km on average, but at 1 km depth at the shallowest. The gravity models show a north-south gradual variation in thickness of the uppermost low density layer comprising rift-fill volcanics from 1-4 km on average. The variation in thickness of this layer from south-north suggests that these volcanic deposits are as a result of volcanic eruption(s) outside Lake Bogoria basin such as Menengai to the south.

The MT survey results show three distinct relatively thick layers in the basin. The first of these layers, which is overlain by high resistivity (50-1000 m) thin (100-500 m) layers, is ~3 km thick and has resistivities ranging between 4-30 -m. This layer is interpreted as the geothermal reservoir and the low resistivities are due to a combination of circulating hot mineralized geothermal fluids, hydrothermal alteration and saline sediments. The second layer is ~10 km thick and resistivity values range between 85-2500 -m and is interpreted to be a fractured and hydrothermally altered basement metamorphic rock. The relatively high degree of fracturing has considerably enhanced circulation of water which gets heated by the underlying dyke injections and thus inducing convective heat transport to the geothermal reservoir. The substratum is characterized by resistivities ranging between 0.5-47 -m and is interpreted as hot dyke injections at depths of about 6-12 km, which are the heat sources for the geothermal system.

Consequently, a heat source and a geothermal reservoir exist in Lake Bogoria basin. The heat source(s) is/are due to cooling dyke injections occurring at depths of 3-6 km on average, but 1 km depth at the shallowest near Arus where steam jets and fumaroles occur. The magnetotelluric method, however, favours depths of 6-12 km for the heat source and this may be attributed to lack of significant resistivity contrast between the dyke injections and the basement rocks where the former have intruded the latter rocks.
More gravity data is warranted so as to precisely define the geometry and areal extent of the heat source in Lake Bogoria basin. However, based on the results of this study, it is recommended that:- 1) exploratory drilling be undertaken in the area near Arus steam jets, 2) even though the study area is not prone to any pre-historic eruptions, microgravity and seismic monitoring be undertaken so as to help in tracking possible magma migration and variations in magma input. Such data could, in turn, play an important role in predicting future eruptive events in Lake Bogoria basin.

Wabomba JN. Kinetics and equilibrium studies of single and multi-component metal ion sorption on a micaceous mineral of kenyan origin.. Nairobi: University of Nairobi; 2011. Abstract

Water pollution by Chemicals is of great public concern. Improvements in the quality and availability of water are often possible at relatively low costs. The objective of this work was to test the efficacy and applicability of a Micaceous mineral of Kenyan origin (herein referred to as Mica-K or the mineral) in the removal of toxic divalent heavy metal ions from water and wastewater systems. Mica-K was characterized and utilized in study of single and multi-component removal of Cu2+, Cd2+ and Zn2+ ions from aqueous solution over wide range of initial metal ion concentrations (25 mglL to 500 mg/L), contact duration (0-3hrs), sorbent dose (0.5-10 gl25ml or 20-400glL), pH (1.5 to 7.5), and temperature (293 to 333 K). The sorption pattern of Cu2+, Cd2+ and Zn2+ ions onto the micaceous mineral followed Langmuir, Freundlich, and DubininKaganer-Radushkevich isotherms. The dependence of heavy metal adsorption on pH was different for each metal ion. The removal of Zn2+ was about 0% at pH 2 and it increased to 93% at pH 7.4. For Cu2+, 72% was removed at pH 2.5 and it increased to 98% at pH 7.4. Cd2+, removal increased with increasing pH from 45% at pH 1.5 to 93% at pH 7.4. In all cases, over 93% of all the three metals were removed at pH 7.4. Metal ion removal was however, considerably affected by the presence of competing metal ions in solution. • 0 0 0 2-"- 2+ 2+. . Thermodynarmc parameters (iJH, iJS and iJG ) for Cu " Cd and Zn sorption onto MicaK were also determined. Kinetic modeling analysis of the Elovich, pseudo-first order, pseudosecond order, intra-particle diffusion, mass transfer and intra-particle diffusivity equations using the linear coefficient of determination R2 values showed that the pseudo-second order equation was the most appropriate model for the description of Cu2+, Cd2+ and Zn2+ transport. Thus the sorption of Cu2+, Cd2+ and Zn2+ ions can be said to follow a pseudo-second order model, with chemical sorption as its rate limiting step. Experiments were also carried out to ascertain the physico-chemical properties of Mica- K. Chemical analysis revealed that the mineral is mainly comprised of Si02, MgO, Ah03 and Fe203. Physical parameters such as specific gravity, void ratio, porosity, hydraulic conductivity (at 20°C), unit weight of dry mineral, unit weight of submerged saturated mineral, unit weight of buoyant mineral, optimum moisture content (OMC), maximum dry density(MDD), and specific surface area have also been determined and reported. Elemental analyses of Mica-K have shown that; major rock-forming mineral elements comprises of AI, Fe, K, and Mg; major ore-mineral elements present include Ba, Ca, Cr, Ni and Ti; and trace elements, are Co, Mn, Cu, P,S, Si, V, B, Hg, Li, Sr and Zn. The most abundant minerals are; feldspars, chlorites, pyrites and kaolinites with dolomites, calcites and quartz being the least abundant. X-ray photoelectron spectroscopic (XPS) analysis for Cu2+, Cd2+ and Zn2+ ion-equilibrated Mica-K, demonstrated that Cu2+, Cd2+ and Zn2+_containing nodules existed on the surface of the mineral. X-Ray diffraction (XRD) studies have pointed to the possibility of formation of metal fluoride, oxide, hydroxide, carbonate and hydrogen carbonate complexes on the surface of Mica-K during metal ion adsorption. Other studies included comparative batch kinetics whereby the effects of; contact time, initial metal ion concentration, weight of mineral used, solution pH, particle size, agitation speed, temperature and nature of metal ion salt were investigated. Comparative batch equilibrium studies involved determination of the isotherms of sorption, maximum sorption level and modeling. Fixed bed experiments were performed to determine the breakthrough curves and study the sorption dynamics. The amount of Cu2+ ions adsorbed in fixed-bed experiment was greater than that of combined alkali and alkaline earth metal cations Mg2+, Ca2+, Na+ and K+ released. This indicates that ion exchange is not the only mechanism by which Cu2+ ions are removed from solution. Regeneration of sorbent for repeated use was carried out using 0.1 M HCI as the desorbing agent. The amount of copper desorbed by the acid was 27.30meq g-l (13.65 mg g") as compared to 14.26meq g-l (7.13mg g-l), copper adsorbed by Mica-K in the column. These shows that Mica-K can be regenerated effectively using weak acids. Excess amounts of acid however, can lead to the degradation of the mineral structure and thus result in the leaching of copper and other ions. Mica-K adsorbent compared quite well with a commercially available Elgalite ion exchange resin from Elga Company UK, when used to treat real water samples from different sources within Kenya and industrial effluents. It has been proven that Mica-K is a good adsorbent for both metal and non-metal ions with the amount of ion adsorbed being dependant on the type of ion, its concentration and solution pH. It is hoped that the data obtained from this research work will illustrate the importance of locally available micaceous minerals in their use as economical adsorbents of heavy metals from water and wastewater systems. It is also hoped that the results will convince the public and the decision makers of the urgent need to develop industrial and domestic uses of the locally available materials for water purification.

M.M. G. Knowledge, Attitudes And Practices Of Glaucoma Patients Attending Clinic At Kenyatta National Hospital.. M.M. K, S.A. M, eds. Nairobi: University of Nairobi; 2011. Abstract

Background: Glaucoma is a characteristic optic neuropathy which typically results in specific patterns of progressive visual field loss and who’s most important risk factor is raised intraocular pressure (IOP). It is second to cataract as a leading cause of global blindness and is the leading cause of irreversible visual loss. In Kenya it is ranked third after cataract and trachoma. Glaucoma is often diagnosed late and accompanied by poor patient compliance and follow-up as it is very slowly progressive and commonly asymptomatic until a very advanced stage of the disease is reached.
Results: We interviewed 78 patients, 47 were male and 31 were female. Age ranged from 19-89 years with a mean age of 61.1 (SD +11.5) years. Seventy nine percent of patients presented with normal visual acuity but 5 (6.4%) presented with bilateral blindness. Mean IOP at presentation was 23.85mmHg with a wide range of 9-60mmHg. Fifty three (67.9%) patients were classified as having some knowledge using a predefined classification system, having poor knowledge of risk factors and treatment options. On compliance to medication, 62 (78.7%) patients reported compliance while 54 (69.2%) reported compliance to all clinic visits. The most common challenges reported with drug use were drops falling on cheeks (41%), cost of drugs (23.1%), and side effects of drugs used (19.2%).The most common impediments to clinic attendance were forgetting (16.7%) and other incidental events (62.5%). Patients had wrong expectation of both treatment and surgery with 29.5% and 32.5% expecting cure from medical and surgical treatment respectively. Compliance to glaucoma medication was perceived to be very important in 88.5% of patients, while 89.7% of patients perceived compliance to follow-up clinics as being very important.
Conclusion: Forty four (56.4%) patients presented late with advanced disc damage and 40 (51.3%) had undergone surgery, the most common being trabeculectomy. There is still a wide gap in knowledge that exists and that needs to be addressed through counseling and further patient education. Self-reported compliance was high and patients had good attitudes towards treatment and follow-up of glaucoma.

G W. THE PREVALENCE OF INTERNET CRIMES ON STUDENTS. Nairobi: University of Nairobi; 2011.
Mburugu PM. The spectrum and short-term outcome of home-based injuries among children presenting to Kenyatta National Hospital.; 2011. Abstract

Background and objectives: Injuries are a major cause of mortality and morbidity worldwide, resulting in over 950,000 deaths in children annually with more than 95% of injury deaths occurring in low income and middle income countries. The home remains a significant setting for a number of deaths and a large number of non fatal injuries. Recent data on the spectrum and outcome of children presenting with home based injuries in Kenya is lacking. The primary purpose of this study was to describe the spectrum and outcomes of home based injuries among children under 18 years of age presenting to Kenyatta National Hospital (KNH) Methodology: This was a short longitudinal survey conducted at the National Referral Hospital KNH between March and April 2010. Children less than 18 years of age with home based injuries were enrolled. We administered a questionnaire with regard to place of occurrence. circumstances surrounding the injury, socio-demographic factors and the clinical profile. We then followed them up for a maximum of 30 days or until death or discharge whichever was shorter to ascertain the outcomes (length of hospital stay, disability or death). Results: A total of 97 cases were identified. The median age was 2 years (IQR: 1.5- 5.0 years). The largest proportion of children 68% were aged between 1 - 4 years. A male preponderance was observed (58.8%). The types of injuries included; injuries resulting from falls 37.1% (fractures 58.3%, concussion/head injury 11.1 % among others), burns 33.0% (scalds 84.4% and flames 15.6%), foreign bodies 12.4% (organic 50% and_non organic 50%), cuts/wounds 8.2%, poisoning 3.1 %, sexual assault 3.1 %, electric shock 2.1 % and bites 1.0%. Eighty six percent of children were admitted with 61.7% having residual disability at 30days and 1 % died. Conclusion: The spectrum of injuries in descending frequency included; injuries resulting from falls 37.1%, burns 33.0%, foreign bodies 12.4%, cuts/wounds 8.2%, poisoning 3.1%, sexual assault 3.1 %, electric shock 2.1 % and bites 1.0%. Adverse short term clinical outcomes included hospitalization (86.6%), prolonged hospitalization for more than 14 days (50.5%), residual disability (61.7%) and death (1%). Recommendations: The frequency, morbidity and disabilty caused by home injuries to children justifies development of possible preventive measures and evaluation of longterm consequences.

Irimu GW. Uptake of best-practice recommendations for management of acutely ill children admitted in Kenyatta National Hospital: a longitudinal study employing participatory action research in a complex environment.; 2011. Abstract

The need for improving practice in low-income settings has been demonstrated in recent research assessing the quality of hospital care. Consequently, the Ministry of Health developed clinical practice guidelines and an evidenced-based programme for their dissemination. This thesis explored what factors influence the uptake of the best-practice recommendations in a university teaching hospital. This thesis used a mixed methods research approach that utilized a before and after design and participatory action research. This approach recognizes that health recommendations are compiled for universal use, but that their successful implementation requires particular attention to the individual and complex socio-political contexts of each setting, both at the micro and -macro level, which in this case was the Kenyatta National Hospital (KNH). This thesis is supported by eighteen months of participant observation, based on ethnographic research methodology and action research. Patients' care was largely inconsistent with best-practice recommendations, with nine of the 17 key indicators having performance of below 10% in the pre-intervention period. The intervention had an absolute effect size of over 20% in eight of the 17 key indicators; three of which had an effect size of over 50%. The indicators that required collective efficacy achieved performance of less than 10% in the post-intervention period. The activities during the action research component failed to predict the trend in practitioners' performance, illustrating the difficulty of gaining a holistic understanding of the quantitative results using component parts of the qualitative results as the lens. The notion of professionalism provided an overarching understanding of the implementation process. There were clear gaps between the stated values espoused in the ideal of professionalism and the observed actions of professionals in KNH. Gaps spanned knowledge management, expertise and skills, teamwork, conscientiousness and patient centeredness. I attributed the gaps in professionalism to complexity of professional development.

Were FH. Use of human nails as a bio-indicator of heavy metals overload in children. Njue W, Murungi J, Wanjau R, eds. Nairobi: Kenyatta University; 2011. Abstract

Metal pollution and its health effects present a challenge currently facing developing countries. Hair and nail were suggested as more attractive biomarkers among various biopsy materials (teeth, bone, urine, blood and other body fluids) in assessing human metal environmental exposure especially in developing countries because the analysis is economical and not susceptible to contaminations. Recent studies have indicated increasing levels of Pb and Cd in urban and agricultural areas. Studies have identified children as a special risk group as absorption and toxicity of toxic metals is inversely proportional to the age. Absorption of these metals in their gastrointestinal tract also depends on nutritional factors and interaction with other dietary components such as those of Zn, Fe and Ca. This study was therefore set to evaluate the concentration of Pb, Ca, Zn, Cd and Fe in the nails of children (n=200) under the age of six years as bioindicators of risk exposure. The concentrations of these metals were compared in toenails and fingernails samples of children (n=33). The sampling covered schools in both urban and rural settings. Factors that were suspected to influence the accumulation of Pb and Cd in children were obtained using a questionnaire. The atomic absorption spectrometry was used to determine the concentrations of the metals. The heavy metal levels in fingernails of children in urban areas were significantly higher than those of rural areas (P < 0.05; df = 168). The mean levels in urban areas were 27.5±1.8mg/g Pb and 0.73±0.08 mg/g Cd while those of rural areas were 19.7±0.9 mg/g Pb and 0.44±0.06 mg/g Cd. The correlation results indicated that high levels of Pb in the fingernail samples negatively correlated with Zn and Fe (R = -0.256 Zn; -0.188 Fe) but not Ca levels while high levels of Cd had a negative relationship with Fe (R = -0.241) only. Other factors that were found to have significant influence were socio-economic background, dietary habits and environmental risk exposure. The results also showed that the school location had more influence on the heavy metals level than the area of residence. The children in a school near the highway were found to have a mean of 34.4±3.5 NLm/g Pb as compared to those whose residence was near the highway (31.6±2.8 mg/g Pb), implying that the contaminants are from a common source. The study established that the mean metal levels were generally higher in the toenail than in fingernail samples. However, the difference was not significant (P > 0.05), therefore either the toenail or the fingernail could be used as bio-indicator. The association of toxic metals in the nails of children with environmental exposure and nutritional factors implies that policies and strategies to reduce the heavy metal levels should be implemented and reinforced to address the health issues affecting children in this country. This could be facilitated by improving the conditions of the schools and residential areas and sensitizing the general public on nutrition and effects of heavy metals.

Reuben M. “Fani katika Utenzi wa Ayubu” . Mbuthia DE, Amiri DS, eds. Nairobi: University of Nairobi; 2011.
Mulama SJ. “Usimulizi katika Utenzi wa Siri Li Asirali’. E.M. DM, K.W. PW, eds. Nairobi: University of Nairobi; 2011.
Ejore P. Influence of cattle rustling in education.. University of Nairobi; 2011. Abstract
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Watuha AI. Maudhui ya waadhi katika utenzi wa adili. University of Nairobi, Kenya; 2011. Abstract
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Mary N. Gichure, PM. Kitala MJDJNM, Kihurani DO. A sero-epidemiological study of African Horse Sickness and associated risk factors in donkey population in Kenya.. Master of Veterinary Epidemiology and Economics, Univesity of Nairobi; 2011. Abstract
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Kiulia NM, Netshikweta R, Page NA, Van Zyl WB, Kiraithe MM, Nyachieo A, Mwenda JM, Taylor MB. The detection of enteric viruses in selected urban and rural river water and sewage in Kenya, with special reference to rotaviruses.. Vol. 109.; 2010. J. Appl. Microbiol. 109(3). Abstract

To determine the occurrence of eight human enteric viruses in surface water and sewage samples from different geographical areas in Kenya.

Nyachieo A, Spiessens C, Chai DC, Kiulia NM, Mwenda JM, D'Hooghe TM. Separate and combined effects of caffeine and dbcAMP on olive baboon (Papio anubis) sperm.. Vol. 39.; 2010. J. Med. Primatol. 39(3). Abstract

Improvement of baboon sperm capacitation is necessary for achieving high in vitro fertilization (IVF) rates in baboons. In this study, we evaluated separate and combined effects of caffeine and dbcAMP on baboon sperm capacitation.

Enskog A, Johannesson L, Chai DC, Dahm-Kähler P, Marcickiewicz J, Nyachieo A, Mwenda JM, Brännström M. Uterus transplantation in the baboon: methodology and long-term function after auto-transplantation.. Vol. 25.; 2010. Hum. Reprod. 25(8). Abstract

Techniques for uterus transplantation (UTx) have been developed in rodent/domestic animals towards future clinical introduction of UTx to treat uterine factor infertility. The aim of this study was to extend the UTx research into a non-human primate species by developing surgical techniques for uterus retrieval and transplantation in the baboon.

Nabulindo DSM. Assessment of preoperative evaluation of geriatric Patients by anaesthetists at the Kenyatta national hospital.; 2010. Abstract

Geriatric is a term used to refer to any patient aged 65years and above. These patients have special needs when it comes to the practice and conduct of anaesthesia. Physiological changes in various organ systems occuring with age compounded by the high incidence of comorbidities in the elderly affect the conduct of anaesthesia .Currently about 1000 geriatric patients are admitted annually into orthopedic, gynecological and general surgical wards at the Kenyatta National Hospital (KNH) and most of them require some form of surgery. Part of the preparation before surgery includes preanaesthetic evaluation by the anaesthetist who will administer anaesthesia on the day of surgery. Currently there is no anaesthetist with a subspecialization in geriatric anaesthesia at KNH. Objective. The objective of this study was to assess the practice of preanaesthetic evaluation of geriatric patients by the anaesthetists at KNH and compare it with the international guidelines formulated by the American Society of Anaesthesiologists. Methodology. The study was an observational, descriptive, cross- sectional study of preanaesthetic evaluations by anaesthetists at KNH done on 100 geriatric patients scheduled for elective surgery.The study site was the KNH general surgical, orthopedic and gynecological wards.The eligible patients who formed the basis of a preanaesthetic review and the anaesthetists were required to fill a consent form before being recruited. Data was collected using a questionnaire from the patients' medical records .The data collected included demographic information,risk assessment,whether functional/mental status was assessed,presence of co-morbidities and if preoperative optimization and medical consultation was requested for 7 Results. Data from the medical records of 100 geriatric patients scheduled for elective surgery was collected with focus on the preanaesthetic evaluation.The ages ranged from 65 - 92 years with a mean of 72.6 years.90% of the patients in the study had a preanaesthetic evaluation done by anaesthetists of different cadres. Most of the patients (81%) were evaluated on the day before surgery.57.8% of the patients were found to have at least one co-morbid condition.ASA physical status was used for risk stratification in all patients although the functional and mental status of the patients was only evaluated in 8.9% of those evaluated.Prepoerative tests were mainly used routinely without considering the patients co-morbidities or the type of surgery.Preoperative optimization of geriatric patients at KNH was requested for by anaesthetists but requests for medical consultation were made for only 11.1% of the evaluated patients. Conclusions. The preoperative evaluation of geriatric patients at KNH does not meet the international standards as per guidelines formulated by the ASA.

Ayuke FO. Biodiversity of soil macrofauna functional groups and their effects on soil structure in West and East African cropping systems, as related to organic resource management, crop rotation and tillage. Wageningen, The Netherlands: Wageningen University; 2010. Abstract

Soil macrofauna, especially earthworms and termites are important components of the soil ecosystem and, as ecosystem engineers, they influence formation and maintenance of the soil structure and regulate soil processes. Despite advances made in understanding the links between soil macrofauna and agricultural productivity, this component of biodiversity is still very much a “black box”. In this thesis, I proposed to link soil biodiversity to soil functioning through the diversity of the soil structures produced by ‘ecosystem engineers’ like earthworms and termites, i.e. organisms, which physically modify and create habitats for other soil organisms and plant roots. This study aimed at providing an understanding of the link between soil macrofauna and crop management practices on soil aggregation and soil organic matter (SOM) dynamics as this is key to the improvement and the management of infertile or degrading soils.
The methodological approach used in this study involved assessment of:
1. How agricultural management affects earthworm and termite diversity across sub-humid to semi-arid tropical zones.
2. The influence of soil macrofauna on soil aggregation and SOM dynamics in agro-ecosystems of sub-Saharan Africa as influenced by management practices.
3. How management practices (e.g. tillage and use of organic inputs) influence macrofauna-induced biogenic structures in East and West African soils.
4. Disclosing farmers’ knowledge and perception on the roles of termites in Western Kenya.

In chapter 2, I examined how agricultural management affects earthworm and termite diversity across sub-humid to semi-arid tropical zones. This study, conducted in 12 long-term agricultural field trials of Eastern and Western Africa, provides new insights on diversity of earthworms and termites in SSA, since it is the first time that a study like this is done on this scale. In each trial, treatments with high and low soil organic C were chosen to represent contrasts in long-term soil management effects, including tillage intensity, organic matter and nutrient management and crop rotations. High soil C was considered to reflect relatively favorable conditions, and low soil C less favourable conditions for soil macrofauna. For each trial, a fallow representing a relatively undisturbed reference was also sampled.
I have shown that earthworm and termite diversity and abundance were low in fallow, high-C and low-C agricultural treatments in 12 long-term trial fields across the sub-humid to semi-arid tropical zones in Eastern and Western Africa. This is in contrast to most typical native or undisturbed forest ecosystems of the tropical zones. Environmental variables contributed 42% and 25% of variation observed in earthworm and termite taxonomic abundance, respectively. Earthworm and termite taxa were less abundant in the relatively cooler, wetter and more clayey sites characteristic of Eastern Africa, compared to the warmer, drier and more sandy sites in West Africa. Continuous crop production has significant negative effects on earthworm-, but little effect on termite diversity, as compared to long-term fallow, and agricultural management resulting in high soil C increases earthworm and termite diversity as compared to low-C soil. I conclude that fewer species of earthworms and termites are favored under agricultural management that leads to lower soil C. Results indicate that soil disturbance that goes with continuous crop production is more detrimental to earthworms than to termites as compared to fallow.

In chapter 3, a broad regional study was conducted to examine how management intensity affects soil macrofauna, and how macrofauna in turn influence soil aggregation in agro-ecosystems of sub-Saharan Africa.
My study has shown that macrofauna, especially earthworms, and to a smaller extent termites, are important drivers of stable soil aggregation, in conjunction with climate, soil organic C content and soil texture in sub-Saharan agroecosystems. However, the beneficial impact of earthworms and termites on soil aggregation is reduced with increasing management intensity and associated soil disturbance due to cultivation. I suggest that this knowledge is important in designing agricultural management systems aimed at increasing long-term soil fertility in sub-Saharan Africa.

In chapter 4, a long-term trial at Kabete, Kenya was selected to examine in detail the interactive effects of organic and inorganic fertilizerson soil macrofauna diversity and soil aggregation and SOM dynamics in arable cropping systems. Differently managed arable systems were compared to a long-term green fallow system representing a relatively undisturbed reference.
Application of manure in combination with fertilizer significantly improved aggregate stability and C and N stabilization in arable soil. Furthermore, manure-fertilizer application enhanced earthworm diversity and biomass. Significant correlations between the amount and C and N contents of aggregate fractions and whole soil C and N were observed with earthworm parameters (Shannon diversity index, abundance and biomass), but not with termite parameters. Factor and regression analyses showed that earthworms had a profound effect on aggregation, C and N stabilization in whole soil and in aggregate fractions, whereas contributions of termites were limited. Therefore, my results indicate that long-term application of manure in combination with fertilizer result in higher earthworm Shannon diversity and biomass, which leads to improved soil aggregation and enhanced C and N stabilization within this more stable soil structure. These practices therefore result in the dual benefits of improving soil physical and chemical properties. In contrast, no significant improvements in soil aggregation and C and N stabilization were found when organic inputs were applied in the form of maize stover as compared to the no-input control, irrespective of fertilizer addition. Under the conditions studied, earthworms were more important drivers of aggregate stability and C and N stabilization in aggregate fractions, but termites less so.

In chapter 5, a micromorphological approach was used to describe and quantify macrofauna-induced biogenic structures in undisturbed soil samples (i.e. thin sections) from long-term field experiments in East and West Africa. Management systems differing in tillage intensity and with or without organic amendments (manure/crop residue) were compared.
My study has shown the soil management practices tillage type and addition of organic inputs influence soil fauna activities with a significant impact on soil structure and hence soil physical properties. Among the management practices assessed across two agroecological zones, fallowing, conservation tillage plus residue application (in East Africa) and hand-hoeing plus manure (in West Africa) enhanced biogenic soil structure formation, resulting in a well developed soil structure and a continuous pore system through many faunal channels. By contrast, intensive tillage and absence of organic inputs resulted in soil with less biogenic soil structural features and was, therefore, prone to slaking.

Chapter 6 describes farmers’ knowledge on the occurrence and behavior of termites, their perception of the importance of termites in their cropping systems and the management of termite activities in their farm fields in Nyabeda, Western Kenya. Being the main actors in environmental conservation or degradation, farmers’ knowledge and perception can enrich scientific understanding of the ecology and sustainable management of termites under different agroecological conditions.
My research has shown that farmers in Nyabeda were aware of the existence of termites, their activities and nesting habits and had local names for termites that they frequently encountered. Geographic location explained 23% of the variance in farmers’ perception and management of termites, whereas socio-economic variables explained only 5%. Ninety percent of the farmers perceived termites as pests and maize was rated as the most susceptible crop to termite attack, especially during the flowering/tasseling stage and in wet periods. More than 88% of the farmers used control measures against termites, further indicating a lack of awareness or appreciation of the beneficial effects often ascribed to termites with respect to soil properties in crop production. There is an urgent need for more research to assess the trade-offs between positive and negative impacts of termites on crop yields, as well as to get an understanding of the effects of different termite control strategies used by farmers on agroecosystem functions.

Sigana DOA. The biology of the mullets (Pisces: Mugilidae) from Kilifi, a tropical mangrove creek on the Kenya coast. Mavuti KM, Ruwa RK, eds. Nairobi: University of Nairobi; 2010.
Koech OK. Effects of Prosopis juliflora Seedpod Meal Supplement on Weight gain of Weaner Galla goats. NAIROBI: UNIVERSITY OF NAIROBI; 2010. Abstractkoech_oscar_thesis.pdf

This study was conducted to determine the effect of increasing amounts of Prosopis juliflora
seedpod meal on the growth rate of weaner Galla goats. The overall aim of this study was to assess
the feasibility of incorporating Prosopis seedpods into a typical dryland livestock production
system. The study further sought to evaluate the economic viability of supplementing goats with
Prosopis seed pods and establish the optimum supplementation level for improved performance.
The experiment involved 20 weaner Galla goats of similar age (6 months) and weights (11-14 kg)
which were randomly assigned to four treatments of five weaners each. The treatments were T1 No
Prosopis (control treatment), T2 (100 g /goat /day Prosopis), T3 (200 g /goat /day Prosopis), and T4
(400g /goat /day Prosopis). Supplementation involved providing the goats with their respective
portions of Prosopis seedpod meal in the morning before the grass hay was offered. The animals
were weighed on weekly basis and the average weight gains calculated as the difference between
that weeks’ weight and the previous week’s weight divided by five. The experiment lasted for 70
days. Overall, all the treatment groups exhibited higher average weekly weight gains than T1
(control) throughout the experimental period. However, for the first 3 weeks, these differences
were not statistically significant (P<0.05). From the fifth week on wards, however, the differences
in growth rates were statistically significant (P<0.05). Overall, treatment T3 exhibited highest total
weight gain (3.96kg), followed by T4 (2.70kg). Group T1 lost weight by the end of the experiment
(-0.009kgs). The cost benefit analysis indicated that it is profitable to supplement the goats with
200g/goat/day, which was the most cost effective with a benefit cost ratio (BCR) of 1.50. T2 was
also cost effective, but at a lower level (RBC=1.47). Treatment T4 was not cost effective BCR
(0.57). It is therefore recommended that supplementation at optimum level of Prosopis seedpods
increases growth rates.

Alasow KB. Efficiency of light curing units in Dental clinics in Nairobi, Kenya.; 2010. Abstract

Background: To achieve adequate cure, a resin composite restoration must be
exposed for a specified duration of time to a light of sufficient intensity and the right
wavelength. However, some commonly used light curing units (LCUs) may yield
inadequately cured restorations due to their insufficient light intensity output.
Furthermore, the efficiency of light curing units in dental clinics and the extent to which
dentists practice the recommended maintenance techniques is largely unknown.
Objective: To determine the efficiency of Light Curing Units (LCUs) in dental clinics in
Nairobi, Kenya.
Study design: A laboratory-based, cross-sectional analytical study.
Study area: The study was set in private and public dental clinics in Nairobi, Kenya. A
total of 83 light curing units selected through a convenient sampling procedure were
used.
Materials and methods: The light intensity output of light curing units in dental clinics
was measured using a digital dental radiometer and the result entered in a data
collection form. Each light curing unit was then used to polymerise two cylindrical resin
composite specimens made using custom-made split brass moulds; one measuring
4mm in diameter and 6mm in thickness used to determine the depth of cure (DOC) and
the other 8mm in diameter and 3mm in thickness used to determine the surface
hardness by using a Vickers Hardness tester. Within 6-7 hours of fabrication, the depth
of cure specimens were immersed in a capsule containing 99%- acetone solvent which
was then vibrated in a mixing device. The DOC was calculated from the undissolved
length of the specimen. The surface Vickers Hardness was evaluated by making three
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surface indentations with a diamond indenter using a load of 200g and a dwell time of
15-seconds. A conversion table was used to convert measurements from the diamond
indentations into hardness numbers. The light intensity output and the depth of cure and
surface micro-hardness numbers of the resin composite specimens were then used to
assess the efficiency of each dental light curing unit. Three main components of the
maintenance history of the light curing units, as well as the age and type of the light
curing unit were also recorded.
The data was entered into a computer using SPSS version 12. The independent sample
t-test, one way analysis of variance (ANOVA) with Post Hoc test and Chi-square tests
were used for data analysis. The results were summarized in tables and figures.
Results: Of the 83 LCUs studied, 43(51.8%) were LED and 39(47.0%) were OTH and 1
(1.2%) was PAC light.
LCU type and light intensity output, DOC and hardness: Mean light intensity for OTH
and LED lights was 526.59mW/cm2 and 493.67mW/cm2 respectively (p=0.574), while
the mean DOC for OTH lights was 1.71mm and LED was 1.67mm (p=0.690). Mean
VHN for LED was 57.44 and for OTH was 44.14 (p=0.713). Light curing unit type had no
statistically significant effect on DOC, surface hardness and the intensity of the light.
Effect of age of LCU on light intensity output, hardness and DOC: Mean light intensity
for LCUs ::;5years was 596.03mW/cm2 and 363.17mW/cm2 for units> 5years old. Age
showed a significant effect on light intensity (p=O.024). The mean DOC for the two age
groups was 1.74mm and 1.57mm respectively (p=O.073). For surface micro-hardness,
the ::; 5years and > 5years age groups gave a mean VHN of 58.81 and 51.46
respectively (p=O.1)
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Efficiency of the LCUs: when intensity was used to measure efficiency, 48 (57.8%)
LCUs were efficient and 35 (42.2%) were inefficient. Only the LCU age significantly
affected efficiency by light intensity output (p=O.008). Only 24 (28.9%) LCUs gave
sufficient DOC as opposed to 59 (71.1%), which gave insufficient DOC. Of the units
tested for surface micro-hardness, 15 (25.9%) had adequate surface micro-hardness
while the rest (43 or 74.1%) had inadequate surface micro-hardness. The type of LCU
and its age did not significantly influence efficiency as measured using depth of cure
and surface micro-hardness of the resin restoration.
On the whole, 11 (19%) of the LCUs which had all the three tests of efficiency done
were satisfactory in all the 3 aspects.
Conclusions: Eleven (19%) of the light curing units used in Nairobi dental clinics were
efficient when subjected to a combined light intensity, and composite resin depth of cure
and surface hardness evaluation, and that the type and maintenance history of a LCU
had no significant influence on its efficiency. Age had a significant influence on the light
intensity of the curing units - there was a decrease in light intensity output with increase
in age of the units. There was a non-linear relationship between the light intensity output
of a LCU and the depth of cure and surface micro-hardness of the cured composite.

Dr Karimi PN. Etiology, Risk Factors And Management Of Infectious Diarrhoea In Children At Kenyatta National Hospital.; 2010. Abstract

Background: Infectious diarrhea is a common cause of mortality and morbidity in developing countries.
World Health Organization attributes 3.5 million deaths a year to diarrhea, with 80 percent of these deaths
occurring in children under the age of five, and most occurring in children between six months and three
years of age. The predisposing factors are mainly due to poor hygiene and most of the cases can be
treated using drugs and supportive measures. Prevention is the main intervention strategy used to prevent
this disease.
Objective: The main objective was to assess the factors that predispose children to diarrhea. The specific
factors assessed were prevalence of bacteria, protozoa, and helminthes, antimicrobial susceptibility of
bacteria, risk factors and management of diarrhea.
Methods: A cross section research design was used and target population was children suffering from
diarrhea and accompanied by their guardians who visited KNH to seek treatment. Three hundred and
eighty four children were selected for the study using simple random sampling. Data was collected using a
questionnaire and stool specimens analyzed in microbiology and parasitology laboratories of Kenyatta
National Hospital. The analysis of data was done using SPSS and data summarized in tables and charts.
Both inferential and descriptive statistics were derived using chi square and confidence intervals.
Results: Majority of the children were between 6-12 months of age and there were more males than
females. The average duration of diarrhea was 4.55 days and majority had suffered from the disease
before. Most of the parents had a certain level of formal education. The fathers had a source of income but
most of the mothers were either self employed or not employed at all. Tap water and toilet facilities were
available to most families and about half of the children had malnutrition.
No organisms were found from the stools of 80.2% of the children. The pathogens isolated were Giardia
lamblia, Entamoeba histolytica, Balantidium coli, Cryptosporidium petvum, Entamoeba coli, Blastocystis
hominis, Endolimax nana, Chilomastix mesnili, Trichiuris trichiura, Salmonella typhi and Salmonella
paratyphi. Bacteria isolated were sensitive to Ciprofioxacin and Levofioxacin but resisted most of the other
drugs tested.
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The risks found to be associated with diarrhea were overcrowding, inadequate hand washing methods,
mixed feeding, none or low level of education of the mother and administration of antibiotics. Majority of the
children had concurrent illnesses and the most common were pneumonia, meningitis, malaria, rickets and
malnutrition. Drugs were mainly prescribed to treat concurrent diseases. The most commonly prescribed
drugs were Zinc Sulphate, Paracetamol, Benzyl penicillin G, Gentamicin, Metronidazole, Multivitamin, Coamoxiclav,
Cefuroxime and Calcimax. ORS was most frequently used fluid and the intravenous ones
included Ringers lactate, Darrows solution, 5% Detrose, Hartmans solution, normal saline and Rehydration
salt for the malnourished.
Conclusion
Only a small proportion of diarrhea in children was caused by intestinal protozoa, helminthes or bacteria.
Majority of the cases occurred during weaning and rehydration was the comerstone of diarrhea
management Most of the drugs used were mainly for treating concurrent illnesses.
Recommendation
Mothers should be taught how to wean children especially on the type of food to use. They should also be
educated on proper hygienic practices especially washing of hands. Bottle feeding should be discouraged
and rational use of antibiotics encouraged

Nyaga JM. External and internal root morphology of the first Permanent molars in a Kenyan population.; 2010. Abstract

Background: A thorough knowledge of dental anatomy and its variability is
critical in clinical dentistry. It is important for the clinician to be familiar with
variations in root morphology for such variations in the roots and canals have
significancein endodontic treatment and restoration of the treated teeth.
Objective: To determine the external and internal root morphology in first
permanentmolars in a Kenyan population.
Study design: This was a cross sectional descriptive study
Study area: The study involved collection of extracted teeth from patients whom
after dental evaluation, a tooth was recommended for extraction in five dental
clinics within Nairobi;- K.N.H.-Dental clinic, U.O.N.-School of Dental Sciences, St
Mary's Hospital Dental clinic, Mbagathi District Hospital Dental clinic and Social
ServicesLeague Dental clinic.
Materials and methods: Maxillary and mandibular first permanent molars were
co~ectedfrom male and female patients aged between 10 and 40 years. The
teeth were collected from individuals who met the inclusion criteria. The teeth
were separated at the collection site based on gender and whether they were
maxillary or mandibular first molars by the researcher and trained research
assistants.After collection, the teeth were further sorted out using the inclusion
criteria.A total of 187 maxillary molars and 189 mandibular molars were studied.
Observationswere done to determine the number of roots, root fusion and the
direction of root curvature. Measurements, using an electronic vernier caliper,
were done to determine the root length in millimetres. A standard clearing
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technique was applied to determine the number of canals and the canal
configurations with reference to Vertucci's classification (1984). A data collection
form was used to record the findings for each tooth after examination
Data analysis and presentation: The data collected was entered into a
computer and analyzed using the Statistical Package for Social Sciences (SPSS)
12.1. Computation was done to determine pattern of root fusion, frequency of
root curvature in a certain direction, calculate the mean root length, number of
canals per root, frequency of various canal configurations and gender variations
in the findings. The data was presented in form of frequency tables, pie charts
and bar graphs.
Results: All the maxillary first molars had three roots while mandibular first
molars had two roots. Root fusion was observed in 3.9% of the maxillary first
molars. Root fusion between distobuccal and palatal root was more frequent
(2.8%) than the mesiobuccal and distobuccal roots (1.1%) and gender variation
in root fusion was not statistically significant. Majority of the mesiobuccal roots
63.6% were curved and of the curved, 95% curved distally. In the distobuccal
root, 49.7% of the roots were curved and majority 77.4% curved mesial. Majority
of the palatal roots were straight (65.3%). Of the curved palatal roots, 92.5%
curved in a buccal direction. In the mandibular first molars, 16.3% of the mesial
roots were straight while the rest were curved distally in both genders. Majority of
distal roots were straight. The gender variations in root curvature in both
maxillary and mandibular first permanent molars were not statistically significant.
The mean root length in palatal, mesiobuccal and distobuccal roots was
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23.28mm, 20.22mm and 19.67mm respectively. While in the mandibular molars,
the mean root length was 21.97mm and 21.38mm in mesial and distal roots
respectively. Males had longer mean root length compared to females in the first
permanent molars. The gender variation in root lengths was statistically
significant (p=0.001).
Majority of the first permanent molars had 3 canals, 70.1% in maxillary and
56.0% in mandibular first molars. The mesial root of mandibular first molars had
two canals in 96.3% of the teeth in both male and females and type IV canal
configuration was most prevalent in the mandibular mesial root among males and
females. The distal root of mandibular first molar had one canal in 57.7% of the
teeth in males and females. There were significant gender variations in the
number of canals and canal configurations in the distal root. Two canals were
more prevalent in females (53.6%) compared to males (30.4%) and a single
canal was more frequent in males (69.6%) compared to females (46.4%)
(P=0.001). Canal types I, " and IV were the most frequent in mandibular distal
root. The gender variation the frequency of canal types I, " and IV in the distal
root was statistically significant (P=0.001). Most of the palatal (98.9%) and all the
distobuccal roots had one canal Vertucci type I configuration. The mesiobuccal
root had 2 canals in 29.4% of the roots in both males and females. Canal
configurations in mesiobuccal root varied widely. Canal types I, II, IV, V, VI and
VII had frequencies of 65.2%, 12.8%, 14.4%,4.3%,2.7% and 0.5% respectively
in both gender.
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Conclusions: The maxillary first molars had three roots while the mandibular
ones had two roots. Root fusion occurred in 3.9% of maxillary first molars.
Palatal and distal root in maxillary and mandibular first molars respectively had
the lowest frequency of curved roots.
In the maxillary first molars, the mean palatal root length was 23.28mm,
mesiobuccal 20.22mm and distobuccal 19.67mm while in mandibular first
permanent molars, mesial root was 21.97 mm and distal 21.38mm.
The mean root lengths were higher in males as compared to females
Most of maxillary first molars 70.1% had three canals while 29.4% had four
canals. Vertucci type I canals configuration was the most prevalent in all roots.
Most of mandibular first molars had three canals 56% while 41% had four canals.
Two canals were more frequent among females 53.6% compared to males
30.4% and Canal types I, II and IV configurations were the most frequent in
mandibular distal root.
Recommendations;
• The palatal root of maxillary and distal root of mandibular first permanent molars
are the most suitable for post placement.
• Three dimensional diagnostic techniques are essential in identification of
anatomical features
• Long and short files should be included in the endodontic armamentarium
• More attention should be directed towards searching for and locating the second
canal in the mesiobuccal and distal roots of maxillary and mandibular first molars
respectively.

WASWA AARONK. GEOPHYSICAL MAPPING OF BURIED RIVER CHANNELS AND OTHER SHALLOW STRUCTURES RECHARGING MAJOR AQUIFERS IN THE LAKE NAKURU BASIN, KENYA RIFT: CASE STUDY FROM KABATINI AQUIFER.. J.O B, ed.; 2010. Abstractabstract.pdf

Abstract
Buried river channels are increasing becoming the target for groundwater exploration due to the unreliability of surface river channels that have been affected by climate changes. Areas located in urban centers like Nakuru town have high population that dictates the higher demand of water. This research covered the geophysical mapping of buried river channels and other shallow structures recharging major aquifers in the upper Nakuru basin of Kenya rift and in particular the Kabatini area. The project aimed at unveiling scientific knowledge of the subsurface geology using resistivity and magnetic geophysical methods. Solving of water shortages and improvement of livelihood for the people of Nakuru and its neighbor hood through proper and more precise geophysical ground water exploration methods was of great importance. The ultimate goal of the report is to provide guidance to policy makers in decision making especially for ground water extraction in Kabatini aquifer. Geology and hydro-geology of the area have been discussed in the report. The field methods used included vertical electrical sounding, electrical resistivity tomography and magnetic survey. Data processing was done using Earth imager software, RES2DINV, and Euler. The findings of the research ascertain that Kabatini area has underground river channel that flows in the north – south direction. The research also shows that the area has some shallow structures which contain low resistivity materials in different locations. It has also been ascertained that the thickness of Kabatini aquifer is more than 150 m.

Ngare P. Indifference Pricing and Hedging for Insurance and Weather Derivatives. Linz- Austria: University of Linz; 2010.
Njage PMK. Microbial diversity, safety and role of predominant lactic acid bacteria in raw and spontaneously fermented camel milk in Kenya and Somalia. Wangoh J, Farah Z, L M, eds. University of Nairobi; 2010. Abstract

Abstract
In Eastern Africa, where 60 % of the world camel population is held, there is a long tradition
of preparing fermented camel milk known as suusac. The fermentation is spontaneous and
results in a product whose quality varies greatly, may be risky and even dangerous for
consumer health due to unpredictable microbial inhabitants. These risk factors arise not only
from unhygienic handling of camel milk but also from zoonotic bacteria usually attributed to
producing animal mastitis. Misuse of common antibiotics in treatment of camels could also
push bacteria to develop mechanisms to evade the inhibitory power of antibotics.
There is now a major change in consumer choice with shift towards good hygienic quality
camel milk and products and also readiness to pay more for the better quality. This calls for
development of formal camel dairy to address this value addition potential and also reduce
health risks leading to improved camel milk commercialisation.
It is therefore important to understand the predominant microorganisms in raw milk and
suusac and to ascertain their potential impact safety and quality of raw camel milk and
suusac. The diversity of pathogens and yeasts in raw and spontaneously fermented camel
milk in Kenya and Somalia was studied using phenotypic and molecular techniques.
Potential pathogenic microorganisms were studied for their virulence and antibiotic
resistance profiles. Technological properties of predominant lactic acid bacteria were studied
as prerequisite to the introduction of an adapted starter culture for suusac fermentation.
A total of 235 presumptive staphylococci isolated from 105 camel milk and related samples
from five locations in Kenya and two locations in Somalia were identified and characterized
phenotypically and genotypically. PCR amplification of the genes encoding antiphagocytic
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capsular polysaccharides cap5 and cap8, and staphylococcal enterotoxins SEA to SEE and
SEG to SEJ was also carried out. Secondly, the antibiotic resistance patterns of 47
Staphylococcus aureus isolates was studied using microdilution assays to determine minimal
inhibitory concentrations and disc diffusion tests. Genotyping was then done using
microarray hybridization and confirmation of antibiotic resistance genes by PCR.
Escherichia coli, Klebsiella pneumoniae Pneumomia and Enterobacter cloacae which have
been implicated worldwide as producers of Extended Spectrum β-lactamases (ESBLs) were
the predominant Enterobacteriaceae in raw milk and suusac. Antibiotic resistance risk posed
by these bacterial pathogens was characterized for 95 isolates both phenotypically and
genotypically. Escherichia coli isolates were also evaluated for presence of virulence factors.
The prevalence and epidemiology of E. coli O157 and non-O157 shigatoxigenic E. coli
(STEC) along the raw and fermented camel milk marketing chain was studied in 70 samples.
Serotypes and associated virulence factors in the isolated strains were also determined.
Various selective media and immunomagnetic separation were used followed by multiplex
PCR for virulence genes stx1, stx2 and eae and for positive samples a second multiplex PCR
to type for the serotypes O157, O113 and O111. PCR-RFLP of the fliC gene also carried out
on the O157, O113 and O111STEC to elucidate the epidemiology of the serotypes.
Yeasts were identified using combination of both phenotypic and genotypic techniques.
Identification was done using API 20C AUX followed by Restriction Fragment Length
Polymorphism (RFLP) of intergenic spacers ITS1 and ITS2 using restriction endonucleases
HhaI, HinfI and HaeIII. RAPD was performed with (GTG)5, (GAC)5, (GACA)4
microsatellite primers and M13 core sequence (5'-GAG GGT GGC GGT TCT-3'). Sequence
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analysis of either ITS1 and ITS2 or the 26S rRNA encoding gene was performed on selected
isolates.
Finally, 95 lactic acid bacteria (LAB) consisting of Lb. helveticus, Lb. fermentum, Lc. lactis
subsp. Lactis and Str. thermophilus isolated from various camel milk and associated sources
from main camel milk production points in Kenya and Somalia were studied for acidification
and metabolic properties. Str. infantarius which is a putative human pathogen was also
studied due to its predominance amongst presumed streptococci isolated to ascertain its role
in the spontaneous fermentation. Initial screening was carried out in a microtiter assay and
LAB were then selected for fermentation in batch culture experiments using a CINAC
system which allowed continuous follow-up of pH changes during fermentation in camel
milk during incubation at 30, 35 and 40oC for 36 h. Parameters including maximal
acidification rate (Vmax), time and pH at which Vmax occurred (tmax and pHmax), lag phase (ta),
time during which the acidification rate was equal to or higher than Vmax/2 (dt50), time to
reach pH 5.0 (tpH5), final pH (pHF) and time to reach final pH (tpHF) were calculated.
Metabolites of sugars, lactose, glucose and galactose and flavour compounds, citrate, acetate,
acetaldehyde, diacetyl and ethanol, were also quantified using High Performance Liquid
Chromatography (HPLC). L(+)-/D(-)-lactic acid production was studied using an enzymatic
assay. Potential cultures were selected based on the number of desirable acidification kinetic
values for fast acidification and also flavor metabolites when compared to the other cultures.
Presumptive staphylococci increased along the market chain. There were 146 (62 %)
confirmed staphylococci isolates of which, 66 (45 %) were Staphylococcus aureus.
Coagulase positive staphylococci were predominant in raw camel milk directly obtained
from the camel (25 %), at the market level (23 %) and fermented milk (suusac) (21 %). S.
XXI
epidermidis accounted for 29 % of coagulase negative Staphyolococci (CNS) studied. The
remaining CNS were distributed among S. simulans (18 %), S. saprophyticus (11 %), S.
haemolyticus (2 %), S. hyicus (2 %), S. xylosus (2 %), S. lentus (1 %), S. carnosus (1 %) and
S. microti (1 %). Aerococcus viridans (1 %), Macrococcus caseolyticus (1 %) and M.
nishinomiyaensis (1 %) were also identified. The gene cap5 encoding antiphagocytic
capsular polysaccharide was observed for 9 (14 %) and cap8 for 16 (24 %) of the isolates.
Enterotoxin genes were observed in 47 % of the isolates with sej in 34 %, seb in 6 %, sed in
5 % and seg in 3 % of the isolates. Amongst the species enterotoxin genes were detected in
90 %, 65 %, 38 % and 22 % of the S. simulans, S. epidermidis, S. sapropyticus and S. aureus
respectively. Rep-PCR genotyping revealed diversity of the isolates though with close
similarities irrespective of the level along the market chain and sampling location indicating
ubiquity of the isolates in primary and secondary environments.
There were 11 (23 %), 12 (26 %), 5 (11 %), 6 (13 %), 3 (6 %) and 18 (38 %) isolates
resistant to ampicillin, gentamicin, streptomycin, tetracycline, trimethoprim, fusidic acid
respectively. Amongst the multi-resistant isolates 2 were resistant to 2 antibiotics, 7 to 3
antibiotics and 6 to 4 or more antibiotics. Based on microarray, all 3 isolates tested were
positive for the β-lactamase resistant genes (blaZ), tetracycline resistance with gene tet38 and
the Panton-Valentine leukocidin gene pvl. Additionally, 2 isolates harboured streptomycin
resistance gene and tetracycline resistance through the gene tet(K). PCR targeting these
genes was performed for all isolates and 6 were positive for tetK, 9 for blaZ and 2 isolates
harboured both tet(K) and blaZ genes.
Enterobacteriaceae were not detected at milking and first collection point but were present at
104- 106 CFU/ml in final market raw camel milk and 103-107 CFU/ml in suusac. The
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Enterobacteriaceae belonged to 14 species and 10 genera. Predominant isolates were
Escherichia coli 1 (47), Klebsiella pneumoniae Pneumoniae (35) and Enterobacter sakazakii
(18). Salmonella arizonae, Serratia odorifera 1, Enterobacter cloacae and Escherichia coli 1
occurred at mean cell counts greater than 8 log cfu/ml. Enterotoxin genes stx1 and stx2 were
not detected in any of the E. coli isolates with only one isolate with sequence coding for
intimin (eae) was detected.
Of the isolates, 61 (63 %) were resistant to ampicillin, of which 46 (48 %) were E. coli, 45
(46%) K. pneumoniae Pneumoniae and 16 (7%) E. cloacae. ESBLs were not phenotypically
detected in any of the isolates by double disc diffusion test. However, PCR revealed
prevalence of blaSHV, blaCTX-M-3-like and blaCTX-M-14-like genes in 37 (60 %), 25 (40 %) and
11 (18 %) of the isolates respectively. K. pneumoniae Pneumoniae not only harbored
majority of the genes (74 % of K. pneumoniae Pneumoniae), but a strain of K. pneumoniae
Pneumoniae possessed all 3 genes and 13 harbored both blaSHV and blaCTX-M-3-like genes.
Thirty six percent of the isolates harbored either single or combinations of factors stx1, stx2
and eae with 78 % being stx1 positive, 18.6 % eae positive, 3.9 % stx1 and stx2 positive and
0.78 % stx2 and eae positive. Prevalence of isolates positive for the virulence factors stx1,
stx2 and eae increased from 32.6 % at herd level to 34.2 % in first collection point and 44.3
% in the final market. Though highest percentage of presumptive E. coli isolates (57 %) were
isolated using EMB agar while the rest were from CHROMagar (23 %) and CT-SMAC (21
%), amongst the isolates harboring virulence genes, 100 %, 12 % and 39 % were isolated
from CT-SMAC, EMB agar and CHROMagar respectively. Serotypes O157, O111 and O113
represented 94 %, 2 % and 4 % of the STEC respectively. Thirty nine different restriction
XXIII
endonuclease digestion profiles were revealed by the RFLP of the flic gene with O157 having
29 profiles bearing 7 clusters with common profiles.
There were low numbers of yeasts in milk at herd level but 4.4±1.4 log cfu/ml and 5 ±1.5 log
cfu/ml at the first collection point and final market respectively. Counts of up to 7.5 ± 2.5 log
cfu/ml were found in laboratory fermented suusac. Amongst the identified isolates, API
enabled the identification of 80 (47%) and resulted in either incorrect identification or
inability to identify the others. RFLP, RAPD and sequence analysis enabled complete
identification to species and some differentiation at strain level with RAPD allowing more
discrimination within species. There were 21 yeast species belonging to the genera
Rhodotorula, Cryptococcus, Candida, Saccharomyces, Trichosporon, Geotrichum and
Issatchenkia. The most frequently isolated yeasts were Saccharomyces cerevisiae (19 % of
the identified isolates), Candida inconspicua (12 %), Trichosporon mucoides (11 %),
Candida famata (11 %), Rhodotorula mucilaginosa (8 %), Candida lusitaniae (6 %),
Cryptococcus laurentii (5 %), Cryptococcus albidus (5 %), Candida guilliermondii (5 %),
and Trichosporon cutaneum (5 %). Lowest viable counts for the identified yeasts were 2.4
cfu/ml for C. tropicalis and highest were 7.6 cfu/ml (range; 2.4-8.5 cfu/ml) for C. famata and
8.0 cfu/ml (range; 2.6-8.5 cfu/ml) for C. guilliermondii.
When LAB were ranked in the increasing order of mean pH from the microtiter acidification
assay, the strains were Str. infantarius (5.32 ±0.36), Lb. helveticus (5.33±0.09), Lc. lactis
subsp. lactis (5.5±0.49), Lb. fermentum (5.67±0.53) and Str. thermophilus (5.7±0.15). Lc.
lactis subsp. lactis had a short ta (145 min), tmax (424.5 min) tpH5 (535 min) and tpHF (30h),
and low pHF (4.10) during incubation at 30 oC. Moreover, at 35oC, the Vmax increased from
0.00531 to 0.006805 pH units min-1, tmax decreased from 424 to 271 min and tpHF decreased
XXIV
from 30.75 to 19.00 min. Even though Str. thermophilus 150A3.1 showed short ta (183 min),
tmax (378 min) and low pHF (4.4) at 30oC, at 35oC Str. thermophilus was in the grouped with
slowest acidifiers. Str. thermophilus 150A3.1 however, produced the highest quantity of
galactose (3.8 g/l) and glucose (3.56 g/l) at 37oC. Str. thermophilus 221A11.3 performed
better at 35 than 30oC with increased Vmax (from 0.00169- 0.0063 pH units min-1) together
with shorter ta ( from 279 to 82.5 min) and tpHF (from 43 to 19.0 h). Str. thermophilus
221A11.3 also produced highest formate (2072 mg/l) at 35oC. Lb. helveticus showed second
highest Vmax (0.00937 pH units min-1), had a low pHmax (5.17), short tpH5 (705 min) and low
pHF (4.23) at 30oC. Lb. helveticus also produced highest amounts of acetaldehyde (106.7
mg/l at 37oC), ethanol (1590 mg/l at 37oC) and acetate (1540 mg/l at 35oC). However highest
quantities of D(-) lactate (1.338 g/l at 37oC) were also produced by Lb. helveticus. Mixed
cultures Lc. Lactis subsp. lactis + Str. thermophilus 150A3.1, acidifed at highest overall Vmax
(0.07999 pH units min-1) and Lc. lactis subsp. lactis + Lb. helveticus to lowest pHF (3.9). By
combining Lb. helveticus with either of Str. thermophilus 221A 11.3 and Str. thermophilus
150A3.1, they produced lactate at highest (7.62 g/l) and second highest (7 g/l) quantities
respectively at 35oC. Lb. helveticus + Str. thermophilus 221A 11.3 also reached pH 4.1
within 33.5 h at 30oC. Even though Str. infantarius had short relatively short tmax at 30oC, at
35oC it reached a lower pHmax (5.29) and acidified at a longer dt50 (1202 min) when
compared with other strains. The range in time it took to reach maximum acidification for all
the strains or their combinations was was however high (9-1204 min at 40oC incubation).
The high prevalence of toxin-producing staphylococci requires consideration for food
hygiene and safety especially regarding the aspect that the milk is consumed raw or as
fermented raw milk.
XXV
Controlled antibiotic therapy in Kenyan and Somali camels should be introduced to prevent
the increase of antibiotic resistant bacteria. Pastoralists should also be instructed on the use
for rapid detection mastitis tests and the best single antibiotic or their combinations that
minimize development of resistances.
Molecular methods remain the most reliable methods of choice for identification of ESBLproducing
enterobacteria isolates. The finding of a high diversity of enterobacteria in camel
milk especially at market level and suusac calls for measures to improve handling of camel
milk.
The higher prevalence of STEC in camel milk than in cases with milk from other species
indicates that this milk could be an important vehicle for transmission of STEC to humans.
Possibility of a continuous contamination with different STEC strains then distribution of
these strains during handling and storage of milk at this point was also revealed. This calls
for interventions on hygienic factors and animal health at all levels in the marketing chain.
A combination of phenotypic and molecular methods for proper yeast identification is
recommended. The high diversity and numbers of yeasts indicate their role in the
fermentation of camel milk and potential for inclusion as starter cultures.
In order to further select and adapt the starter cultures, sensory analysis, antibiotic
susceptibility tests and also survival of the cultures under different preservation methods
should be studied in order to optimize their application. The robust nature of Str. infantarius
calls for challenge tests including Str. infantarius as a contaminant to further select starter
combinations that would show competitive advantage over this predominant but potentially
pathogenic bacterium.

Mbuge DO. Predicting the Service Life of Plastic Lining using Viscoelaticity. Nairobi: Univeristy of Nairobi; 2010.
Wakibi SN. Prevalence & Predictors of Non-Adherence to free HAART in Nairobi, Kenya. Nairobi: Jomo Kenyatta University of Agriculture and Technology; 2010.
Mohamed AS;, Mohamed AS. The Prevalence Of Cardiac Arrhythjviias And Associated Risk Factors Among Patients With Chronic Obstructive Pulmonary Disease At Kenyatta National Hospital.; 2010. Abstract

Background
Cardiac arrhythmias are common in COPD patients and are a major cause of morbidity and
mortality, especially the persistent supraventricular and ventricular rhythm disorders.
Multiple factors such as hypoxemia! hypercapnia, acidosis. right heart failure and medication
e.g. xanthene derivatives, steroids and β2 agonists have been implicated.
Recently P wave dispersion and QTc wave dispersion have been reported to predict the
development of atrial fibrillation and ventricular arrhythmias respectively.
Objective
To determine the prevalence of cardiac arrhythmias among patients with COPD, and describe
the associated factors.
Study Design
Cross-sectional descriptive study done over a period of six months prospectively
Setting
Outpatient Chest clinic and chest ward, Kenyatta National Hospital.
Study Population
COPD patients who met the eligibility criteria.
Results
A total of207 patients with COPD were studied. The male to female ratio was 2.3: I. The
mean (SO) age of the study population was 66.7(8.5.) years. The median duration of COPD
diagnosis was 1 year (range-0- 6 years) and the median duration of follow-up was also 1 year
(range- 0-5 years). Past smokers accounted for 99.8% while only 1% were current
smokers.The main occupation sited was agriculture at 72.9%.Most of the patients(97.1%)
were on medication with majority (35.7%) on a combination of LAB A, SABA, oral
theophylline, and inhaled steroids. A minority (21.6%) used the medications regularly; 'the
rest intermittently.
The prevalence of arrhythmia was 14% (95%C1 9.3-18.7). The commonest arrhythmia was
VPB (51.7%). Atrial fibrillation accounted for 24%. Atrial fib +VPB accounted for 10.3%,
while 13.8% had 3° heart block. Majority (96%) of those with arrhythmias were in stage III &
IV of COPD.
A higher COPD stage, Hypokalemia, hypomagnesaemia, hypoxia, hypercapnia, acidosis, and
longer QTc & P-wave dispersion was significantly associated with arrhythmias (p

Akweya BA. Prevalence of streptococcus agalactiae and staphylococcus aureus in camel (Camelus dromedarius) milk in Garissa and Wajir districts of Kenya, their sensitivity to antibiotics and acceptability of camel milk and its products. Wangoh J, Gitau P, eds. University of Nairobi; 2010. Abstract

Abstract
Camel milk is commonly consumed raw by pastoralists in arid areas who may
be unaware of the risks posed by such milk. It was therefore very important to
determine the prevalence of Staphylococcus aureus and Streptococcus
agalactiae, which are some of the most common pathogens in such milk.
Camel milk samples from Garissa and Wajir were analyzed to determine the
prevalence of Staphylococcus aureus and Streptococcus agalactiae. The
antibiotic resistance of the bacteria was also studied. Milk samples (n =207)
were aseptically obtained from primary marketing agents. Samples were
analyzed for the presence of Staphylococcus aureus and Streptococcus
agalactiae. The confirmed Staphylococcus aureus and Streptococcus
agalactiae were subjected to diffusion sensitivity test. Resistance was
determined by measuring the diameter of the zone cleared by the antibacterial
and the isolates were reported as susceptible, intermediate, or resistant.
Questionnaires were administered to evaluate camel milk and milk product
acceptability.
The prevalence of Staphylococcus aureus and Streptococcus agalactiae in the
two districts differed with Garissa having higher percent incidence both for
Staphylococcus aureus (34.95%) and Streptococcus agalactiae (37.79%).
Wajir, had lower prevalence of Staphylococcus aureus (10.58%) and
Streptococcus agalactiae (7.69%). Staphylococcus aureus and Streptococcus
agalactiae were resistant to most of the antibiotics except Gentamicin.
x
Although camel milk and milk products were acceptable, each had different
quality parameters that attracted customers. The most important purchasing
criterion for raw camel milk was taste (27%, 19% and 18%) for Wajir, Garissa
and Nairobi respectively. While packaging (18%, 18% and 16%) was more
important for pasteurized milk also in the same order. For yoghurt the most
important purchasing criteria were taste (18%) and aroma (19%). The taste of
sour camel milk is the most important attribute in both Garissa (30%) and
Nairobi (24%).
The results indicate the potential health risk of consuming raw camel milk and
increasing incidences of resistance of mastitis organisms to the common
antibiotics. There is need to educate camel milk producers on hygienic milk
production as well as inform the raw camel milk consumers on dangers
involved. Marketing of camel milk and products can be enhanced using the
attributes appropriate for each product in the respective district.

Charles Walter (Eds.). Sur la conjecture de la minimale résolution de l’ideal d’un arrangement general d’un grand nombre de points dans un espace projectif. Universite de Nice Sophia-Antipolis; 2010. Abstract

The Minimal Resolution Conjecture is known and has been verified for Projective Spaces of dimension 2 and 3. Also there many counter examples for example for 11 points in a Projective Space of dimension 6, 12 points in a Projective Spaces of dimension 7. However, for Projective Spaces of dimension 4, it is believed to be true but the complete proof has not been written up so far. F Lauze tackled part of the resolution in his thesis.

Ndiritu JM. Technical trading support system (TTSS); A Stock Market Analyst Support System. Nairobi: University of Nairobi; 2010.
Kivindu RM. Theoretical and Experimental study of a Multi-pass two-glass cover solar air heater under transient conditions .; 2010. Abstract

The major problems experienced with solar air heaters are their non-reliability as their operation largely depends on weather conditions which keep on changing. This study was aimed at providing and experimentally validating a transient based model for predicting the performance of multi-pass solar air heaters operating on changing weather conditions. A transient prediction model was developed by considering the thermal capacities of the collector components and the flowing air. Differential equations were developed by considering the energy interactions and balances for the various components of the collector, and then solved nUmerically. The developed model was tested with input data of insolation, ambient temperature, wind velocity and solar time and then validated experimentally by use of a single collector which was designed to accommodate all the four flow arrangements investigated ( SPM, DMPM, DTPM and TPM). The time constant of the collector constructed was determined experimentally to be 27 minutes. The theoretical collector performance results indicated a transient behavior for changing weather conditions. This was' also confirmed by the experiment carried out whose data were recorded and plotted at intervals of two minutes Based on air temperature rise and collector efficiency both the developed theoretical model and experimental set up indicated that the triple pass mode is superior to the other modes, with the single pass mode ranked the lowest in performance. The developed ~UlputaticmaI prediction model had a standard deviational error of 1.8 to 2.1 % as compared to the experimental values which had an error of2.7 to 9.6%. The TPM had the lowest error (1.8%) while the SPM had the highest (2.1%). When compared to other models and experiments, the results were in good agreement. The developed model confirmed that air temperature rise in the collector is a function of available solar insolation and prevailing weather conditions such as; cloud cover, ambient temperature and wind. It was found that, in actual sense thermal solar collectors do expenence transient conditions and the developed transient model was necessary, and is expected to reduce the day long experiments that need to' be carried out to. acquire the performance characteristics of solar air heaters under changing weather conditions.

Okeng'o GO'a. A theoretical Study of Stellar Pulsations in Young Brown Dwarfs. Lindsay PR, Olivier DE, eds. Cape Town: UWC/UCT; 2010.msc_thesis.pdf
Kimengu EK. Usage of electronic information resources in academic libraries. Nairobi: Univesity of Nairobi; 2010.
.W.Okuku M. “Uchanganuzi wa Kiisimu wa baadhi ya matini za Kiswahili: mtazamo wa Pragmatiki Leksia’’ . E.M. DM, J PH, eds. Nairobi: University of Nairobi; 2010.
Nyamori JM. A 2- Year Retrospective Study On The Pattern Of Retinobh.storna In Kenya.; 2009. Abstract

Background: The national epidemiological characteristics of retinoblastoma in Kenya have not been determined. The diagnosis of this cancer is mainly clinical; histology determines tumour extent. Late diagnosis of this otherwise curable malignancy is associated with high mortality.
Aim: To determine the incidence and pattern of presentation of retinoblastoma in Kenya.
Design: A retrospective case series
Setting: All 75 eye care centres in the 8 provinces of Kenya as registered in the Ministry of health eye information system.
Methods: With permission, clinical registers at eye care centers were reviewed to identify cases of retinoblastoma that presented from 1sr January 2006 to 31st December 2007. Only centers that reported cases were visited to record patient's clinical and demographic data in a questionnaire. Cross-referred cases were analysed once to avoid double-counting.
Results: A total of 206 suspected cases presented to 46 eye care facilities but 58 cases (28.2%) were lost
after referral. Of 148 traced cases, 28.4% were self referrals and of the referred cases, most (21.6%) were
from central province. Only 63.5% of cases were finally treated at 2 teaching and referral hospitals.After
excluding 3 missing files and 13 cases that were ruled out on histology, 132 confirmed cases(166 eyes) were
subsequently analysed. The mean delay in first presentation was 6.75 months and delay after referral was
1.69 months. Leukocoria was the most common presenting complaint (91.7% cases) and sign (71.1 % eyes).
There were 25.8% bilateral cases and 78.2% unilateral cases with mean ages of 26 and 35.9 months
respectively. The male to female ratio was 1.49:1. Only 4.5% had a positive family history. Most (32.6%)
cases resided in the Rift valley province. There was no association between ethnicity and bilaterality. The annual incidence of retinoblastoma in 2007 was 1:17,030 live births.
Conclusions: A significant proportion of cases were lost after referral. The late presentation was associated with advanced disease. Leukocoria was the most common finding. Most cases resided in the Rift valley province. The incidence of retinoblastoma was similar to most countries but may be an underestimate.
Recommendations: Public education ancl screening with the red reflex test by primary health care workers would ensure early detection. Quality control measures in record keeping would ensure accuracy. A retinoblastoma registry would provide accurate estimates through register-based studies. Further research is necessary to investigate the lost cases after referral, delays in presentation and barriers to uptake of services.

Kiai W. An Analysis of Planning and Implementation of HIV and AIDS Communication Interventions by NGOs in Kenya. Prof. Siimiy Wandibba PIN, ed. Nairobi: University of Nairobi; 2009.abstract.doc
Jama HH. The behaviour of tubular steel beams subjected to transverse blast loads.; 2009. Abstract

A series of blast experiments was performed on tubular beams with different cross-section slenderness, lengths and boundary conditions. As a result of a transverse blast load, cold-formed hollow beams undergo global and local permanent deformations. Global deformation refers to the overall beam bending deformation and local deformation refers to the local cross section failure of the beams. The local deformations were complex and the measurement of the local deformation was taken to be the distance traversed by the top flange. It was observed that as the impulse on the beams was increased, the deformed cross section changed from a molar to a tear-drop shape. It was found that the impulse recorded using a ballistic pendulum is directly proportional to the mass of the explosive detonated. Further, as a result of the experimental work undertaken, it was found that a ballistic pendulum can be used to achieve replicable results. The global deformation of tubular beams subjected to blast loads is significantly affected by the boundary condition at the supports. As in the quasi-static testing regime, beams with fixed-ended supports deform less than beams with partially-fixed supports. In the range tested, it was found that local deformations of SHS beams are not affected by axial restraint. This can be understood if the beam is idealised as consisting of four plates of equal size. Initially the impulse is imparted only onto the top flange which has only ¼ of the mass of the beam. Therefore, severe local deformations occur at the top flange before the rest of the beam responds. The local deformations of all the beams tested progressed in a similar manner from molar to tear-drop shape as the magnitude of the impulse was increased. Nevertheless, the local deformations of the 300mm and 600mm beams are similar, the local deformation/beam depth being observed in the range of 1~1.4. The global deformations of the Series III beams, when compared to the Series IV beams, appear to indicate prima facie that global deformation is inversely proportional to the length of these beams. This apparent contradiction of beam theory is explained by the fact that the 1000mm beam is heavier than the 600mm span. In addition, the local deformation of the 1000mm beam occurs over a longer length and absorbs more energy. The interaction between local deformation and global beam bending deformation was investigated by examining the energy distribution. In this analysis shear effects were shown to be negligible and were therefore excluded. A proposal by Wegener and Martin [2] was utilised to simplify the analysis. Wegener and Martin [2] hypothesised that local and global deformations are uncoupled, with the local deformations preceding the global deformations. The energy consumed in the local deformation was estimated from the final deformed cross-section using hingeline mechanics. Stationary and rolling hinge approaches were utilised and found to yield similar energy levels. Thereafter, the principle of the conservation of energy was invoked and the distribution of the energy consumed in local and global deformation of the beams was shown. The energy consumed in the local deformation of the fixed 600mm span beams was found to be 63%, 66% and 49% of the input energy for the 35mm, 40mm and 50mm beams respectively. In the 600 mm span beams with partially-fixed boundary condition, a similar distribution of the energy was found. In the 1000mm beams, there was significantly more energy consumed in local deformation as shown by the fact that 73%, 69% and 83% of the input energy was consumed in local deformation for the 35mm, 40mm and 50mm beams respectively. SHS steel beams subjected to blast loads were found to undergo local cross-sectional deformations that consumed more than 50% of the input energy, which can be estimated using rigid-plastic analysis and the experimental results. Once the energy consumed in the local deformation is accounted for, the flexural beam bending deformation can be found using the bound of Jones equations and the remaining energy. Using these results, a semi-empirical general design guideline which yields a lower bound solution has been outlined and a design guideline has been proposed. Finite element simulations of some of the experiments were performed in order to determine the influence of strain-rate hardening and thermal softening on the results. Two boundary conditions, fully-fixed and partially-fixed beams with 600 mm span lengths were simulated. Linear Piecewise Plasticity (LPP), Linear Piecewise Plasticity with strain-rate (LPP+ ) and Linear Piecewise Plasticity with strain-rate and thermal softening (LPP+ +T) material models were used.

Thoithi GN;, Faith A. Country case study: Kenya.; 2009.
Thoithi GN, Faith A. Country case study: Kenya.; 2009.
Mwenda JN. A Critical Evaluation of Checking of Fixed Boundary Surveys in Kenya. Stockholm: Kungliga Tekniska Högskolan (KTH; 2009.
Hussein AA. Effects of Disturbance on Small Mammals and vegetation Diversity in Oloolua Forest, Kenya. Nairobi, Kenya.: University of Nairobi.; 2009.
J.K MUSINGI. Effects of Large Dams on Public Health in a Semi-Arid Environment: A case Study of Masinga Dam. Hekima Journal, Special Edition, faculty of Arts, University of Nairobi; 2009. Abstract

The  study found out that Masinga Dam has adversely affected the public health in the communities around the dam. malaria was the most prevalent ailment followed by typhoid fever. Bilharzia has also increased since the dam was constructed.

Nyarwath O. An exposition and critique of H. Odera Oruka's philosophy. Odhiambo PJA, Ogutu PGEM, eds. Nairobi: University of Nairobi; 2009.
Kangethe J. Factors influencing utilisation of E-journals at Daystar University. department MMCKUL-, ed. Kenyatta University; 2009.
Oketch-Oboth JB. Health Psychology.; 2009.
Muasya MK. Malocclusion and traumatic dental injuries in relation to over-jet and lip posture in 12-15 year old in Nairobi.; 2009. Abstract

Aim: To determine the prevalence and pattern of occurrence of malocclusion and
traumatic injuries to permanent anterior teeth and establish any association
between traumatic injuries, over-jet and lip posture.
Design: This was a descriptive cross-sectional survey.
Setting: The study was carried out in public primary schools in the City of
Nairobi, Kenya over a period of three months.
Subjects and methods: A sample of 1382 boys and girls aged 12-15 years was
obtained by multi-stage random sampling of children in 8 divisions, then 16
zones, then schools were interviewed. Registration for malocclusion was done
using the Dental Aesthetic Index (DAI) and tae variables sought included missing
teeth, crowding, over-jet and antero-posterior molar relations. Two hundred and
twenty two children with history of traumatic dental injuries were identified. A
structured questionnaire was used to obtain information on the trauma,
symptoms associated, cause, site of trauma and if any treatment was sought.
The data was collected by clinical examination of permanent anterior teeth of the
children based on a modification of the WHO criteria with some variables sought
including: number of teeth injured, type of teeth injured, classification of the
trauma and type of treatment if any. Data was analysed aided by computer using
the Statistical Package for Social Sciences (SPSS) programme. Chi-square and
odds ratios statistical tests were done to determine the differences in
malocclusion and trauma experience between males and females and the
difference in trauma experience by different overjet groupings and lip posture.
Student's t-test was used to determine difference in mean overjet between
Xll
children who had sustained traumatic dental injuries and those who had not. A p
value of less than 0.05 was considered significant.
Results: Seven hundred and thirty two (53.0%) of the children examined had
either no abnormality or only minor malocclusion, 318(23%) had definite
malocclusion, 176(12.7%) and 156(11.3%) had severe malocclusion and very
severe or handicapping malocclusion respectively. The mean OAI was 26.6.
Prevalence and severity of malocclusion for male and female children did not
differ significantly (p=0.139). The prevalence of TOls was 16.1%. Males had
experienced a significantly higher prevalence of trauma (18.8%) than females
(13.5%) p=0.008. Amongst the male children, falls were the leading cause of
TOls (37.3%). Approximately half (44.8%) of the females did not remember the

cause of injury while 31(36.5%) had sustained TOls due to falls. One hundred
and seventy two (77.5%) children who had experienced TOls had no symptoms
associated with the traumatized teeth. Ninety six (43.2%) of the children were
injured while in the home environment. The maxillary central incisors were the
most commonly traumatized teeth accounting for 220(73.5%) out of 299 injured
teeth. The most frequently observed type of dental trauma was enamel fracture
206(68.9%) followed by enamel-dentin fracture 71(23.8%). Two hundred (90%)
children had not sought treatment for TOls. When frequency of TOls in the
children was related to overjet, it was found that out of the 886 children with
overjet of 0-3 mm 104(11.8%) had experienced TOls. Out of the 502 children with
overjet greater than 3 mm, 118 (23.5%) were found to have TOI. The prevalence
of TOls in children with overjet greater than 3 mm was significantly higher than
that in children with overjet of 3 mm and less (p=O.OOO).A significantly higher
prevalence of TOls was found when children with incompetent lips 124(55.9%)
were compared to those with competent lips 98(44.1%), (p=O.OOO).
Conclusion: There was an overall high prevalence of malocclusion among the
children with no significant gender difference for most of the traits. The OAI
criteria produced a mean OAI score of 26.6, with 11.3% of subjects exhibiting
handicapping malocclusion. Overall traumatized permanent incisors were found
to occur fairly frequently with 68.9% of the injured teeth having sustained enamel
injuries. A very high proportion of traumatized teeth were untreated. Male
gender, overjet greater than 3 mm and incompetent lips were found to be
statistically significant risk factors for traumatic dental injuries.
Recommendation: Facilities and personnel should be put in place so that
children with very severe or handicapping malocclusion can benefit from
subsidized orthodontic therapy by specialists. There is need to improve oral
health policies in Kenya so as to incorporate periodic checks ups in order to
promptly diagnose and give advice on treatment of TOIs. The high proportion of
untreated dental trauma among the children calls for improvement in children,
parents and teacher education.

Kaindi MDW. Microbiological quality of camel milk along the market chain and its correlation with foodborne illness among children and young adults in Isiolo, Kenya. Wangoh J, Schelling E, Imungi JK, eds. University of Nairobi; 2009. Abstract

General Abstract
The study was done to determine the microbiological quality of raw camel milk along the
informal market chain and to assess risk factors in symptoms of food-borne illnesses and the
role of camel milk in the diet of camel pastoralists. Camel milk samples were collected from
the milking point, camel milk first collection point (primary collectors) in the local market
center and at the final market in Nairobi. Microbiological assessment involved enumeration
of total bacterial count (TBC), presumptive Streptococcal/ Enterococcal count (PSEC), Yeast
and Mold count (YMC), Enterobacteriaceae count (EBC) , and presumptive Staphylococcal
count (PSC). Deterrn ination of the shelf Iife of pasteurized camel milk stored at 4-7°C, 2SoC,
and at 30°C was also investigated. Raw camel milk was pasteurized at 6SoC for 30 minutes in
a water bath. Further, a cross sectional study was carried out by interviewing 993 randomly
selected households in peri-urban zone of Isiolo town to assess risk factors in symptoms of
food-borne illnesses with special attention given to the consumption of camel milk, cow milk
and goat milk.
Results indicate that microbial counts were increasing along the marketing chain. Camels'
milk milked in aseptic manner from the udder had TBC 2.1 x 101-4. 7x 104 cfuml', PSEC
1.8xI01-2.4xI04 cfumrl. Bulked milk at the herd level had TBC 9.2xl02-1.7xl04 cfuml",
I PSEC 3.7x10 I-3.4x.I0- ~ cfuml -I, YMC 2.lx10 I-?2.7xI0- cfurnl -I,EBC I.lxlO I-8.lxI0 2 cfuml -I
and PSC 3.Sxl02-8.3xl03 cfumrl. Bulked camel milk at the primary collector at the local
market center had TBC I.lxl03-S.6xl05 cfuml", PSEC 3.1xlOI-2.7xl04 cfuml', YMC
bulked milk at the final market in Nairobi had TBC 4.7xl05-107 cfuml", PSEC 2.0xl02-
9.lxI04-2.8xl05 cfumrl.Milk at the milking level had TBCs not exceeding microbiological
XIV
limit of 105 cfumri and thus a grade I quality milk. At primary collectors 25% had EBC
exceeding 103 cfuml' indicating grade Il quality of milk. 75% of bulked milk at the final
market exceeded the TBC acceptable limits of 106 cfuml' and EBC of 5.0xl 04 cfumri which
is in grade III and IV quality of raw milk which per the Kenya bureau of Standards 2006,
indicates poor quality milk and a threat to human health.
The Kenya Bureau of Standards specifications for pasteurized cow milk were applied as
criteria to establish the shelf life of camel milk. The shelf life was considered ended when the
Total bacteria counts exceeded 3.0x 104 cfurnl', Enterobacteriaceae count was> 10 cfum!"i
or alcohol test positive. Raw milk used had Total Bacteria Count 5.7x 105 cfuml',
Enterobacteriaceae Count l.4x 104 cfuml", Presumptive Streptococcal/ Enterococcal Count
1.2xl04 cfuml', Presumptive Staphylococcal Count 6.7x103 cfuml', Yeast and mold Count
9.5xlOi cfuml', acidity 0.16%, pH 6.64, antibiotic residue free, hydrogen peroxide free and
alcohol test negative. The residue TBC after pasteurization process was less than 10 cfuml i
while EBC, PSEC, PSC and YMC were completely destroyed. TBC of pasteurized camel
milk stored at 4-7°C exceeded the KEBS specifications in 49-54 days while TBCs of camel
milk stored at 25°C and at 30°C exceeded the limit in less than 24 hours. Thus with
appropriate refrigeration, pasteurized camel milk keeps for longer periods than when exposed
to high ambient temperatures.
Results of the cross-sectional survey indicate raw camel milk as highly significant to foodborne
illnesses. Raw camel milk had odds ratio (OR) 2.1; 95% confidence interval (CI) 1.38-
3.22, and p-value of 0.001 for cases with diarrhoea and/or vomiting either with or without
fever. Raw camel milk was also found to have OR 3.4; 95% CI= 1.52-7.80; p= 0.003 for
cases with diarrhoea and/or vomiting without fever and was not significant for cases with
xv
vomiting without fever (OR 2.9; 95% CI 0.91- 8.97; p=0.071). Backward selection
multivariate logistic regression indicates raw camel milk as a risk factor to food-borne
poisoning with OR 2.6; 95% CI=1.61-4.31, p=O.OOO; Log likelihood value (P (LRX2)) =
8.0002; raw cow milk emerged as a protective factor with OR 0.5; 95% CI=0.33-0.89,
p=0.015, P (LRX2) = 0.0145. Washing of hands with soap, treating drinking water, boiling of
milk, presence of proper drainage system and improved pit latrine emerged as significant
protective factors to symptoms of food-borne poisoning. Since unhygienically handled raw
camel milk was associated with food-borne illnesses, consumers of camel milk should be
sensitized either to boil or consume processed camel milk. This study recommends for urgent
development and adaptation of feasible and sustainable interventions to improve the camel
milk hygiene and safety in Kenya and to mitigate food-borne related diseases in the agropastoral
ist regions.

Kariuki PN. MODELLING ASYNCHRONOUS DISTRIBUTED E-LEARNING ENVIRONMENT. Nairobi: UoN; 2009. Abstract

The world today has some very advanced ICT services and high quality life indicators. The existing online e-learning environments have been designed with this in mind, and are therefore reliant on reliable means of communication for their access. However, access to Internet which facilitates access to these online e-learning environments is not universal, and poses a significant cost to the user. The lack of access to online educational resources whether for economical or logistics reasons excludes otherwise eligible students from the course. This is a significant issue in rural and lower socioeconomic neighborhoods. On the other hand, occasional loss of connectivity, bandwidth provider problems or the need to take down parts of the network for maintenance still renders asynchronous communication dependant e-learning system inaccessible at times. This calls for new methods and technology to supplement traditional online based training and instruction and provide continuous learning even when offline.
This research project present an Asynchronous Distributed e-learning Environment model that overcomes the challenges faced in the usage and implementation of synchronous communication dependant e-learning platforms. The learning environment proposed in this research overcomes the infrastructural challenges of access to online learning environment by providing an alternative mechanism that allows learning to continue even with minimal or unreliable communication infrastructure, thereby overcoming the infrastructural access barrier posed by the convectional e-learning environment. The system is modeled in conformity with the existing e-learning systems that are driven by network connectivity, having most of the features that are characteristic of today’s e-learning platform.

Kisipan ML. The morphology and morphometry of the male reproductive system of the rufous sengi (Elephantulus rufescens).. Onyango DW, Makanya AN, Oduor-Okelo D, eds. Nairobi: Kisipan, M.L.; 2009. Abstract

The Morphology of the male reproductive system of rufous sengi was studied using light and electron microscopy while the testicular morphometry was studied using stereology. The system consisted of the cylindrical-shaped testes, genital ducts, accessory sex glands and the penis.
The testes were intra-abdominal, located just caudal to the kidneys and comprised of a parenchyma bound by tunica albuginea. The parenchyma was composed of the seminiferous tubules and the interstitial tissue; the former being more predominant than the later and exhibiting complete spermatogenesis. The interstitial tissue occurred either between the seminiferous tubules, mainly in relatively larger spaces formed when three or four seminiferous tubules approximate or beneath the tunica albuginea. The Leydig cells were mainly polyhedral with irregular nuclei and numerous lipid droplets within the cytoplasm but, in cases where the interstitial tissue made extension into a narrow space between two adjoining seminiferous tubules, the Leydig cells therein were longate with rod-shaped nuclei.
The testicular arteries branched off from renal arteries and ran caudo-laterally to the testis without convolutions or intimate association with the vein. The testicular veins also followed a straight course, without pampiniform plexuses. These animals had separate right and left caudal vena cavae which received ipsilateral testicular and renal veins. After receiving the renal veins, the left caudal vena cava crossed to the right side to join the right one to form a common caudal vena cava which then extended cranially up to the right atrium.
The genital ducts were constituted by the rete testis, efferent ductules, epididymis, and the urethra. The rete testis was made up of interconnecting channels located outside the testicular parenchyma while the efferent ductules connected the rete testis to the caput epididymis. The epididymis consisted of a highly coiled duct organized into three topographic regions; the caput, corpus and cauda epididymis. The caput epididymis was applied on dorso-lateral border, extending from cranial to the caudal pole of the testis. The corpus epididymis extended caudally from the caput to a position between the pelvic urethra and the rectum where it joined the cauda epididymis. The cauda epididymis was organized into a pear-shaped mass, located in a somewhat lateral position between the rectum and the pelvic urethra. The caput and corpus epididymis were lined by a tall pseudostratified columnar epithelium while the cauda epididymis was lined by cuboidal or low columnar epithelium. The ductus deferens was short and connected the cauda epididymis with the pelvic urethra. The urethra consisted of two parts; the pelvic and the penile urethra. The pelvic urethra, surrounded by a thick muscular coat, extended from the neck of the urinary bladder to the bulb of the penis and received the deferent ducts, uterus masculinus and the ducts of the accessory sex glands.The penile urethra extended from the bulb of penis to the tip of the penis.
The accessory sex glands consisted of the prostate and the bulbourethral glands. The prostate gland was composed of several paired lobes organized into two groups, the cranial and the caudal group of lobes, also referred to as the cranial and the caudal prostates respectively. The cranial prostate consisted of lobes organized around the neck of urinary bladder and included the ventral, laterodorsal and the medio-dorsal lobes. The caudal prostate consisted of a single pair of lobes located dorsal to the pelvic urethra.
The mean reference volume of the sengi testis was 0.089 ± 0.003 cm3, 98.3% of which was constituted by the parenchyma and the rest being contributed by the capsule. The seminiferous tubules occupied 90.94% of the testicular parenchyma, while the interstitial tissue on the other hand occupied about 9.07% of the parenchyma with 7.87% of its volume being contributed by the subcapsular interstitial tissue.

Mwashando AH. Preverlence of mycobacterium tuberculosis at Mewa Hospital. Mombasa: Mombasa Poly University College; 2009.athumani-_h._diploma_project-2.pdf
Osano OB. Short term outcome and cost analysis of children admitted with rotavirus gastroenteritis.; 2009. Abstract

Background
Rotavirus infection is the single most common cause of acute gastroenteritis in children
under five years of age. Rotavirus gastroenteritis (RVG) has a high morbidity and mortality in
children in Kenya. The costs of care and treatment for rotavirus gastroenteritis are high.
Comprehensive data on the outcomes and cost of care of RVG in Kenya are lacking.
Objective
To determine the short term clinical outcomes and compute average cost of care for children
admitted to Kenyatta National Hospital (KNH) with rotavirus gastroenteritis.
Methodology
A short longitudinal survey at Kenyatta National Hospital, Nairobi, Kenya from February to
May 2008. A minimum sample size of 165 was sufficient for both primary and secondary
objectives of this study. This samples size was calculated using mortality as the worst
outcome with a mortality rate of 11.6%. Children less than 3 years of age admitted to the
paediatric wards with a diagnosis of acute gastroenteritis were tested for rotavirus in stool
samples using a rapid antigen detection kit and ELISA. Those found positive for rotavirus
and gave consent were recruited into the study. A full clinical evaluation was done and a predesigned
questionnaire administered. The recruited patients were followed up till discharge
or death. Their outcomes, costs incurred and the bills they paid were entered into the
questionnaire. The average costs were then calculated.
Results
Five hundred of the children admitted to KNH with acute gastroenteritis were screened for
rotavirus. One hundred and ninety one (38.2%) of them tested positive for rotavirus in stool
and 172 children were recruited into the study. Of the 172 children, 87.8% were discharged
within one week, 8.1% stayed for more than 7 days while 4.1% died. The average cost of
care per child admitted with rotavirus gastroenteritis was Kshs 6,505.79 to the patient, Kshs.
14,178.21 and Kshs. 16,556.08 to the hospital and economy/society respectively using the
National Hospital Insurance Fund bed charge rates. Children who had co-morbidities had
worse outcomes in comparison to those who did not have any co-morbidity.
Conclusion
Rotavirus gastroenteritis has a significant impact on young children and their families in
terms of long hospital stay, high morbidity and mortality. It incurs considerable resource
utilization in health care settings, substantial costs for national health care and lost work
days to the economy.
Recommendation
A cost benefit analysis for the whole country should be done to guide in policy making for
routine rotavirus vaccination

Wahome EW. UNIVERSITY OF NA’. fcO^'. Ogutu DM, ed. Nairobi: Nairobi; 2009. Abstractwahome_strategic_planning_practices_adopted_by_the_university_of_university_of_nairobi.pdf

Strategic planning is the cornerstone of every organization without which the organization will
never know where it is going or whether it will ever get there. While strategic planning is
important, what is o f more importance is how it is practiced in the different institutions or
organizations Different scholars and author have advanced that strategic planning can be formed
implicit as well as formulated explicitly (Mintzerberg 1991 and Johnson and Scoles, 1993).
While several studies have been done in Kenya on the strategic planning practices, most of them
have been to general to elicit a comprehensive view on strategic planning practices adopted by
institutions.

Xujing. Comparative Study of China-US MBA Education . : Northeast Normal University ; 2008.
Kisiroche. IR. : “Sauti ya mwanamke dhidi ya Ubabedume katika tamthilia tatu za Kiswahili’’ . E.M. DM, K.W PW, eds. Nairobi: University of Nairobi; 2008.
Muthee JK. Acute and Subacute Toxicity of Nicandra physaloides (L) Gaertn in Mice and Calves Respectively. Nairobi; 2008. Abstractabstract.pdf

The plant Nicandra physaloides (L) Gaertn, commonly known as the' apple of Peru' is a member of the solaneceae family. It has been widely associated with livestock poisoning in Kenya and elsewhere. The clinical signs reportedly associated with its poisoning are circling, tremors of the hind limbs, tachycardia, bloat, convulsions, coma and death. In the current study the acute toxicity was determined by intra-peritoneal injections of the aqueous extracts from different plant parts in a total of one hundred and fifty (150) white Swiss mice aged between to and 12 weeks and divided in groups of six (3 males and 3 females) for each dosage level. The median lethal dose (LDso) was then calculated by the method of Reed and Muench (1938). The subacute toxicity was determined by feeding five groups of two male Friesian calves each, aged between 8 and 10 months, at 0 (control), 4, 8, 16 and 32% levels of dried ground whole plant material in wheat bran for 14 weeks. The physiological parameters of rectal temperature, respiration, heart rate and ruminal motility were taken from all the calves every morning for the whole period of the experiment. The blood for hematology (5ml in EDTA) and biochemistry (l5ml without anticoagulant) was collected weekly via the jugular vene-puncture after thorough disinfection of the site with surgical spirit. LDso values for the leaf, fruit and whole plant extracts were 1.82, 2.58 and 3.62 g/kg body weight respectively, therefore, classifying the plant as slightly toxic according to Loomis (1978). The clinical signs showed by the mice were starry coat, slowed movements, fast respiration, gasping for air and leaping into the air before collapsing. The treated calves transiently exhibited muzzle drying, heart beat irregularity, loose feces, staggering gaits and lower growth rate than the control group. The activity of the enzyme gammaglutamyltransferase (GGT) and the mean corpuscular volume (MeV) were significantly lower (P0.05) between the treated and control groups in respect of the other assayed hematological (total protein. hemoglobin, red blood cells, packed cell volume, mean corpuscular hemoglobin concentration, white blood cells, lymphocytes and neutrophils) and biochemical (aspartate aminotransferase, creatinine and blood urea nitrogen) parameters. There were no mortalities, no gross or histopathological lesions in all the groups. The possible reasons for the difference in behaviour between the calves in this experiment and the suspected natural cases were thought to be due to the variations in animal susceptibility or even plant toxin content. It is concluded that the plant Nicandra physaloides growing around the Kabete areas of Kenya may contain toxic phytochemicals that may cause poisoning in livestock if consumed. Nicandra physaloides is known to contain glycosides, steroids and alkaloids from earlier studies. More studies are necessary to determine the nature of these phytotoxins and their exact mode of action. Meanwhile livestock keepers are advised to control this plant in their pastures and avoid its consumption by animals.

Kiama W. Alcohol Related Deaths Amongst Drivers, Passengers, Pedestrians Andcyclists In Nairobi.; 2008. Abstract

Introduction
Alcohol and its effects on persons have use in both civil and criminal
litigation. In terms of civil matters alcohol has impact in the insurance
industry as relates to road traffic accidents, personal accidents claims
and also life insurance claims. Excessive alcohol has been blamed as a
cause of many deaths resulting from road traffic accidents, assault, stab
.wounds, crime and drowning (I).This has been taken to be so. This has
largely remained unverified by scientific research in Kenya.
The purpose of the study is to determine the incidence of alcohol related
deaths in road traffic accidents by measuring alcohol levels in vitreous
humor. Clinical studies have been conducted in this area but there has
not been a forensic pathology study in this area.
Hypothesis
Most deaths of road users in Nairobi are alcohol related.
Study Objects
The study objectives were broadly to determine alcohol related deaths
amongst drivers, passengers, pedestrians and cyclists between January
2007 and March 2007, specifically to determine the presence and levels
of exogenous alcohol levels in vitreous humors of dead bodies from road
traffic accidents; to determine the presence of microorganism in vitreous
humor as a marker of presence of endogenous alcohol and so as a
quality control and to establish the prevalence of alcohol related deaths
in road traffic accidents.
Study Design
A descriptive cross sectional study
Study setting
The study was conducted at the City Mortuary in Nairobi. It is the
biggest mortuary in Nairobi and receives most of the deceased persons
involved in road traffic accidents in Nairobi and its environs.
Methodology
The study subjects consisted of dead bodies of those who died due to
road traffic accidents in Nairobi and were selected consecutively.
The study involved collection of vitreous humor from the deceased
persons.
The sample for alcohol estimation was put into a fluoride bottle
which was tightly closed and sealed with cellotape and transported in a
cooler box and stored at -4 degrees Celsius until time of analysis.
The samples for microbiology were inoculated immediately at the site of
collection into Robertson's cooked media, sobourrounds dextrose agar
media and blood agar.
Results
The study established that out of the 101 subjects 21 had presence of
alcohol in the vitreous humor. Of the 21 subjects 6 had microorganisms
grown from their vitreous humor and were excluded from further
analysis. Exogenous alcohol was therefore established in 15 subjects
which was 15.8%.
The class of persons involved were distributed as passengers
who were 7 out of a total of 36 (46.7%), cyclists who were 3 out of a total
of 24 (20%),pedestrians who were 3 out of a total of 24 (20%) and drivers
2 drivers out of a total of 17 (13.3%).Amongst the males sampled 22.9%
had exogenous alcohol while amongst the females those that had
exogenous alcohol were 16.1%.
Conclusion
The prevalence of exogenous alcohol in bodies from road traffic
accidents was 15.8% this would form a basis for social interventions.
Passengers contributed a larger percentage of the class of persons
involved. The total percentage of death from road traffic accidents was
40% for pedestrians and cyclists.
Recommendations
There is need to structure roads to provide space for pedestrian and
cyclists to reduce contact with motor vehicles. Drivers and passengers
composed 60% of those found to have exogenous alcohol it is therefore
recommended that there be policies on alcohol intake and driving which
would set the legally acceptable drink and drive levels.

Karimi PN. Assessment of drug utilisation and patient knowledge on management of hypertension.; 2008. Abstract

Hypertension is a common cause of morbidity and mortality. It is a chronic disease and hence requires long-term management. Inadequate control leads to complications that may be fatal if not treated. 5-10 % of the general population is hypertensive. Unfortunately, most victims are not aware of their status and diagnosis is usually accidental especially after complications have set in. Objective The overall objective of this study was to assess patient's knowledge on proper management of hypertension and the types of antihypertensive drugs used at KNH. Aspects covered included types of drugs used, lifestyle issues such as salt intake, exercise, weight loss, use of alcohol and smoking status. Methods The study was conducted at KNH in the department of internal medicine. A cross sectional study design was used and the target population was hypertensive patients. Data was collected using a questionnaire that was filled after interviewing the patients and looking at their hospital records. Fifty patients were selected using systematic random sampling. Data was analyzed using descriptive statistics such as frequency distribution tables, charts and graphs. Statistical techniques used included percentages, figures and mean, standard deviation and confidence intervals. Relationship between variables was evaluated using chi-square. Results All the patients were adults with a mean age of 56.16 years and majority were females (76%). Majority of the respondents were overweight with a mean body mass index of 27.9Kg/m2 • Minority (12.2%) had no formal education and majority (53.2%) was not aware of the normal blood pressure reading. Most patients were unaware of the fact that hypertension can cause complications such as heart failure ( 56%), kidney damage (64%), visual damage (60%) and disturbance of circulation to lower limbs (70%). On average, patients were aware of four out of six non pharmacological measures in the management of hypertension had mixed. All the respondents were either on two (28%), 11 three (50%) or four (22%) antihypertensive drugs. The drugs that were mainly prescribed included Hydrochlorthiazide (58%), Losartan (38%), Amlodipine (34%), Nifedipine (32%), Enalapril (30%) and Atenolol (30%). The association between education level and awareness of complications was statistically significant but that between education level and awareness of non pharmacological management had mixed results. Conclusion A significant proportion of the respondents were not aware of complications and non pharmacological measures of managing hypertension. Antihypertensive drugs were not rationally prescribed. Recommendation Patient education regarding non-pharmacological methods of management and awareness of complications of hypertension should be intensified and rational prescribing should be practiced at KNH.

Ndetei DM;, Khasakhala L;, Ongecha-Owuor F;, Kuria M;, Mutiso V;, Syanda J;, Kokonya D. Attitudes toward Psychiatry: A Survey of Medical Students at the University of Nairobi, Kenya.; 2008. Abstract

A dissonance between a positive attitude toward psy- chiatry as a specialty and the choice of psychiatryas acareerhasbeennotedinanumberofstudies(1–5).Various explanations have been proposed for this phenomenon. According to one of the studies, the teaching of psychiatry at the undergraduatelevelwasdisorganizedornot done properly (1). Other studies have reported that compared to other specialists, psychiatrists are perceived to earnlessmoney,tobelessrespected,andtohavelessprestige (1, 6). Notwithstanding, psychiatry has been rated higher than any other discipline on intellectual challenge (5). Although the studies mentioned so far (1–5) generally reported that disparity between a positive attitude and choice as a career exists, the actual levels of dissonance varybetweenstudiesandbetweencountries.Oneprobable explanationforthiswidevariationcouldbethedifferences

Kiplagat D. DATA CAPTURE MODEL FOR UTILITY PROVIDERS USING HAND HELD DEVICES VIA MOBILE NETWORK: CASE FOR NAIROBI WATER COMPANY. Orwa DD, ed. Nairobi: University of Nairobi; 2008. Abstract

Utility providers faces a major task of collecting data from their remote installations. In order to be more efficient there is a growing need to reengineer there operations to make them more efficient, effective and customer focused while reducing the cost of operation both in terms of personnel involved, time and the actual operational costs. With the current emergence of 3G networks in wireless network there is need for this companies to look closely at mobile computing as the most cost effective solution to fixing there problems.

This research project mainly targeted the utility providers and the focus was to come up with a cost effective, secure, usable, adaptable, portable and above all extensible mobile data collection model that can be combined with other e-enabling technologies to create a holistic system for utility providers to reengineer their current business processes to make them more efficient and effective thereby improving on customer perception.

Using the WAP model has the preferred technology, this research as added to the voices of WAP proponents who have been suppressed by the opponents by proposing a solution to solve the current major problem of WAP, lack of end to end security which its opponents have used has a weapon to discredit the WAP technology. This has been done by using the kannel Gateway which can be configured within the web server of the organization hence no need of an external provider.

This research as shown that there is actually no need to acquire other devices to enhance meter reading. The mobile phones can be used to achieve a lot. If the recommended further work can be pursuit it can be seen that the capabilities of mobile phones are enormous and can actually transform the way companies conduct their business.

Machio P. Demand for Maternal Health Care Services in Kenya. University of Nairobi; 2008.
Juma G, Chimtawi M, Ahuya PO, Njagi PGN, Rü BL, Magoma G, Silvain J-F, Calatayud P-A. Distribution of chemo- and mechanoreceptors on the antennae and maxillae of Busseola fusca larvae. PO Box 62000, Nairobi, Kenya: 4Jomo Kenyatta University of Agriculture and Technology; 2008.abstracts_juma.pdf
WINFRED DR MWANGI. An Evaluation of the administration of Land Development Applications in Nairobi, Kenya.. Nairobi: University of Nairobi; 2008.
Wafubwa RM. Factors affecting documentation of Intraoperative nursing care at Kenyatta National hospital main theatre.; 2008. Abstract

Documentation plays a key role in the construction of social reality (Anderson 2006,
Levy2003, Searle 1996). A descriptive cross-section study conducted among nurses
working at Kenyatta national hospital (KNH) main theatre within a period of 9 months,
where both qualitative and quantitative methods used to collect data. The study aimed at
determining factors affecting documentation of intraoperative nursing care given to
patients while undergoing surgery in KNH theaters.
A self-administered structure questionnaire for the respondents, an interview guide for
face-to-face interview of the key informants and an observation guide using the record
files of patients who were ready for discharge from the unit back to the ward to collect
data on intraoperative nursing documentation. A simple random sampling method was
used to select a sample of 83 out of 96 qualified nurses, employed by KNH and working
in the operating theatre, who were willing to participate in the study.
The results showed Results showed that knowledge on hospital policy and perception
which included; lack of time, lack of provision in file to document and perception that no
nursing is done in theatre were statistically significant to intraoperative documentation (p
< 0.05). The study concluded that nurses perception and knowledge on hospital policy
affected intraoperative nursing care documentation.

Magembe EM. Genetic diversity analysis among cowpea [vigna unguiculata (l.) walp] accessions from Sub-Saharan Africa using simple sequence repeats (ssr's).; 2008. Abstract

Cowpea is one of the most important legumes in the world. 1t is the second most
important pulse crop in tropical Africa after common beans (Phaseolus vulgaris). Cowpea
is valued for the high protein content of its grains which is about 25%. In Africa, where
animal protein is not always freely available/ affordable, cowpea provides a valuable
source of proteins. Cowpea diversity and relatedness in Africa is poorly understood. This
lack of knowledge and information inhibits the use of novel germplasm and novel alleles
in breeding programs and results in potential crop improvement bottlenecks. A core set of
1430 accessions of cowpea landraces from Sub-Saharan Africa were identified from the
International Institute of Tropical Agriculture's (lIT A) global cowpea collection (15003
accessions). In this study sixteen SSR markers were used to evaluate the genetic diversity
cowpea landraces in Sub-Saharan Africa.
Within the core set a total of 125 alleles were detected with the mean number of alleles
per marker being 7.8. The number of alleles per SSR ranged from 2 to 18. The mean
polymorphism information content (PIC) was 0.4531 with the most informative marker
being VM70 with a PIC of 0.8636 while the least informative marker was VM54 with a
PIC of 0.0376. The overall level of genetic diversity, measured as heterozygosities was
medium to low, with an average gene diversity of 0.4988. The gene diversity (H) ranged
from 0.0383 for VM54 to 0.8760 for VM70. The genetic diversity in West Africa was
higher than North Africa indicated by H of 0.4987 and 0.4129 respectively. The mean
observed heterozygosity was low (0.0953) as expected from a predominantly inbreeding
species. Gene differentiation (FsT) among populations was low (0.095) suggesting free
gene flow between populations, a result confirmed by genetic distance (DA), and
phylogenetic analysis. In, contrast, FJS which can be taken variously as a measure of
heterozygote deficiency and departure from the Hardy-Weinberg equilibrium, but also as
a measure of inbreeding, was found to be extremely high at 0.797.

thesis PD. In spite of difference. Making sense of the Coexistence between the Kamba and the Maasai Peoples of Kenya; 2008. Abstract

n/a

Munyiva NMM. Location-based multilingual mobile phone browser case: Agricultural Information System Access. Odongo PO, ed.; 2008. Abstract

There has been a drastic growth in mobile phone usage in Kenya over the past few years .In June of 1999, Kenya had 15,000 mobile phone subscribers. By the end of 2004 the country had 3.4 million subscribers, and by mid-2005 the number was estimated to be over 4 million. [2]In addition prices of {WAP}-enabled smart phones have declined drastically over the recent past. There is an immense amount of agricultural information in Kenya that has been acquired by various research institutions and Non Government organizations. This information is largely in form of books, journals and articles and only limited static information is available on the web sites. In addition there is no single website that captures all information relating to Agricultural production that is required by farmers in a user friendly, location and language localized manner. Agricultural information applications developed that utilize mobile phone technology are mainly Short Message Service ({SMS}) based which do not take advantage of the full capabilities of phones available in the market. This project sets out to develop a system that will facilitate access to Agricultural information on the internet via mobile phones through creation of an interface that is location based meaning it determines the geographical position of a user and Multilingual that is there are various choices of languages that can be used to access the system In addition it sets out to merge all information required by farmers for Agricultural production into one Agricultural information system site. Display of required information will be based on geographical location of the user. The system utilizes {WAP} technology for the web interface and J2ME technology for the mobile phone interface using the {GSM} network to acquire location information. All the theory, rnethodology and implementation of the system are highlighted and illustrated inthis project report.

Njeri LN. Ocular findings in children attending occupational therapy clinic at Kenyatta National Hospital.; 2008. Abstract

There is a high prevalence of ocular abnormalities in children with physical and mental
disabilities which are often overlooked due to the difficulties encountered while
examining them.
OBJECTIVES
To describe the pattern of ocular abnormalities, their correlation with the physical
disorders and describe associated risk factors in children attending the Occupational
therapy clinic at KNH.
STUDY DESIGN
Cross sectional hospital based study at the Occupational therapy clinic in KNH.A
hundred and eighty seven children were examined." from both the general paediatric unit
and the sensory integration unit.
RESULTS
A total of 187 children were examined, males were 109(58%) and females were 78(42%).
The mean age was 2.56 years. The youngest child was 0.25 years and the oldest patient
being 13 years with a range of 12.75 years .. The majority of the children were between
one and two years, representing 45.5% of the whole group. Majority of the patients had
cerebral palsy, 160(85.6%), while ADHD and autism had almost equal proportions,
20(10.7%) and 18(9.6%) respectively. Only one child had learning disability, which
represented 0.5%. Some patients had multiple diagnoses. Among the children, 62% had
ocular anomalies. Children with CP had a much higher prevalence (58.3%) compared to
the sensory integration deficit group (3.7%). The common ocular abnormalities included
cortical visual impairment 48.7%, refractive errors 39% and squints 34.2%. Other less
frequent findings included strabismic amblopia13.4%, nystagmus 12.8%, and optic
atrophy 5.3%. Corneal scars, cataracts, maculopathy and eyelid anomalies comprised of
small proportion (5%). Association between physical disability and ocular anomalies was
noted in patients with cerebral palsy compared with sensory integration group.
Strabismus, cortical visual impairment and myopia were more likely to occur in patients
with cerebral palsy. Significant hyperopia was noted only in the cerebral palsy group.

There was no significant association noted between amblyopia, nystagmus and optic
atrophy and either of the physical disability. Some of the known risk factors for the
physical disabilities were observed to have an association with the ocular anomalies.
Strabismus and cortical visual impairment were more likely to occur in patient with
neonatal jaundice, while refractive errors in patients with congenital causes and optic
atrophy in patients with meningitis. No significant association was noted between
nystagmus, and amblyopia and any of the risk factors. Co-morbid conditions associated
with the physical conditions included speech (29.9%), epilepsy (18.7%), mental
retardation (MR) 8%, dental problems 8%, hearing loss 6.4% and breathing difficulties
4.3%.
CONCLUSION .•
Visual disabilities in children with physical disabilities were common. Cortical visual
impairment, refractive errors, squint and amblyopia, were seen in a large proportion of
these children. Children with CP had a much higher prevalence compared to the sensory
integration deficit group.
RECOMMENDATION
All Children with cerebral palsy and sensory integration deficits should be referred to
ophthalmologist and low vision specialist for assessment as part of a broad
multidisciplinary approach to their management. The occupational, speech and hearing
therapists should work closely with the low vision specialists in co-ordinating the
physical and ocular rehabilitation. Low vision unit should be started at KNH and
specialist should be trained to provide the much needed services to these children. Follow
up of the patients for evaluation of long term outcome of the visual interventions to be
offered with the aim of improving the quality of treatment options.

Ahramjian L, Carson A, Collins P, Kirloss R, Lang J, Makunda C, Moses Z, Oh SJ, Reinhardt J, Service E, Smith M, Styger K, Vagen K. The Philadelphia Public Space Project. Philadelphia: University of Pennsylvania; 2008.
Mulli TK. Proteomic investigation for gingival crevicular fluid biomarkers in periodontitis. Hughes FJ, ed. London: Queen Mary University of London; 2008.
McGill T, of of and Science ULFA. Functionally non-adaptive retinal plasticity in rat models of human retinal degenerative disease. Lethbridge, Alta. : University of Lethbridge, Faculty of Arts and Science, 2008; 2008. Abstract

The established model used for evaluating potential therapies for retinal disease has significant limitations. A new model is proposed to account for these limitations: the visual adaptation model. The visual adaptation model was developed to provide a novel approach for testing potential treatments for retinal disease, and the work in this thesis provides empirical support for this model. Specifically, we evaluated two potential therapies for retinal degenerative disease and examined their effects on vision and retinal anatomy. In addition, the profile of retinal reorganization and its functional correlates were examined in RCS rats and transgenic rats which express a rhodopsin mutation; however, immunohistological work targeted one specific line (S334ter-4). Collectively, these studies provide evidence that supports the retinal adaptation model. These studies also provide a novel view of retinal and visual function in retinal disease which should be considered when evaluating treatments involving retinal degeneration.

Njoroge HG. : “Mwingilianomatini katika Fasihi ya Kiswahili: Tata za Asumini Na Rosa Mistika. E.M. DM, Olali DT, eds. Nairobi: University of Nairobi; 2007.
Githui FW, Mutua F, Bauwens W. Assessing the impacts of environmental change on the hydrology of the Nzoia catchment, in the Lake Victoria Basin. Brussel: Vrije Universiteit Brussel; 2007. Abstract

The main objective of this study was to assess the past and potential future environmental changes, and their impact on the hydrology of the Nzoia catchment. More specifically, the study has analyzed the historical climatic (1962-2004) and land cover changes (1973-2001) that have taken place in the Nzoia River catchment in Kenya, and the effect these have had on the hydrology of the catchment. It has also made use of land cover and climate change scenarios for the future to determine the potential effects these will have on the catchment. The Soil and Water Assessment Tool (SWAT) model was used to investigate the impact of land cover and climatic change on streamflow of the study area. The model was set up using readily available spatial and temporal data, and calibrated against measured daily discharge. The land cover changes within the watershed were examined through classification of satellite images and a land cover change model generated the land cover change scenarios for the year 2020. Climate change scenarios were obtained from general circulation models (GCMs) for the period 2010-2039 (ie 2020s) and 2040-2069 (ie 2050s). The climate change IPCC SRES scenarios A2 and B2 were selected. To this purpose, rainfall and temperature scenarios based on the GCMs CCSR, CSIRO, ECHAM4, GFDL and HADCM3 were superimposed on the calibrated SWAT model.

Muohi, A. W.(2007). Bioaccumulation of trace metals in biota (algae and chironomids) from Kenyan Saline Lakes (Bogoria and Nakuru): Evaluation and verification of two compartment toxicokinetic models.. Oldenburg: Carl von Ossietzky Universität Oldenburg, Germany, Institut für Chemie und Biologie des Meeres (ICBM).; 2007.
Owakah F. A Critique of the Culture of Philosophy: Challenges and Opportunities for Philosophy in Africa.. Nyasani J, ed. Nairobi: University of Nairobi; 2007.
Khainga KA. The diagnostic role of ultrasonography in patients with thyroid gland enlargement at Kenyatta National Hospital, Nairobi, Kenya (E. Africa)..; 2007. Abstract

Background
/\ prospective cross section study was carried out at the Department or Diagnostic
Imaging and Radiation Medicine of the University of Nairobi, the X-ray Department of
Kenyatta National Hospital (KNH), the Thyroid Clinic [TC] of KNll and the Department
of Pathology. University of Nairobi.
During the study in a period spannmg SIX months, 70 patients presenting with
goiter at KNH thyroid clinic and sent for ultrasound evaluation, were recruited into the
investigation using purposeful sampling technique. Demographic data was gathered for
each case before ultrasonography being carried out on the thyroid gland using real time
and Doppler modes in axial [transverse] and longitudinal [sagittal] planes. The
sonographic features of each thyroid nodule studied were size, internal consistency,
echogenicity relative to adjacent tissue. vascularity at CFI, margination and presence of
calcification and a sonoluscent peripheral halo.
lesions then underwent FNA for cytology or excision biopsy lor histology to
rule out malignancy. Data collection was done using a presorted questionnaire filled by
the researcher. It was analyzed by SPSS computer software and results presented in form
tables, charts and graphs.
Results: ()2.R(/'i) or patients with thyroid enlargement were female. The male: female
ratio was found to he I: I). The age range or patients with thyroid enlargement varied
from 18 to 77yrs. Goiter was most noticeable' in the 4th through to ih decades [from 21
to GO years J with 75% or the patients in this study falling in this age range.
The rate ofmalignancy in this study is 2.9(10 having registered only two cases.
The findings indicate that there exists a relationship between the cytological status and
the age 01' the patients, internal consistency. outline/margin, presence or the peripheral
halo. vascularity and presence of calcifications. There was no signi Iicant relationship
established between the cytological findings and the variables gender. number of nodules
and echogenicity.

Ndiritu GM. Effectiveness of cash budgeting in public institutions. Nairobi: University of Nairobi; 2007. Abstractndiritu_george_muriuki_-_effectiveness_of_cash_budgeting_in_public_institutions.pdf

This study involved understanding the cash budget process and its effectiveness in Telkom Kenya Limited. The firm understudy is wholly owned by the government and has been in existence for over six years. Cash budget is an indispensable tool which assists organizations to manage their cash flows over a given period of time. The study therefore attempted to evaluate how the firm has employed a cash budget as a management tool. It involved understanding the cash budgeting process and its effectiveness in improving the management of cash. It also involved appreciating the role of liquidity management in the firm by ensuring sustenance of enough cash for operations while investing excess cash profitably. The study also assessed the weaknesses the firm faces in management of cash and how this management tool can be implemented as a strategy to alleviate the same. The study was done through interviewing the relevant staff using an interview guide to understand how the cash budget is prepared and used in decision making in the organization. The data collected was analyzed using descriptive statistics and historical information used as benchmark. Information relating to how the cash budget helped in forecasting cash flows and its flexibility in accommodating un-budgeted transactions assisted to evaluate cash budget effectiveness. The relevant literature was used as the benchmark to evaluate effectiveness. The study revealed that the firm ends up loosing huge cash amounts due to lack of established and operationalised mechanisms and strategies to harmonize cash collection and expenditure. There were many pitfalls with loose controls which ensured that the cash budget does not capture the total cash movement in the organization. There was also cash planning mismatch due to poor coordination between the various operationally related departments vested with management of cash. For example actualization of projects by engineers took longer than foreseen but is usually cash budgeted for. Operational expenditure also took the larger chunk of the cash generated instead of capital expenditure thus leading to dwindling cash sources in the future. To ensure the cash budget is. valuable and effective, the firm needs to strive and achieve set standards. As a prerequisite also, the firm's operations when managing cash need to be coordinated and harmonized to ensure that the cash budget objectives are achievable.

undefined. Effects of lactoperoxidase system in camel milk for preservation and fermentation purposes. Wangoh J, Lamuka PO, eds. University of Nairobi; 2007. Abstract

Summary
This study was conducted to investigate preservative effect of the LPsystem
on both raw and pasteurized camel milk. The effect of the LPsystem
on selected starter cultures in the raw and pasteurized camel
milk was also investigated. Experiments were therefore conducted to:
 evaluate the effect of LP-system activation on shelf-life of raw
camel milk with the underlying activities being to:
o determine the duration of antibacterial effect in camel milk
stored at different temperatures after activation of its LPsystem
and
o monitor effect on keeping quality of increasing
concentrations of sodium thiocyanate and hydrogen
peroxide within physiological limits.
 determine the effect of the LP-system on keeping quality in
pasteurised camel milk
 determine the effect of the LP-system on starter culture activity in
camel heat treated and raw camel milk.
The concentration of thiocyanate occurring naturally in the milk used in
the present investigations ranged from 9.7 to 36.4 mg/l. No addition of
thiocyanate was therefore necessary to activate the LP-system. The
average thiocyanate values of camel milk from different sites were
2
15.8, 32.9 and 9.74 mg/l and were significantly different (p<0.001)
across the three sampling sites in this study.
Changes in total viable counts between LP-activated and LPinactivated
camel milk were determined during storage at 10, 20 and
30°C. Viable counts increased with storage temperature. Microbial
growth was halted for 15, 17 and 76 hours at 30, 20 and 10°C
respectively by activation of the LP-system in raw camel milk. At 30°C
the effect was mainly bacteriostatic and at 20°C, there was an initial
bactericidal effect in the first 15 hours. At 10°C, the bactericidal effect
was noted throughout the period of 76 hours.
The titratable acidity between LP-activated and LP-inactivated camel
milk was determined during storage at 10, 20 and 30°C. There lag in
acid production of 14, 23, and 10 hours at 10, 20 and 30°C
respectively as compared to the controls and was significantly different
(p>0.05) across the three incubation temperatures. Shelf life difference
between LP-system activated samples and their respective controls
was 19 hours at both 10 and 20°C and 4 hours at 30°C.
The differences in mean acid produced between the control samples
and the activated samples, however, were 0.12, 0.61 and 0.49 for 10,
20 and 30°C respectively. Inhibition of acid production by the LPsystem
increased from significant (p<0.05) during storage at 10°C to
highly significant (p<0.01) during storage at 20 and 30°C. The present
investigation therefore shows that by activating the LP-system it is
3
possible to extend the storage period of raw camel milk and that the
effect of the LP-system on the microbes present varies with
temperature of storage.
The effect of increasing levels of thiocyanate and hydrogen peroxide
on antibacterial activity of LP-system in raw camel milk at 30ºC was
investigated. Changes in total viable counts and lactic acid
development in raw camel milk at concentrations of 0, 10:10, 20:20,
30:30 and 40:40ppms, NaSCN
-
:H2O2 were monitored. The delay in
multiplication of bacteria increased significantly with an increase in the
LP-system components from no lag phase in the control to 4, 6, 11.5
and 9.5 hours in the 10:10, 20:20, 30:30 and 40:40 ppm levels of
NaSCN/H2O2 respectively.. The lag in acid production was 0, 4.8, 6, 12
and 8 hours for 0, 10:10, 20:20, 30:30 and 40:40 ppm dose of
NaSCN:H2O2, respectively. The shelf life of the camel milk was 4, 6,
12, 16 and 16 hours, respectively, for 0, 10:10, 20:20, 30:30 and 40:40
ppm dose of NaSCN:H2O2.
Lactoperoxidase system (LPS) was activated in camel milk followed by
pasteurization after 0, 4, and 8 hours after of storage.
This resulted in a shelf life of 15, 32, 17 and 17 days for the nonactivated
control and those activated after 0, 4, and 8 hours of storage
respectively during storage of samples at 10ºC. At 20°C, the shelf life
was 6, 13, 9 and 7 days for non-activated control and those activated
after 0, 4, and 8 hours of storage respectively. These results showed
4
a significant effect of storage time prior to pasteurisation on the effect
of the LP-system on the surviving microflora between the control and
activated samples at all the 3 times of storage prior to pasteurisation
(p<0.001). The number of viable bacteria in untreated sample reached
108 after 45 days compared to 105-107 in treated samples during
storage at 10ºC and 108 after 15 days in untreated compared to 107-
106 in treated samples under storage at 20ºC. The mean specific
growth rates at 10ºC storage temperature were 0.51, 0.2, 0.41 and 0.5
for the inactivated control, activated and pasteurized after 0, 4, and 8
hours respectively and were significantly lower in the LP-treated camel
milk samples than in the control (p<0.001). At 20ºC storage
temperature, the mean specific growth rates were 1,46, 0.27, 0.69 and
1 for the inactivated control, activated and pasteurized after 0, 4, and 8
hours respectively. These were also significantly lower in the LPtreated
camel milk samples than in the control (p<0.001)
Sensitivity of lactic starter cultures to LP-system was investigated by
monitoring acid production by mesophillic, thermophillic and Suusac
starter cultures in both LP-system treated and untreated camel milk.
Inoculation with starter was done after zero, 4 and 8 hours of storage
of LP-activated samples.
In all the three starters, LP-system activation resulted in a significant
slow down in acid development in raw camel milk activated and
inoculated immediately. For the thermophillic starter mean lactic acid
5
was 0.41, 0.32, 0.35 and 0.36 for the inactivated control sample and
those activated then inoculated with starter after 0, 4, and 8 hours
respectively. The differences in means between the control and the
activated samples were very highly significant (p<0.001), highly
significant (p<0.01) and not significant (p>0.05) at the inoculation times
o, 4 and 8 respectively. For the Suusac starter, mean lactic acid was
0.67, 0.62, 0.67 and 0.52 for the inactivated control sample and those
activated then inoculated with starter after 0, 4, and 8 hours
respectively. The differences in means between the control and
activated samples were highly significant (p<0.01) at all the inoculation
times after activation. However, for mesophillic starter culture the mean
values of lactic acid produced were 0.53, 0.48, 0.42 and 0.54 for the
inactivated control and activated then inoculated with starter after 0, 4,
and 8 hours respectively. The differences in means between the
control and activated samples were significant (p<0.01) at 0 and 4
hours and non-significant (p>0.05) at 8 hours. This implied that camel
milk preserved using this method could support satisfactory mesophillic
and thermophillic starter culture activity if the milk is held prior to
processing.
The investigation on the effect of the LP-system on starter activity in
camel milk heat-treated prior to inoculation showed that heat treatment
reduced starter inhibition by the LP-system for the mesophillic and
thermophillic starter cultures for samples LP-system activated, heat
6
treated and inoculated at immediately. For the mesophillic starter mean
lactic acid values for the inactivated control sample, activated and then
inoculated after 0, 4 and 8 hours were 0.52, 0.52, 0.54 and 0.40
respectively. The differences in mean lactic acid values between the
control and activated samples showed that a non-significant effect of
inoculation time at time 0 (p>0.05), a significant effect after 4 hours
(p<0.05), and a very highly significant effect (p<0.001) after 8 hours.
Mean lactic acid values for the thermophillic starter for the inactivated
control sample and those activated and then inoculated after 0, 4 and 8
hours were 0.52, 0.52, 0.54 and 0.40 respectively. The inhibition
changed from insignificant (p>0.05) on inoculation at time 0 and 4
hours (p<0.05) and was highly significant (p<0.01) on inoculation after
8 hours. Thus the inhibitory effect of the LP-system on mesophillic
and thermophillic starter culture activity in heat treated camel milk
apparently is reactivated and increases with time of preservation of raw
milk by LP-system. However with suusac starter, the mean lactic acid
values inactivated control sample and those activated and then
inoculated after 0, 4 and 8 hours respectively were 0.69, 0.58, 0.64
and 0.71. At zero and four hours after activation inhibition was
significant (p<0.05) compared to a non-significantly different inhibition
(p>0.05) on inoculation after 8 hours of storage.
The use of the LP-system might therefore have a significant influence
on the time taken to reach the desired pH in the vat, which is a critical
7
factor for the manufacturer of fermented camel milk and this influence
is dependent on the time of preservation of raw camel milk prior to
processing of fermented products.

Kimata MD, Mwangi(S)RW, Mathiu(S)P. Effects of Rearing Methods and Hormones on Growth and Reproduction of the Helmeted Guinea Fowl Numida meleagris. Nairobi: University of Nairobi; 2007.
Karimi PN. Etiology and risk factors of bacterial wound infections.; 2007. Abstract

Background: Kenyatta National Hospital (KNH) is a referral center serving patients from
Kenya and beyond. There are several departments among them orthopedics which houses
many patients with wounds, some of which are infected thereby increasing morbidity and
mortality. This research focused on etiology and risk factors of bacterial wound infections in
the orthopedics wards.
Objective: To assess the factors that contribute to wound infections. The specific factors
assessed were prevalence of aerobic bacteria. use of antibiotics and clinical practices among
the nurses when dressing wounds.
:VIethods: A descriptive research design was used and target populations were nurses and
hospitalized patients in the department of orthopedics at KNH. Sixteen nurses and one
hundred and fifteen patients were selected using simple random sampling and convenience
sampling techniques respectively. Data was collected using a questionnaire and specimens
taken from wounds analyzed in microbiology laboratories ofUON and KNH.
Results: The prevalence of bacteria isolated was; Pseudomonas spp. (42.6%). Proteus spp.
(33.9%). Staphylococcus aureus (33%). Klebsiella spp. (7.9%), Streptococcus faecalis
(6.1%), Enterbacter spp. (2.6%), Alcaligenes spp. (1.7%), Citrobacter freundii (0.9%),
Serratia spp. (0.9%), and Acinetobacter baumanii (0.9%).
The sensitivity patterns were as follows: Pseudomonas spp.; Pipril/Tozabactam (89.9%),
Meropenem (75.5%). Gentamycin (55.1%), Amikacin (73.5%), Ceftazidime (82.6%),
Ceftriaxone (30.6%), TicatcilliniClavulonic acid (65.3%) and Piperacillin (83.7%).
Proteus spp.: Ceftazidime (89.7%), Ceftriaxone (79.5%), Ciprofloxacin (87.2%), Augmentin
(76.9°/0). Cefuroxime (61.5%). Piperaciliin H8.7%)"Gentamycin (-1-6.2%)

Ndohvu JB. An Exposition of the Foundations of the Philosophy of Human Natiure. Nyasani PJ, ed. Nairobi: University of Nairobi; 2007.
Odero AN. HYBRID METHOD OF MOMENTS (MOM)/FINITE ELEMENT METHOD (FEM) FORMULATION FOR PROBLEMS OF TRANSMISSION THROUGH NON-BACKED AND WAVEGUIDE-BACKED CAVITIES OF ARBITRARY SHAPE IN THICK CONDUCTING SCREENS . Benard KD, ed. Juja: JKUAT; 2007. Abstract

Concerted efforts have been made towards developing more elaborate techniques for solving aperture coupling problems. The majority of these techniques, however, deal with apertures of regular shapes and, in each case, only a particular problem has been solved. It is only with the development of numerical methods, such as the Method of Moments and Finite Element Method that it has become possible to treat irregularly shaped apertures.

However, each of the above methods has its own advantages and disadvantages when applied to different problems. The Method of Moments is an integral equation method which handles unbounded problems very effectively but becomes computationally intensive when material and structural inhomogeneities exist. In contrast, the true power of the finite element method is revealed in three-dimensional volume formulations in the presence of material and structural inhomogeneities. The method requires less computer time and storage because of its sparse and banded matrix. The matrix filling time is also negligible when simple basis functions are used. For complex basis functions, the matrix filling time can be significant.

A suitably implemented hybrid method takes advantage of the strengths of the individual methods constituting it while avoiding their weaknesses. This research therefore, as one of its objectives, has developed a hybrid method that combines the method of moments and the finite element method (MOM/FEM). The analysis is based upon the "generalized network formulation" for aperture problems. The cavity region is subdivided into tetrahedral elements resulting in triangular elements on the surfaces of the apertures.

In this work, a hybrid MOM/FEM solution procedure for the general problem of apertures of arbitrary shapes in thick conducting screens and waveguide walls has been developed and used in the analysis of a variety of representative problems. Appropriate modeling of the aperture/cavity has been carried out using tetrahedral and triangular elements. Suitably defined sets of basis functions have been integrated into the formulation which is capable of accurately evaluating fields of apertures of arbitrary shape. The problem has been formulated by invoking the equivalence principles and utilizing boundary conditions on the apertures/cavity to derive equations which have then been transformed into matrices that are then solved numerically by simulation on a digital computer. The finite element method, employing reliable vector formulation, has been employed in the computation of the interior admittance matrix. Here, edge elements or tetrahedra in which the degrees of freedom are assigned to the edges rather than the nodes are utilized. This resulted in the avoidance of nonphysical or spurious modes, a difficulty that arises when node-based elements are used. Based on the preceding formulation, extensive computation of various parameters for apertures/cavities of various shapes has been done and results presented. The two main classes of problems treated in this study comprise apertures of arbitrary shape in thick conducting screens and waveguide-backed apertures.

Kihiko D. Injuries sustained by children who fall from a height as seen at an urban Kenyan hospital.; 2007. Abstract

Topic: To determine the pattern of injuries in children who fall from a height.
Introduction: Most injuries sustained by children who fall from a height are of the blunt
type. Despite there being literature that characterises injuries in general, few studies have
focused on fall-related injuries. Most of these studies are conducted in the primarily
urban western countries. No such study has been conducted in Kenya, and the existing
hospital records may not adequately reflect the full spectrum of these injuries. The aim of
this study was to provide data on the type of injuries that children sustain when they fall
from a height.
Methodology: This was a prospective descriptive study of children aged 0-13 years who
sustained injuries after falling from any height. It was conducted at a large urban hospital
serving a large population (bed capacity of about 1,200). A statistically acceptable sample
size of 80 was picked and all the injuries diagnosed were characterised. The outcome of
the injuries was also investigated. The study took duration of 6 months, 14th Nov 2006-
30th May 2007, during which the sample size was fulfilled.
Results: A total of 80 children were recruited into the study. Boys were 61 (76%) and girls
19(24%), with an age range 0-13 years. Most injuries occurred at home (78.75%) after
falling from buildings (33.75%), and were of mild-to-moderate severity. 13.4% sustained
haemorrhage, 16.5% sustained facial injuries, 25.2% sustained CNS injuries, 43.3%
sustained various fractures, and 1.6% sustained abdominal trauma. The head and
musculoskeletal systems were the most likely regions to be injured. No thoracic or pelvic
fractures were recorded. Recovery was good in most instances.
Conclusion: Most children who sustain injuries after a fall do so from falling from a
building. They are most likely to sustain distal fractures and head injury than other types
of injuries, mostly of mild-moderate severity.

Ojuka DK. Isolated distal radial fractures in children aged 6 to 15years: incidence of redisplacement after casting as seen in Kenyatta national hospital.; 2007. Abstract

Aim
The main aim of the study was to evaluate the incidence of redisplacement of distal radial
fractures in children aged between 6 and 15 years and factors contributing to it at the
Kenyatta National Hospital.
Methodology
'If This was a prospective study carried over eight months from the 22nd June 2005 to 28th
February 2006.0ne hundred patients were recruited. The fracture was reduced by the
plaster technicians, the usual personnel who reduce these fractures at casualty; reduction
was acceptable if the dorsal or volar angulation was less than 20°. The patients were then
followed up in the fracture clinic in the next two weeks with another x-ray. It was
determined at this point whether there was presence of healing or redisplacement.
Redisplacement was regarded as the presence of dorsal volar angulation of greater than
20° or translation greater than 50%. The end point of the study was at week four, x-ray of
the distal forearm either showed evidence of redisplacement or evidence of healing at
week four in other remaining patients. The data was collected and entered into statistical
package for social sciences (SPSS) 12.0 version.
It was analyzed using odds ratio, Fisher's exact test and Chi-square test where
appropriate. The difference within the variables was taken to be significance if the p
value was less than 0.05.
Results
One patient had fracture of both distal radial bones making the total number of fractures
to be 101. Thirty-seven of which were female and thirty four sustained their fractures as a
result of involvement in games. Ninety two fractures involved the metaphysis and nine
were in the distal third of the radial diaphysis, sixty five were complete fractures while
thirty two were torus and only four were greenstick fractures. Fifty nine were angulated
(fifty eight dorsal and one volar) and forty two were non-angulated. There were fifty nine
displacements, (fifty six dorsal, one volar and two bayonet apposition) and forty two nondisplaced
fractures. There were fifty one fractures with no translation of one fragment on
the other, thirty five fractures having less than 50% translation and fifteen having greater
than 50% translation. Fifty four fractures were judged to be as a result of bending forces
and fifteen as a result of shear forces and thirty two as a result of compression forces.
Ninety nine patients got below elbow cast while only one had above elbow. Twenty two
patients were given analgesics/sedation at reduction while seventy eight had the reduction
under no analgesia! sedation.
At week two nine (seven patients did not turn up and two did not have check x- rays)
patients were not accounted for; and at week four another nine patients (five did not turn
up and four did not have check X rays) were not accounted for. At week two, thirteen
fractures redisplaced and were remanipulated, and at week four two of the thirteen
remanipulated at week two maintained their reduction but four other fractures which had
not redisplaced at week two redisplaced making them fifteen all of whom were admitted
for operative reduction.
In consideration of the whole population seen with isolated distal radial fractures, the
incidence of redisplacement would be 14.1% at week two and 18.1 % at week four, but
considered as a percentage to the complete and greenstick (which are the fractures at risk
of red isplacement) it would be 20.3% at week two and 21.9% at week four. The
determinants of redisplacement were; angulation with a p value of 0.021, translation with
a p value of 0.009 , completeness of fracture with a p value of 0.004, displacement with a
p value of 0.006 and imperfect reduction with p value of 0.003 .
Conclusion
The incidence of redisplacement of isolated distal fracture in children 6-15 years as seen
in this study is comparable to international figures. The factors contributing to
redisplacement are completeness of the fracture, initial displacement, translation and
imperfect reduction. These factors constitute risk factors to redisplacement of the
complete fractures.

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Waweru MM;, Ojwang SB;, Kingondu CS;, Karanja JG;, Kamau RK;, Waweru W. A Review Paper of the Cervical Cytology Diagnosis Services at the Department of Obstetrics and Gynaecology Laboratories.; 2007. Abstract

Invasive cancer of the cervix is considered a preventable disease because cancers develop slowly through per-cancerous changes to invasive cancer in about 10 - 15 years. Pap smear screening for the early detection of cancer of the cervix contributes to early successful treatment

Ojwang SB;, Waweru MM;, Kingondu CS;, Karanja JG;, Kamau RK;, Waweru W. A Review Paper of the Cervical Cytology Diagnosis Services at the Department of Obstetrics and Gynaecology Laboratories.; 2007. Abstract

Invasive cancer of the cervix is considered a preventable disease because cancers develop slowly through per-cancerous changes to invasive cancer in about 10 - 15 years. Pap smear screening for the early detection of cancer of the cervix contributes to early successful treatment

Karanja JG;, Waweru MM;, Ojwang SB;, Kingondu CS;, Kamau RK;, Waweru W. A Review Paper of the Cervical Cytology Diagnosis Services at the Department of Obstetrics and Gynaecology Laboratories.; 2007. Abstract

Invasive cancer of the cervix is considered a preventable disease because cancers develop slowly through per-cancerous changes to invasive cancer in about 10 - 15 years. Pap smear screening for the early detection of cancer of the cervix contributes to early successful treatment

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