DR. MURIITHI ANNE WANGECHI

The removal of deciduous canine tooth buds in early childhood is a practice that has been documented in Kenya and in neighboring countries. This paper describes the occurrence, rationale and method of this practice amongst rural Kenyan Maasai. In a group of 95 children aged between six months and two years, who were examined in 1991/92, 87% were found to have undergone the removal of one or more deciduous canine tooth buds. In an older age group (3-7 years of age), 72% of the 111 children examined exhibited missing mandibular or maxillary deciduous canines. It was found that the actual removal of a deciduous tooth bud is often performed by middle-aged Maasai women who enucleate the developing tooth using a pointed pen-knife. There exists a strong belief among the Maasai that diarrhoea, vomiting and other febrile illnesses of early childhood are caused by the gingival swelling over the canine region, and which is thought to contain 'worms' or 'nylon' teeth. The immediate and long-term hazards of this practice include profuse bleeding, infection and damage to the developing permanent canines. A multi-disciplinary approach involving social anthropologists in addition to dental and medical personnel, is recommend in order to discourage this harmful operation that appears to be on the increase

Department of Human Anatomy, University of Nairobi, Kenya. Despite extensive investigation, pain cannot always be adequately diagnosed or cured. Subsequently, the management of pain can be daunting. The diagnosis of pain, however, is crucial to its effective management because of the grave influence that pain has on the quality of life. The biggest drawback in the management of pain is the lack of understanding, on the part of the practitioner, of the peripheral and central modulation of pain. The objective of this paper is to briefly review the current concepts in the recognition of and classification of pain, with emphasis on orofacial pain. PMID: 8033773 [PubMed - indexed for MEDLINE]

Regulated gastric emptying is necessary for the complete digestion and absorption of
intestinal chyme. However, experiments have shown that the extrinsic denervation of
stomach and duodenum does not result in a cessation of gastric function. Furthermore,
the components necessary for the integration and relay of neural information
have been demonstrated in the intrinsic nervous network of the gut. A possible hypothesis
therefore, is that the enteric nervous system may playa role in the regulation of gastric
function. The purpose of this study was to establish whether or not stimulation of the
duodenal mucosa of an in vitro rabbit stomach-duodenum preparation has any effect on
gastric motility.
Electrically stimulated changes in intragastric pressure were used as indicators of gastric
motility and recorded with an intragastric balloon connected to a transducer and chart
recorder. The records were made in both the presence and absence of mechanical and
chemical stimulation of the duodenal mucosa. A comparative analysis was carried out on
the frequency and amplitude of electrically stimulated gastric contractions, and of the
peristaltic contractions that took place after electrical stimulation of the stomach wall.
The results were found to differ depending on the type of duodenal stimulus applied.
Duodenal distension did not attenuate or amplify the subsequent gastric response to
electric stimulation of the stomach wall. However, a disturbance in the inherent pattern of
gastric peristaltic contractions was observed. In contrast, the presence of hydrochloric
acid in the duodenum, reduced the force of the electrically stimulated gastric contraction
by half, but the inherent pattern of peristalsis that followed the electrical stimulation
appeared unaltered.
These results suggest the existence of a gastric motility regulation mechanism in the
rabbit that is mediated by the enteric nervous system and that responds to stimulation of
the duodenal mucosa.