OBJECTIVE: To determine the pattern of occurrence of dental injuries in the 0-15 year-olds. DESIGN: A retrospective study. SETTING: Kenyatta National Hospital, Nairobi. SUBJECTS: Five hundred and five patient records with dental injuries were retrieved and analysed. RESULTS: A total of 505 patient records with dental injuries were retrieved and analysed. Most of the injuries were recorded in the year 1999 (22.2%). Boys were more affected (63.0%) than girls (37.0%). The main presenting complaint recorded was pain (75.8%).The majority of the patients (69.5%) presented for treatment during the same day or the day after trauma. Falls were the leading cause of injuries (73.5%). Most injuries involved two teeth (47.1%) and the maxillary central incisors were the most affected teeth both in the primary (67.5%) and permanent (64.0%) dentitions. Luxation injuries were the most common type of dental trauma with 47.5% occurring in the permanent teeth and 77.3% in the primary teeth. The main radiographic investigation performed was intraoral periapical views (52.9%) following which dental extraction (34.4%) was the main treatment modality offered. CONCLUSION: Prospective cross-sectional studies to determine the prevalence of dental injuries are needed. Furthermore improving the knowledge of dental practitioners through continuing dental education programmes would help in updating them on current trends in managing these injuries.

Department of Paediatric Dentistry/Orthodontics, Faculty of Dental Sciences, University of Nairobi, PO Box 19676, Nairobi, Kenya. OBJECTIVES: To evaluate the socio-demographic characteristics, chief complaints and clinical presentation of children attending a private dental clinic in Nairobi, Kenya. DESIGN: A retrospective survey of dental clinic records. SETTING: A private dental clinic in Nairobi, Kenya. SUBJECTS: All patients aged 0-18 years who were first-time attenders at the dental clinic during a three year period. RESULTS: The records of 800 patients were examined, comprising 395 males and 405 female children. The average age was 7.2 years (95%CI, 6.9-7.4). Referral to the clinic for treatment was mostly by self (81.4%). Most patients (57.9%) were self-sponsored for their dental treatment. Majority of the patients attending (86.8%) did not clinically have any underlying medical conditions. The major complaints for most patients were dental decay (27.4%) and dental pain (21.6%). Very few children (7.6%) attended for dental check-up. Five hundred and forty nine (68.6%) of the children suffered from dental decay while 294 (36.8%) suffered from gingivitis. The average number of teeth decayed was 4.02, SD +/- 2.4 (95% CI 3.8-4.2). Most carious lesions occurred in the younger children. There was a significant increase in the occurrence of decay over the three year period of the study. Significantly higher levels of gingivitis was observed in the prepubertal and pubertal age group. Attendance for traumatic injuries was relatively low with only 46 (5.8%) children reporting traumatic injuries to their dentitions. Most traumatic injuries involved the anterior teeth as a result of falls. Treatment given at the first visit was mainly restorative (28.6%) followed by dental extractions (25.4%). CONCLUSION: The average are of patients attending the clinic was 7.2 years. Interdisciplinary referral was low since most patients were self-referred and self sponsored for treatment. Dental caries was prevalent, necessitating a high demand for restorative treatment. Although gingivitis was less prevalent, it was significant among children in the prepubertal years.

OBJECTIVES: To evaluate the socio-demographic characteristics, chief complaints and clinical presentation of children attending a private dental clinic in Nairobi, Kenya. DESIGN: A retrospective survey of dental clinic records. SETTING: A private dental clinic in Nairobi, Kenya. SUBJECTS: All patients aged 0-18 years who were first-time attenders at the dental clinic during a three year period. RESULTS: The records of 800 patients were examined, comprising 395 males and 405 female children. The average age was 7.2 years (95%CI, 6.9-7.4). Referral to the clinic for treatment was mostly by self (81.4%). Most patients (57.9%) were self-sponsored for their dental treatment. Majority of the patients attending (86.8%) did not clinically have any underlying medical conditions. The major complaints for most patients were dental decay (27.4%) and dental pain (21.6%). Very few children (7.6%) attended for dental check-up. Five hundred and forty nine (68.6%) of the children suffered from dental decay while 294 (36.8%) suffered from gingivitis. The average number of teeth decayed was 4.02, SD +/- 2.4 (95% CI 3.8-4.2). Most carious lesions occurred in the younger children. There was a significant increase in the occurrence of decay over the three year period of the study. Significantly higher levels of gingivitis was observed in the prepubertal and pubertal age group. Attendance for traumatic injuries was relatively low with only 46 (5.8%) children reporting traumatic injuries to their dentitions. Most traumatic injuries involved the anterior teeth as a result of falls. Treatment given at the first visit was mainly restorative (28.6%) followed by dental extractions (25.4%). CONCLUSION: The average are of patients attending the clinic was 7.2 years. Interdisciplinary referral was low since most patients were self-referred and self sponsored for treatment. Dental caries was prevalent, necessitating a high demand for restorative treatment. Although gingivitis was less prevalent, it was significant among children in the prepubertal years.

OBJECTIVES: To evaluate the socio-demographic characteristics, chief complaints and clinical presentation of children attending a private dental clinic in Nairobi, Kenya. DESIGN: A retrospective survey of dental clinic records. SETTING: A private dental clinic in Nairobi, Kenya. SUBJECTS: All patients aged 0-18 years who were first-time attenders at the dental clinic during a three year period. RESULTS: The records of 800 patients were examined, comprising 395 males and 405 female children. The average age was 7.2 years (95%CI, 6.9-7.4). Referral to the clinic for treatment was mostly by self (81.4%). Most patients (57.9%) were self-sponsored for their dental treatment. Majority of the patients attending (86.8%) did not clinically have any underlying medical conditions. The major complaints for most patients were dental decay (27.4%) and dental pain (21.6%). Very few children (7.6%) attended for dental check-up. Five hundred and forty nine (68.6%) of the children suffered from dental decay while 294 (36.8%) suffered from gingivitis. The average number of teeth decayed was 4.02, SD +/- 2.4 (95% CI 3.8-4.2). Most carious lesions occurred in the younger children. There was a significant increase in the occurrence of decay over the three year period of the study. Significantly higher levels of gingivitis was observed in the prepubertal and pubertal age group. Attendance for traumatic injuries was relatively low with only 46 (5.8%) children reporting traumatic injuries to their dentitions. Most traumatic injuries involved the anterior teeth as a result of falls. Treatment given at the first visit was mainly restorative (28.6%) followed by dental extractions (25.4%). CONCLUSION: The average are of patients attending the clinic was 7.2 years. Interdisciplinary referral was low since most patients were self-referred and self sponsored for treatment. Dental caries was prevalent, necessitating a high demand for restorative treatment. Although gingivitis was less prevalent, it was significant among children in the prepubertal years.

OBJECTIVES: To evaluate the socio-demographic characteristics, chief complaints and clinical presentation of children attending a private dental clinic in Nairobi, Kenya. DESIGN: A retrospective survey of dental clinic records. SETTING: A private dental clinic in Nairobi, Kenya. SUBJECTS: All patients aged 0-18 years who were first-time attenders at the dental clinic during a three year period. RESULTS: The records of 800 patients were examined, comprising 395 males and 405 female children. The average age was 7.2 years (95%CI, 6.9-7.4). Referral to the clinic for treatment was mostly by self (81.4%). Most patients (57.9%) were self-sponsored for their dental treatment. Majority of the patients attending (86.8%) did not clinically have any underlying medical conditions. The major complaints for most patients were dental decay (27.4%) and dental pain (21.6%). Very few children (7.6%) attended for dental check-up. Five hundred and forty nine (68.6%) of the children suffered from dental decay while 294 (36.8%) suffered from gingivitis. The average number of teeth decayed was 4.02, SD +/- 2.4 (95% CI 3.8-4.2). Most carious lesions occurred in the younger children. There was a significant increase in the occurrence of decay over the three year period of the study. Significantly higher levels of gingivitis was observed in the prepubertal and pubertal age group. Attendance for traumatic injuries was relatively low with only 46 (5.8%) children reporting traumatic injuries to their dentitions. Most traumatic injuries involved the anterior teeth as a result of falls. Treatment given at the first visit was mainly restorative (28.6%) followed by dental extractions (25.4%). CONCLUSION: The average are of patients attending the clinic was 7.2 years. Interdisciplinary referral was low since most patients were self-referred and self sponsored for treatment. Dental caries was prevalent, necessitating a high demand for restorative treatment. Although gingivitis was less prevalent, it was significant among children in the prepubertal years.

OBJECTIVES: To evaluate the socio-demographic characteristics, chief complaints and clinical presentation of children attending a private dental clinic in Nairobi, Kenya. DESIGN: A retrospective survey of dental clinic records. SETTING: A private dental clinic in Nairobi, Kenya. SUBJECTS: All patients aged 0-18 years who were first-time attenders at the dental clinic during a three year period. RESULTS: The records of 800 patients were examined, comprising 395 males and 405 female children. The average age was 7.2 years (95%CI, 6.9-7.4). Referral to the clinic for treatment was mostly by self (81.4%). Most patients (57.9%) were self-sponsored for their dental treatment. Majority of the patients attending (86.8%) did not clinically have any underlying medical conditions. The major complaints for most patients were dental decay (27.4%) and dental pain (21.6%). Very few children (7.6%) attended for dental check-up. Five hundred and forty nine (68.6%) of the children suffered from dental decay while 294 (36.8%) suffered from gingivitis. The average number of teeth decayed was 4.02, SD +/- 2.4 (95% CI 3.8-4.2). Most carious lesions occurred in the younger children. There was a significant increase in the occurrence of decay over the three year period of the study. Significantly higher levels of gingivitis was observed in the prepubertal and pubertal age group. Attendance for traumatic injuries was relatively low with only 46 (5.8%) children reporting traumatic injuries to their dentitions. Most traumatic injuries involved the anterior teeth as a result of falls. Treatment given at the first visit was mainly restorative (28.6%) followed by dental extractions (25.4%). CONCLUSION: The average are of patients attending the clinic was 7.2 years. Interdisciplinary referral was low since most patients were self-referred and self sponsored for treatment. Dental caries was prevalent, necessitating a high demand for restorative treatment. Although gingivitis was less prevalent, it was significant among children in the prepubertal years.

Department of Dental Surgery, University of Nairobi. Four hundred and forty-six children attending nursery schools in Nairobi were examined for caries and gingivitis. Assessment of social class was based on the occupation of the head of the child's household. Amongst 3-year-old children, 62% were caries-free and the mean dmft was 1.35. Amongst 5-year-olds 50% were caries-free and the mean dmft was 1.88. Thirty-seven per cent of the children had evidence of gingivitis, with the proportion changing little with age. There was no evidence of either caries or gingivitis being significantly related to social class, although children in the higher classes had more filled teeth.

Four hundred and forty-six children attending nursery schools in Nairobi were examined for caries and gingivitis. Assessment of social class was based on the occupation of the head of the child's household. Amongst 3-year-old children, 62% were caries-free and the mean dmft was 1.35. Amongst 5-year-olds 50% were caries-free and the mean dmft was 1.88. Thirty-seven per cent of the children had evidence of gingivitis, with the proportion changing little with age. There was no evidence of either caries or gingivitis being significantly related to social class, although children in the higher classes had more filled teeth.

Four hundred and forty-six children attending nursery schools in Nairobi were examined for caries and gingivitis. Assessment of social class was based on the occupation of the head of the child's household. Amongst 3-year-old children, 62% were caries-free and the mean dmft was 1.35. Amongst 5-year-olds 50% were caries-free and the mean dmft was 1.88. Thirty-seven per cent of the children had evidence of gingivitis, with the proportion changing little with age. There was no evidence of either caries or gingivitis being significantly related to social class, although children in the higher classes had more filled teeth.

Operations Research techniques involving modelling a situation or a problem and finding an optimal solution for it. These tools are not designed nor intended to replace managerial decision making, but rather their purpose is to aid in the decision-making process by providing a quantitative basis for decision making. Unfortunately, the proliferation of OR tools in organizational decision making has been lacking, with concerns been expressed about the limited awareness of the business community of OR's potential and capability. Current study was based in the premise that students provide an appropriate avenue, as agent of change, in sensitizing and demonstrating the potential and capacity of OR tools/techniques in resolving various problems, both in public and private sector. Study aimed at evaluating the use of OR as tools of data analysis at MBA level. A sample of 100 MBA research projects undertaken between 2005 and 2007 was randomly selected and their objectives and selected data analysis tools recorded. Where OR tools were not used, the research evaluated if there was a possibility of using OR tools. Results indicated low usage of OR as data analysis, though there was a high potential for the use of OR tools.

Operations Research techniques involving modelling a situation or a problem and finding an optimal solution for it. These tools are not designed nor intended to replace managerial decision making, but rather their purpose is to aid in the decision-making process by providing a quantitative basis for decision making. Unfortunately, the proliferation of OR tools in organizational decision making has been lacking, with concerns been expressed about the limited awareness of the business community of OR's potential and capability. Current study was based in the premise that students provide an appropriate avenue, as agent of change, in sensitizing and demonstrating the potential and capacity of OR tools/techniques in resolving various problems, both in public and private sector. Study aimed at evaluating the use of OR as tools of data analysis at MBA level. A sample of 100 MBA research projects undertaken between 2005 and 2007 was randomly selected and their objectives and selected data analysis tools recorded. Where OR tools were not used, the research evaluated if there was a possibility of using OR tools. Results indicated low usage of OR as data analysis, though there was a high potential for the use of OR tools.

Operations Research techniques involving modelling a situation or a problem and finding an optimal solution for it. These tools are not designed nor intended to replace managerial decision making, but rather their purpose is to aid in the decision-making process by providing a quantitative basis for decision making. Unfortunately, the proliferation of OR tools in organizational decision making has been lacking, with concerns been expressed about the limited awareness of the business community of OR's potential and capability. Current study was based in the premise that students provide an appropriate avenue, as agent of change, in sensitizing and demonstrating the potential and capacity of OR tools/techniques in resolving various problems, both in public and private sector. Study aimed at evaluating the use of OR as tools of data analysis at MBA level. A sample of 100 MBA research projects undertaken between 2005 and 2007 was randomly selected and their objectives and selected data analysis tools recorded. Where OR tools were not used, the research evaluated if there was a possibility of using OR tools. Results indicated low usage of OR as data analysis, though there was a high potential for the use of OR tools.

Operations Research techniques involving modelling a situation or a problem and finding an optimal solution for it. These tools are not designed nor intended to replace managerial decision making, but rather their purpose is to aid in the decision-making process by providing a quantitative basis for decision making. Unfortunately, the proliferation of OR tools in organizational decision making has been lacking, with concerns been expressed about the limited awareness of the business community of OR's potential and capability. Current study was based in the premise that students provide an appropriate avenue, as agent of change, in sensitizing and demonstrating the potential and capacity of OR tools/techniques in resolving various problems, both in public and private sector. Study aimed at evaluating the use of OR as tools of data analysis at MBA level. A sample of 100 MBA research projects undertaken between 2005 and 2007 was randomly selected and their objectives and selected data analysis tools recorded. Where OR tools were not used, the research evaluated if there was a possibility of using OR tools. Results indicated low usage of OR as data analysis, though there was a high potential for the use of OR tools.

Operations Research techniques involving modelling a situation or a problem and finding an optimal solution for it. These tools are not designed nor intended to replace managerial decision making, but rather their purpose is to aid in the decision-making process by providing a quantitative basis for decision making. Unfortunately, the proliferation of OR tools in organizational decision making has been lacking, with concerns been expressed about the limited awareness of the business community of OR's potential and capability. Current study was based in the premise that students provide an appropriate avenue, as agent of change, in sensitizing and demonstrating the potential and capacity of OR tools/techniques in resolving various problems, both in public and private sector. Study aimed at evaluating the use of OR as tools of data analysis at MBA level. A sample of 100 MBA research projects undertaken between 2005 and 2007 was randomly selected and their objectives and selected data analysis tools recorded. Where OR tools were not used, the research evaluated if there was a possibility of using OR tools. Results indicated low usage of OR as data analysis, though there was a high potential for the use of OR tools.

Operations Research techniques involving modelling a situation or a problem and finding an optimal solution for it. These tools are not designed nor intended to replace managerial decision making, but rather their purpose is to aid in the decision-making process by providing a quantitative basis for decision making. Unfortunately, the proliferation of OR tools in organizational decision making has been lacking, with concerns been expressed about the limited awareness of the business community of OR's potential and capability. Current study was based in the premise that students provide an appropriate avenue, as agent of change, in sensitizing and demonstrating the potential and capacity of OR tools/techniques in resolving various problems, both in public and private sector. Study aimed at evaluating the use of OR as tools of data analysis at MBA level. A sample of 100 MBA research projects undertaken between 2005 and 2007 was randomly selected and their objectives and selected data analysis tools recorded. Where OR tools were not used, the research evaluated if there was a possibility of using OR tools. Results indicated low usage of OR as data analysis, though there was a high potential for the use of OR tools.

Operations Research techniques involving modelling a situation or a problem and finding an optimal solution for it. These tools are not designed nor intended to replace managerial decision making, but rather their purpose is to aid in the decision-making process by providing a quantitative basis for decision making. Unfortunately, the proliferation of OR tools in organizational decision making has been lacking, with concerns been expressed about the limited awareness of the business community of OR's potential and capability. Current study was based in the premise that students provide an appropriate avenue, as agent of change, in sensitizing and demonstrating the potential and capacity of OR tools/techniques in resolving various problems, both in public and private sector. Study aimed at evaluating the use of OR as tools of data analysis at MBA level. A sample of 100 MBA research projects undertaken between 2005 and 2007 was randomly selected and their objectives and selected data analysis tools recorded. Where OR tools were not used, the research evaluated if there was a possibility of using OR tools. Results indicated low usage of OR as data analysis, though there was a high potential for the use of OR tools.

Operations Research techniques involving modelling a situation or a problem and finding an optimal solution for it. These tools are not designed nor intended to replace managerial decision making, but rather their purpose is to aid in the decision-making process by providing a quantitative basis for decision making. Unfortunately, the proliferation of OR tools in organizational decision making has been lacking, with concerns been expressed about the limited awareness of the business community of OR's potential and capability. Current study was based in the premise that students provide an appropriate avenue, as agent of change, in sensitizing and demonstrating the potential and capacity of OR tools/techniques in resolving various problems, both in public and private sector. Study aimed at evaluating the use of OR as tools of data analysis at MBA level. A sample of 100 MBA research projects undertaken between 2005 and 2007 was randomly selected and their objectives and selected data analysis tools recorded. Where OR tools were not used, the research evaluated if there was a possibility of using OR tools. Results indicated low usage of OR as data analysis, though there was a high potential for the use of OR tools.

Operations Research techniques involving modelling a situation or a problem and finding an optimal solution for it. These tools are not designed nor intended to replace managerial decision making, but rather their purpose is to aid in the decision-making process by providing a quantitative basis for decision making. Unfortunately, the proliferation of OR tools in organizational decision making has been lacking, with concerns been expressed about the limited awareness of the business community of OR's potential and capability. Current study was based in the premise that students provide an appropriate avenue, as agent of change, in sensitizing and demonstrating the potential and capacity of OR tools/techniques in resolving various problems, both in public and private sector. Study aimed at evaluating the use of OR as tools of data analysis at MBA level. A sample of 100 MBA research projects undertaken between 2005 and 2007 was randomly selected and their objectives and selected data analysis tools recorded. Where OR tools were not used, the research evaluated if there was a possibility of using OR tools. Results indicated low usage of OR as data analysis, though there was a high potential for the use of OR tools.

Operations Research techniques involving modelling a situation or a problem and finding an optimal solution for it. These tools are not designed nor intended to replace managerial decision making, but rather their purpose is to aid in the decision-making process by providing a quantitative basis for decision making. Unfortunately, the proliferation of OR tools in organizational decision making has been lacking, with concerns been expressed about the limited awareness of the business community of OR's potential and capability. Current study was based in the premise that students provide an appropriate avenue, as agent of change, in sensitizing and demonstrating the potential and capacity of OR tools/techniques in resolving various problems, both in public and private sector. Study aimed at evaluating the use of OR as tools of data analysis at MBA level. A sample of 100 MBA research projects undertaken between 2005 and 2007 was randomly selected and their objectives and selected data analysis tools recorded. Where OR tools were not used, the research evaluated if there was a possibility of using OR tools. Results indicated low usage of OR as data analysis, though there was a high potential for the use of OR tools.

Operations Research techniques involving modelling a situation or a problem and finding an optimal solution for it. These tools are not designed nor intended to replace managerial decision making, but rather their purpose is to aid in the decision-making process by providing a quantitative basis for decision making. Unfortunately, the proliferation of OR tools in organizational decision making has been lacking, with concerns been expressed about the limited awareness of the business community of OR's potential and capability. Current study was based in the premise that students provide an appropriate avenue, as agent of change, in sensitizing and demonstrating the potential and capacity of OR tools/techniques in resolving various problems, both in public and private sector. Study aimed at evaluating the use of OR as tools of data analysis at MBA level. A sample of 100 MBA research projects undertaken between 2005 and 2007 was randomly selected and their objectives and selected data analysis tools recorded. Where OR tools were not used, the research evaluated if there was a possibility of using OR tools. Results indicated low usage of OR as data analysis, though there was a high potential for the use of OR tools.

Operations Research techniques involving modelling a situation or a problem and finding an optimal solution for it. These tools are not designed nor intended to replace managerial decision making, but rather their purpose is to aid in the decision-making process by providing a quantitative basis for decision making. Unfortunately, the proliferation of OR tools in organizational decision making has been lacking, with concerns been expressed about the limited awareness of the business community of OR's potential and capability. Current study was based in the premise that students provide an appropriate avenue, as agent of change, in sensitizing and demonstrating the potential and capacity of OR tools/techniques in resolving various problems, both in public and private sector. Study aimed at evaluating the use of OR as tools of data analysis at MBA level. A sample of 100 MBA research projects undertaken between 2005 and 2007 was randomly selected and their objectives and selected data analysis tools recorded. Where OR tools were not used, the research evaluated if there was a possibility of using OR tools. Results indicated low usage of OR as data analysis, though there was a high potential for the use of OR tools.

Operations Research techniques involving modelling a situation or a problem and finding an optimal solution for it. These tools are not designed nor intended to replace managerial decision making, but rather their purpose is to aid in the decision-making process by providing a quantitative basis for decision making. Unfortunately, the proliferation of OR tools in organizational decision making has been lacking, with concerns been expressed about the limited awareness of the business community of OR's potential and capability. Current study was based in the premise that students provide an appropriate avenue, as agent of change, in sensitizing and demonstrating the potential and capacity of OR tools/techniques in resolving various problems, both in public and private sector. Study aimed at evaluating the use of OR as tools of data analysis at MBA level. A sample of 100 MBA research projects undertaken between 2005 and 2007 was randomly selected and their objectives and selected data analysis tools recorded. Where OR tools were not used, the research evaluated if there was a possibility of using OR tools. Results indicated low usage of OR as data analysis, though there was a high potential for the use of OR tools.

Operations Research techniques involving modelling a situation or a problem and finding an optimal solution for it. These tools are not designed nor intended to replace managerial decision making, but rather their purpose is to aid in the decision-making process by providing a quantitative basis for decision making. Unfortunately, the proliferation of OR tools in organizational decision making has been lacking, with concerns been expressed about the limited awareness of the business community of OR's potential and capability. Current study was based in the premise that students provide an appropriate avenue, as agent of change, in sensitizing and demonstrating the potential and capacity of OR tools/techniques in resolving various problems, both in public and private sector. Study aimed at evaluating the use of OR as tools of data analysis at MBA level. A sample of 100 MBA research projects undertaken between 2005 and 2007 was randomly selected and their objectives and selected data analysis tools recorded. Where OR tools were not used, the research evaluated if there was a possibility of using OR tools. Results indicated low usage of OR as data analysis, though there was a high potential for the use of OR tools.

Operations Research techniques involving modelling a situation or a problem and finding an optimal solution for it. These tools are not designed nor intended to replace managerial decision making, but rather their purpose is to aid in the decision-making process by providing a quantitative basis for decision making. Unfortunately, the proliferation of OR tools in organizational decision making has been lacking, with concerns been expressed about the limited awareness of the business community of OR's potential and capability. Current study was based in the premise that students provide an appropriate avenue, as agent of change, in sensitizing and demonstrating the potential and capacity of OR tools/techniques in resolving various problems, both in public and private sector. Study aimed at evaluating the use of OR as tools of data analysis at MBA level. A sample of 100 MBA research projects undertaken between 2005 and 2007 was randomly selected and their objectives and selected data analysis tools recorded. Where OR tools were not used, the research evaluated if there was a possibility of using OR tools. Results indicated low usage of OR as data analysis, though there was a high potential for the use of OR tools.

Operations Research techniques involving modelling a situation or a problem and finding an optimal solution for it. These tools are not designed nor intended to replace managerial decision making, but rather their purpose is to aid in the decision-making process by providing a quantitative basis for decision making. Unfortunately, the proliferation of OR tools in organizational decision making has been lacking, with concerns been expressed about the limited awareness of the business community of OR's potential and capability. Current study was based in the premise that students provide an appropriate avenue, as agent of change, in sensitizing and demonstrating the potential and capacity of OR tools/techniques in resolving various problems, both in public and private sector. Study aimed at evaluating the use of OR as tools of data analysis at MBA level. A sample of 100 MBA research projects undertaken between 2005 and 2007 was randomly selected and their objectives and selected data analysis tools recorded. Where OR tools were not used, the research evaluated if there was a possibility of using OR tools. Results indicated low usage of OR as data analysis, though there was a high potential for the use of OR tools.

Possible nifedipine-digoxin interaction was investigated in rats by comparing lethal doses of intravenously infused digoxin in control and experimental rats. In the experimental rats, nifedipine was administered intraperitoneally, 30 minutes prior to infusing digoxin at a constant rate of 40mcg per minute. Results indicate that nifedipine administered within the dosage range 0.5-2.0mg per kg rat body weight, lowered the lethal dose of intravenously infused digoxin by 26-38% compared with control rats, thus indicating a synergistic effect between the two drugs. There was very little dose dependence of this effect. It is concluded that concomitant administration of nifedipine and digoxin in humans may lead to drug interactions.

Contents of tetracycline, its degradation products (epitetracycline, epianhydrotetracycline, anhydrotetracycline) and a fermentation impurity (2-acetyl-2-decarboxamidotetracycline) were determined in four raw materials, 12 batches of six ointment products, four eye ointment products and nine batches of five capsule products, all sampled from the Kenyan market. The analytical method was liquid chromatography on a column packed with a poly(styrenedivinyl-benzene) material (8-microns PLRP-S 100 A). All raw materials and finished products had tetracycline contents and impurity levels within the prescribed compendial limits.

During a 4 year period (January 1983 to December 1986), 418 requests for drug analysis were received in the Drug Analysis and Research Unit, Department of Pharmacy, University of Nairobi. Of these requests, 212 were from Medical Supplies Coordination Unit, 190 from Government hospitals and health research institutions, 11 from the Ministry of Health Headquarters (Director of Medical Services and Chief Pharmacist) and 5 came from local pharmaceutical manufacturers. Of the samples analysed, 70.8% were from local manufacturers, 26.1% were imported and 3.1% were from undeclared sources. Failure to comply with test for quality, as set out in official compendia (B.P. Eur. ph. Ip, etc.) were observed at 45.8% for locally manufactured drugs and 31.4% for imported drug products.

During a 4 year period (January 1983 to December 1986), 418 requests for drug analysis were received in the Drug Analysis and Research Unit, Department of Pharmacy, University of Nairobi. Of these requests, 212 were from Medical Supplies Coordination Unit, 190 from Government hospitals and health research institutions, 11 from the Ministry of Health Headquarters (Director of Medical Services and Chief Pharmacist) and 5 came from local pharmaceutical manufacturers. Of the samples analysed, 70.8% were from local manufacturers, 26.1% were imported and 3.1% were from undeclared sources. Failure to comply with test for quality, as set out in official compendia (B.P. Eur. ph. Ip, etc.) were observed at 45.8% for locally manufactured drugs and 31.4% for imported drug products.

During a 4 year period (January 1983 to December 1986), 418 requests for drug analysis were received in the Drug Analysis and Research Unit, Department of Pharmacy, University of Nairobi. Of these requests, 212 were from Medical Supplies Coordination Unit, 190 from Government hospitals and health research institutions, 11 from the Ministry of Health Headquarters (Director of Medical Services and Chief Pharmacist) and 5 came from local pharmaceutical manufacturers. Of the samples analysed, 70.8% were from local manufacturers, 26.1% were imported and 3.1% were from undeclared sources. Failure to comply with test for quality, as set out in official compendia (B.P. Eur. ph. Ip, etc.) were observed at 45.8% for locally manufactured drugs and 31.4% for imported drug products.

During a 4 year period (January 1983 to December 1986), 418 requests for drug analysis were received in the Drug Analysis and Research Unit, Department of Pharmacy, University of Nairobi. Of these requests, 212 were from Medical Supplies Coordination Unit, 190 from Government hospitals and health research institutions, 11 from the Ministry of Health Headquarters (Director of Medical Services and Chief Pharmacist) and 5 came from local pharmaceutical manufacturers. Of the samples analysed, 70.8% were from local manufacturers, 26.1% were imported and 3.1% were from undeclared sources. Failure to comply with test for quality, as set out in official compendia (B.P. Eur. ph. Ip, etc.) were observed at 45.8% for locally manufactured drugs and 31.4% for imported drug products.

One hundred and five chicken egg samples were taken from seven geographical locations in Kenya and analyzed for organochlorine pesticide residues using gas-liquid chromatography. Nine organochlorine compounds were detected: alpha- and gamma-HCH/BHC (hexachlorocyclohexane/benzene hexachloride), aldrin, dieldrin, p,p'-DDE [1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene], p,p'-DDD (TDE) [2,2-bis(p-chlorophenyl)-1,1-dichloroethane] (tetrachlorodiphenylethane), o,p'-DDD [2-(o-chlorophenyl)-2-(p-chlorophenyl)-1,1-dichloroethane], o,p'-DDT [2-(o-chlorophenyl)-2-(p-chlorophenyl)-1,1,1-trichloroethane], and p,p'-DDT. Eighteen of the samples contained DDT levels exceeding the practical residue limit (0.5 ppm). The mean DDT residue content was 0.68 ppm, a result influenced greatly by the high contamination in the 18 samples. Both individual and mean residue levels for other organochlorine pesticides detected were well within the respective practical residue limits.

Residue levels of the chlorinated hydrocarbons p,p'-DDT (2,2-bis(p-chlorophenyl)-1,1,1-trichloroethane), p,p'-DDE (2,2-bis(p-chlorophenyl)-1,1-dichloroethane), hexachlorobenzene (HCB), alpha-, beta-, and gamma-hexachlorocyclohexane (HCH), aldrin, dieldrin, and polychlorinated biphenyls (PCBs) were determined in human milk of Kenyan mothers living in different areas of Kenya. The main organochlorine contaminants found in all the milk samples analyzed were p,p'-DDT and p,p'-DDE. Great regional differences were found, and mean levels of sum DDT and DDT/DDE ratio ranged from 1.1 to 18.7 mg/kg milk fat and from 0.7 to 5.7, respectively. In general, relatively low residue levels of HCB, alpha-HCH, beta-HCH, aldrin, and dieldrin were detected in 59, 37, 27, 37, and 19%, respectively, of all the milk samples analyzed. Quantifiable residue levels of PCBs and alpha-HCH were not found. The results were examined in relation to differences in living conditions with regard to agricultural activities, dietary habits, and reported use of pesticides in the various sampling areas.

Residue levels of the chlorinated hydrocarbons p,p'-DDT (2,2-bis(p-chlorophenyl)-1,1,1-trichloroethane), p,p'-DDE (2,2-bis(p-chlorophenyl)-1,1-dichloroethane), hexachlorobenzene (HCB), alpha-, beta-, and gamma-hexachlorocyclohexane (HCH), aldrin, dieldrin, and polychlorinated biphenyls (PCBs) were determined in human milk of Kenyan mothers living in different areas of Kenya. The main organochlorine contaminants found in all the milk samples analyzed were p,p'-DDT and p,p'-DDE. Great regional differences were found, and mean levels of sum DDT and DDT/DDE ratio ranged from 1.1 to 18.7 mg/kg milk fat and from 0.7 to 5.7, respectively. In general, relatively low residue levels of HCB, alpha-HCH, beta-HCH, aldrin, and dieldrin were detected in 59, 37, 27, 37, and 19%, respectively, of all the milk samples analyzed. Quantifiable residue levels of PCBs and alpha-HCH were not found. The results were examined in relation to differences in living conditions with regard to agricultural activities, dietary habits, and reported use of pesticides in the various sampling areas.

Residue levels of the chlorinated hydrocarbons p,p'-DDT (2,2-bis(p-chlorophenyl)-1,1,1-trichloroethane), p,p'-DDE (2,2-bis(p-chlorophenyl)-1,1-dichloroethane), hexachlorobenzene (HCB), alpha-, beta-, and gamma-hexachlorocyclohexane (HCH), aldrin, dieldrin, and polychlorinated biphenyls (PCBs) were determined in human milk of Kenyan mothers living in different areas of Kenya. The main organochlorine contaminants found in all the milk samples analyzed were p,p'-DDT and p,p'-DDE. Great regional differences were found, and mean levels of sum DDT and DDT/DDE ratio ranged from 1.1 to 18.7 mg/kg milk fat and from 0.7 to 5.7, respectively. In general, relatively low residue levels of HCB, alpha-HCH, beta-HCH, aldrin, and dieldrin were detected in 59, 37, 27, 37, and 19%, respectively, of all the milk samples analyzed. Quantifiable residue levels of PCBs and alpha-HCH were not found. The results were examined in relation to differences in living conditions with regard to agricultural activities, dietary habits, and reported use of pesticides in the various sampling areas.

Residue levels of the chlorinated hydrocarbons p,p'-DDT (2,2-bis(p-chlorophenyl)-1,1,1-trichloroethane), p,p'-DDE (2,2-bis(p-chlorophenyl)-1,1-dichloroethane), hexachlorobenzene (HCB), alpha-, beta-, and gamma-hexachlorocyclohexane (HCH), aldrin, dieldrin, and polychlorinated biphenyls (PCBs) were determined in human milk of Kenyan mothers living in different areas of Kenya. The main organochlorine contaminants found in all the milk samples analyzed were p,p'-DDT and p,p'-DDE. Great regional differences were found, and mean levels of sum DDT and DDT/DDE ratio ranged from 1.1 to 18.7 mg/kg milk fat and from 0.7 to 5.7, respectively. In general, relatively low residue levels of HCB, alpha-HCH, beta-HCH, aldrin, and dieldrin were detected in 59, 37, 27, 37, and 19%, respectively, of all the milk samples analyzed. Quantifiable residue levels of PCBs and alpha-HCH were not found. The results were examined in relation to differences in living conditions with regard to agricultural activities, dietary habits, and reported use of pesticides in the various sampling areas.

Residue levels of the chlorinated hydrocarbons p,p'-DDT (2,2-bis(p-chlorophenyl)-1,1,1-trichloroethane), p,p'-DDE (2,2-bis(p-chlorophenyl)-1,1-dichloroethane), hexachlorobenzene (HCB), alpha-, beta-, and gamma-hexachlorocyclohexane (HCH), aldrin, dieldrin, and polychlorinated biphenyls (PCBs) were determined in human milk of Kenyan mothers living in different areas of Kenya. The main organochlorine contaminants found in all the milk samples analyzed were p,p'-DDT and p,p'-DDE. Great regional differences were found, and mean levels of sum DDT and DDT/DDE ratio ranged from 1.1 to 18.7 mg/kg milk fat and from 0.7 to 5.7, respectively. In general, relatively low residue levels of HCB, alpha-HCH, beta-HCH, aldrin, and dieldrin were detected in 59, 37, 27, 37, and 19%, respectively, of all the milk samples analyzed. Quantifiable residue levels of PCBs and alpha-HCH were not found. The results were examined in relation to differences in living conditions with regard to agricultural activities, dietary habits, and reported use of pesticides in the various sampling areas.

Residue levels of the chlorinated hydrocarbons p,p'-DDT (2,2-bis(p-chlorophenyl)-1,1,1-trichloroethane), p,p'-DDE (2,2-bis(p-chlorophenyl)-1,1-dichloroethane), hexachlorobenzene (HCB), alpha-, beta-, and gamma-hexachlorocyclohexane (HCH), aldrin, dieldrin, and polychlorinated biphenyls (PCBs) were determined in human milk of Kenyan mothers living in different areas of Kenya. The main organochlorine contaminants found in all the milk samples analyzed were p,p'-DDT and p,p'-DDE. Great regional differences were found, and mean levels of sum DDT and DDT/DDE ratio ranged from 1.1 to 18.7 mg/kg milk fat and from 0.7 to 5.7, respectively. In general, relatively low residue levels of HCB, alpha-HCH, beta-HCH, aldrin, and dieldrin were detected in 59, 37, 27, 37, and 19%, respectively, of all the milk samples analyzed. Quantifiable residue levels of PCBs and alpha-HCH were not found. The results were examined in relation to differences in living conditions with regard to agricultural activities, dietary habits, and reported use of pesticides in the various sampling areas.

Residue levels of the chlorinated hydrocarbons p,p'-DDT (2,2-bis(p-chlorophenyl)-1,1,1-trichloroethane), p,p'-DDE (2,2-bis(p-chlorophenyl)-1,1-dichloroethane), hexachlorobenzene (HCB), alpha-, beta-, and gamma-hexachlorocyclohexane (HCH), aldrin, dieldrin, and polychlorinated biphenyls (PCBs) were determined in human milk of Kenyan mothers living in different areas of Kenya. The main organochlorine contaminants found in all the milk samples analyzed were p,p'-DDT and p,p'-DDE. Great regional differences were found, and mean levels of sum DDT and DDT/DDE ratio ranged from 1.1 to 18.7 mg/kg milk fat and from 0.7 to 5.7, respectively. In general, relatively low residue levels of HCB, alpha-HCH, beta-HCH, aldrin, and dieldrin were detected in 59, 37, 27, 37, and 19%, respectively, of all the milk samples analyzed. Quantifiable residue levels of PCBs and alpha-HCH were not found. The results were examined in relation to differences in living conditions with regard to agricultural activities, dietary habits, and reported use of pesticides in the various sampling areas.

Cathinone, a potent psychostimulant isolated from young shoots of Catha edulis was given to four human volunteers. Examination of urine collected from the volunteers at predetermined intervals showed the presence of unchanged cathinone, d-norpseudoephedrine, and two unidentified basic substances. The observed biotransformation of cathinone to the less potent psychostimulant, d-norpseudoephedrine involves reduction of a ketone group to alcohol, a common metabolic pathway in humans.

Cathinone, a potent psychostimulant isolated from young shoots of Catha edulis was given to four human volunteers. Examination of urine collected from the volunteers at predetermined intervals showed the presence of unchanged cathinone, d-norpseudoephedrine, and two unidentified basic substances. The observed biotransformation of cathinone to the less potent psychostimulant, d-norpseudoephedrine involves reduction of a ketone group to alcohol, a common metabolic pathway in humans.

Cathinone, a potent psychostimulant isolated from young shoots of Catha edulis was given to four human volunteers. Examination of urine collected from the volunteers at predetermined intervals showed the presence of unchanged cathinone, d-norpseudoephedrine, and two unidentified basic substances. The observed biotransformation of cathinone to the less potent psychostimulant, d-norpseudoephedrine involves reduction of a ketone group to alcohol, a common metabolic pathway in humans.

Cathinone, a potent psychostimulant isolated from young shoots of Catha edulis was given to four human volunteers. Examination of urine collected from the volunteers at predetermined intervals showed the presence of unchanged cathinone, d-norpseudoephedrine, and two unidentified basic substances. The observed biotransformation of cathinone to the less potent psychostimulant, d-norpseudoephedrine involves reduction of a ketone group to alcohol, a common metabolic pathway in humans.

Cathinone, a potent psychostimulant isolated from young shoots of Catha edulis was given to four human volunteers. Examination of urine collected from the volunteers at predetermined intervals showed the presence of unchanged cathinone, d-norpseudoephedrine, and two unidentified basic substances. The observed biotransformation of cathinone to the less potent psychostimulant, d-norpseudoephedrine involves reduction of a ketone group to alcohol, a common metabolic pathway in humans.

Cathinone, a potent psychostimulant isolated from young shoots of Catha edulis was given to four human volunteers. Examination of urine collected from the volunteers at predetermined intervals showed the presence of unchanged cathinone, d-norpseudoephedrine, and two unidentified basic substances. The observed biotransformation of cathinone to the less potent psychostimulant, d-norpseudoephedrine involves reduction of a ketone group to alcohol, a common metabolic pathway in humans.

In a case of poisoning involving 70 cattle analysis of specimens obtained during post mortem examination showed that the toxic substances were arsenic and toxaphene. This was consistent with both the clinical and post mortem findings. Arsenic was detected in water from an abandoned cattle dip in the farm. Soil samples collected in the vicinity of the dip contained both arsenic and toxaphene.

In a case of poisoning involving 70 cattle analysis of specimens obtained during post mortem examination showed that the toxic substances were arsenic and toxaphene. This was consistent with both the clinical and post mortem findings. Arsenic was detected in water from an abandoned cattle dip in the farm. Soil samples collected in the vicinity of the dip contained both arsenic and toxaphene.

Four hundred and forty-six children attending nursery schools in Nairobi were examined for caries and gingivitis. Assessment of social class was based on the occupation of the head of the child's household. Amongst 3-year-old children, 62% were caries-free and the mean dmft was 1.35. Amongst 5-year-olds 50% were caries-free and the mean dmft was 1.88. Thirty-seven per cent of the children had evidence of gingivitis, with the proportion changing little with age. There was no evidence of either caries or gingivitis being significantly related to social class, although children in the higher classes had more filled teeth.

Four hundred and forty-six children attending nursery schools in Nairobi were examined for caries and gingivitis. Assessment of social class was based on the occupation of the head of the child's household. Amongst 3-year-old children, 62% were caries-free and the mean dmft was 1.35. Amongst 5-year-olds 50% were caries-free and the mean dmft was 1.88. Thirty-seven per cent of the children had evidence of gingivitis, with the proportion changing little with age. There was no evidence of either caries or gingivitis being significantly related to social class, although children in the higher classes had more filled teeth.

Four hundred and forty-six children attending nursery schools in Nairobi were examined for caries and gingivitis. Assessment of social class was based on the occupation of the head of the child's household. Amongst 3-year-old children, 62% were caries-free and the mean dmft was 1.35. Amongst 5-year-olds 50% were caries-free and the mean dmft was 1.88. Thirty-seven per cent of the children had evidence of gingivitis, with the proportion changing little with age. There was no evidence of either caries or gingivitis being significantly related to social class, although children in the higher classes had more filled teeth.

Four hundred and forty-six children attending nursery schools in Nairobi were examined for caries and gingivitis. Assessment of social class was based on the occupation of the head of the child's household. Amongst 3-year-old children, 62% were caries-free and the mean dmft was 1.35. Amongst 5-year-olds 50% were caries-free and the mean dmft was 1.88. Thirty-seven per cent of the children had evidence of gingivitis, with the proportion changing little with age. There was no evidence of either caries or gingivitis being significantly related to social class, although children in the higher classes had more filled teeth.

Four hundred and forty-six children attending nursery schools in Nairobi were examined for caries and gingivitis. Assessment of social class was based on the occupation of the head of the child's household. Amongst 3-year-old children, 62% were caries-free and the mean dmft was 1.35. Amongst 5-year-olds 50% were caries-free and the mean dmft was 1.88. Thirty-seven per cent of the children had evidence of gingivitis, with the proportion changing little with age. There was no evidence of either caries or gingivitis being significantly related to social class, although children in the higher classes had more filled teeth.

Four hundred and forty-six children attending nursery schools in Nairobi were examined for caries and gingivitis. Assessment of social class was based on the occupation of the head of the child's household. Amongst 3-year-old children, 62% were caries-free and the mean dmft was 1.35. Amongst 5-year-olds 50% were caries-free and the mean dmft was 1.88. Thirty-seven per cent of the children had evidence of gingivitis, with the proportion changing little with age. There was no evidence of either caries or gingivitis being significantly related to social class, although children in the higher classes had more filled teeth.

Four hundred and forty-six children attending nursery schools in Nairobi were examined for caries and gingivitis. Assessment of social class was based on the occupation of the head of the child's household. Amongst 3-year-old children, 62% were caries-free and the mean dmft was 1.35. Amongst 5-year-olds 50% were caries-free and the mean dmft was 1.88. Thirty-seven per cent of the children had evidence of gingivitis, with the proportion changing little with age. There was no evidence of either caries or gingivitis being significantly related to social class, although children in the higher classes had more filled teeth.

In a case of poisoning involving 70 cattle analysis of specimens obtained during post mortem examination showed that the toxic substances were arsenic and toxaphene. This was consistent with both the clinical and post mortem findings. Arsenic was detected in water from an abandoned cattle dip in the farm. Soil samples collected in the vicinity of the dip contained both arsenic and toxaphene.

In a case of poisoning involving 70 cattle analysis of specimens obtained during post mortem examination showed that the toxic substances were arsenic and toxaphene. This was consistent with both the clinical and post mortem findings. Arsenic was detected in water from an abandoned cattle dip in the farm. Soil samples collected in the vicinity of the dip contained both arsenic and toxaphene.

In a case of poisoning involving 70 cattle analysis of specimens obtained during post mortem examination showed that the toxic substances were arsenic and toxaphene. This was consistent with both the clinical and post mortem findings. Arsenic was detected in water from an abandoned cattle dip in the farm. Soil samples collected in the vicinity of the dip contained both arsenic and toxaphene.

OBJECTIVES: The objectives of this study were to determine patterns of contraceptive utilization among sexually active HIV-1-seropositive women postpartum and to identify correlates of hormonal contraception uptake. GOAL: The goal of this study was to improve delivery of family planning services to HIV-1-infected women in resource-limited settings. STUDY DESIGN: HIV-1-infected pregnant women were followed prospectively in a perinatal HIV-1 transmission study. Participants were referred to local clinics for contraceptive counseling and management. RESULTS: Among 319 HIV-1-infected women, median time to sexual activity postpartum was 2 months and 231 (72%) women used hormonal contraception for at least 2 months during follow-up, initiating use at approximately 3 months postpartum (range, 1-11 months). Overall, 101 (44%) used DMPA, 71 (31%) oral contraception, and 59 (25%) switched methods during follow-up. Partner notification, infant mortality, and condom use were similar between those using and not using contraception. CONCLUSIONS: Using existing the healthcare infrastructure, it is possible to achieve high levels of postpartum hormonal contraceptive utilization among HIV-1-seropositive women.

OBJECTIVES: To describe the early response to World Health Organization (WHO)-recommended nonnucleoside reverse transcriptase inhibitor (NNRTI)-based first-line highly active antiretroviral therapy (HAART) in HIV-1-infected Kenyan children unexposed to nevirapine. DESIGN: Observational prospective cohort. METHODS: HIV-1 RNA level, CD4 lymphocyte count, weight for age z score, and height for age z score were measured before the initiation of HAART and every 3 to 6 months thereafter. Children received no nutritional supplements. RESULTS: Sixty-seven HIV-1-infected children were followed for a median of 9 months between August 2004 and November 2005. Forty-seven (70%) used zidovudine, lamivudine (3TC), and an NNRTI (nevirapine or efavirenz), whereas 25% used stavudine (d4T), 3TC, and an NNRTI. Nevirapine was used as the NNRTI by 46 (69%) children, and individual antiretroviral drug formulations were used by 63 (94%), with only 4 (6%) using a fixed-dose combination of d4T, 3TC, and nevirapine (Triomune; Cipla, Mumbai, India). In 52 children, the median height for age z score and weight for age z score rose from -2.54 to -2.17 (P<0.001) and from -2.30 to -1.67 (P=0.001), respectively, after 6 months of HAART. Hospitalization rates were significantly reduced after 6 months of HAART (17% vs. 58%; P<0.001). The median absolute CD4 count increased from 326 to 536 cells/microL (P<0.001), the median CD4 lymphocyte percentage rose from 5.8% before treatment to 15.4% (P<0.001), and the median viral load fell from 5.9 to 2.2 log10 copies/mL after 6 months of HAART (P<0.001). Among 43 infants, 47% and 67% achieved viral suppression to less than 100 copies/mL and 400 copies/mL, respectively, after 6 months of HAART. CONCLUSION: Good early clinical and virologic response to NNRTI-based HAART was observed in HIV-1-infected Kenyan children with advanced HIV-1 disease.

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Alpha-defensins are proteins exhibiting in vitro anti-HIV-1 activity that may protect against mother-to-child transmission of HIV-1 via breast milk. Correlates of alpha-defensins in breast milk and transmission risk were determined in a cohort of HIV-1-infected pregnant women in Nairobi followed for 12 months postpartum with their infants. Maternal blood was collected antenatally and at delivery for HIV-1 viral load and infant HIV-1 infection status was determined < 48 h after birth and at months 1, 3, 6, 9, and 12. Breast milk specimens collected at month 1 were assayed for alpha-defensins, HIV-1 RNA, subclinical mastitis, and CC and CXC chemokines. We detected alpha-defensins in breast milk specimens from 108 (42%) of 260 HIV-1-infected women. Women with detectable alpha-defensins (> or =50 pg/ml) had a median concentration of 320 pg/ml and significantly higher mean breast milk HIV-1 RNA levels than women with undetectable alpha-defensins (2.9 log(10) copies/ml versus 2.5 log(10) copies/ml

{ OBJECTIVES: To identify potential predictors of mortality, to determine mortality rate and to identify prevalent causes of death in a cohort of HIV-1 exposed uninfected infants. DESIGN: Prospective cohort study. SETTING: Kenyatta National Hospital, Nairobi, Kenya. SUBJECTS: Three hundred and fifty one HIV-1 exposed uninfected post-neonatal infants who survived to one year of age. RESULTS: Sixteen infants died (post-neonatal mortality rate of 47/1000 live births), 14 (88%) before six months of age. The most frequently identified medical conditions at death included bronchopneumonia, diarrhoea and failure to thrive. In multivariate analysis, prematurity (RR=10.5, 95%CI 3.8-29.1, p<0.001), teenage motherhood (RR=3.6, Cl 1.0-13.2

{ OBJECTIVES: To identify potential predictors of mortality, to determine mortality rate and to identify prevalent causes of death in a cohort of HIV-1 exposed uninfected infants. DESIGN: Prospective cohort study. SETTING: Kenyatta National Hospital, Nairobi, Kenya. SUBJECTS: Three hundred and fifty one HIV-1 exposed uninfected post-neonatal infants who survived to one year of age. RESULTS: Sixteen infants died (post-neonatal mortality rate of 47/1000 live births), 14 (88%) before six months of age. The most frequently identified medical conditions at death included bronchopneumonia, diarrhoea and failure to thrive. In multivariate analysis, prematurity (RR=10.5, 95%CI 3.8-29.1, p<0.001), teenage motherhood (RR=3.6, Cl 1.0-13.2

An 18 year female sickler (HbSS) presented with repeated history of epistaxis and bleeding gums. Features consistent with pseudoxanthoma elasticum were observed, such as hyper-extensile redundant skin folds in the neck, axilla, inguinal areas and abdomen. The skin biopsy showed swollen, clumped and fragmented elastic fibres and calcium deposits in the deep and mid reticular dermis, consistent with pseudoxanthoma elasticum. This is a well recognised complication of sickle cell disease which has not been described in Kenya.

BACKGROUND: CD8 T lymphocytes are important in HIV-1 control and mediate virus-specific immunity in the blood and genital tract. The induction and monitoring of mucosal CD8 cell responses will be an important component of HIV-1 vaccine trials, but information regarding the frequency, phenotype and function of genital tract CD8 cell responses is lacking. METHODS: Simultaneous blood and cervical cytobrush samples were obtained from 16 HIV-1-infected Kenyan sex workers. Epitope-specific CD8 T lymphocyte frequencies in the blood and genital tract were analysed after short-term peptide incubation and intracellular cytokine staining for interferon-gamma (IFN gamma). RESULTS: Cervical sampling resulted in adequate cell numbers for analysis in 10/16 women. Background IFN gamma production was higher in CD3+/CD8+ lymphocytes from the genital tract than from blood (0.48% versus 0.1%; P < 0.01). Responses to staphylococcal enterotoxin B were detected in cervical CD8 lymphocytes from 10/10 women, at a similar frequency to blood (16.7% in cervix and 13.3% in blood; P = 0.4). HIV-1-specific responses were detected the cervix of 8/10 women, with a trend to higher response frequencies in the genital tract than blood (2.1% versus 0.8%; P = 0.09). Co-expression of integrin CD103 (alpha E beta 7), a mucosal marker, was used to confirm the mucosal origin of cervical responses. CONCLUSIONS: Cytobrush sampling and intracellular cytokine staining is well suited to the analysis of cervical CD8 cell responses. The frequency of functional virus-specific CD3+/CD8+ T cells is similar in the genital tract and blood of HIV-1-infected women. The role of genital tract CD8 cell responses in HIV-1 control warrants further investigation.

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BACKGROUND: Road Traffic Accidents (RTAs) are a major cause of morbidity and mortality in Kenya. Victims may suffer multiple injuries including maxillofacial injuries. In most developing countries RTAs are the leading cause of maxillofacial injuries. In an attempt to reduce RTAs, the government of Kenya has enacted a legislation requiring mandatory fitting of speed governors and safety belts by passenger service vehicles. OBJECTIVE: To describe the characteristics and pattern of maxillofacial and associated injuries sustained in road traffic accidents. DESIGN: A cross-sectional study. SETTING: Kenyatta National Hospital (KNH). SUBJECTS: All patients involved in RTAs brought to casualty and the dental department of KNH as well as accident victims admitted to the KNH mortuary over a four- month period from September 2004 to December 2004. RESULTS: Four hundred and thirteen (85.7%) had non-fatal injuries whereas 69 (14.3%) had sustained fatal injuries. Males in the 21-30-year age group were the most affected. Most accidents occurred during weekends with pedestrians being the leading casualties in 59.5% and 71.4% of non-fatal and fatal cases respectively. Most accidents were caused by passenger service vehicles (matatus) which were responsible for 62% and 40.6% of non-fatal and fatal injuries respectively. Non-use of safety belts was reported in 56.6% of the cases who suffered non-fatal injuries. In the non-fatal category 89.6% of the casualties had soft tissue injuries (STIs) involving the craniofacial region with facial cuts being the majority (69.2%). Two hundred and seventy three (66.1%) incidents of other STIs than those of the head region were noted, the lower limbs accounting for 45.4% of these. Only 5.1% of the casualties with non-fatal injuries had fractures involving the maxillofacial skeleton. Skeletal injuries other than those involving the maxillofacial region were found in 142 (34.1%) incidents. In the fatal category head injury alone was the leading cause of death accounting for 37.7% of the cases followed by head and chest injuries combined which were responsible for 13% of the cases. CONCLUSION: Injuries to the maxillofacial skeleton appear to be uncommon in this series. Pedestrians in their third decade of life are most affected with passenger service vehicles being responsible in the majority of the cases. RECOMMENDATIONS: Interventional programmes targeting pedestrians and those in the third and fourth decades of life should be enacted.

OBJECTIVE: To document the occurrence of cases of ameloblastic fibroma. DESIGN: A retrospective study. SETTING: The Division of Oral Pathology and Oral Medicine histopathology laboratory at the Faculty of Dental Sciences, University of Nairobi, January 1991 to December 2000. RESULTS: Seven complete records of histopathologically confirmed cases of ameloblastic fibroma were identified. There were four male and three female cases with an age range of 10 to 22 years (mean=14 years). Remarkably, six of the cases had lesions in the molar regions of the mandible with a single case with a maxillary molar area lesion. One of the cases had the neoplasm associated with an unerupted tooth. From the clinical notes all the patients were managed by meticulous enucleation and curettage of the lesions. After follow up periods ranging from several months to eight years no recurrences had been recorded. CONCLUSION: Evidently ameloblastic fibroma is an uncommon neoplasm as noted in the earlier literature. Although the lesions can be quite extensive at the time of diagnosis, the recurrence rate appears to be relatively low if the neoplasms are meticulously extirpated.

Extra-abdominal fibromatosis (desmoid tumour) is a rare aggressive neoplasm with a tendency to infiltrate local structures but rarely metastasises or undergoes spontaneous malignant transformation. The treatment of choice is surgery, however, recurrences have been reported even after wide-field resection. This article presents a case of extra-abdominal fibromatosis that had extensively invaded the mandible.

Although military conflicts are common on the African continent, there is a paucity of data regarding bomb-blast injuries in this region and in Kenya in particular. This paper describes the pattern of maxillofacial injuries sustained after the August 1998 bomb blast that occurred in Nairobi, Kenya. A retrospective cross-sectional study was carried out using hospital-based records of 290 bomb-blast survivors admitted at the Kenyatta National Referral and Teaching Hospital in Nairobi. Using a self-designed form to record information about variables such as the sex and age of the survivors and type of location of soft- and hard-tissue injuries, it was found that of the 290 bomb-blast survivors, 78% had sustained one or more maxillofacial injuries. Soft-tissue injuries (cuts, lacerations or bruises) were the most common, constituting 61.3% of all injuries in the maxillofacial region; 27.6% had severe eye injuries, while 1.4% had fractures in the cranio-facial region. This paper concludes that the effective management of bomb-blast injuries as well as those caused by other types of disaster requires a multidisciplinary approach. The high percentage of maxillofacial injuries confirm that maxillofacial surgeons should form an integral part of this multidisciplinary team.

A case of a female neonate with Pierre Robin Syndrome with frequent cyanotic episodes and feeding difficulties which could not be adequately managed by positioning and oral airway placement is presented. Tongue-anterior mandible fusion procedure was performed with satisfactory results.

A case of a female neonate with Pierre Robin Syndrome with frequent cyanotic episodes and feeding difficulties which could not be adequately managed by positioning and oral airway placement is presented. Tongue-anterior mandible fusion procedure was performed with satisfactory results.

A case of a female neonate with Pierre Robin Syndrome with frequent cyanotic episodes and feeding difficulties which could not be adequately managed by positioning and oral airway placement is presented. Tongue-anterior mandible fusion procedure was performed with satisfactory results.

A retrospective study of the hospital records revealed that 39 cases of mandibular fractures presented at Kisii District Hospital during a two-year period. 27 cases were due to interpersonal violence while road traffic accidents and accidental falls accounted for 9 and 3 of the cases respectively. The male ratio was 2.9:1. Majority (26 cases) of the patients were aged between 20 and 39 years. The commonly involved fracture site was the left body of the mandible accounting for 20 of the fractures.

{ The Blantyre coma scale (BCS) is used to assess children with severe falciparum malaria, particularly as a criterion for cerebral malaria, but it has not been formally validated. We compared the BCS to the Adelaide coma scale (ACS), for Kenyan children with severe malaria. We examined the inter-observer agreement between 3 observers in the assessment of coma scales on 17 children by measuring the proportion of agreement (PA), disagreement rate (DR) and fixed sample size kappa (kappa n). We assessed the sensitivity and specificity of the scales in detecting events (seizures and hypoglycaemia) in 240 children during admission and the usefulness of the scales in predicting outcome. There was considerable disagreement between observers in the assessment of both scales (BCS: PA = 0.55

A retrospective study of the hospital records revealed that 39 cases of mandibular fractures presented at Kisii District Hospital during a two-year period. 27 cases were due to interpersonal violence while road traffic accidents and accidental falls accounted for 9 and 3 of the cases respectively. The male ratio was 2.9:1. Majority (26 cases) of the patients were aged between 20 and 39 years. The commonly involved fracture site was the left body of the mandible accounting for 20 of the fractures.

Open wound healing following dehorning using a wire saw was observed in 25 cattle aged between 1 and 5 years. Initially, there was a marked thickening of the scab over the wound as a ridge near the skin margin. A pale yellow to pink membrane then developed from the sides of the frontal sinus opening. Granulation tissue formed to fill the frontal sinus opening before healing by epithelization, followed by wound contraction. In some animals a bony horn stump projecting about 2-3 mm above the wound surface appeared which underwent osteosis; the dead bone gradually loosened and fell off during the healing process; histological sections revealed the presence of numerous osteoclasts lining the bone spicules. The presence of the frontal sinus and the stump of the horn processes left after dehorning are factors that make the healing of an open dehorning wound unique compared with other wounds

Open wound healing following dehorning using a wire saw was observed in 25 cattle aged between 1 and 5 years. Initially, there was a marked thickening of the scab over the wound as a ridge near the skin margin. A pale yellow to pink membrane then developed from the sides of the frontal sinus opening. Granulation tissue formed to fill the frontal sinus opening before healing by epithelization, followed by wound contraction. In some animals a bony horn stump projecting about 2-3 mm above the wound surface appeared which underwent osteosis; the dead bone gradually loosened and fell off during the healing process; histological sections revealed the presence of numerous osteoclasts lining the bone spicules. The presence of the frontal sinus and the stump of the horn processes left after dehorning are factors that make the healing of an open dehorning wound unique compared with other wounds

Open wound healing following dehorning using a wire saw was observed in 25 cattle aged between 1 and 5 years. Initially, there was a marked thickening of the scab over the wound as a ridge near the skin margin. A pale yellow to pink membrane then developed from the sides of the frontal sinus opening. Granulation tissue formed to fill the frontal sinus opening before healing by epithelization, followed by wound contraction. In some animals a bony horn stump projecting about 2-3 mm above the wound surface appeared which underwent osteosis; the dead bone gradually loosened and fell off during the healing process; histological sections revealed the presence of numerous osteoclasts lining the bone spicules. The presence of the frontal sinus and the stump of the horn processes left after dehorning are factors that make the healing of an open dehorning wound unique compared with other wounds

Open wound healing following dehorning using a wire saw was observed in 25 cattle aged between 1 and 5 years. Initially, there was a marked thickening of the scab over the wound as a ridge near the skin margin. A pale yellow to pink membrane then developed from the sides of the frontal sinus opening. Granulation tissue formed to fill the frontal sinus opening before healing by epithelization, followed by wound contraction. In some animals a bony horn stump projecting about 2-3 mm above the wound surface appeared which underwent osteosis; the dead bone gradually loosened and fell off during the healing process; histological sections revealed the presence of numerous osteoclasts lining the bone spicules. The presence of the frontal sinus and the stump of the horn processes left after dehorning are factors that make the healing of an open dehorning wound unique compared with other wounds

Open wound healing following dehorning using a wire saw was observed in 25 cattle aged between 1 and 5 years. Initially, there was a marked thickening of the scab over the wound as a ridge near the skin margin. A pale yellow to pink membrane then developed from the sides of the frontal sinus opening. Granulation tissue formed to fill the frontal sinus opening before healing by epithelization, followed by wound contraction. In some animals a bony horn stump projecting about 2-3 mm above the wound surface appeared which underwent osteosis; the dead bone gradually loosened and fell off during the healing process; histological sections revealed the presence of numerous osteoclasts lining the bone spicules. The presence of the frontal sinus and the stump of the horn processes left after dehorning are factors that make the healing of an open dehorning wound unique compared with other wounds

Open wound healing following dehorning using a wire saw was observed in 25 cattle aged between 1 and 5 years. Initially, there was a marked thickening of the scab over the wound as a ridge near the skin margin. A pale yellow to pink membrane then developed from the sides of the frontal sinus opening. Granulation tissue formed to fill the frontal sinus opening before healing by epithelization, followed by wound contraction. In some animals a bony horn stump projecting about 2-3 mm above the wound surface appeared which underwent osteosis; the dead bone gradually loosened and fell off during the healing process; histological sections revealed the presence of numerous osteoclasts lining the bone spicules. The presence of the frontal sinus and the stump of the horn processes left after dehorning are factors that make the healing of an open dehorning wound unique compared with other wounds

Open wound healing following dehorning using a wire saw was observed in 25 cattle aged between 1 and 5 years. Initially, there was a marked thickening of the scab over the wound as a ridge near the skin margin. A pale yellow to pink membrane then developed from the sides of the frontal sinus opening. Granulation tissue formed to fill the frontal sinus opening before healing by epithelization, followed by wound contraction. In some animals a bony horn stump projecting about 2-3 mm above the wound surface appeared which underwent osteosis; the dead bone gradually loosened and fell off during the healing process; histological sections revealed the presence of numerous osteoclasts lining the bone spicules. The presence of the frontal sinus and the stump of the horn processes left after dehorning are factors that make the healing of an open dehorning wound unique compared with other wounds

Open wound healing following dehorning using a wire saw was observed in 25 cattle aged between 1 and 5 years. Initially, there was a marked thickening of the scab over the wound as a ridge near the skin margin. A pale yellow to pink membrane then developed from the sides of the frontal sinus opening. Granulation tissue formed to fill the frontal sinus opening before healing by epithelization, followed by wound contraction. In some animals a bony horn stump projecting about 2-3 mm above the wound surface appeared which underwent osteosis; the dead bone gradually loosened and fell off during the healing process; histological sections revealed the presence of numerous osteoclasts lining the bone spicules. The presence of the frontal sinus and the stump of the horn processes left after dehorning are factors that make the healing of an open dehorning wound unique compared with other wounds

Open wound healing following dehorning using a wire saw was observed in 25 cattle aged between 1 and 5 years. Initially, there was a marked thickening of the scab over the wound as a ridge near the skin margin. A pale yellow to pink membrane then developed from the sides of the frontal sinus opening. Granulation tissue formed to fill the frontal sinus opening before healing by epithelization, followed by wound contraction. In some animals a bony horn stump projecting about 2-3 mm above the wound surface appeared which underwent osteosis; the dead bone gradually loosened and fell off during the healing process; histological sections revealed the presence of numerous osteoclasts lining the bone spicules. The presence of the frontal sinus and the stump of the horn processes left after dehorning are factors that make the healing of an open dehorning wound unique compared with other wounds

Open wound healing following dehorning using a wire saw was observed in 25 cattle aged between 1 and 5 years. Initially, there was a marked thickening of the scab over the wound as a ridge near the skin margin. A pale yellow to pink membrane then developed from the sides of the frontal sinus opening. Granulation tissue formed to fill the frontal sinus opening before healing by epithelization, followed by wound contraction. In some animals a bony horn stump projecting about 2-3 mm above the wound surface appeared which underwent osteosis; the dead bone gradually loosened and fell off during the healing process; histological sections revealed the presence of numerous osteoclasts lining the bone spicules. The presence of the frontal sinus and the stump of the horn processes left after dehorning are factors that make the healing of an open dehorning wound unique compared with other wounds

Open wound healing following dehorning using a wire saw was observed in 25 cattle aged between 1 and 5 years. Initially, there was a marked thickening of the scab over the wound as a ridge near the skin margin. A pale yellow to pink membrane then developed from the sides of the frontal sinus opening. Granulation tissue formed to fill the frontal sinus opening before healing by epithelization, followed by wound contraction. In some animals a bony horn stump projecting about 2-3 mm above the wound surface appeared which underwent osteosis; the dead bone gradually loosened and fell off during the healing process; histological sections revealed the presence of numerous osteoclasts lining the bone spicules. The presence of the frontal sinus and the stump of the horn processes left after dehorning are factors that make the healing of an open dehorning wound unique compared with other wounds

Open wound healing following dehorning using a wire saw was observed in 25 cattle aged between 1 and 5 years. Initially, there was a marked thickening of the scab over the wound as a ridge near the skin margin. A pale yellow to pink membrane then developed from the sides of the frontal sinus opening. Granulation tissue formed to fill the frontal sinus opening before healing by epithelization, followed by wound contraction. In some animals a bony horn stump projecting about 2-3 mm above the wound surface appeared which underwent osteosis; the dead bone gradually loosened and fell off during the healing process; histological sections revealed the presence of numerous osteoclasts lining the bone spicules. The presence of the frontal sinus and the stump of the horn processes left after dehorning are factors that make the healing of an open dehorning wound unique compared with other wounds

Open wound healing following dehorning using a wire saw was observed in 25 cattle aged between 1 and 5 years. Initially, there was a marked thickening of the scab over the wound as a ridge near the skin margin. A pale yellow to pink membrane then developed from the sides of the frontal sinus opening. Granulation tissue formed to fill the frontal sinus opening before healing by epithelization, followed by wound contraction. In some animals a bony horn stump projecting about 2-3 mm above the wound surface appeared which underwent osteosis; the dead bone gradually loosened and fell off during the healing process; histological sections revealed the presence of numerous osteoclasts lining the bone spicules. The presence of the frontal sinus and the stump of the horn processes left after dehorning are factors that make the healing of an open dehorning wound unique compared with other wounds

Open wound healing following dehorning using a wire saw was observed in 25 cattle aged between 1 and 5 years. Initially, there was a marked thickening of the scab over the wound as a ridge near the skin margin. A pale yellow to pink membrane then developed from the sides of the frontal sinus opening. Granulation tissue formed to fill the frontal sinus opening before healing by epithelization, followed by wound contraction. In some animals a bony horn stump projecting about 2-3 mm above the wound surface appeared which underwent osteosis; the dead bone gradually loosened and fell off during the healing process; histological sections revealed the presence of numerous osteoclasts lining the bone spicules. The presence of the frontal sinus and the stump of the horn processes left after dehorning are factors that make the healing of an open dehorning wound unique compared with other wounds

Open wound healing following dehorning using a wire saw was observed in 25 cattle aged between 1 and 5 years. Initially, there was a marked thickening of the scab over the wound as a ridge near the skin margin. A pale yellow to pink membrane then developed from the sides of the frontal sinus opening. Granulation tissue formed to fill the frontal sinus opening before healing by epithelization, followed by wound contraction. In some animals a bony horn stump projecting about 2-3 mm above the wound surface appeared which underwent osteosis; the dead bone gradually loosened and fell off during the healing process; histological sections revealed the presence of numerous osteoclasts lining the bone spicules. The presence of the frontal sinus and the stump of the horn processes left after dehorning are factors that make the healing of an open dehorning wound unique compared with other wounds

Open wound healing following dehorning using a wire saw was observed in 25 cattle aged between 1 and 5 years. Initially, there was a marked thickening of the scab over the wound as a ridge near the skin margin. A pale yellow to pink membrane then developed from the sides of the frontal sinus opening. Granulation tissue formed to fill the frontal sinus opening before healing by epithelization, followed by wound contraction. In some animals a bony horn stump projecting about 2-3 mm above the wound surface appeared which underwent osteosis; the dead bone gradually loosened and fell off during the healing process; histological sections revealed the presence of numerous osteoclasts lining the bone spicules. The presence of the frontal sinus and the stump of the horn processes left after dehorning are factors that make the healing of an open dehorning wound unique compared with other wounds

Open wound healing following dehorning using a wire saw was observed in 25 cattle aged between 1 and 5 years. Initially, there was a marked thickening of the scab over the wound as a ridge near the skin margin. A pale yellow to pink membrane then developed from the sides of the frontal sinus opening. Granulation tissue formed to fill the frontal sinus opening before healing by epithelization, followed by wound contraction. In some animals a bony horn stump projecting about 2-3 mm above the wound surface appeared which underwent osteosis; the dead bone gradually loosened and fell off during the healing process; histological sections revealed the presence of numerous osteoclasts lining the bone spicules. The presence of the frontal sinus and the stump of the horn processes left after dehorning are factors that make the healing of an open dehorning wound unique compared with other wounds

Open wound healing following dehorning using a wire saw was observed in 25 cattle aged between 1 and 5 years. Initially, there was a marked thickening of the scab over the wound as a ridge near the skin margin. A pale yellow to pink membrane then developed from the sides of the frontal sinus opening. Granulation tissue formed to fill the frontal sinus opening before healing by epithelization, followed by wound contraction. In some animals a bony horn stump projecting about 2-3 mm above the wound surface appeared which underwent osteosis; the dead bone gradually loosened and fell off during the healing process; histological sections revealed the presence of numerous osteoclasts lining the bone spicules. The presence of the frontal sinus and the stump of the horn processes left after dehorning are factors that make the healing of an open dehorning wound unique compared with other wounds

Open wound healing following dehorning using a wire saw was observed in 25 cattle aged between 1 and 5 years. Initially, there was a marked thickening of the scab over the wound as a ridge near the skin margin. A pale yellow to pink membrane then developed from the sides of the frontal sinus opening. Granulation tissue formed to fill the frontal sinus opening before healing by epithelization, followed by wound contraction. In some animals a bony horn stump projecting about 2-3 mm above the wound surface appeared which underwent osteosis; the dead bone gradually loosened and fell off during the healing process; histological sections revealed the presence of numerous osteoclasts lining the bone spicules. The presence of the frontal sinus and the stump of the horn processes left after dehorning are factors that make the healing of an open dehorning wound unique compared with other wounds

Open wound healing following dehorning using a wire saw was observed in 25 cattle aged between 1 and 5 years. Initially, there was a marked thickening of the scab over the wound as a ridge near the skin margin. A pale yellow to pink membrane then developed from the sides of the frontal sinus opening. Granulation tissue formed to fill the frontal sinus opening before healing by epithelization, followed by wound contraction. In some animals a bony horn stump projecting about 2-3 mm above the wound surface appeared which underwent osteosis; the dead bone gradually loosened and fell off during the healing process; histological sections revealed the presence of numerous osteoclasts lining the bone spicules. The presence of the frontal sinus and the stump of the horn processes left after dehorning are factors that make the healing of an open dehorning wound unique compared with other wounds

Open wound healing following dehorning using a wire saw was observed in 25 cattle aged between 1 and 5 years. Initially, there was a marked thickening of the scab over the wound as a ridge near the skin margin. A pale yellow to pink membrane then developed from the sides of the frontal sinus opening. Granulation tissue formed to fill the frontal sinus opening before healing by epithelization, followed by wound contraction. In some animals a bony horn stump projecting about 2-3 mm above the wound surface appeared which underwent osteosis; the dead bone gradually loosened and fell off during the healing process; histological sections revealed the presence of numerous osteoclasts lining the bone spicules. The presence of the frontal sinus and the stump of the horn processes left after dehorning are factors that make the healing of an open dehorning wound unique compared with other wounds

Open wound healing following dehorning using a wire saw was observed in 25 cattle aged between 1 and 5 years. Initially, there was a marked thickening of the scab over the wound as a ridge near the skin margin. A pale yellow to pink membrane then developed from the sides of the frontal sinus opening. Granulation tissue formed to fill the frontal sinus opening before healing by epithelization, followed by wound contraction. In some animals a bony horn stump projecting about 2-3 mm above the wound surface appeared which underwent osteosis; the dead bone gradually loosened and fell off during the healing process; histological sections revealed the presence of numerous osteoclasts lining the bone spicules. The presence of the frontal sinus and the stump of the horn processes left after dehorning are factors that make the healing of an open dehorning wound unique compared with other wounds

Open wound healing following dehorning using a wire saw was observed in 25 cattle aged between 1 and 5 years. Initially, there was a marked thickening of the scab over the wound as a ridge near the skin margin. A pale yellow to pink membrane then developed from the sides of the frontal sinus opening. Granulation tissue formed to fill the frontal sinus opening before healing by epithelization, followed by wound contraction. In some animals a bony horn stump projecting about 2-3 mm above the wound surface appeared which underwent osteosis; the dead bone gradually loosened and fell off during the healing process; histological sections revealed the presence of numerous osteoclasts lining the bone spicules. The presence of the frontal sinus and the stump of the horn processes left after dehorning are factors that make the healing of an open dehorning wound unique compared with other wounds

Open wound healing following dehorning using a wire saw was observed in 25 cattle aged between 1 and 5 years. Initially, there was a marked thickening of the scab over the wound as a ridge near the skin margin. A pale yellow to pink membrane then developed from the sides of the frontal sinus opening. Granulation tissue formed to fill the frontal sinus opening before healing by epithelization, followed by wound contraction. In some animals a bony horn stump projecting about 2-3 mm above the wound surface appeared which underwent osteosis; the dead bone gradually loosened and fell off during the healing process; histological sections revealed the presence of numerous osteoclasts lining the bone spicules. The presence of the frontal sinus and the stump of the horn processes left after dehorning are factors that make the healing of an open dehorning wound unique compared with other wounds

Open wound healing following dehorning using a wire saw was observed in 25 cattle aged between 1 and 5 years. Initially, there was a marked thickening of the scab over the wound as a ridge near the skin margin. A pale yellow to pink membrane then developed from the sides of the frontal sinus opening. Granulation tissue formed to fill the frontal sinus opening before healing by epithelization, followed by wound contraction. In some animals a bony horn stump projecting about 2-3 mm above the wound surface appeared which underwent osteosis; the dead bone gradually loosened and fell off during the healing process; histological sections revealed the presence of numerous osteoclasts lining the bone spicules. The presence of the frontal sinus and the stump of the horn processes left after dehorning are factors that make the healing of an open dehorning wound unique compared with other wounds

Open wound healing following dehorning using a wire saw was observed in 25 cattle aged between 1 and 5 years. Initially, there was a marked thickening of the scab over the wound as a ridge near the skin margin. A pale yellow to pink membrane then developed from the sides of the frontal sinus opening. Granulation tissue formed to fill the frontal sinus opening before healing by epithelization, followed by wound contraction. In some animals a bony horn stump projecting about 2-3 mm above the wound surface appeared which underwent osteosis; the dead bone gradually loosened and fell off during the healing process; histological sections revealed the presence of numerous osteoclasts lining the bone spicules. The presence of the frontal sinus and the stump of the horn processes left after dehorning are factors that make the healing of an open dehorning wound unique compared with other wounds

{ The Blantyre coma scale (BCS) is used to assess children with severe falciparum malaria, particularly as a criterion for cerebral malaria, but it has not been formally validated. We compared the BCS to the Adelaide coma scale (ACS), for Kenyan children with severe malaria. We examined the inter-observer agreement between 3 observers in the assessment of coma scales on 17 children by measuring the proportion of agreement (PA), disagreement rate (DR) and fixed sample size kappa (kappa n). We assessed the sensitivity and specificity of the scales in detecting events (seizures and hypoglycaemia) in 240 children during admission and the usefulness of the scales in predicting outcome. There was considerable disagreement between observers in the assessment of both scales (BCS: PA = 0.55

{ The Blantyre coma scale (BCS) is used to assess children with severe falciparum malaria, particularly as a criterion for cerebral malaria, but it has not been formally validated. We compared the BCS to the Adelaide coma scale (ACS), for Kenyan children with severe malaria. We examined the inter-observer agreement between 3 observers in the assessment of coma scales on 17 children by measuring the proportion of agreement (PA), disagreement rate (DR) and fixed sample size kappa (kappa n). We assessed the sensitivity and specificity of the scales in detecting events (seizures and hypoglycaemia) in 240 children during admission and the usefulness of the scales in predicting outcome. There was considerable disagreement between observers in the assessment of both scales (BCS: PA = 0.55

{ The Blantyre coma scale (BCS) is used to assess children with severe falciparum malaria, particularly as a criterion for cerebral malaria, but it has not been formally validated. We compared the BCS to the Adelaide coma scale (ACS), for Kenyan children with severe malaria. We examined the inter-observer agreement between 3 observers in the assessment of coma scales on 17 children by measuring the proportion of agreement (PA), disagreement rate (DR) and fixed sample size kappa (kappa n). We assessed the sensitivity and specificity of the scales in detecting events (seizures and hypoglycaemia) in 240 children during admission and the usefulness of the scales in predicting outcome. There was considerable disagreement between observers in the assessment of both scales (BCS: PA = 0.55

{ The Blantyre coma scale (BCS) is used to assess children with severe falciparum malaria, particularly as a criterion for cerebral malaria, but it has not been formally validated. We compared the BCS to the Adelaide coma scale (ACS), for Kenyan children with severe malaria. We examined the inter-observer agreement between 3 observers in the assessment of coma scales on 17 children by measuring the proportion of agreement (PA), disagreement rate (DR) and fixed sample size kappa (kappa n). We assessed the sensitivity and specificity of the scales in detecting events (seizures and hypoglycaemia) in 240 children during admission and the usefulness of the scales in predicting outcome. There was considerable disagreement between observers in the assessment of both scales (BCS: PA = 0.55

{ The Blantyre coma scale (BCS) is used to assess children with severe falciparum malaria, particularly as a criterion for cerebral malaria, but it has not been formally validated. We compared the BCS to the Adelaide coma scale (ACS), for Kenyan children with severe malaria. We examined the inter-observer agreement between 3 observers in the assessment of coma scales on 17 children by measuring the proportion of agreement (PA), disagreement rate (DR) and fixed sample size kappa (kappa n). We assessed the sensitivity and specificity of the scales in detecting events (seizures and hypoglycaemia) in 240 children during admission and the usefulness of the scales in predicting outcome. There was considerable disagreement between observers in the assessment of both scales (BCS: PA = 0.55

{ The Blantyre coma scale (BCS) is used to assess children with severe falciparum malaria, particularly as a criterion for cerebral malaria, but it has not been formally validated. We compared the BCS to the Adelaide coma scale (ACS), for Kenyan children with severe malaria. We examined the inter-observer agreement between 3 observers in the assessment of coma scales on 17 children by measuring the proportion of agreement (PA), disagreement rate (DR) and fixed sample size kappa (kappa n). We assessed the sensitivity and specificity of the scales in detecting events (seizures and hypoglycaemia) in 240 children during admission and the usefulness of the scales in predicting outcome. There was considerable disagreement between observers in the assessment of both scales (BCS: PA = 0.55

{ The Blantyre coma scale (BCS) is used to assess children with severe falciparum malaria, particularly as a criterion for cerebral malaria, but it has not been formally validated. We compared the BCS to the Adelaide coma scale (ACS), for Kenyan children with severe malaria. We examined the inter-observer agreement between 3 observers in the assessment of coma scales on 17 children by measuring the proportion of agreement (PA), disagreement rate (DR) and fixed sample size kappa (kappa n). We assessed the sensitivity and specificity of the scales in detecting events (seizures and hypoglycaemia) in 240 children during admission and the usefulness of the scales in predicting outcome. There was considerable disagreement between observers in the assessment of both scales (BCS: PA = 0.55

{ The Blantyre coma scale (BCS) is used to assess children with severe falciparum malaria, particularly as a criterion for cerebral malaria, but it has not been formally validated. We compared the BCS to the Adelaide coma scale (ACS), for Kenyan children with severe malaria. We examined the inter-observer agreement between 3 observers in the assessment of coma scales on 17 children by measuring the proportion of agreement (PA), disagreement rate (DR) and fixed sample size kappa (kappa n). We assessed the sensitivity and specificity of the scales in detecting events (seizures and hypoglycaemia) in 240 children during admission and the usefulness of the scales in predicting outcome. There was considerable disagreement between observers in the assessment of both scales (BCS: PA = 0.55

{ The Blantyre coma scale (BCS) is used to assess children with severe falciparum malaria, particularly as a criterion for cerebral malaria, but it has not been formally validated. We compared the BCS to the Adelaide coma scale (ACS), for Kenyan children with severe malaria. We examined the inter-observer agreement between 3 observers in the assessment of coma scales on 17 children by measuring the proportion of agreement (PA), disagreement rate (DR) and fixed sample size kappa (kappa n). We assessed the sensitivity and specificity of the scales in detecting events (seizures and hypoglycaemia) in 240 children during admission and the usefulness of the scales in predicting outcome. There was considerable disagreement between observers in the assessment of both scales (BCS: PA = 0.55

{ The Blantyre coma scale (BCS) is used to assess children with severe falciparum malaria, particularly as a criterion for cerebral malaria, but it has not been formally validated. We compared the BCS to the Adelaide coma scale (ACS), for Kenyan children with severe malaria. We examined the inter-observer agreement between 3 observers in the assessment of coma scales on 17 children by measuring the proportion of agreement (PA), disagreement rate (DR) and fixed sample size kappa (kappa n). We assessed the sensitivity and specificity of the scales in detecting events (seizures and hypoglycaemia) in 240 children during admission and the usefulness of the scales in predicting outcome. There was considerable disagreement between observers in the assessment of both scales (BCS: PA = 0.55

{ The Blantyre coma scale (BCS) is used to assess children with severe falciparum malaria, particularly as a criterion for cerebral malaria, but it has not been formally validated. We compared the BCS to the Adelaide coma scale (ACS), for Kenyan children with severe malaria. We examined the inter-observer agreement between 3 observers in the assessment of coma scales on 17 children by measuring the proportion of agreement (PA), disagreement rate (DR) and fixed sample size kappa (kappa n). We assessed the sensitivity and specificity of the scales in detecting events (seizures and hypoglycaemia) in 240 children during admission and the usefulness of the scales in predicting outcome. There was considerable disagreement between observers in the assessment of both scales (BCS: PA = 0.55

A case of primary intracerebral haemorrhage complicated by cerebral abscess is presented with a review of the literature.

OBJECTIVE: To determine the status of environmental and occupational lead exposure in selected areas in Nairobi, Kenya. DESIGN: Cross sectional study. SETTING: Kariobangi North, Babadogo, Waithaka and Pumwani for assessment of environmental exposure to lead (Pb) and Ziwani Jua Kali works for assessment of occupational lead exposure. Olkalou in Nyandarua District was the covariate study area. SUBJECTS: Three hundred and eight children and adults participated. RESULTS: Blood lead levels (BLLs) obtained for the entire sample (n = 308) ranged from 0.4 to 65 microg/dl of blood. One hundred and sixty nine (55%) of the total sample had levels equal to or below 4.9 microg/dl, while 62 (20%) of the sample had levels ranging from 5.0 to 9.9 microg/dl. Blood lead levels above 10 microg/dl were recorded in 77 (25%) of the total sample. Within Nairobi, 32 (15.3%) of the study subjects in areas meant for assessment of environmental lead exposure had levels above the WHO/CDC action levels of 10 microg/dl of blood. The mean BLL for the occupationally exposed (Ziwani Jua kali) was 22.6 +/- 13.4 microg/dl. Among the workers, 89% had BLLs above 10 microg/dl. In general, 15% of the entire sample (for both environmental and occupational groups) in Nairobi had BLLs above 15 microg/dl. The covariate group at Olkalou had a mean BLL of 1.3 +/- 0.9 microg/dl. CONCLUSION: The prevalence of environmental lead exposure to the general public is high in Nairobi compared to Olkalou where non exposure was reported. Occupational lead exposure has been identified to be at alarming levels and urgent intervention measures are recommended.

OBJECTIVES: To review if there is a change in the maternal mortality rate at the Kenyatta National Hospital since the inception of the Millennium Development Goal strategy in 1990, compared to earlier reviews. DESIGN: A retrospective descriptive study. SETTING: Kenyatta National Hospital. SUBJECTS: Maternal deaths attributed directly to obstetric causes. MAIN OUTCOME MEASURES: Determination of maternal mortality rates of all patients admitted to the Kenyatta National Hospital Maternity and died after admission up till six weeks of admission. Also determine any avoidable causes of the same. RESULTS: During the period under review, there were 27,455 deliveries and 253 maternal deaths giving a maternal mortality ratio of 921.5 per 100,000 live births. Direct obstetric causes accounted for 71% of all maternal deaths with sepsis, haemorrhage, and hypertension being the leading causes. Respiratory tract infections associated with HIV/ AIDS infection was the prominent indirect cause. 67.5% of deaths occurred in women aged between 25 and 35 years and 78.7% were Para 2 or less. Evidently there was poor antenatal clinic attendance with only 28.6% having had any attendance at all. CONCLUSION: Antenatal clinic attendance needs to be re-emphasised if an impact is to be realised in curbing maternal mortality; moreover there is need for early referrals and encouraging mothers to deliver under skilled care.

OBJECTIVES: To determine the value of clinical foetal distress in predicting early perinatal outcome. DESIGN: Prospective cohort study. SETTING: Kenyatta National Hospital. SUBJECTS: Fifty eight newborns delivered via Caesarian section with a diagnosis of clinical foetal distress were compared with another group of 58 newborns delivered similarly, but without clinical foetal distress. RESULTS: Newborn acidemia was found in 71% of newborns with clinical foetal distress in contrast to 17% in newborns without foetal distress. Low Apgar score at one minute was noted in about 59% of newborns with foetal distress compared with 31% in newborns without foetal distress. Similarly, 24.1% of neonates with clinical foetal distress had low Apgar score at five minutes compared with 3.4% in those without foetal distress. Thirty one percent of newborns with clinical foetal distress were admitted to newborn unit for more than 24 hours due to respiratory distress or birth asphyxia compared to 17% of those without foetal distress. The incidence of morbidity and or mortality in newborns exposed to foetal distress was twice the one of newborns without foetal distress. CONCLUSION: The results obtained in this study agreed with those who consider intrapartum passage of meconeum and abnormal foetal heart rate and rhythm to signify clinical foetal distress that carries bad prognostic outcome. These two parameters should still be used to indicate foetal distress which requires immediate institution of supportive therapy and immediate delivery.

BACKGROUND: Thyroid dysfunction can be evaluated by measuring serum thyroid stimulating hormone (TSH), total tri-iodothyronine (T3) and total thyroxine (T4) which will establish euthyroidism, hyperthyroidism and hypothyroidism. Fine needle aspiration (FNA) is the diagnostic test of choice in determining whether a nodule is benign or malignant. OBJECTIVE: To correlate hormonal levels to FNA cytologic findings. DESIGN: A cross-sectional study. SETTING: Kenyatta National Hospital (KNH). RESULTS: Forty two patients had their thyroid profiles done and the results were correlated with FNA diagnosis. Majority of patients had nodular goiter (83.3%), of which 47.6% had euthyroidism, 16.7% had biochemical euthyroidism, 11.9% had hyperthyroidism, 4.8% had sub-clinical hyperthyroidism and 2.4% had sub-clinical hypothyroidism. Three patients (7.1%) with FNA diagnosis of non-diagnostic sample had euthyroidism while 2.4% each with papillary carcinoma, thyroglossal cyst, and atypia, had a hormonal profile of euthyroidism. There was no significant statistical difference (p > 0.05) of the mean levels of T4 (0.406), T3 (0.311), and TSH (0.90), between and within the various groups of FNA cytological diagnoses. CONCLUSION: The study showed that there was no correlation between T4, T3, and TSH measurements and FNA cytological diagnoses.

OBJECTIVE: We compared 12-month continuation rates, menstrual bleeding patterns and other aspects of acceptability between users of Cyclofem and users of Depo-Provera. METHODS: The life-table method was used to calculate quarterly continuation rates. In all, 360 Kenyan women were randomly assigned to one of the two contraceptives. User-satisfaction questionnaires were administered at 6 and 12 months or at discontinuation, whichever occurred first. RESULTS: The 1-year continuation rate was 75.4% for Depo-Provera users versus 56.5% for Cyclofem users (p<.001). Main reasons for discontinuation included difficulty making clinic visits (45.1% for Cyclofem vs. 40% for Depo-Provera), menstrual changes (14.1% vs. 12.5%) and nonmenstrual problems (15.5% vs. 12.5%). None of the Depo-Provera users and 8.5% of the Cyclofem users claimed frequency of visits as the main reason for discontinuation. In all, 70.6% of the Depo-Provera users were amenorrheic after 12 months, as were 20.8% of the Cyclofem users. CONCLUSIONS: The 1-year continuation rate was higher for Depo-Provera than for Cyclofem. There was no important difference in discontinuation rates because of menstrual problems; the difference mainly reflected the frequency of visits required.

OBJECTIVE: We compared 12-month continuation rates, menstrual bleeding patterns and other aspects of acceptability between users of Cyclofem and users of Depo-Provera. METHODS: The life-table method was used to calculate quarterly continuation rates. In all, 360 Kenyan women were randomly assigned to one of the two contraceptives. User-satisfaction questionnaires were administered at 6 and 12 months or at discontinuation, whichever occurred first. RESULTS: The 1-year continuation rate was 75.4% for Depo-Provera users versus 56.5% for Cyclofem users (p<.001). Main reasons for discontinuation included difficulty making clinic visits (45.1% for Cyclofem vs. 40% for Depo-Provera), menstrual changes (14.1% vs. 12.5%) and nonmenstrual problems (15.5% vs. 12.5%). None of the Depo-Provera users and 8.5% of the Cyclofem users claimed frequency of visits as the main reason for discontinuation. In all, 70.6% of the Depo-Provera users were amenorrheic after 12 months, as were 20.8% of the Cyclofem users. CONCLUSIONS: The 1-year continuation rate was higher for Depo-Provera than for Cyclofem. There was no important difference in discontinuation rates because of menstrual problems; the difference mainly reflected the frequency of visits required.

OBJECTIVES: To determine the prevalence of malaria in donor units in a low and a high endemic region in Kenya and evaluate the cost effectiveness of recipient anti-malarial prophylaxis and pre-transfusion screening (using an automated method) as options to prevent post transfusion malaria. DESIGN: A descriptive cross-sectional study. SETTING: Two regional blood banks, Nairobi and its environs (National Blood Transfusion Services, Nairobi) a low malaria endemic region and western region (National Blood Transfusion Services, Kisumu) high malaria endemic region. SUBJECTS: All the donated units were included in the study for analysis, during the duration of study, from the two study sites. MAIN OUTCOME MEASURES: Prevalence of malaria in donor units in low endemic area (Nairobi) and high endemic area (Kisumu). Cost per case prevented for the two options, Option I Prophylactic administration of anti-malarial (sulfadoxine pyrimethamine SP) drugs to recipients, and Option II pre-transfusion screening using an automated technique. RESULTS: A malaria prevalence of 0.67% was found in Nairobi and its environments (low endemic) and 8.63% for Kisumu and its environments (high endemic area). The cost analysis showed a cost per case prevented of Ksh.105 (US$1.4) adult, Ksh.52.5 (US$0. 69) and paediatric for the option of recipient prophylaxis using an SP based drug. The cost escalated to Ksh.592 (US$7.79) adult Ksh.444 (US$5.84) paediatric if the prophylaxis was upgraded to the recommended artemisinin derivative (ACT-artemisinin based combination) and for the option of pre-transfusion screening using an automated technique the cost was Ksh.2.08 (US$0.03). CONCLUSION: The prevalence of malaria in donors showed the expected regional variation in the low and high endemic areas and was comparable to data obtained elsewhere. If malaria positive donor units were to be excluded from the national blood supply, an estimated 5% (compared to 1.3% for human Immunodeficiency virus, 3.6% for hepatitis B virus and 1.3% for hepatitis C virus) would be wasted. The cost per case prevented of transfusion-associated malaria is considerably higher for recipient antimalarial prophylaxis than pre-transfusion screening using an automated technique. The cost escalates by five to seven times if the newer artemesinin based combination antimalarial drugs are adopted.

OBJECTIVES: To determine the status of blood donor haematology in two regional sites in Kenya and to assess the potential role of automated haematology in National blood bank process control. DESIGN: A cross sectional descriptive study. SETTING: Two regional blood banks–Nairobi and its environs (Blood Transfusion Services, Nairobi) and Western Region (National Blood Transfusion Services, Kisumu). MAIN OUTCOME MEASURES: Distribution, mean, median, and 95% percentile ranges of haemoglobin (Hb), red cell parameters (red cell count, haematocrit, MCV, MCH and MCHC), total and differential white blood cell (WBC) counts, and platelet counts in the two donor populations. RESULTS: A significant number of donations (16.5% in Kisumu and 3.4% in Nairobi) showed haemoglobin levels below the recommended National Blood Transfusion Service (NBTS) guideline of 42g/unit. Compared to Kisumu, Nairobi donors had significantly (p < 0.001) higher Hb, MCV and MCH values while the red blood cell counts and MCHC values were similar (p > 0.05). A low MCV (< 78 fl) was observed in 12.4% and 3.4% of Kisumu and Nairobi donors respectively. Both populations showed similar but significant frequencies (Kisumu, 21.3%; Nairobi, 18.7%) of mild neutropenia (< 1.5 x 10(9)/1), while eosinophilia (> 0.5 x 10(9)/1 in the tropics the cut off is > 0.6 x 109) was more prominent in Kisumu donors (18.8% versus 8.5%). Platelet counts were also significantly lower in Kisumu donors, with the prevalence of thrombocytopenia (< 150 x 10(9)/1) being considerably higher (15.9% versus 3.7%). CONCLUSIONS: A significant number of Kenyan donors showed abnormal haematology profiles that may indicate underlying pathology. Such abnormalities are not detected by current blood transfusion services screening practices and there may be a need to strengthen donor selection criteria to protect both donors and recipients.

Department of Animal Physiology, Reproductive Biology Unit, University of Nairobi, P.O. Box 30197, Nairobi, Kenya. The effects of Schistosoma mansoni (S. mansoni) infection on plasma levels of bioactive luteinising hormone (LH) and testosterone in the New Zealand rabbit model were studied. S. mansoni infection significantly decreased the pulse frequency (P < 0.05), amplitude (P < 0.05), area under LH curve (P < 0.05) and mean plasma LH concentrations (P < 0.05) on days 42 and 70 post-infection, as compared to values for day 14 pre-infection. Areas under the response curves for plasma testosterone levels decreased significantly (P < 0.05) on days 42 and 70 post-infection in infected animals compared to day 14 pre-infection. In the praziquantel-treated group, the levels of LH and testosterone remained unchanged throughout the experimental period. The pulsatile secretion of LH was completely inhibited in S. mansoni-infected animals 70 days post-infection. These results suggest that the effects on reproductive gonadal hormones caused by S. mansoni in the rabbit model may partly be induced by alteration in pituitary synthesis or release of LH.

The presence of human immunodeficiency virus (HIV) in genital secretions is regarded as a risk factor for sexual and perinatal transmission of HIV. A better understanding of correlates of genital shedding of HIV is crucial to the development of effective strategies against transmission of this virus. Events during menstrual cycle are likely to influence local immune responses and viral load in genital secretions, and hence determine susceptibility to HIV or efficiency of virus transmission. We report, in this study, preliminary findings on the relationship of menstrual cycle to genital mucosal and systemic immunity in female olive baboons (Papio anubis) experimentally inoculated with simian/human immunodeficiency virus (SHIV)89.6P.

The presence of human immunodeficiency virus (HIV) in genital secretions is regarded as a risk factor for sexual and perinatal transmission of HIV. A better understanding of correlates of genital shedding of HIV is crucial to the development of effective strategies against transmission of this virus. Events during menstrual cycle are likely to influence local immune responses and viral load in genital secretions, and hence determine susceptibility to HIV or efficiency of virus transmission. We report, in this study, preliminary findings on the relationship of menstrual cycle to genital mucosal and systemic immunity in female olive baboons (Papio anubis) experimentally inoculated with simian/human immunodeficiency virus (SHIV)89.6P.

The presence of human immunodeficiency virus (HIV) in genital secretions is regarded as a risk factor for sexual and perinatal transmission of HIV. A better understanding of correlates of genital shedding of HIV is crucial to the development of effective strategies against transmission of this virus. Events during menstrual cycle are likely to influence local immune responses and viral load in genital secretions, and hence determine susceptibility to HIV or efficiency of virus transmission. We report, in this study, preliminary findings on the relationship of menstrual cycle to genital mucosal and systemic immunity in female olive baboons (Papio anubis) experimentally inoculated with simian/human immunodeficiency virus (SHIV)89.6P.

The presence of human immunodeficiency virus (HIV) in genital secretions is regarded as a risk factor for sexual and perinatal transmission of HIV. A better understanding of correlates of genital shedding of HIV is crucial to the development of effective strategies against transmission of this virus. Events during menstrual cycle are likely to influence local immune responses and viral load in genital secretions, and hence determine susceptibility to HIV or efficiency of virus transmission. We report, in this study, preliminary findings on the relationship of menstrual cycle to genital mucosal and systemic immunity in female olive baboons (Papio anubis) experimentally inoculated with simian/human immunodeficiency virus (SHIV)89.6P.

Reproductive Biology Unit, Department of Animal Physiology, University of Nairobi, Kenya. dochiel@kisian.mimcom.net The presence of human immunodeficiency virus (HIV) in genital secretions is regarded as a risk factor for sexual and perinatal transmission of HIV. A better understanding of correlates of genital shedding of HIV is crucial to the development of effective strategies against transmission of this virus. Events during menstrual cycle are likely to influence local immune responses and viral load in genital secretions, and hence determine susceptibility to HIV or efficiency of virus transmission. We report, in this study, preliminary findings on the relationship of menstrual cycle to genital mucosal and systemic immunity in female olive baboons (Papio anubis) experimentally inoculated with simian/human immunodeficiency virus (SHIV)89.6P.

Reproductive Biology Unit, Department of Animal Physiology, University of Nairobi, Kenya. dochiel@kisian.mimcom.net The presence of human immunodeficiency virus (HIV) in genital secretions is regarded as a risk factor for sexual and perinatal transmission of HIV. A better understanding of correlates of genital shedding of HIV is crucial to the development of effective strategies against transmission of this virus. Events during menstrual cycle are likely to influence local immune responses and viral load in genital secretions, and hence determine susceptibility to HIV or efficiency of virus transmission. We report, in this study, preliminary findings on the relationship of menstrual cycle to genital mucosal and systemic immunity in female olive baboons (Papio anubis) experimentally inoculated with simian/human immunodeficiency virus (SHIV)89.6P.

Reproductive Biology Unit, Department of Animal Physiology, University of Nairobi, Kenya. dochiel@kisian.mimcom.net The presence of human immunodeficiency virus (HIV) in genital secretions is regarded as a risk factor for sexual and perinatal transmission of HIV. A better understanding of correlates of genital shedding of HIV is crucial to the development of effective strategies against transmission of this virus. Events during menstrual cycle are likely to influence local immune responses and viral load in genital secretions, and hence determine susceptibility to HIV or efficiency of virus transmission. We report, in this study, preliminary findings on the relationship of menstrual cycle to genital mucosal and systemic immunity in female olive baboons (Papio anubis) experimentally inoculated with simian/human immunodeficiency virus (SHIV)89.6P.

Reproductive Biology Unit, Department of Animal Physiology, University of Nairobi, Kenya. dochiel@kisian.mimcom.net The presence of human immunodeficiency virus (HIV) in genital secretions is regarded as a risk factor for sexual and perinatal transmission of HIV. A better understanding of correlates of genital shedding of HIV is crucial to the development of effective strategies against transmission of this virus. Events during menstrual cycle are likely to influence local immune responses and viral load in genital secretions, and hence determine susceptibility to HIV or efficiency of virus transmission. We report, in this study, preliminary findings on the relationship of menstrual cycle to genital mucosal and systemic immunity in female olive baboons (Papio anubis) experimentally inoculated with simian/human immunodeficiency virus (SHIV)89.6P.

Reproductive Biology Unit, Department of Animal Physiology, University of Nairobi, Kenya. dochiel@kisian.mimcom.net The presence of human immunodeficiency virus (HIV) in genital secretions is regarded as a risk factor for sexual and perinatal transmission of HIV. A better understanding of correlates of genital shedding of HIV is crucial to the development of effective strategies against transmission of this virus. Events during menstrual cycle are likely to influence local immune responses and viral load in genital secretions, and hence determine susceptibility to HIV or efficiency of virus transmission. We report, in this study, preliminary findings on the relationship of menstrual cycle to genital mucosal and systemic immunity in female olive baboons (Papio anubis) experimentally inoculated with simian/human immunodeficiency virus (SHIV)89.6P.

OBJECTIVE: To determine if women receiving intrauterine devices (IUCDs) outside of menses have an acceptable rate of insertion problems and subsequent IUCD-related complications. DESIGN: Cross-sectional and prospective cohort study of insertions at times other than during menses. SETTING: The study was carried out in two government family planning (FP) clinics in Nairobi, Kenya. SUBJECTS: After appropriate pre-test and post-test HIV counselling, 1686 women requesting IUCDs at two FP clinics between 1994 and 1995 in Nairobi were enrolled at baseline into a study examining the effect of human immuno-deficiency virus (HIV) infection on IUCD-related complications. Six hundred and forty nine women (156 HIV-infected and 493 HIV-uninfected) were selected for the four month follow up study. They were classified according to their menstrual cycle status at time of IUCD insertion. MAIN OUTCOME MEASURES: Problems at the time of insertion (pain, bleeding, immediate expulsion) and IUCD-related complications through four months. RESULTS: Rates of immediate insertion problems were low in the women who had insertions during menses (7.0%), outside of menses (4.0%) or had oligomenorrhea/amenorrhea (2.6%). The adjusted odds ratios for IUCD insertion problems outside of menses and in oligomenorrhea/amenorrhea (versus women with insertion during menses) were 0.54 (95 % CI 0.18-1.59) and 0.39 (95% CI 0.12-1.29) respectively. IUCD-related complications were higher in the oligomenorrhea/amenorrhea (11.5%) or insertion outside of menses (6.9%), than the within menses (4.3%) groups. However, the differences were not statistically significant. Adjusted odds ratios for IUCD outside of menses and oligomenorrhoea/amenorrhea groups were 1.65 (95% CI 0.21-12.91) and 2.72 (95% CI 0.34-21.71) respectively. CONCLUSION: The results confirm that the IUCD can be safely inserted outside of menses with minimal insertion difficulties and subsequent complications. Availability of IUCDs outside of menses may enhance IUCD acceptance in Kenya and create better opportunity for visual screening of the cervix for sexually transmitted infections.

OBJECTIVE: To determine if women receiving intrauterine devices (IUCDs) outside of menses have an acceptable rate of insertion problems and subsequent IUCD-related complications. DESIGN: Cross-sectional and prospective cohort study of insertions at times other than during menses. SETTING: The study was carried out in two government family planning (FP) clinics in Nairobi, Kenya. SUBJECTS: After appropriate pre-test and post-test HIV counselling, 1686 women requesting IUCDs at two FP clinics between 1994 and 1995 in Nairobi were enrolled at baseline into a study examining the effect of human immuno-deficiency virus (HIV) infection on IUCD-related complications. Six hundred and forty nine women (156 HIV-infected and 493 HIV-uninfected) were selected for the four month follow up study. They were classified according to their menstrual cycle status at time of IUCD insertion. MAIN OUTCOME MEASURES: Problems at the time of insertion (pain, bleeding, immediate expulsion) and IUCD-related complications through four months. RESULTS: Rates of immediate insertion problems were low in the women who had insertions during menses (7.0%), outside of menses (4.0%) or had oligomenorrhea/amenorrhea (2.6%). The adjusted odds ratios for IUCD insertion problems outside of menses and in oligomenorrhea/amenorrhea (versus women with insertion during menses) were 0.54 (95 % CI 0.18-1.59) and 0.39 (95% CI 0.12-1.29) respectively. IUCD-related complications were higher in the oligomenorrhea/amenorrhea (11.5%) or insertion outside of menses (6.9%), than the within menses (4.3%) groups. However, the differences were not statistically significant. Adjusted odds ratios for IUCD outside of menses and oligomenorrhoea/amenorrhea groups were 1.65 (95% CI 0.21-12.91) and 2.72 (95% CI 0.34-21.71) respectively. CONCLUSION: The results confirm that the IUCD can be safely inserted outside of menses with minimal insertion difficulties and subsequent complications. Availability of IUCDs outside of menses may enhance IUCD acceptance in Kenya and create better opportunity for visual screening of the cervix for sexually transmitted infections.

OBJECTIVE: To determine if women receiving intrauterine devices (IUCDs) outside of menses have an acceptable rate of insertion problems and subsequent IUCD-related complications. DESIGN: Cross-sectional and prospective cohort study of insertions at times other than during menses. SETTING: The study was carried out in two government family planning (FP) clinics in Nairobi, Kenya. SUBJECTS: After appropriate pre-test and post-test HIV counselling, 1686 women requesting IUCDs at two FP clinics between 1994 and 1995 in Nairobi were enrolled at baseline into a study examining the effect of human immuno-deficiency virus (HIV) infection on IUCD-related complications. Six hundred and forty nine women (156 HIV-infected and 493 HIV-uninfected) were selected for the four month follow up study. They were classified according to their menstrual cycle status at time of IUCD insertion. MAIN OUTCOME MEASURES: Problems at the time of insertion (pain, bleeding, immediate expulsion) and IUCD-related complications through four months. RESULTS: Rates of immediate insertion problems were low in the women who had insertions during menses (7.0%), outside of menses (4.0%) or had oligomenorrhea/amenorrhea (2.6%). The adjusted odds ratios for IUCD insertion problems outside of menses and in oligomenorrhea/amenorrhea (versus women with insertion during menses) were 0.54 (95 % CI 0.18-1.59) and 0.39 (95% CI 0.12-1.29) respectively. IUCD-related complications were higher in the oligomenorrhea/amenorrhea (11.5%) or insertion outside of menses (6.9%), than the within menses (4.3%) groups. However, the differences were not statistically significant. Adjusted odds ratios for IUCD outside of menses and oligomenorrhoea/amenorrhea groups were 1.65 (95% CI 0.21-12.91) and 2.72 (95% CI 0.34-21.71) respectively. CONCLUSION: The results confirm that the IUCD can be safely inserted outside of menses with minimal insertion difficulties and subsequent complications. Availability of IUCDs outside of menses may enhance IUCD acceptance in Kenya and create better opportunity for visual screening of the cervix for sexually transmitted infections.

Department of Obstetrics and Gynecology, University of Nairobi, Kenya. medmicro@ken.healthnet.org A cross-sectional descriptive study on knowledge, attitudes, and practice about emergency contraception (EC) was conducted among nurses and nursing students using a self-administered questionnaire. One-hundred-sixty-seven qualified nurses and 63 nursing students completed the questionnaire. Over 95% listed at least one regular contraceptive method but only 2.6% spontaneously listed EC as a contraceptive method, whereas 48% of the respondents had heard of EC. Significantly more nursing students than qualified nurses were familiar with EC. Knowledge about the types of EC, applications, and side effects was poor and 49% of the respondents considered EC as an abortifacient. Of those familiar with EC, 77% approved its use for rape victims and 21% for adolescents and schoolgirls. Only 3.5% of all respondents had personally used EC in the past, 23% of those familiar with EC intend to use it in the future, whereas 53% intend to provide or promote it. The view that EC was abortifacient negatively influenced the decision to use or provide EC in the future. The present findings suggest that the level of knowledge of EC is poor and more information is needed. These findings indicate the potential to popularize emergency contraception in Kenya among nurses and nursing students. PIP: A descriptive research study on knowledge, attitudes and practices with regard to emergency contraception (EC) was conducted using a questionnaire among 167 nurses and 63 nursing students in Nairobi, Kenya. Results revealed that 95% recorded at least one regular contraceptive method. About 48% of the respondents had heard about EC, but only 2.6% had used it. More nursing students than qualified nurses were aware of EC. There was poor knowledge about the types, applications and side effects of EC. Some 49% of the subjects regarded EC as an abortifacient. About 77% of those knowledgeable about EC approved its use for rape victims and 21% for adolescents and schoolgirls. Only about 3.5% had personally used it. Some 23% of those aware of EC intended to use it in the future. About 53% planned to provide or promote it. The perception that EC is abortifacient affected the decision whether to use or provide it. The data imply that there is potential for effective promotion of EC among nurses and nursing students in Kenya.

Aga Khan Hospital, Nairobi. Forty females, age 14 to 35 years (mean 28.6 years) with chronic renal failure (CRF) were included in the study. Their menstrual patterns were noted. The function of their hypothalamo-pituitary-ovarian axis was assessed by the serum levels of follicle stimulating hormone (FSH), Luteinising hormone (LH), prolactin (PrL), estradiol (E2) and progesterone (P) at different phases of the menstrual cycle in patients who continued to have normal menses (Group 1) and at weekly intervals for six weeks in patients with menstrual disturbances (Group II). The mean hormone levels during the initial contact Luteal phase in group I were FSH 12.0 IU/L (N, 1.0-3.0 IU/L), LH 1.8IU/L (N 1.5-101U/L), PrL 652mIU/L (N, 100-600 mIU/L) mE2 160 pmol/L (N 400-1400 pmol/L) and P5 nmol/L (N 14-60 nmol/L) for group I. Corresponding values for group II were 1.2, 10.3, 250, 600 and 3.0 in relevant units. All patients (fourteen) with end stage renal disease (ESRD) had amenorrhoae. On the other hand, most patients with stable CRF (22/26) had normal menses. Following initiation of therapy (conservative or dialytic), there was no significant alteration in the hormonal profile or menstrual pattern. We conclude that other factors apart from the hormonal imbalances, may be responsible for the menstrual disturbances noted in patients with CRF.

Aga Khan Hospital, Nairobi. Forty females, age 14 to 35 years (mean 28.6 years) with chronic renal failure (CRF) were included in the study. Their menstrual patterns were noted. The function of their hypothalamo-pituitary-ovarian axis was assessed by the serum levels of follicle stimulating hormone (FSH), Luteinising hormone (LH), prolactin (PrL), estradiol (E2) and progesterone (P) at different phases of the menstrual cycle in patients who continued to have normal menses (Group 1) and at weekly intervals for six weeks in patients with menstrual disturbances (Group II). The mean hormone levels during the initial contact Luteal phase in group I were FSH 12.0 IU/L (N, 1.0-3.0 IU/L), LH 1.8IU/L (N 1.5-101U/L), PrL 652mIU/L (N, 100-600 mIU/L) mE2 160 pmol/L (N 400-1400 pmol/L) and P5 nmol/L (N 14-60 nmol/L) for group I. Corresponding values for group II were 1.2, 10.3, 250, 600 and 3.0 in relevant units. All patients (fourteen) with end stage renal disease (ESRD) had amenorrhoae. On the other hand, most patients with stable CRF (22/26) had normal menses. Following initiation of therapy (conservative or dialytic), there was no significant alteration in the hormonal profile or menstrual pattern. We conclude that other factors apart from the hormonal imbalances, may be responsible for the menstrual disturbances noted in patients with CRF.

Aga Khan Hospital, Nairobi. Forty females, age 14 to 35 years (mean 28.6 years) with chronic renal failure (CRF) were included in the study. Their menstrual patterns were noted. The function of their hypothalamo-pituitary-ovarian axis was assessed by the serum levels of follicle stimulating hormone (FSH), Luteinising hormone (LH), prolactin (PrL), estradiol (E2) and progesterone (P) at different phases of the menstrual cycle in patients who continued to have normal menses (Group 1) and at weekly intervals for six weeks in patients with menstrual disturbances (Group II). The mean hormone levels during the initial contact Luteal phase in group I were FSH 12.0 IU/L (N, 1.0-3.0 IU/L), LH 1.8IU/L (N 1.5-101U/L), PrL 652mIU/L (N, 100-600 mIU/L) mE2 160 pmol/L (N 400-1400 pmol/L) and P5 nmol/L (N 14-60 nmol/L) for group I. Corresponding values for group II were 1.2, 10.3, 250, 600 and 3.0 in relevant units. All patients (fourteen) with end stage renal disease (ESRD) had amenorrhoae. On the other hand, most patients with stable CRF (22/26) had normal menses. Following initiation of therapy (conservative or dialytic), there was no significant alteration in the hormonal profile or menstrual pattern. We conclude that other factors apart from the hormonal imbalances, may be responsible for the menstrual disturbances noted in patients with CRF.

Aga Khan Hospital, Nairobi. Forty females, age 14 to 35 years (mean 28.6 years) with chronic renal failure (CRF) were included in the study. Their menstrual patterns were noted. The function of their hypothalamo-pituitary-ovarian axis was assessed by the serum levels of follicle stimulating hormone (FSH), Luteinising hormone (LH), prolactin (PrL), estradiol (E2) and progesterone (P) at different phases of the menstrual cycle in patients who continued to have normal menses (Group 1) and at weekly intervals for six weeks in patients with menstrual disturbances (Group II). The mean hormone levels during the initial contact Luteal phase in group I were FSH 12.0 IU/L (N, 1.0-3.0 IU/L), LH 1.8IU/L (N 1.5-101U/L), PrL 652mIU/L (N, 100-600 mIU/L) mE2 160 pmol/L (N 400-1400 pmol/L) and P5 nmol/L (N 14-60 nmol/L) for group I. Corresponding values for group II were 1.2, 10.3, 250, 600 and 3.0 in relevant units. All patients (fourteen) with end stage renal disease (ESRD) had amenorrhoae. On the other hand, most patients with stable CRF (22/26) had normal menses. Following initiation of therapy (conservative or dialytic), there was no significant alteration in the hormonal profile or menstrual pattern. We conclude that other factors apart from the hormonal imbalances, may be responsible for the menstrual disturbances noted in patients with CRF.

Aga Khan Hospital, Nairobi. Forty females, age 14 to 35 years (mean 28.6 years) with chronic renal failure (CRF) were included in the study. Their menstrual patterns were noted. The function of their hypothalamo-pituitary-ovarian axis was assessed by the serum levels of follicle stimulating hormone (FSH), Luteinising hormone (LH), prolactin (PrL), estradiol (E2) and progesterone (P) at different phases of the menstrual cycle in patients who continued to have normal menses (Group 1) and at weekly intervals for six weeks in patients with menstrual disturbances (Group II). The mean hormone levels during the initial contact Luteal phase in group I were FSH 12.0 IU/L (N, 1.0-3.0 IU/L), LH 1.8IU/L (N 1.5-101U/L), PrL 652mIU/L (N, 100-600 mIU/L) mE2 160 pmol/L (N 400-1400 pmol/L) and P5 nmol/L (N 14-60 nmol/L) for group I. Corresponding values for group II were 1.2, 10.3, 250, 600 and 3.0 in relevant units. All patients (fourteen) with end stage renal disease (ESRD) had amenorrhoae. On the other hand, most patients with stable CRF (22/26) had normal menses. Following initiation of therapy (conservative or dialytic), there was no significant alteration in the hormonal profile or menstrual pattern. We conclude that other factors apart from the hormonal imbalances, may be responsible for the menstrual disturbances noted in patients with CRF.

Aga Khan Hospital, Nairobi. Forty females, age 14 to 35 years (mean 28.6 years) with chronic renal failure (CRF) were included in the study. Their menstrual patterns were noted. The function of their hypothalamo-pituitary-ovarian axis was assessed by the serum levels of follicle stimulating hormone (FSH), Luteinising hormone (LH), prolactin (PrL), estradiol (E2) and progesterone (P) at different phases of the menstrual cycle in patients who continued to have normal menses (Group 1) and at weekly intervals for six weeks in patients with menstrual disturbances (Group II). The mean hormone levels during the initial contact Luteal phase in group I were FSH 12.0 IU/L (N, 1.0-3.0 IU/L), LH 1.8IU/L (N 1.5-101U/L), PrL 652mIU/L (N, 100-600 mIU/L) mE2 160 pmol/L (N 400-1400 pmol/L) and P5 nmol/L (N 14-60 nmol/L) for group I. Corresponding values for group II were 1.2, 10.3, 250, 600 and 3.0 in relevant units. All patients (fourteen) with end stage renal disease (ESRD) had amenorrhoae. On the other hand, most patients with stable CRF (22/26) had normal menses. Following initiation of therapy (conservative or dialytic), there was no significant alteration in the hormonal profile or menstrual pattern. We conclude that other factors apart from the hormonal imbalances, may be responsible for the menstrual disturbances noted in patients with CRF.

Aga Khan Hospital, Nairobi. Forty females, age 14 to 35 years (mean 28.6 years) with chronic renal failure (CRF) were included in the study. Their menstrual patterns were noted. The function of their hypothalamo-pituitary-ovarian axis was assessed by the serum levels of follicle stimulating hormone (FSH), Luteinising hormone (LH), prolactin (PrL), estradiol (E2) and progesterone (P) at different phases of the menstrual cycle in patients who continued to have normal menses (Group 1) and at weekly intervals for six weeks in patients with menstrual disturbances (Group II). The mean hormone levels during the initial contact Luteal phase in group I were FSH 12.0 IU/L (N, 1.0-3.0 IU/L), LH 1.8IU/L (N 1.5-101U/L), PrL 652mIU/L (N, 100-600 mIU/L) mE2 160 pmol/L (N 400-1400 pmol/L) and P5 nmol/L (N 14-60 nmol/L) for group I. Corresponding values for group II were 1.2, 10.3, 250, 600 and 3.0 in relevant units. All patients (fourteen) with end stage renal disease (ESRD) had amenorrhoae. On the other hand, most patients with stable CRF (22/26) had normal menses. Following initiation of therapy (conservative or dialytic), there was no significant alteration in the hormonal profile or menstrual pattern. We conclude that other factors apart from the hormonal imbalances, may be responsible for the menstrual disturbances noted in patients with CRF.

Aga Khan Hospital, Nairobi. Forty females, age 14 to 35 years (mean 28.6 years) with chronic renal failure (CRF) were included in the study. Their menstrual patterns were noted. The function of their hypothalamo-pituitary-ovarian axis was assessed by the serum levels of follicle stimulating hormone (FSH), Luteinising hormone (LH), prolactin (PrL), estradiol (E2) and progesterone (P) at different phases of the menstrual cycle in patients who continued to have normal menses (Group 1) and at weekly intervals for six weeks in patients with menstrual disturbances (Group II). The mean hormone levels during the initial contact Luteal phase in group I were FSH 12.0 IU/L (N, 1.0-3.0 IU/L), LH 1.8IU/L (N 1.5-101U/L), PrL 652mIU/L (N, 100-600 mIU/L) mE2 160 pmol/L (N 400-1400 pmol/L) and P5 nmol/L (N 14-60 nmol/L) for group I. Corresponding values for group II were 1.2, 10.3, 250, 600 and 3.0 in relevant units. All patients (fourteen) with end stage renal disease (ESRD) had amenorrhoae. On the other hand, most patients with stable CRF (22/26) had normal menses. Following initiation of therapy (conservative or dialytic), there was no significant alteration in the hormonal profile or menstrual pattern. We conclude that other factors apart from the hormonal imbalances, may be responsible for the menstrual disturbances noted in patients with CRF.

Aga Khan Hospital, Nairobi. Forty females, age 14 to 35 years (mean 28.6 years) with chronic renal failure (CRF) were included in the study. Their menstrual patterns were noted. The function of their hypothalamo-pituitary-ovarian axis was assessed by the serum levels of follicle stimulating hormone (FSH), Luteinising hormone (LH), prolactin (PrL), estradiol (E2) and progesterone (P) at different phases of the menstrual cycle in patients who continued to have normal menses (Group 1) and at weekly intervals for six weeks in patients with menstrual disturbances (Group II). The mean hormone levels during the initial contact Luteal phase in group I were FSH 12.0 IU/L (N, 1.0-3.0 IU/L), LH 1.8IU/L (N 1.5-101U/L), PrL 652mIU/L (N, 100-600 mIU/L) mE2 160 pmol/L (N 400-1400 pmol/L) and P5 nmol/L (N 14-60 nmol/L) for group I. Corresponding values for group II were 1.2, 10.3, 250, 600 and 3.0 in relevant units. All patients (fourteen) with end stage renal disease (ESRD) had amenorrhoae. On the other hand, most patients with stable CRF (22/26) had normal menses. Following initiation of therapy (conservative or dialytic), there was no significant alteration in the hormonal profile or menstrual pattern. We conclude that other factors apart from the hormonal imbalances, may be responsible for the menstrual disturbances noted in patients with CRF.

This pilot study aimed to determine the feasibility of a larger study of contraception and risk of HIV infection in women. We also measured risk factors for and occurrence of HIV infection in the participants. A cohort of 1537 seronegative women attending a family planning clinic in Nairobi, Kenya was enrolled and followed for up to 12 months per woman. HIV testing was done quarterly. A nested case-control analysis was done with seroconverting women (cases) and 3 matched controls per case, who had detailed interviews and received physical examinations and STD tests. The prevalence of HIV at enrollment was 6.1%; seropositive women were excluded from further analysis. The 12-month life-table cumulative incidence of HIV was 2.1 per 100 women (95% confidence interval [CI] 1.1-3.2). In the nested case-control analysis (17 cases and 51 controls), the crude odds ratio of HIV infection comparing oral contraceptive (OC) users with other women was 3.5 (95%) CI 0.8-21.5), which persisted after control for single confounders at a time. The putative association between OC use sand HIV infection is critical to public health policy, yet no study has been conducted specifically to measure it, yielding weak and conflicting evidence. We intend to conduct a larger study with a similar design as the current pilot study, which confirmed the feasibility of a more definitive project.

This pilot study aimed to determine the feasibility of a larger study of contraception and risk of HIV infection in women. We also measured risk factors for and occurrence of HIV infection in the participants. A cohort of 1537 seronegative women attending a family planning clinic in Nairobi, Kenya was enrolled and followed for up to 12 months per woman. HIV testing was done quarterly. A nested case-control analysis was done with seroconverting women (cases) and 3 matched controls per case, who had detailed interviews and received physical examinations and STD tests. The prevalence of HIV at enrollment was 6.1%; seropositive women were excluded from further analysis. The 12-month life-table cumulative incidence of HIV was 2.1 per 100 women (95% confidence interval [CI] 1.1-3.2). In the nested case-control analysis (17 cases and 51 controls), the crude odds ratio of HIV infection comparing oral contraceptive (OC) users with other women was 3.5 (95%) CI 0.8-21.5), which persisted after control for single confounders at a time. The putative association between OC use sand HIV infection is critical to public health policy, yet no study has been conducted specifically to measure it, yielding weak and conflicting evidence. We intend to conduct a larger study with a similar design as the current pilot study, which confirmed the feasibility of a more definitive project.

This pilot study aimed to determine the feasibility of a larger study of contraception and risk of HIV infection in women. We also measured risk factors for and occurrence of HIV infection in the participants. A cohort of 1537 seronegative women attending a family planning clinic in Nairobi, Kenya was enrolled and followed for up to 12 months per woman. HIV testing was done quarterly. A nested case-control analysis was done with seroconverting women (cases) and 3 matched controls per case, who had detailed interviews and received physical examinations and STD tests. The prevalence of HIV at enrollment was 6.1%; seropositive women were excluded from further analysis. The 12-month life-table cumulative incidence of HIV was 2.1 per 100 women (95% confidence interval [CI] 1.1-3.2). In the nested case-control analysis (17 cases and 51 controls), the crude odds ratio of HIV infection comparing oral contraceptive (OC) users with other women was 3.5 (95%) CI 0.8-21.5), which persisted after control for single confounders at a time. The putative association between OC use sand HIV infection is critical to public health policy, yet no study has been conducted specifically to measure it, yielding weak and conflicting evidence. We intend to conduct a larger study with a similar design as the current pilot study, which confirmed the feasibility of a more definitive project.

Department of Anthropology and Carolina Population Center, University of North Carolina, Chapel Hill 27516, USA. The frequently reported observation that nomadic populations have lower fertility than their settled counterparts is often attributed to what are perceived as harsh, stressful conditions under which the nomads live. But the consequences of the hypothesized stresses for the reproductive biology or demography of these populations have been documented only a little. Traditionally, the Turkana of northwest Kenya are nomadic herders, but increasing numbers have settled on agricultural development schemes. We used an array of hormonal assays along with anthropometric indexes of nutritional status and interviews covering reproductive history, recent menstruation, diet, and health to compare reproductive function in nomadic and settled Turkana women. First morning urine samples were collected for three consecutive days during a series of surveys. Human choriogonadotropin (hCG; a marker for pregnancy), luteinizing hormone (LH; an indicator of ovulation), and pregnanediol glucuronide (PdG; an indicator of postovulatory luteal function) were assessed in the field with commercially available dipstick enzyme immunoassays. These assays along with the interview data allowed us to determine the reproductive status (e.g., pregnant or cycling, and if cycling, which phase of the ovarian cycle) of 166 nomadic and 194 settled Turkana women. The cross-sectional classifications allowed inferences of conception rates and normality of ovarian function. Follow-up surveys provided rates of pregnancy loss. Compared with the settled women, the nomadic women exhibited lower pregnancy rates and cycling nomadic women were less likely to show evidence of ovulation or luteal function. These results suggest that reproductive function of the nomadic women is diminished relative to the settled women. However, the settled women experienced a much higher rate of pregnancy loss, which may mean that their effective fecundability is in fact lower than that of the nomadic women. This study is the first to apply such a wide range of hormonal assays in the field. It demonstrates that field-based assays are feasible and robust and can play an important role in epidemiological and biodemographic studies, even in remote locations under conditions that would ordinarily be considered incompatible with on-site laboratory analysis.

Department of Obstetrics and Gynaecology, University of Nairobi, Kenya. This pilot study aimed to determine the feasibility of a larger study of contraception and risk of HIV infection in women. We also measured risk factors for and occurrence of HIV infection in the participants. A cohort of 1537 seronegative women attending a family planning clinic in Nairobi, Kenya was enrolled and followed for up to 12 months per woman. HIV testing was done quarterly. A nested case-control analysis was done with seroconverting women (cases) and 3 matched controls per case, who had detailed interviews and received physical examinations and STD tests. The prevalence of HIV at enrollment was 6.1%; seropositive women were excluded from further analysis. The 12-month life-table cumulative incidence of HIV was 2.1 per 100 women (95% confidence interval [CI] 1.1-3.2). In the nested case-control analysis (17 cases and 51 controls), the crude odds ratio of HIV infection comparing oral contraceptive (OC) users with other women was 3.5 (95%) CI 0.8-21.5), which persisted after control for single confounders at a time. The putative association between OC use sand HIV infection is critical to public health policy, yet no study has been conducted specifically to measure it, yielding weak and conflicting evidence. We intend to conduct a larger study with a similar design as the current pilot study, which confirmed the feasibility of a more definitive project.

Normal postpartum women, who had a spontaneous vaginal delivery of one full-term male infant, free of congenital abnormalities and other diseases, were recruited for this study. Thirteen women received 150 mg depot-medroxy-progesterone acetate (DMPA), intramuscularly on days 42 + 1 and 126 + 1 postpartum. Infants of nine mothers, who did not receive DMPA, served as controls. Blood samples were collected from treated mothers on days 44, 47, 74, 124, 128, and 130 postpartum for medroxyprogesterone acetate (MPA) measurements. Four-hour urine collections were obtained from all 22 infants in the morning on days 38, 40, 42, 44, 46, 53, 60, 67, 74, 88, 102, 116, 122, 124, 126, 128, 130, and 137. Urinary follicle stimulating hormone (FSH), luteinizing hormone (LH), unconjugated testosterone, and unconjugated cortisol were measured by radioimmunoassay, and serum MPA and urinary MPA metabolites were measured by gas chromatography-mass spectrometry (GC-MS). No MPA metabolites could be detected in the urine of the infants from the DMPA-receiving mothers. Hormonal profiles in the urine samples were not suppressed in comparison with those of the control infants. The present study demonstrates that DMPA, administered to the mother, does not influence the hormonal regulation of the breast-fed normal male infant.

Normal postpartum women, who had a spontaneous vaginal delivery of one full-term male infant, free of congenital abnormalities and other diseases, were recruited for this study. Thirteen women received 150 mg depot-medroxy-progesterone acetate (DMPA), intramuscularly on days 42 + 1 and 126 + 1 postpartum. Infants of nine mothers, who did not receive DMPA, served as controls. Blood samples were collected from treated mothers on days 44, 47, 74, 124, 128, and 130 postpartum for medroxyprogesterone acetate (MPA) measurements. Four-hour urine collections were obtained from all 22 infants in the morning on days 38, 40, 42, 44, 46, 53, 60, 67, 74, 88, 102, 116, 122, 124, 126, 128, 130, and 137. Urinary follicle stimulating hormone (FSH), luteinizing hormone (LH), unconjugated testosterone, and unconjugated cortisol were measured by radioimmunoassay, and serum MPA and urinary MPA metabolites were measured by gas chromatography-mass spectrometry (GC-MS). No MPA metabolites could be detected in the urine of the infants from the DMPA-receiving mothers. Hormonal profiles in the urine samples were not suppressed in comparison with those of the control infants. The present study demonstrates that DMPA, administered to the mother, does not influence the hormonal regulation of the breast-fed normal male infant.

Normal postpartum women, who had a spontaneous vaginal delivery of one full-term male infant, free of congenital abnormalities and other diseases, were recruited for this study. Thirteen women received 150 mg depot-medroxy-progesterone acetate (DMPA), intramuscularly on days 42 + 1 and 126 + 1 postpartum. Infants of nine mothers, who did not receive DMPA, served as controls. Blood samples were collected from treated mothers on days 44, 47, 74, 124, 128, and 130 postpartum for medroxyprogesterone acetate (MPA) measurements. Four-hour urine collections were obtained from all 22 infants in the morning on days 38, 40, 42, 44, 46, 53, 60, 67, 74, 88, 102, 116, 122, 124, 126, 128, 130, and 137. Urinary follicle stimulating hormone (FSH), luteinizing hormone (LH), unconjugated testosterone, and unconjugated cortisol were measured by radioimmunoassay, and serum MPA and urinary MPA metabolites were measured by gas chromatography-mass spectrometry (GC-MS). No MPA metabolites could be detected in the urine of the infants from the DMPA-receiving mothers. Hormonal profiles in the urine samples were not suppressed in comparison with those of the control infants. The present study demonstrates that DMPA, administered to the mother, does not influence the hormonal regulation of the breast-fed normal male infant.

Forty females, age 14 to 35 years (mean 28.6 years) with chronic renal failure (CRF) were included in the study. Their menstrual patterns were noted. The function of their hypothalamo-pituitary-ovarian axis was assessed by the serum levels of follicle stimulating hormone (FSH), Luteinising hormone (LH), prolactin (PrL), estradiol (E2) and progesterone (P) at different phases of the menstrual cycle in patients who continued to have normal menses (Group 1) and at weekly intervals for six weeks in patients with menstrual disturbances (Group II). The mean hormone levels during the initial contact Luteal phase in group I were FSH 12.0 IU/L (N, 1.0-3.0 IU/L), LH 1.8IU/L (N 1.5-101U/L), PrL 652mIU/L (N, 100-600 mIU/L) mE2 160 pmol/L (N 400-1400 pmol/L) and P5 nmol/L (N 14-60 nmol/L) for group I. Corresponding values for group II were 1.2, 10.3, 250, 600 and 3.0 in relevant units. All patients (fourteen) with end stage renal disease (ESRD) had amenorrhoae. On the other hand, most patients with stable CRF (22/26) had normal menses. Following initiation of therapy (conservative or dialytic), there was no significant alteration in the hormonal profile or menstrual pattern. We conclude that other factors apart from the hormonal imbalances, may be responsible for the menstrual disturbances noted in patients with CRF.

Forty females, age 14 to 35 years (mean 28.6 years) with chronic renal failure (CRF) were included in the study. Their menstrual patterns were noted. The function of their hypothalamo-pituitary-ovarian axis was assessed by the serum levels of follicle stimulating hormone (FSH), Luteinising hormone (LH), prolactin (PrL), estradiol (E2) and progesterone (P) at different phases of the menstrual cycle in patients who continued to have normal menses (Group 1) and at weekly intervals for six weeks in patients with menstrual disturbances (Group II). The mean hormone levels during the initial contact Luteal phase in group I were FSH 12.0 IU/L (N, 1.0-3.0 IU/L), LH 1.8IU/L (N 1.5-101U/L), PrL 652mIU/L (N, 100-600 mIU/L) mE2 160 pmol/L (N 400-1400 pmol/L) and P5 nmol/L (N 14-60 nmol/L) for group I. Corresponding values for group II were 1.2, 10.3, 250, 600 and 3.0 in relevant units. All patients (fourteen) with end stage renal disease (ESRD) had amenorrhoae. On the other hand, most patients with stable CRF (22/26) had normal menses. Following initiation of therapy (conservative or dialytic), there was no significant alteration in the hormonal profile or menstrual pattern. We conclude that other factors apart from the hormonal imbalances, may be responsible for the menstrual disturbances noted in patients with CRF.

Forty females, age 14 to 35 years (mean 28.6 years) with chronic renal failure (CRF) were included in the study. Their menstrual patterns were noted. The function of their hypothalamo-pituitary-ovarian axis was assessed by the serum levels of follicle stimulating hormone (FSH), Luteinising hormone (LH), prolactin (PrL), estradiol (E2) and progesterone (P) at different phases of the menstrual cycle in patients who continued to have normal menses (Group 1) and at weekly intervals for six weeks in patients with menstrual disturbances (Group II). The mean hormone levels during the initial contact Luteal phase in group I were FSH 12.0 IU/L (N, 1.0-3.0 IU/L), LH 1.8IU/L (N 1.5-101U/L), PrL 652mIU/L (N, 100-600 mIU/L) mE2 160 pmol/L (N 400-1400 pmol/L) and P5 nmol/L (N 14-60 nmol/L) for group I. Corresponding values for group II were 1.2, 10.3, 250, 600 and 3.0 in relevant units. All patients (fourteen) with end stage renal disease (ESRD) had amenorrhoae. On the other hand, most patients with stable CRF (22/26) had normal menses. Following initiation of therapy (conservative or dialytic), there was no significant alteration in the hormonal profile or menstrual pattern. We conclude that other factors apart from the hormonal imbalances, may be responsible for the menstrual disturbances noted in patients with CRF.

Forty females, age 14 to 35 years (mean 28.6 years) with chronic renal failure (CRF) were included in the study. Their menstrual patterns were noted. The function of their hypothalamo-pituitary-ovarian axis was assessed by the serum levels of follicle stimulating hormone (FSH), Luteinising hormone (LH), prolactin (PrL), estradiol (E2) and progesterone (P) at different phases of the menstrual cycle in patients who continued to have normal menses (Group 1) and at weekly intervals for six weeks in patients with menstrual disturbances (Group II). The mean hormone levels during the initial contact Luteal phase in group I were FSH 12.0 IU/L (N, 1.0-3.0 IU/L), LH 1.8IU/L (N 1.5-101U/L), PrL 652mIU/L (N, 100-600 mIU/L) mE2 160 pmol/L (N 400-1400 pmol/L) and P5 nmol/L (N 14-60 nmol/L) for group I. Corresponding values for group II were 1.2, 10.3, 250, 600 and 3.0 in relevant units. All patients (fourteen) with end stage renal disease (ESRD) had amenorrhoae. On the other hand, most patients with stable CRF (22/26) had normal menses. Following initiation of therapy (conservative or dialytic), there was no significant alteration in the hormonal profile or menstrual pattern. We conclude that other factors apart from the hormonal imbalances, may be responsible for the menstrual disturbances noted in patients with CRF.

Forty females, age 14 to 35 years (mean 28.6 years) with chronic renal failure (CRF) were included in the study. Their menstrual patterns were noted. The function of their hypothalamo-pituitary-ovarian axis was assessed by the serum levels of follicle stimulating hormone (FSH), Luteinising hormone (LH), prolactin (PrL), estradiol (E2) and progesterone (P) at different phases of the menstrual cycle in patients who continued to have normal menses (Group 1) and at weekly intervals for six weeks in patients with menstrual disturbances (Group II). The mean hormone levels during the initial contact Luteal phase in group I were FSH 12.0 IU/L (N, 1.0-3.0 IU/L), LH 1.8IU/L (N 1.5-101U/L), PrL 652mIU/L (N, 100-600 mIU/L) mE2 160 pmol/L (N 400-1400 pmol/L) and P5 nmol/L (N 14-60 nmol/L) for group I. Corresponding values for group II were 1.2, 10.3, 250, 600 and 3.0 in relevant units. All patients (fourteen) with end stage renal disease (ESRD) had amenorrhoae. On the other hand, most patients with stable CRF (22/26) had normal menses. Following initiation of therapy (conservative or dialytic), there was no significant alteration in the hormonal profile or menstrual pattern. We conclude that other factors apart from the hormonal imbalances, may be responsible for the menstrual disturbances noted in patients with CRF.

Forty females, age 14 to 35 years (mean 28.6 years) with chronic renal failure (CRF) were included in the study. Their menstrual patterns were noted. The function of their hypothalamo-pituitary-ovarian axis was assessed by the serum levels of follicle stimulating hormone (FSH), Luteinising hormone (LH), prolactin (PrL), estradiol (E2) and progesterone (P) at different phases of the menstrual cycle in patients who continued to have normal menses (Group 1) and at weekly intervals for six weeks in patients with menstrual disturbances (Group II). The mean hormone levels during the initial contact Luteal phase in group I were FSH 12.0 IU/L (N, 1.0-3.0 IU/L), LH 1.8IU/L (N 1.5-101U/L), PrL 652mIU/L (N, 100-600 mIU/L) mE2 160 pmol/L (N 400-1400 pmol/L) and P5 nmol/L (N 14-60 nmol/L) for group I. Corresponding values for group II were 1.2, 10.3, 250, 600 and 3.0 in relevant units. All patients (fourteen) with end stage renal disease (ESRD) had amenorrhoae. On the other hand, most patients with stable CRF (22/26) had normal menses. Following initiation of therapy (conservative or dialytic), there was no significant alteration in the hormonal profile or menstrual pattern. We conclude that other factors apart from the hormonal imbalances, may be responsible for the menstrual disturbances noted in patients with CRF.

Forty females, age 14 to 35 years (mean 28.6 years) with chronic renal failure (CRF) were included in the study. Their menstrual patterns were noted. The function of their hypothalamo-pituitary-ovarian axis was assessed by the serum levels of follicle stimulating hormone (FSH), Luteinising hormone (LH), prolactin (PrL), estradiol (E2) and progesterone (P) at different phases of the menstrual cycle in patients who continued to have normal menses (Group 1) and at weekly intervals for six weeks in patients with menstrual disturbances (Group II). The mean hormone levels during the initial contact Luteal phase in group I were FSH 12.0 IU/L (N, 1.0-3.0 IU/L), LH 1.8IU/L (N 1.5-101U/L), PrL 652mIU/L (N, 100-600 mIU/L) mE2 160 pmol/L (N 400-1400 pmol/L) and P5 nmol/L (N 14-60 nmol/L) for group I. Corresponding values for group II were 1.2, 10.3, 250, 600 and 3.0 in relevant units. All patients (fourteen) with end stage renal disease (ESRD) had amenorrhoae. On the other hand, most patients with stable CRF (22/26) had normal menses. Following initiation of therapy (conservative or dialytic), there was no significant alteration in the hormonal profile or menstrual pattern. We conclude that other factors apart from the hormonal imbalances, may be responsible for the menstrual disturbances noted in patients with CRF.

Forty females, age 14 to 35 years (mean 28.6 years) with chronic renal failure (CRF) were included in the study. Their menstrual patterns were noted. The function of their hypothalamo-pituitary-ovarian axis was assessed by the serum levels of follicle stimulating hormone (FSH), Luteinising hormone (LH), prolactin (PrL), estradiol (E2) and progesterone (P) at different phases of the menstrual cycle in patients who continued to have normal menses (Group 1) and at weekly intervals for six weeks in patients with menstrual disturbances (Group II). The mean hormone levels during the initial contact Luteal phase in group I were FSH 12.0 IU/L (N, 1.0-3.0 IU/L), LH 1.8IU/L (N 1.5-101U/L), PrL 652mIU/L (N, 100-600 mIU/L) mE2 160 pmol/L (N 400-1400 pmol/L) and P5 nmol/L (N 14-60 nmol/L) for group I. Corresponding values for group II were 1.2, 10.3, 250, 600 and 3.0 in relevant units. All patients (fourteen) with end stage renal disease (ESRD) had amenorrhoae. On the other hand, most patients with stable CRF (22/26) had normal menses. Following initiation of therapy (conservative or dialytic), there was no significant alteration in the hormonal profile or menstrual pattern. We conclude that other factors apart from the hormonal imbalances, may be responsible for the menstrual disturbances noted in patients with CRF.

Forty females, age 14 to 35 years (mean 28.6 years) with chronic renal failure (CRF) were included in the study. Their menstrual patterns were noted. The function of their hypothalamo-pituitary-ovarian axis was assessed by the serum levels of follicle stimulating hormone (FSH), Luteinising hormone (LH), prolactin (PrL), estradiol (E2) and progesterone (P) at different phases of the menstrual cycle in patients who continued to have normal menses (Group 1) and at weekly intervals for six weeks in patients with menstrual disturbances (Group II). The mean hormone levels during the initial contact Luteal phase in group I were FSH 12.0 IU/L (N, 1.0-3.0 IU/L), LH 1.8IU/L (N 1.5-101U/L), PrL 652mIU/L (N, 100-600 mIU/L) mE2 160 pmol/L (N 400-1400 pmol/L) and P5 nmol/L (N 14-60 nmol/L) for group I. Corresponding values for group II were 1.2, 10.3, 250, 600 and 3.0 in relevant units. All patients (fourteen) with end stage renal disease (ESRD) had amenorrhoae. On the other hand, most patients with stable CRF (22/26) had normal menses. Following initiation of therapy (conservative or dialytic), there was no significant alteration in the hormonal profile or menstrual pattern. We conclude that other factors apart from the hormonal imbalances, may be responsible for the menstrual disturbances noted in patients with CRF.

Forty females, age 14 to 35 years (mean 28.6 years) with chronic renal failure (CRF) were included in the study. Their menstrual patterns were noted. The function of their hypothalamo-pituitary-ovarian axis was assessed by the serum levels of follicle stimulating hormone (FSH), Luteinising hormone (LH), prolactin (PrL), estradiol (E2) and progesterone (P) at different phases of the menstrual cycle in patients who continued to have normal menses (Group 1) and at weekly intervals for six weeks in patients with menstrual disturbances (Group II). The mean hormone levels during the initial contact Luteal phase in group I were FSH 12.0 IU/L (N, 1.0-3.0 IU/L), LH 1.8IU/L (N 1.5-101U/L), PrL 652mIU/L (N, 100-600 mIU/L) mE2 160 pmol/L (N 400-1400 pmol/L) and P5 nmol/L (N 14-60 nmol/L) for group I. Corresponding values for group II were 1.2, 10.3, 250, 600 and 3.0 in relevant units. All patients (fourteen) with end stage renal disease (ESRD) had amenorrhoae. On the other hand, most patients with stable CRF (22/26) had normal menses. Following initiation of therapy (conservative or dialytic), there was no significant alteration in the hormonal profile or menstrual pattern. We conclude that other factors apart from the hormonal imbalances, may be responsible for the menstrual disturbances noted in patients with CRF.

PIP: This survey was conducted at the Kenyatta National Hospital between March-June 1988 to assess the attitudes, basic knowledge and personal use of contraceptives among the nursing staff and to determine how these would influence family planning utilization in the country. In 1987, a similar survey was conducted among the physicians at this same hospital. A total of 432 nurses were interviewed; 64.4% of the nurses were currently using contraceptives and 7.7% had used them continuously. The IUD was used by 47.1% of the nurses. 62.3% of the nurses indicated that they would be able to discuss contraceptive use with their teenage daughters but only 29.6% would provide contraceptives. 66.7% of the nurses had extensive knowledge of contraceptives (over 60% knowledge) but knowledge concerning male contraceptives and newer methods such as Norplant was poor. author's modified

PIP: The effects of the triphasic oral contraceptive (OC) ethinyl estradiol (EE) and levonorgestrel (LNG) on lipid and lipoprotein metabolism were evaluated in 97 black Kenyan women. Subjects were recruited from the Family Planning Clinic and were followed for 12 months. There was an increase in fasting levels of total cholesterol. These changes were not statistically significant. However, the triglyceride increase was statistically significant at 9 months and 12 months (p0.05). The high density cholesterol remained unchanged. Thus, this triphasic OC was found to have minimal effect on lipid and lipoprotein metabolism. author's modified

PIP: The effects of the triphasic oral contraceptive (OC) ethinyl estradiol (EE) and levonorgestrel (LNG) on lipid and lipoprotein metabolism were evaluated in 97 black Kenyan women. Subjects were recruited from the Family Planning Clinic and were followed for 12 months. There was an increase in fasting levels of total cholesterol. These changes were not statistically significant. However, the triglyceride increase was statistically significant at 9 months and 12 months (p0.05). The high density cholesterol remained unchanged. Thus, this triphasic OC was found to have minimal effect on lipid and lipoprotein metabolism. author's modified

PIP: The effects of the triphasic oral contraceptive (OC) ethinyl estradiol (EE) and levonorgestrel (LNG) on lipid and lipoprotein metabolism were evaluated in 97 black Kenyan women. Subjects were recruited from the Family Planning Clinic and were followed for 12 months. There was an increase in fasting levels of total cholesterol. These changes were not statistically significant. However, the triglyceride increase was statistically significant at 9 months and 12 months (p0.05). The high density cholesterol remained unchanged. Thus, this triphasic OC was found to have minimal effect on lipid and lipoprotein metabolism. author's modified

PIP: The effects of the triphasic oral contraceptive (OC) ethinyl estradiol (EE) and levonorgestrel (LNG) on lipid and lipoprotein metabolism were evaluated in 97 black Kenyan women. Subjects were recruited from the Family Planning Clinic and were followed for 12 months. There was an increase in fasting levels of total cholesterol. These changes were not statistically significant. However, the triglyceride increase was statistically significant at 9 months and 12 months (p0.05). The high density cholesterol remained unchanged. Thus, this triphasic OC was found to have minimal effect on lipid and lipoprotein metabolism. author's modified

Kenya Medical Research Institute, Clinical Research Centre, Nairobi. Twenty nine patients with rickets were studied in a one year period. The majority of patients (17/29) were below 2 years of age. Most of them had nutritional rickets resulting from a combination of factors. Premature delivery, nonexposure to sunlight, nutritional marasmus and inappropriate dietary intake. Some had familial hypophosphataemic rickets, others had renal tubular acidosis while the rest had rickets with a familial tendency. Both the previous hospital records and the present study indicate that rickets is a persistent problem in children in the community and should be suspected in children who present with features of failure to thrive, among other conditions.

Kenya Medical Research Institute, Clinical Research Centre, Nairobi. Twenty nine patients with rickets were studied in a one year period. The majority of patients (17/29) were below 2 years of age. Most of them had nutritional rickets resulting from a combination of factors. Premature delivery, nonexposure to sunlight, nutritional marasmus and inappropriate dietary intake. Some had familial hypophosphataemic rickets, others had renal tubular acidosis while the rest had rickets with a familial tendency. Both the previous hospital records and the present study indicate that rickets is a persistent problem in children in the community and should be suspected in children who present with features of failure to thrive, among other conditions.

Kenya Medical Research Institute, Clinical Research Centre, Nairobi. Twenty nine patients with rickets were studied in a one year period. The majority of patients (17/29) were below 2 years of age. Most of them had nutritional rickets resulting from a combination of factors. Premature delivery, nonexposure to sunlight, nutritional marasmus and inappropriate dietary intake. Some had familial hypophosphataemic rickets, others had renal tubular acidosis while the rest had rickets with a familial tendency. Both the previous hospital records and the present study indicate that rickets is a persistent problem in children in the community and should be suspected in children who present with features of failure to thrive, among other conditions.

PIP: 125 black Kenyan women attending the Kenyatta National Family Welfare Clinic were randomly allocated to combined and fixed dose oral contraceptives (Eugynon: 500 mcg dl-norgestrel + 50 mcg ethinyl estradiol or Microgynon: 150 mcg levonorgestel + 30 mcg ethinyl estradiol). They were between 18-33 years of age with a mean of 25 +or- 7 years. The mean parity of this group was 3 and they had a mean education standard of 8 years. Fasting blood sampled were taken on recruitment (control cycle) and thereafter once for cycles 1, 3, 6, 9, and 12 during OC use. HDL-cholesterol was estimated in the sear. The 2 OCs elicited a significant decrease in levels of HDL-cholesterol (p0.01). author's modified

PIP: 125 black Kenyan women attending the Kenyatta National Family Welfare Clinic were randomly allocated to combined and fixed dose oral contraceptives (Eugynon: 500 mcg dl-norgestrel + 50 mcg ethinyl estradiol or Microgynon: 150 mcg levonorgestel + 30 mcg ethinyl estradiol). They were between 18-33 years of age with a mean of 25 +or- 7 years. The mean parity of this group was 3 and they had a mean education standard of 8 years. Fasting blood sampled were taken on recruitment (control cycle) and thereafter once for cycles 1, 3, 6, 9, and 12 during OC use. HDL-cholesterol was estimated in the sear. The 2 OCs elicited a significant decrease in levels of HDL-cholesterol (p0.01). author's modified

PIP: 125 black Kenyan women attending the Kenyatta National Family Welfare Clinic were randomly allocated to combined and fixed dose oral contraceptives (Eugynon: 500 mcg dl-norgestrel + 50 mcg ethinyl estradiol or Microgynon: 150 mcg levonorgestel + 30 mcg ethinyl estradiol). They were between 18-33 years of age with a mean of 25 +or- 7 years. The mean parity of this group was 3 and they had a mean education standard of 8 years. Fasting blood sampled were taken on recruitment (control cycle) and thereafter once for cycles 1, 3, 6, 9, and 12 during OC use. HDL-cholesterol was estimated in the sear. The 2 OCs elicited a significant decrease in levels of HDL-cholesterol (p0.01). author's modified

PIP: 125 black Kenyan women attending the Kenyatta National Family Welfare Clinic were randomly allocated to combined and fixed dose oral contraceptives (Eugynon: 500 mcg dl-norgestrel + 50 mcg ethinyl estradiol or Microgynon: 150 mcg levonorgestel + 30 mcg ethinyl estradiol). They were between 18-33 years of age with a mean of 25 +or- 7 years. The mean parity of this group was 3 and they had a mean education standard of 8 years. Fasting blood sampled were taken on recruitment (control cycle) and thereafter once for cycles 1, 3, 6, 9, and 12 during OC use. HDL-cholesterol was estimated in the sear. The 2 OCs elicited a significant decrease in levels of HDL-cholesterol (p0.01). author's modified

PIP: 125 black Kenyan women attending the Kenyatta National Family Welfare Clinic were randomly allocated to combined and fixed dose oral contraceptives (Eugynon: 500 mcg dl-norgestrel + 50 mcg ethinyl estradiol or Microgynon: 150 mcg levonorgestel + 30 mcg ethinyl estradiol). They were between 18-33 years of age with a mean of 25 +or- 7 years. The mean parity of this group was 3 and they had a mean education standard of 8 years. Fasting blood sampled were taken on recruitment (control cycle) and thereafter once for cycles 1, 3, 6, 9, and 12 during OC use. HDL-cholesterol was estimated in the sear. The 2 OCs elicited a significant decrease in levels of HDL-cholesterol (p0.01). author's modified

PIP: 125 black Kenyan women attending the Kenyatta National Family Welfare Clinic were randomly allocated to combined and fixed dose oral contraceptives (Eugynon: 500 mcg dl-norgestrel + 50 mcg ethinyl estradiol or Microgynon: 150 mcg levonorgestel + 30 mcg ethinyl estradiol). They were between 18-33 years of age with a mean of 25 +or- 7 years. The mean parity of this group was 3 and they had a mean education standard of 8 years. Fasting blood sampled were taken on recruitment (control cycle) and thereafter once for cycles 1, 3, 6, 9, and 12 during OC use. HDL-cholesterol was estimated in the sear. The 2 OCs elicited a significant decrease in levels of HDL-cholesterol (p0.01). author's modified

PIP: 125 black Kenyan women attending the Kenyatta National Family Welfare Clinic were randomly allocated to combined and fixed dose oral contraceptives (Eugynon: 500 mcg dl-norgestrel + 50 mcg ethinyl estradiol or Microgynon: 150 mcg levonorgestel + 30 mcg ethinyl estradiol). They were between 18-33 years of age with a mean of 25 +or- 7 years. The mean parity of this group was 3 and they had a mean education standard of 8 years. Fasting blood sampled were taken on recruitment (control cycle) and thereafter once for cycles 1, 3, 6, 9, and 12 during OC use. HDL-cholesterol was estimated in the sear. The 2 OCs elicited a significant decrease in levels of HDL-cholesterol (p0.01). author's modified

PIP: 125 black Kenyan women attending the Kenyatta National Family Welfare Clinic were randomly allocated to combined and fixed dose oral contraceptives (Eugynon: 500 mcg dl-norgestrel + 50 mcg ethinyl estradiol or Microgynon: 150 mcg levonorgestel + 30 mcg ethinyl estradiol). They were between 18-33 years of age with a mean of 25 +or- 7 years. The mean parity of this group was 3 and they had a mean education standard of 8 years. Fasting blood sampled were taken on recruitment (control cycle) and thereafter once for cycles 1, 3, 6, 9, and 12 during OC use. HDL-cholesterol was estimated in the sear. The 2 OCs elicited a significant decrease in levels of HDL-cholesterol (p0.01). author's modified

PIP: 125 black Kenyan women attending the Kenyatta National Family Welfare Clinic were randomly allocated to combined and fixed dose oral contraceptives (Eugynon: 500 mcg dl-norgestrel + 50 mcg ethinyl estradiol or Microgynon: 150 mcg levonorgestel + 30 mcg ethinyl estradiol). They were between 18-33 years of age with a mean of 25 +or- 7 years. The mean parity of this group was 3 and they had a mean education standard of 8 years. Fasting blood sampled were taken on recruitment (control cycle) and thereafter once for cycles 1, 3, 6, 9, and 12 during OC use. HDL-cholesterol was estimated in the sear. The 2 OCs elicited a significant decrease in levels of HDL-cholesterol (p0.01). author's modified