J Nat Prod. 2015 Dec 24;78(12):2932-9. doi: 10.1021/acs.jnatprod.5b00581. Epub 2015 Dec 14.
Rotenoids, Flavonoids, and Chalcones from the Root Bark of Millettia usaramensis.
Deyou T1, Gumula I1, Pang F2, Gruhonjic A, Mumo M1, Holleran J3, Duffy S3, Fitzpatrick PA, Heydenreich M4, Landberg G, Derese S1, Avery V3, Rissanen K2, Erdélyi M, Yenesew A1.
Author information
Abstract
Five new compounds, 4-O-geranylisoliquiritigenin (1), 12-dihydrousararotenoid B (2), 12-dihydrousararotenoid C (3), 4'-O-geranyl-7-hydroxyflavanone (4), and 4'-O-geranyl-7-hydroxydihydroflavanol (5), along with 12 known natural products (6-17) were isolated from the CH2Cl2/MeOH (1:1) extract of the root bark of Millettia usaramensis ssp. usaramensis by chromatographic separation. The purified metabolites were identified by NMR spectroscopic and mass spectrometric analyses, whereas their absolute configurations were established on the basis of chiroptical data and in some cases also by X-ray crystallography. The crude extract was moderately active (IC50 = 11.63 μg/mL) against the ER-negative MDB-MB-231 human breast cancer cell line, and accordingly compounds 6, 8, 9, 10, 12, and 16 also showed moderate to low cytotoxic activities (IC50 25.7-207.2 μM). The new natural product 1 exhibited antiplasmodial activity with IC50 values of 3.7 and 5.3 μM against the chloroquine-sensitive 3D7 and the chloroquine-resistant Dd2 Plasmodium falciparum strains, respectively, and was also cytotoxic to the HEK293 cell line.

Introduction Knowledge of anatomical variations in the origin and in the course of the dorsal metatarsal arteries (DMTAs) is valuable for many procedures, including reconstructive surgeries and flap selection. However, there is a paucity of data on these arteries among black Africans. Materials and Methods The present study studied the origin and the location of DMTAs in 30 formalin-fixed cadaveric feet of adult black Kenyans at the Department of Human Anatomy of the University of Nairobi, Nairobi, Kenya. Results Dorsal metatarsal arteries were present in all of the cases. Of the right dorsalis pedis artery (DPA), in the majority of the cases, the 1st DMTA arose as the continuation of the DPA, while the 2nd to 4th DMTAs were given off as branches from the arcuate artery (AA). On the left feet, in the majority of the cases, the 1st DMTA arose as the continuation of the DPA, while the rest were given off as branches from the AA. In relation to the dorsal interossei muscles, all of the the arteries were either within the muscle fibers (53%) or beneath them (47%), on the right side. On the left side, the 1st DMTA was above the muscles in 40% of the cases; within the muscles in 53%; and beneath the muscles in 7%. The 2nd and 3rd DMTAs were above the muscles in 57% and in 53% of the cases, respectively. Conclusion These results reveal that the DMTAs show variation in their origin and position relative to the dorsal interossei muscles. These variations display bilateral asymmetry.

Background: Diabetes mellitus (DM) is a chronic metabolic disease that is characterized by persistent hyperglycemia. Monitoring of glycaemic control ir individuals with DM is currently done by a combination of short term, that is daily monitoring of blood glucose and long term biochemical tests especially glycatec haemoglobin(HbA1c) which is done every 2-4 months. Glycated albumin (GA) is a new test for intermediate glycaemic control. It measures averaged plasma gluCOSE level over two to four weeks. This enables closer monitoring and evaluation ot treatment regimen faster than HbAlc.
Objectives: To compare glycated haemoglobin to glycated albumin levels as a measure of monitoring glycaemic control in diabetic patients.
Design: A prospective comparative study.
Methods: The study was carried out on diabetic patients attending the diabetic clinic
at Kenyatta National Hospital.
Results: A total of 260 patients were enrolled into the study. The mean age was 52 years with a standard deviation of 12.3. There was a female preponderance of 60.4%, Random blood sugar analysis showed that, the population with good glycaemic control constituted 156 (60%). Majority of the patients had good glycaemic control 170 (65.4%) based on the HbAlc assay, compared to 39.4% in GA.There was a good correlation between HbAlc and glycated albumin with R2value of 0.64.
Conclusion: More patients showed good glycaemic control based on HbAlc compared to glycated albumin. There was correlation between .HbAlc and glycated albumin with R2 value of 0.64. There is need to introduce glycated albumin as a method of intermediate glycaemic control in the hospital.

4-Aminoquinolines were hybridized with artemisinin and 1,4-naphthoquinone derivatives via the Ugi four-component condensation reaction, and their biological activities investigated. The artemisinin-containing compounds 6a–c and its salt 6c-citrate were the most active target compounds in the antiplasmodial assays. However, despite the potent in vitro activities, they also displayed cytotoxicity against a mammalian cell-line, and had lower therapeutic indices than chloroquine. Morphological changes in parasites treated with these artemisinin-containing hybrid compounds were similar to those observed after addition of artemisinin. These hybrid compounds appeared to share mechanism(s) of action with both chloroquine and artemisinin: they exhibited potent b-hematin inhibitory activities; they caused an increase in accumulation of hemoglobin within the parasites that was intermediate between the increase observed with artesunate and chloroquine; and they also appeared to inhibit endocytosis as suggested by the decrease in the number of transport vesicles in the parasites. No cross-resistance with chloroquine was observed for these hybrid compounds, despite the fact that they contained the chloroquinoline moiety. The hybridization strategy therefore appeared to be borrowing the best from both classes of antimalarials.

A series of dihydroartemisinin derivatives were synthesized via an aza-Michael addition reaction to a dihydroartemisinin-based acrylate and were evaluated for antiplasmodial and antitumor activity. The target compounds showed excellent antiplasmodial activity, with dihydroartemisinin derivatives 5, 7, 9 and 13 exhibiting IC50 values of 610 nM against both D10 and Dd2 strains of Plasmodium falciparum. Derivative 4d was the most active against the HeLa cancer cell line, with an IC50 of 0.37 lM and the highest tumor specificity.

Department of Peridontology & Preventive Dentistry, Guy's Hospital Dental School, UMDS, London, UK. Bone loss in chronic periodontitis was assessed from panoramic radiographs by direct measurement from the cemento-enamel junction (CEJ) and by measuring the proportion of the tooth length supported by bone. Mesial and distal bone levels of all available teeth were assessed for 50 patients aged 30-39 years referred for periodontal treatment. 85% and 74% of surfaces were measurable by the proportional and direct techniques, respectively. 27% of surfaces had no bone loss according to the proportional score, whereas 22% had a CEJ to alveolar bone distance of less than 2 mm. In addition, over half the surfaces with a proportional bone loss score of zero had a CEJ to alveolar bone distance of 2 mm or more, and for each proportional bone loss score, there was considerable overlap in the CEJ to alveolar bone distances recorded. The validity of the CEJ to alveolar bone measurements was established by comparison with direct measurements at periodontal surgery. The results support the use of direct measurement from the CEJ to alveolar bone rather than the assessment of the proportion of the tooth length within the bone when investigating bone loss from panoramic radiographs. This population of 30-40-year-old periodontal patients had a mean of 50% of sites with a CEJ to alveolar bone distance of 3 mm or more, and at such sites, there was a mean additional bone loss of 2.1 mm.

No abstract available. PMID: 3333346 [PubMed - indexed for MEDLINE]

A survey of 272 University of Nairobi undergraduate students was undertaken to assess their dental chairside experience and what reasons they gave for failing to seek dental treatment. Most respondents considered dental treatment uncomfortable and painful. The cost of treatment and fear arising from information given by other dental patients were important reasons that kept the respondents from visiting a dental clinic. This paper reveals the need for the dental profession to play a greater role in reducing costs of treatment and odontophobia.

Department of Dental Surgery, College of Health Sciences, Nairobi, Kenya. Traditionally, diseases that affect the periodontium have over the years been referred to as periodontal disease. This implies that these diseases are a single disease entity or only one disease, "periodontal disease," affects the periodontium. To date, dental literature is replete with several diseases that affect the periodontium. Most of these diseases exhibit unique bacteriological, immunological, biochemical and clinical features. It is these characteristics that qualify them to be regarded as individual or different disease entities. Biased by these recent reports on distinct diseases that affect the periodontium, several dental authors have written articles where they have preferred the term "periodontal diseases" to "periodontal disease," when discussing and reporting on the diseases that affect the periodontium. This paper suggests and discusses the reasons why scientists have continued to use the term periodontal disease and presents arguments why this terminology is inappropriate. It is suggested that the term "periodontal disease" be replaced by the term "periodontal diseases".

Two hundred and thirty one miraa chewers and 199 non miraa chewers were assessed for gingivitis, loss of attachment and oral hygiene status. The mean gingivitis score among miraa chewers was 1.6 and 1.7 among non miraa chewers (P less than 0.05). The mean facial gingivitis score among miraa chewers was 1.5 and 1.6 among non miraa chewers (P greater than 0.05). The mean distal gingivitis score among miraa chewers was 1.5 and 1.7 among non miraa chewers (P less than 0.05). The mean lingual gingivitis score among miraa chewers was lower than that of non miraa chewers (P less than 0.05). The means of loss of attachment of the teeth of miraa chewers were equal to those of non miraa chewers. Although the mean surface plaque scores of miraa chewers were generally lower than those of non miraa chewers, only the mean lingual plaque score of miraa chewers was found to be significantly lower than that of non miraa chewers (P less than 0.05). It is concluded that the oral hygiene status of miraa chewers was generally better than that of non miraa chewers and there was no evidence to show that chewing miraa is detrimental to periodontal health.

No abstract available. PMID: 3333346 [PubMed - indexed for MEDLINE]

A survey of 272 University of Nairobi undergraduate students was undertaken to assess their dental chairside experience and what reasons they gave for failing to seek dental treatment. Most respondents considered dental treatment uncomfortable and painful. The cost of treatment and fear arising from information given by other dental patients were important reasons that kept the respondents from visiting a dental clinic. This paper reveals the need for the dental profession to play a greater role in reducing costs of treatment and odontophobia.

Department of Dental Surgery, Dental School, College of Health Sciences, Nairobi. Seven hundred and seventy five files of edentulous patients seen at the Department of Dental Surgery, University of Nairobi were scrutinized for the presence or absence of routine radiographs prior to treatment. 180 (23.2%) had radiographs. 26% of the radiographs had 51 positive radiological findings. 17.3% were roots, 3.9% were unerupted teeth, 6.7% were radiopacities and 0.6% were radiolucencies. 52.9% of the radiological findings were in the mandible and 47.1% were in the maxilla. In the mandible, 44.4% of the radiological findings were in the anterior region and 55.6% were found posteriorly. 66.7% of the maxillary radiological findings were in the anterior region and 33.3% were found posteriorly. Since some of the positive radiological findings such as the retained roots and unerupted teeth might lead to infection, cysts or poor dentures fit, it is recommended that whenever possible, all edentulous patients be examined radiographically prior to treatment.

Department of Dental Surgery, College of Health Sciences, Nairobi. The purpose of this study was to compare the efficacy of a chewing stick and a tooth brush in plaque control. The study composed of two groups of 11 and 8 children aged 13 to 16 years who were randomly selected from a peri-urban school near Nairobi. Results showed that, except for the participants with moderate amounts of plaque, the net changes in the mean number of surfaces with a given plaque score were more when the participants were using a toothbrush than when they were using a chewing stick. For the group of participants who started using a chewing stick before they changed to the toothbrush, there were no significant net changes in the mean number of surfaces with a given plaque score except for those surfaces which had mild plaque deposits. It is concluded that for the patients with severe plaque deposits, the toothbrush is more efficacious than the chewing stick in plaque control. However, for those patients with moderate plaque deposits, the chewing stick is as efficacious as the toothbrush in plaque control.

No abstract available. PMID: 3333346 [PubMed - indexed for MEDLINE]

No abstract available. PMID: 6535699 [PubMed - indexed for MEDLINE]

The periodontal health status of diabetic patients and the association between periodontal disease and treatment mode, age and duration of diabetes were investigated in 86 dentulous men and women aged between 20 years and 69 years. 43 were diabetics regularly controlled at Kenyatta National Hospital Diabetic Clinic and 43 were non-diabetics attending medical outpatient clinic at the same hospital for minor ailments. Diabetic patients were found to have significant severer levels of periodontal disease than the non-diabetics. The difference persisted with increasing age. No correlation was found between treatment mode and duration of diabetes on one hand and the severity of periodontal disease on the other.

This study was done to determine the nature of utilization of dental auxiliaries and medical emergencies in private dental surgeries in Kenya. A self administering questionnaire with pre-paid postage was mailed to 138 dentists. 27.5% responded. 81.6% used dental auxiliaries and the main reason was to improve efficiency in managing patients. 93.5% of the auxiliaries were on job trained secondary school graduates. 63.2% of the respondents delegated duties which were mainly non-clinical. 26.3% did not delegate any duties. In a descending order, the reasons for non delegation were: that it would be risky to patients, not allowed by law, they did not find it necessary and that auxiliaries were not held responsible if something went wrong. The main duties delegated to the auxiliaries were cleaning of instruments and sterilization, mixing of restorative materials and preparing amalgam. Delegation was done primarily based on auxiliaries capability to perform the procedure and meet the set standards. 57.9% indicated that they rarely encountered medical emergencies. Syncope was the commonest emergency encountered. 72.7% indicated that auxiliaries could not handle medical emergencies because they were not trained. It is concluded that most dentists did not delegate clinical duties to dental auxiliaries and medical emergencies were rare.

The oral hygiene habits and dental health awareness of 541 Kenyan children from a peri-urban and urban school and aged 9-15 years, were investigated. 80.2% of the urban children and 43.1% of the peri-urban children had visited a dentist before. 12.4% of the urban children and 9.2% of the peri-urban children knew that bacteria cause dental caries. Over 87% of the children from either school knew that dental caries and periodontitis can be prevented. The main reason for visiting a dentist was to have tooth extraction. Failure to brush teeth was believed to be the cause of gingival bleeding by 38.9% of the peri-urban children and 37.6% of the urban children. 67.2% of the peri-urban children and 39.5% of the urban children brushed their teeth thrice daily. 21.1% of the peri-urban children and 2% of the urban children used a chewing stick to brush their teeth. More urban children (96.5%) used a toothbrush than peri-urban children (64.8%). None of the children from either school admitted using traditional cleaning aids such as the finger and charcoal. It is concluded that there were no consistent differences in oral hygiene habits and dental health awareness between peri-urban and urban children.

No abstract available. PMID: 3249689 [PubMed - indexed for MEDLINE]

No abstract available. PMID: 6535699 [PubMed - indexed for MEDLINE]

The aim of this study was to determine the prevalence of midline diastema, tongue tie and frenum attachments amongst school children in Nairobi. A total of 1802 children aged between 4 and 16 years were selected randomly using multistage sampling technique. To avoid oversampling in either sex, a proportionate sampling procedure was used. Thereafter, a thorough intra-oral examination was carried out using a mouth mirror under artificial or natural light with the children lying on a supine position. Presence or absence of midline interdental spaces unusually bigger than other interdental spaces were noted and recorded on a prepared dateacollection form. Accurate location of the origin of the frenum was done using Placek et al Morphological-functional classification of the labial frenum attachments. Data was analyzed manually by tally method. Results showed that 35% had upper and lower midline diastema. 55% were females and 45% were males. Their mean age was 7.6 years. 0.2% had a high lingual frenum. The commonest location of frenum attachment amongst children with lower midline diastema was the mucogingival junction (86%) whereas amongst those with upper midline diastema it was attached gingiva (50%). None of the children had frenum attachment on the interdental papilla. It was concluded that the maxilla had a higher prevalence of midline diastema than the mandible and that papillary penetrating frenum attachments amongst these patients were higher in the maxilla than the mandible.

Department of Dental Surgery College of Health Sciences, University of Nairobi, Kenya. This study was done to determine the nature of utilization of dental auxiliaries and medical emergencies in private dental surgeries in Kenya. A self administering questionnaire with pre-paid postage was mailed to 138 dentists. 27.5% responded. 81.6% used dental auxiliaries and the main reason was to improve efficiency in managing patients. 93.5% of the auxiliaries were on job trained secondary school graduates. 63.2% of the respondents delegated duties which were mainly non-clinical. 26.3% did not delegate any duties. In a descending order, the reasons for non delegation were: that it would be risky to patients, not allowed by law, they did not find it necessary and that auxiliaries were not held responsible if something went wrong. The main duties delegated to the auxiliaries were cleaning of instruments and sterilization, mixing of restorative materials and preparing amalgam. Delegation was done primarily based on auxiliaries capability to perform the procedure and meet the set standards. 57.9% indicated that they rarely encountered medical emergencies. Syncope was the commonest emergency encountered. 72.7% indicated that auxiliaries could not handle medical emergencies because they were not trained. It is concluded that most dentists did not delegate clinical duties to dental auxiliaries and medical emergencies were rare.

Dental School, College of Health Sciences, Nairobi, Kenya, Africa. A case of fanconi's anemia was referred to the Dental School from the Department of Pediatrics. The patient was a 24-year-old male and a product of a consanguineous marriage. His chief complaint was loose and falling teeth, which has started at the age of 16 years. The first teeth to fall out were the first permanent molars followed by mandibular and maxillary anteriors. General examination showed that the patient was of normal intelligence and small for his age. He had no palmar plantar hyperkeratosis and was not diabetic. A total of 19 teeth remained in the mouth, most of them with grade three mobility. The remaining molars and first maxillary premolars had grade three furcation involvement. Most of the teeth had periodontal pockets more than 10 mm deep. Full mouth intraoral periapical radiographs and orthopantomographic views showed severe horizontal bone loss uncommensurate with the patient's age. In view of the patient's history and severe bone loss at an early age, the diagnosis was juvenile periodontitis associated with Fanconi's anemia.

No abstract available. PMID: 4042945 [PubMed - indexed for MEDLINE]

This paper gives general information on the location of Kenya, its demography, economy, organisation of health services, general health policy, health financing, oral health infrastructure, problems that hamper health financing and proposals on how to solve these problems. Further, a summary of health status of the Kenyan people is given based on the results of studies. The mean DMFT for the rural and urban populations is low and there is no evidence of an increase or decrease. Similarly, the prevalence of periodontitis is low (1-10%), with no increase. Ulcerative lesions are rare (0.12%). The most common birth defects are cleft lip and palate. Oral cancer is very low, accounting for 2% of all malignancies. Comparative studies have not demonstrated any dramatic change in the frequency of oral cancer for the last 25 years. Oral candidiasis is the most prevalent oral lesion amongst HIV/AIDS patients. In June 2003, Kenya formulated a National Oral Health Policy, which gives direction on how to improve the oral health status of the citizens.

The objective of this study was to determine the knowledge and attitude of Nairobi University students towards dental health care in Kenya. A self administered questionnaire given to 400 students in person who responded and handed them over immediately. The students had a mean age of 22.4 years, 45.3% were males and 54.5% were females. Extractions, restorations and replacement of teeth were known to majority of the students. However, almost half of the students preferred extraction to restoration and 49.2% considered restoration of deciduous teeth unnecessary. 79% indicated that they would undergo scaling. It is therefore recommended that an effective mode of transmitting positive information about various dental treatment modalities be established.

Traditionally, diseases that affect the periodontium have over the years been referred to as periodontal disease. This implies that these diseases are a single disease entity or only one disease, "periodontal disease," affects the periodontium. To date, dental literature is replete with several diseases that affect the periodontium. Most of these diseases exhibit unique bacteriological, immunological, biochemical and clinical features. It is these characteristics that qualify them to be regarded as individual or different disease entities. Biased by these recent reports on distinct diseases that affect the periodontium, several dental authors have written articles where they have preferred the term "periodontal diseases" to "periodontal disease," when discussing and reporting on the diseases that affect the periodontium. This paper suggests and discusses the reasons why scientists have continued to use the term periodontal disease and presents arguments why this terminology is inappropriate. It is suggested that the term "periodontal disease" be replaced by the term "periodontal diseases".

Department of Peridontology & Preventive Dentistry, Guy's Hospital Dental School, UMDS, London, UK. Bone loss in chronic periodontitis was assessed from panoramic radiographs by direct measurement from the cemento-enamel junction (CEJ) and by measuring the proportion of the tooth length supported by bone. Mesial and distal bone levels of all available teeth were assessed for 50 patients aged 30-39 years referred for periodontal treatment. 85% and 74% of surfaces were measurable by the proportional and direct techniques, respectively. 27% of surfaces had no bone loss according to the proportional score, whereas 22% had a CEJ to alveolar bone distance of less than 2 mm. In addition, over half the surfaces with a proportional bone loss score of zero had a CEJ to alveolar bone distance of 2 mm or more, and for each proportional bone loss score, there was considerable overlap in the CEJ to alveolar bone distances recorded. The validity of the CEJ to alveolar bone measurements was established by comparison with direct measurements at periodontal surgery. The results support the use of direct measurement from the CEJ to alveolar bone rather than the assessment of the proportion of the tooth length within the bone when investigating bone loss from panoramic radiographs. This population of 30-40-year-old periodontal patients had a mean of 50% of sites with a CEJ to alveolar bone distance of 3 mm or more, and at such sites, there was a mean additional bone loss of 2.1 mm.

No abstract available. PMID: 4042945 [PubMed - indexed for MEDLINE]

No abstract available. PMID: 3333346 [PubMed - indexed for MEDLINE]

The objective of this study was to determine the knowledge and attitude of Nairobi University students towards dental health care in Kenya. A self administered questionnaire given to 400 students in person who responded and handed them over immediately. The students had a mean age of 22.4 years, 45.3% were males and 54.5% were females. Extractions, restorations and replacement of teeth were known to majority of the students. However, almost half of the students preferred extraction to restoration and 49.2% considered restoration of deciduous teeth unnecessary. 79% indicated that they would undergo scaling. It is therefore recommended that an effective mode of transmitting positive information about various dental treatment modalities be established.

Department of Dental Surgery, College of Health Sciences, Nairobi, Kenya. Traditionally, diseases that affect the periodontium have over the years been referred to as periodontal disease. This implies that these diseases are a single disease entity or only one disease, "periodontal disease," affects the periodontium. To date, dental literature is replete with several diseases that affect the periodontium. Most of these diseases exhibit unique bacteriological, immunological, biochemical and clinical features. It is these characteristics that qualify them to be regarded as individual or different disease entities. Biased by these recent reports on distinct diseases that affect the periodontium, several dental authors have written articles where they have preferred the term "periodontal diseases" to "periodontal disease," when discussing and reporting on the diseases that affect the periodontium. This paper suggests and discusses the reasons why scientists have continued to use the term periodontal disease and presents arguments why this terminology is inappropriate. It is suggested that the term "periodontal disease" be replaced by the term "periodontal diseases".

The objectives of this study were to determine the frequency of alveolar osteitis at Kenyatta National Hospital (KNH), most affected age group and the reasons for underlying extractions. Out of 8,393 extractions 273 (3.3%) developed alveolar osteitis. 98.5% of the teeth that developed alveolar osteitis were molars and premolars. 52% of the patients that developed alveolar osteitis were females and 48% were males. The mandible was more affected than the maxilla. The percentage distribution of alveolar osteitis according to age groups 10-19 year, 30-39 years, 40-49 years, 50-59 years and 60-69 years were 6.2%, 53.1%, 23.8%, 5.5%, 4.8% and 2.9% respectively. On the average, patients reported with alveolar osteitis 5.7 days following extraction. Out of 8,393 extractions, 72.5% were due to dental caries, 18% were due to periodontitis and the rest were due to other causes. It was concluded that the frequency and average, patients reported with alveolar osteitis 5.7 days following extraction. Out of 8,393 extractions, 72.5% were due to dental caries, 18% were due to periodontitis and the rest were due to other causes. It was concluded that the frequency and pattern of development of a alveolar osteitis at KNH was similar to that reported in developed countries.

No abstract available. PMID: 3333346 [PubMed - indexed for MEDLINE]

A survey of 272 University of Nairobi undergraduate students was undertaken to assess their dental chairside experience and what reasons they gave for failing to seek dental treatment. Most respondents considered dental treatment uncomfortable and painful. The cost of treatment and fear arising from information given by other dental patients were important reasons that kept the respondents from visiting a dental clinic. This paper reveals the need for the dental profession to play a greater role in reducing costs of treatment and odontophobia.

Department of Dental Surgery, Dental School, College of Health Sciences, Nairobi. Seven hundred and seventy five files of edentulous patients seen at the Department of Dental Surgery, University of Nairobi were scrutinized for the presence or absence of routine radiographs prior to treatment. 180 (23.2%) had radiographs. 26% of the radiographs had 51 positive radiological findings. 17.3% were roots, 3.9% were unerupted teeth, 6.7% were radiopacities and 0.6% were radiolucencies. 52.9% of the radiological findings were in the mandible and 47.1% were in the maxilla. In the mandible, 44.4% of the radiological findings were in the anterior region and 55.6% were found posteriorly. 66.7% of the maxillary radiological findings were in the anterior region and 33.3% were found posteriorly. Since some of the positive radiological findings such as the retained roots and unerupted teeth might lead to infection, cysts or poor dentures fit, it is recommended that whenever possible, all edentulous patients be examined radiographically prior to treatment.

Department of Dental Surgery, College of Health Sciences, Nairobi. The purpose of this study was to compare the efficacy of a chewing stick and a tooth brush in plaque control. The study composed of two groups of 11 and 8 children aged 13 to 16 years who were randomly selected from a peri-urban school near Nairobi. Results showed that, except for the participants with moderate amounts of plaque, the net changes in the mean number of surfaces with a given plaque score were more when the participants were using a toothbrush than when they were using a chewing stick. For the group of participants who started using a chewing stick before they changed to the toothbrush, there were no significant net changes in the mean number of surfaces with a given plaque score except for those surfaces which had mild plaque deposits. It is concluded that for the patients with severe plaque deposits, the toothbrush is more efficacious than the chewing stick in plaque control. However, for those patients with moderate plaque deposits, the chewing stick is as efficacious as the toothbrush in plaque control.

No abstract available. PMID: 3333346 [PubMed - indexed for MEDLINE]

No abstract available. PMID: 6535699 [PubMed - indexed for MEDLINE]

A survey of 272 University of Nairobi undergraduate students was undertaken to assess their dental chairside experience and what reasons they gave for failing to seek dental treatment. Most respondents considered dental treatment uncomfortable and painful. The cost of treatment and fear arising from information given by other dental patients were important reasons that kept the respondents from visiting a dental clinic. This paper reveals the need for the dental profession to play a greater role in reducing costs of treatment and odontophobia.

The purpose of this study was to assess the knowledge, practices and attitudes towards HIV Positive/AIDS patients among 112 dentists from public institutions in Nairobi using a self-administered questionnaire. 94(83.9%) responded. Over 74% had managed HIV positive/AIDS patients. In general, respondents' knowledge and preventive measures against HIV infection were satisfactory. 8.5% did not find use of protective eye wear absolutely necessary. 33% used protective covers routinely. 52.1% advocated for the screening of all suspected cases of AIDS before treatment. 27.7% felt that HIV positive health workers and those with AIDS should not be allowed to treat patients. 53.2% felt that they should be given the right to decide on treating HIV Positive/AIDS patients. 10.6% supported the idea that AIDS patients be isolated from uninfected individuals. It is concluded that a substantial number of dentists were wanting in their attitudes towards HIV positive/AIDS patients.

Dental School, College of Health Sciences, Nairobi, Kenya. The purpose of this study was to compare the oral hygiene and periodontal health status of 497 randomly selected Kenyan and Indian adult populations aged between 20 and 35 years. Oral hygiene and periodontal health status were assessed using Silness and Loe plaque Index and Russel's Periodontal Index respectively. Results revealed that the overall mean plaque and periodontal index scores of Kenyan participants were significantly lower than those of Indians. Increase of mean Periodontal index with age was found to be significant among Kenyan participants and insignificant among Indian participants Kenyan female participants were found to have significant lower mean plaque and periodontal index scores than males. However, the mean periodontal index score of Indian male participants was found to be lower than that of female participants. It is concluded that Kenyan participants had better periodontal and oral hygiene status than Indian participants and that Indian females unlike Kenyan females had poorer periodontal health status than male.

No abstract available. PMID: 3505209 [PubMed - indexed for MEDLINE]

No abstract available. PMID: 6535699 [PubMed - indexed for MEDLINE]

The objectives of this study were to determine the frequency of Acute Necrotising Gingivitis (ANG), its sex and age distribution, ethnicity and seasonal variation amongst patients at the Dental Unit of Kenyatta National Hospital (KNH) in Nairobi, Kenya. Cards of patients who were seen in the Dental Unit of KNH in 1992/1993, were scrutinised for positive diagnosis of ANG, age, sex, presenting signs and symptoms and treatment that was given. Of the 53,572 patients who were treated, (0.15 per cent) had ANG. Their age range was 1.5-46 years (Mean = 14.5 years), with 58.5 per cent being below 11 years and 32.9 per cent being between 21 and 40 years. The most affected ethnic groups were the Luos and Kikuyus, while 72 per cent of the patients were seen in March and April, and between September and December. It is concluded that the frequency of ANG was low, ANG affected children and adults, and that ANG varied seasonally. PMID: 10907433 [PubMed - indexed for MEDLINE]

Department of Dental Surgery, College of Health Sciences, University of Nairobi. This study was done as part of a WHO international survey of orofacial mutilations and NOMA cases referred to out-patient clinic and care centers in 1992. Files of 16,000 patients who were treated at the Dental Unit of Kenyatta National Hospital (KNH) were scrutinized for the occurrence of NOMA and other ulcerative oral lesions. Of these, 30% had acute necrotizing ulcerative gingivitis with a male to female ratio of 5:1. 25% had aphthous ulcers with a male to female ratio of 3:2. Equal numbers of patients (10%) had angular cheilitis, aspirin burn and oral candidiasis. Similarly, equal numbers of patients (5%) had NOMA, atypical ulceration and radiotherapy induced ulceration. It was concluded that NOMA and other ulcerative oral lesions were rare among the patients who were treated at the Dental Unit of KNH.

A case of fanconi's anemia was referred to the Dental School from the Department of Pediatrics. The patient was a 24-year-old male and a product of a consanguineous marriage. His chief complaint was loose and falling teeth, which has started at the age of 16 years. The first teeth to fall out were the first permanent molars followed by mandibular and maxillary anteriors. General examination showed that the patient was of normal intelligence and small for his age. He had no palmar plantar hyperkeratosis and was not diabetic. A total of 19 teeth remained in the mouth, most of them with grade three mobility. The remaining molars and first maxillary premolars had grade three furcation involvement. Most of the teeth had periodontal pockets more than 10 mm deep. Full mouth intraoral periapical radiographs and orthopantomographic views showed severe horizontal bone loss uncommensurate with the patient's age. In view of the patient's history and severe bone loss at an early age, the diagnosis was juvenile periodontitis associated with Fanconi's anemia.

No abstract available. PMID: 6597936 [PubMed - indexed for MEDLINE]

This paper gives general information on the location of Kenya, its demography, economy, organisation of health services, general health policy, health financing, oral health infrastructure, problems that hamper health financing and proposals on how to solve these problems. Further, a summary of health status of the Kenyan people is given based on the results of studies. The mean DMFT for the rural and urban populations is low and there is no evidence of an increase or decrease. Similarly, the prevalence of periodontitis is low (1-10%), with no increase. Ulcerative lesions are rare (0.12%). The most common birth defects are cleft lip and palate. Oral cancer is very low, accounting for 2% of all malignancies. Comparative studies have not demonstrated any dramatic change in the frequency of oral cancer for the last 25 years. Oral candidiasis is the most prevalent oral lesion amongst HIV/AIDS patients. In June 2003, Kenya formulated a National Oral Health Policy, which gives direction on how to improve the oral health status of the citizens.

Department of Dental Surgery, College of Health Sciences, University of Nairobi. The purpose of this study was to assess knowledge, practices and attitudes towards HIV positive and AIDS patients amongst 71 dental auxiliaries using on a self administered questionnaire. 65 (91.5%) returned the questionnaire. In general, respondents' knowledge was fair. 87.7% felt that dentistry as practised in Kenya today carries a high risk of transmission of HIV primarily because of improper sterilization of instruments. 72.3% had changed their sex habits since they became aware of the dangers posed by indiscriminate sex. Over 67% used gloves and masks routinely when assisting in the management of AIDS patients. Over 33% did not use protective eye wear and protective covers on operatories routinely because they were not provided by the employer. 27.7% felt that AIDS and HIV positive health workers should stop treating patients. 64.6% advocated that the cost of buying materials and equipment to prevent cross infection be met by the patient and the employer or dentist. 23.1% supported the idea that HIV positive and AIDS patients be isolated from uninfected individuals. In conclusion, a substantial number of dental auxiliaries were wanting in their knowledge, practices and attitudes towards HIV positive/AIDS patients.

The oral hygiene habits and dental health awareness of 541 Kenyan children from a peri-urban and urban school and aged 9-15 years, were investigated. 80.2% of the urban children and 43.1% of the peri-urban children had visited a dentist before. 12.4% of the urban children and 9.2% of the peri-urban children knew that bacteria cause dental caries. Over 87% of the children from either school knew that dental caries and periodontitis can be prevented. The main reason for visiting a dentist was to have tooth extraction. Failure to brush teeth was believed to be the cause of gingival bleeding by 38.9% of the peri-urban children and 37.6% of the urban children. 67.2% of the peri-urban children and 39.5% of the urban children brushed their teeth thrice daily. 21.1% of the peri-urban children and 2% of the urban children used a chewing stick to brush their teeth. More urban children (96.5%) used a toothbrush than peri-urban children (64.8%). None of the children from either school admitted using traditional cleaning aids such as the finger and charcoal. It is concluded that there were no consistent differences in oral hygiene habits and dental health awareness between peri-urban and urban children.

Department of Peridontology & Preventive Dentistry, Guy's Hospital Dental School, UMDS, London, UK. Bone loss in chronic periodontitis was assessed from panoramic radiographs by direct measurement from the cemento-enamel junction (CEJ) and by measuring the proportion of the tooth length supported by bone. Mesial and distal bone levels of all available teeth were assessed for 50 patients aged 30-39 years referred for periodontal treatment. 85% and 74% of surfaces were measurable by the proportional and direct techniques, respectively. 27% of surfaces had no bone loss according to the proportional score, whereas 22% had a CEJ to alveolar bone distance of less than 2 mm. In addition, over half the surfaces with a proportional bone loss score of zero had a CEJ to alveolar bone distance of 2 mm or more, and for each proportional bone loss score, there was considerable overlap in the CEJ to alveolar bone distances recorded. The validity of the CEJ to alveolar bone measurements was established by comparison with direct measurements at periodontal surgery. The results support the use of direct measurement from the CEJ to alveolar bone rather than the assessment of the proportion of the tooth length within the bone when investigating bone loss from panoramic radiographs. This population of 30-40-year-old periodontal patients had a mean of 50% of sites with a CEJ to alveolar bone distance of 3 mm or more, and at such sites, there was a mean additional bone loss of 2.1 mm.

No abstract available. PMID: 4042945 [PubMed - indexed for MEDLINE]

The objective of this study was to determine the knowledge and attitude of Nairobi University students towards dental health care in Kenya. A self administered questionnaire given to 400 students in person who responded and handed them over immediately. The students had a mean age of 22.4 years, 45.3% were males and 54.5% were females. Extractions, restorations and replacement of teeth were known to majority of the students. However, almost half of the students preferred extraction to restoration and 49.2% considered restoration of deciduous teeth unnecessary. 79% indicated that they would undergo scaling. It is therefore recommended that an effective mode of transmitting positive information about various dental treatment modalities be established.

Department of Dental Surgery, College of Health Sciences, Nairobi, Kenya. Traditionally, diseases that affect the periodontium have over the years been referred to as periodontal disease. This implies that these diseases are a single disease entity or only one disease, "periodontal disease," affects the periodontium. To date, dental literature is replete with several diseases that affect the periodontium. Most of these diseases exhibit unique bacteriological, immunological, biochemical and clinical features. It is these characteristics that qualify them to be regarded as individual or different disease entities. Biased by these recent reports on distinct diseases that affect the periodontium, several dental authors have written articles where they have preferred the term "periodontal diseases" to "periodontal disease," when discussing and reporting on the diseases that affect the periodontium. This paper suggests and discusses the reasons why scientists have continued to use the term periodontal disease and presents arguments why this terminology is inappropriate. It is suggested that the term "periodontal disease" be replaced by the term "periodontal diseases".

Department of Peridontology & Preventive Dentistry, Guy's Hospital Dental School, UMDS, London, UK. Bone loss in chronic periodontitis was assessed from panoramic radiographs by direct measurement from the cemento-enamel junction (CEJ) and by measuring the proportion of the tooth length supported by bone. Mesial and distal bone levels of all available teeth were assessed for 50 patients aged 30-39 years referred for periodontal treatment. 85% and 74% of surfaces were measurable by the proportional and direct techniques, respectively. 27% of surfaces had no bone loss according to the proportional score, whereas 22% had a CEJ to alveolar bone distance of less than 2 mm. In addition, over half the surfaces with a proportional bone loss score of zero had a CEJ to alveolar bone distance of 2 mm or more, and for each proportional bone loss score, there was considerable overlap in the CEJ to alveolar bone distances recorded. The validity of the CEJ to alveolar bone measurements was established by comparison with direct measurements at periodontal surgery. The results support the use of direct measurement from the CEJ to alveolar bone rather than the assessment of the proportion of the tooth length within the bone when investigating bone loss from panoramic radiographs. This population of 30-40-year-old periodontal patients had a mean of 50% of sites with a CEJ to alveolar bone distance of 3 mm or more, and at such sites, there was a mean additional bone loss of 2.1 mm.

No abstract available. PMID: 3333346 [PubMed - indexed for MEDLINE]

A survey of 272 University of Nairobi undergraduate students was undertaken to assess their dental chairside experience and what reasons they gave for failing to seek dental treatment. Most respondents considered dental treatment uncomfortable and painful. The cost of treatment and fear arising from information given by other dental patients were important reasons that kept the respondents from visiting a dental clinic. This paper reveals the need for the dental profession to play a greater role in reducing costs of treatment and odontophobia.

Department of Dental Surgery, College of Health Sciences, University of Nairobi, Kenya. During a recent scientific meeting held in Botswana (16th-19th October 1991), it was reported that the oral health situation in developing countries was typified by an increase in the prevalence of dental diseases. Kenya was cited as one of the typical examples of this worrying trend. For there to be an increase in dental diseases, there must be a concomitant increase or an upward shift in the main aetiological factor(s) or factors associated with dental diseases. This paper looks at these factors in relation to periodontal disease and reviews some of the major prevalence studies of periodontal disease that have been carried out in Kenya. It also presents some arguments to show that there is no unequivocal evidence that periodontal disease is on the increase in Kenya.

Two hundred and thirty one miraa chewers and 199 non miraa chewers were assessed for gingivitis, loss of attachment and oral hygiene status. The mean gingivitis score among miraa chewers was 1.6 and 1.7 among non miraa chewers (P less than 0.05). The mean facial gingivitis score among miraa chewers was 1.5 and 1.6 among non miraa chewers (P greater than 0.05). The mean distal gingivitis score among miraa chewers was 1.5 and 1.7 among non miraa chewers (P less than 0.05). The mean lingual gingivitis score among miraa chewers was lower than that of non miraa chewers (P less than 0.05). The means of loss of attachment of the teeth of miraa chewers were equal to those of non miraa chewers. Although the mean surface plaque scores of miraa chewers were generally lower than those of non miraa chewers, only the mean lingual plaque score of miraa chewers was found to be significantly lower than that of non miraa chewers (P less than 0.05). It is concluded that the oral hygiene status of miraa chewers was generally better than that of non miraa chewers and there was no evidence to show that chewing miraa is detrimental to periodontal health.

No abstract available. PMID: 3333346 [PubMed - indexed for MEDLINE]

No abstract available. PMID: 6535699 [PubMed - indexed for MEDLINE]

A survey of 272 University of Nairobi undergraduate students was undertaken to assess their dental chairside experience and what reasons they gave for failing to seek dental treatment. Most respondents considered dental treatment uncomfortable and painful. The cost of treatment and fear arising from information given by other dental patients were important reasons that kept the respondents from visiting a dental clinic. This paper reveals the need for the dental profession to play a greater role in reducing costs of treatment and odontophobia.

Cancrum oris cases are occasionally treated in various hospitals in Kenya. Despite this, only one case has been reported in literature. Besides, no epidemiological or treatment studies of cancrum oris has been carried out in Kenya. We report an unusual case of a 17 year old Kenyan female with oral cutaneous fistula and tissue atrophy on the left cheek following cancrum oris infection in childhood. Since most cancrum oris cases are a sequela of acute necrotizing gingivitis (ANG), prevention of cancrum oris can be achieved by early and prompt remedial measures once a diagnosis of ANG is established. Failure to do this might lead to cancrum oris with its attendant disfiguring complications some of which might be impossible to treat in developing countries where the requisite personnel is lacking or inadequate.

Dental School, College of Health Sciences, Nairobi, Kenya. The purpose of this study was to compare the oral hygiene and periodontal health status of 497 randomly selected Kenyan and Indian adult populations aged between 20 and 35 years. Oral hygiene and periodontal health status were assessed using Silness and Loe plaque Index and Russel's Periodontal Index respectively. Results revealed that the overall mean plaque and periodontal index scores of Kenyan participants were significantly lower than those of Indians. Increase of mean Periodontal index with age was found to be significant among Kenyan participants and insignificant among Indian participants Kenyan female participants were found to have significant lower mean plaque and periodontal index scores than males. However, the mean periodontal index score of Indian male participants was found to be lower than that of female participants. It is concluded that Kenyan participants had better periodontal and oral hygiene status than Indian participants and that Indian females unlike Kenyan females had poorer periodontal health status than male.

No abstract available. PMID: 3333346 [PubMed - indexed for MEDLINE]

No abstract available. PMID: 6535699 [PubMed - indexed for MEDLINE]

The objectives of this study were to determine the frequency of Acute Necrotising Gingivitis (ANG), its sex and age distribution, ethnicity and seasonal variation amongst patients at the Dental Unit of Kenyatta National Hospital (KNH) in Nairobi, Kenya. Cards of patients who were seen in the Dental Unit of KNH in 1992/1993, were scrutinised for positive diagnosis of ANG, age, sex, presenting signs and symptoms and treatment that was given. Of the 53,572 patients who were treated, (0.15 per cent) had ANG. Their age range was 1.5-46 years (Mean = 14.5 years), with 58.5 per cent being below 11 years and 32.9 per cent being between 21 and 40 years. The most affected ethnic groups were the Luos and Kikuyus, while 72 per cent of the patients were seen in March and April, and between September and December. It is concluded that the frequency of ANG was low, ANG affected children and adults, and that ANG varied seasonally. PMID: 10907433 [PubMed - indexed for MEDLINE]

Dental School, College of Health Sciences, Nairobi. Cancrum oris cases are occasionally treated in various hospitals in Kenya. Despite this, only one case has been reported in literature. Besides, no epidemiological or treatment studies of cancrum oris has been carried out in Kenya. We report an unusual case of a 17 year old Kenyan female with oral cutaneous fistula and tissue atrophy on the left cheek following cancrum oris infection in childhood. Since most cancrum oris cases are a sequela of acute necrotizing gingivitis (ANG), prevention of cancrum oris can be achieved by early and prompt remedial measures once a diagnosis of ANG is established. Failure to do this might lead to cancrum oris with its attendant disfiguring complications some of which might be impossible to treat in developing countries where the requisite personnel is lacking or inadequate.

The oral hygiene habits and dental health awareness of 541 Kenyan children from a peri-urban and urban school and aged 9-15 years, were investigated. 80.2% of the urban children and 43.1% of the peri-urban children had visited a dentist before. 12.4% of the urban children and 9.2% of the peri-urban children knew that bacteria cause dental caries. Over 87% of the children from either school knew that dental caries and periodontitis can be prevented. The main reason for visiting a dentist was to have tooth extraction. Failure to brush teeth was believed to be the cause of gingival bleeding by 38.9% of the peri-urban children and 37.6% of the urban children. 67.2% of the peri-urban children and 39.5% of the urban children brushed their teeth thrice daily. 21.1% of the peri-urban children and 2% of the urban children used a chewing stick to brush their teeth. More urban children (96.5%) used a toothbrush than peri-urban children (64.8%). None of the children from either school admitted using traditional cleaning aids such as the finger and charcoal. It is concluded that there were no consistent differences in oral hygiene habits and dental health awareness between peri-urban and urban children.

No abstract available. PMID: 3249689 [PubMed - indexed for MEDLINE]

No abstract available. PMID: 6535699 [PubMed - indexed for MEDLINE]

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This paper gives general information on the location of Kenya, its demography, economy, organisation of health services, general health policy, health financing, oral health infrastructure, problems that hamper health financing and proposals on how to solve these problems. Further, a summary of health status of the Kenyan people is given based on the results of studies. The mean DMFT for the rural and urban populations is low and there is no evidence of an increase or decrease. Similarly, the prevalence of periodontitis is low (1-10%), with no increase. Ulcerative lesions are rare (0.12%). The most common birth defects are cleft lip and palate. Oral cancer is very low, accounting for 2% of all malignancies. Comparative studies have not demonstrated any dramatic change in the frequency of oral cancer for the last 25 years. Oral candidiasis is the most prevalent oral lesion amongst HIV/AIDS patients. In June 2003, Kenya formulated a National Oral Health Policy, which gives direction on how to improve the oral health status of the citizens.

Department of Dental Surgery, College of Health Sciences, University of Nairobi. The purpose of this study was to assess knowledge, practices and attitudes towards HIV positive and AIDS patients amongst 71 dental auxiliaries using on a self administered questionnaire. 65 (91.5%) returned the questionnaire. In general, respondents' knowledge was fair. 87.7% felt that dentistry as practised in Kenya today carries a high risk of transmission of HIV primarily because of improper sterilization of instruments. 72.3% had changed their sex habits since they became aware of the dangers posed by indiscriminate sex. Over 67% used gloves and masks routinely when assisting in the management of AIDS patients. Over 33% did not use protective eye wear and protective covers on operatories routinely because they were not provided by the employer. 27.7% felt that AIDS and HIV positive health workers should stop treating patients. 64.6% advocated that the cost of buying materials and equipment to prevent cross infection be met by the patient and the employer or dentist. 23.1% supported the idea that HIV positive and AIDS patients be isolated from uninfected individuals. In conclusion, a substantial number of dental auxiliaries were wanting in their knowledge, practices and attitudes towards HIV positive/AIDS patients.

Department of Peridontology & Preventive Dentistry, Guy's Hospital Dental School, UMDS, London, UK. Bone loss in chronic periodontitis was assessed from panoramic radiographs by direct measurement from the cemento-enamel junction (CEJ) and by measuring the proportion of the tooth length supported by bone. Mesial and distal bone levels of all available teeth were assessed for 50 patients aged 30-39 years referred for periodontal treatment. 85% and 74% of surfaces were measurable by the proportional and direct techniques, respectively. 27% of surfaces had no bone loss according to the proportional score, whereas 22% had a CEJ to alveolar bone distance of less than 2 mm. In addition, over half the surfaces with a proportional bone loss score of zero had a CEJ to alveolar bone distance of 2 mm or more, and for each proportional bone loss score, there was considerable overlap in the CEJ to alveolar bone distances recorded. The validity of the CEJ to alveolar bone measurements was established by comparison with direct measurements at periodontal surgery. The results support the use of direct measurement from the CEJ to alveolar bone rather than the assessment of the proportion of the tooth length within the bone when investigating bone loss from panoramic radiographs. This population of 30-40-year-old periodontal patients had a mean of 50% of sites with a CEJ to alveolar bone distance of 3 mm or more, and at such sites, there was a mean additional bone loss of 2.1 mm.

No abstract available. PMID: 4042945 [PubMed - indexed for MEDLINE]

The objective of this study was to determine the knowledge and attitude of Nairobi University students towards dental health care in Kenya. A self administered questionnaire given to 400 students in person who responded and handed them over immediately. The students had a mean age of 22.4 years, 45.3% were males and 54.5% were females. Extractions, restorations and replacement of teeth were known to majority of the students. However, almost half of the students preferred extraction to restoration and 49.2% considered restoration of deciduous teeth unnecessary. 79% indicated that they would undergo scaling. It is therefore recommended that an effective mode of transmitting positive information about various dental treatment modalities be established.

Department of Dental Surgery, College of Health Sciences, Nairobi, Kenya. Traditionally, diseases that affect the periodontium have over the years been referred to as periodontal disease. This implies that these diseases are a single disease entity or only one disease, "periodontal disease," affects the periodontium. To date, dental literature is replete with several diseases that affect the periodontium. Most of these diseases exhibit unique bacteriological, immunological, biochemical and clinical features. It is these characteristics that qualify them to be regarded as individual or different disease entities. Biased by these recent reports on distinct diseases that affect the periodontium, several dental authors have written articles where they have preferred the term "periodontal diseases" to "periodontal disease," when discussing and reporting on the diseases that affect the periodontium. This paper suggests and discusses the reasons why scientists have continued to use the term periodontal disease and presents arguments why this terminology is inappropriate. It is suggested that the term "periodontal disease" be replaced by the term "periodontal diseases".

A study was carried out on 117 smallholder dairy cattle herds in Kikuyu Division
of Kiambu District Kenya between April 2004 and December 2004 to determine
the incidence of periparturient conditions (downer cow syndrome, dystocia, milk
fever and retained placenta among others) in smallholder dairy cattle herds and
the associated factors (plausible predictor variables; age, parity and management
systems among others) from a total of 206 dairy cattle. Data were collected during
farm visits by observation, interviews using semi-structured questionnaires and
clinical examination of animals. The most common conditions encountered were
downer cow syndrome (12.6 %), dystocia (17.0 %), mastitis (9.5 %), metritis (7.3 %)
milk fever (13 %) and retained afterbirth (26.6 %). The overall cumulative incidence
of the periparturient conditions was 67 %. Animals with milk fever were 5 times
more likely to develop retained placenta (P=0.04) while those with a history of
having developed retained placenta in a previous parturition were at 2 times more
likely to develop retained afterbirth (P=0.05). Cows with milk fever were 9 times
more likely to develop owner cow syndrome (P <0.001) while those that were not
given supplemental feed in the last trimester were 4.8 times more likely to develop
downer cow syndrome (P=0.007). Animals that had dystocia were 3.9 times more
likely to develop metritis (P=0.02) and while those with retained placenta were 5.2
times more likely to develop metritis (P=0.03). In addition, animals with dystocia
were 10.55 times more likely to develop postpartum haemorrhage (P=0.01) and
58.9 times more likely to develop injuries to the birth canal (P<0.01). From this
study it can be concluded that downer cow syndrome, dystocia, mastitis, metritis,
milk fever and retained placenta were the most common periparturient conditions
in smallholder dairy cattle herds in Kikuyu division of Kiambu district

In this retrospective study carried out covering the period, 1978-1991, 62 neonates were seen, diagnosed and treated for intestinal atresia which included: duodenal atresia and stenosis, small bowel atresia and atresia of large bowel. Locations of obstruction were duodenal in 17 patients, jejunal in 25 patients, jejuno-ileal in 5 and colon in two. Duodenal atresia was noted in 9 infants and duodenal stenosis due to annular pancreas, Ladd's bands with malrotation of bowel in 8. Associated anomalies which were observed were anorectal malformations in 2 and malrotation in 2 infants. Birth weights ranged from 1450 gm to 3000 gm. Prematurity was recorded in 11 infants. Diagnosis of intestinal atresia in our patients was made clinically and radiologically. Intestinal atresia in neonates was differentiated from other causes of obstruction such as Meconium Ileus, Hirschsprung's disease, neonatal volvulus, rectal atresia in anorectal malformations. Treatment of infants with intestinal atresia was surgical. Surgical techniques used depended on pathological findings. In 36 patients, complications such as functional obstructions with vomiting and failure to thrive, malabsorption, aspiration, bronchopneumonia, sepsis were observed. Overall mortality rate in our cases was 25 (41.9%) out of 62 patients.

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Herein we report on the semisynthesis and biological evaluation of b-amino alcohol derivatives of the natural product totarol and other simple aromatic systems. All beta-amino alcohol derivatives of totarol exhibited higher antiplasmodial activity than totarol [IC50: 11.69 microM (K1, chloroquine and multi-drug resistant strain), and 11.78 microM (D10, chloroquine sensitive strain)]—12e was the most active [IC50: 0.63 microM (K1), and 0.61 microM (D10)]. The phenyl and naphthyl b-amino alcohol derivatives were much less active than their corresponding totarol equivalents. The majority of the b-amino alcohol derivatives of totarol were more active against K1 than the D10 strains of Plasmodium falciparum, a trend similar to the inverse relationship observed with the established aryl-amino alcohol antimalarial mefloquine. Selected compounds were shown to affect erythrocyte morphology, inhibit erythrocyte invasion and trigger CQ accumulation.

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The precise period when experience shapes neural circuits in the mouse visual system is unknown. We used Arc induction to monitor the functional pattern of ipsilateral eye representation in cortex during normal development and after visual deprivation. After monocular deprivation during the critical period, Arc induction reflects ocular dominance (OD) shifts within the binocular zone. Arc induction also reports faithfully expected OD shifts in cat. Shifts towards the open eye and weakening of the deprived eye were seen in layer 4 after the critical period ends and also before it begins. These shifts include an unexpected spatial expansion of Arc induction into the monocular zone. However, this plasticity is not present in adult layer 6. Thus, functionally assessed OD can be altered in cortex by ocular imbalances substantially earlier and far later than expected.

The precise period when experience shapes neural circuits in the mouse visual system is unknown. We used Arc induction to monitor the functional pattern of ipsilateral eye representation in cortex during normal development and after visual deprivation. After monocular deprivation during the critical period, Arc induction reflects ocular dominance (OD) shifts within the binocular zone. Arc induction also reports faithfully expected OD shifts in cat. Shifts towards the open eye and weakening of the deprived eye were seen in layer 4 after the critical period ends and also before it begins. These shifts include an unexpected spatial expansion of Arc induction into the monocular zone. However, this plasticity is not present in adult layer 6. Thus, functionally assessed OD can be altered in cortex by ocular imbalances substantially earlier and far later than expected.

Throughout the world, waste sector has been implicated in significant contribution to anthropogenic greenhouse gas (GHG) emissions. Involving communities in recycling their solid waste would ensure climate change effect mitigation and resilience. This study was carried out to improve waste management practices through a community-led intervention at Kube-Atenda community in Ibadan, Nigeria. The study adopted a quasi-experimental design, comprising mixed method of data collection such as semi- structured questionnaire and a life-cycle-based model for calculating greenhouse gas generation potentials of various waste management practices in the area. A systematic random sampling was used to select sixty (60) households for a survey on knowledge, attitude and practices of waste management through Recovery, Reduction, Reuse and Recycling (4Rs) before and after the training intervention. Data collected were summarized using descriptive statistics, chi-square test, t-test and ANOVA at p = 0.05. The mean age of the respondent was 49.7 ± 16.7 and 68.3% were females. Respondents’ knowledge scores before and after the intervention were significantly different: 7.07 ± 1.48 and 11.6 ± 1.6 while attitude scores were: 8.2 ± 2.3 and 13.5 ± 0.8. There were significant differences in the major waste disposal practices in the community before and after the intervention. All (100%) the participants were willing to participate in waste recycling business and the model predicted that adoption of 4Rs strategy had a great potential in saving greenhouse gas emissions in the community. The behavior of the community people has changed towards waste management that promote climate change mitigation and adaptation through waste reduction, reuse, and resource recovery.

Introduction
Acute kidney injury (AKI) results in a decline in the glomerular filtration rate. It has a high
prevalence both in the developed and developing countries and is frequently encountered in
hospitalized patients; it has a negative impact on mortality and morbidity.
Objectives
This study was designed to determine the prevalence of community acquired acute kidney injury
in all patients admitted to the medical wards at Kenyatta National Hospital during the study
period, to determine the severity of acute kidney injury based on the KDIGO criteria and to
elucidate the associated risk factors of acute kidney injury. The management modalities were
described as well as their outcomes at the point of discharge or after 2 weeks.
Method
A longitudinal study was carried out on acute kidney injury at Kenyatta National Hospital. All
patients over the age of 13 years admitted to the general medical wards were followed up
prospectively for 2 weeks and those diagnosed to have AKI were assessed daily for severity, risk
factors and outcome
Results
A total of 136 patients were enrolled from August 20th 2016 to November 22nd 2016. The period
prevalence was found to be 8.1% at admission. Most of the patients had stage 1 AKI (51.5%)
while the rest had stage 2 and stage 3 AKI (48.6%). Only 2 patients underwent RRT. The median
length of stay was 9 days, 11 days and 10 days in stages 1, 2 and 3 respectively. There was no
association between AKI severity and length of hospital stay. 60% had non-recovery while 21
patients (18.6%) recovered fully and the more severe the AKI, the lesser the chances of recovery
with a p value of 0.045. The in-hospital all- cause mortality during the study period was 23
patients (16.9%). The severity of AKI increased the chances of mortality with a p value of
0.012. The commonest cause of AKI was pre-renal, followed by intrinsic then obstructive.
Conclusion
AKI is common in our environment. Similar findings have been noted in developed countries.
Prevalence and mortality in patients with AKI is high. The severity of AKI was associated with
non- recovery, mortality and need of renal replacement therapy with no association in the length
of hospital stay.

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Ganglion cells that had complex receptive field properties, namely, On-Off and On direction-selective cells, orientation-selective cells, local edge detectors, and uniformity detectors (suppressed by contrast cells) were recorded in an isolated superfused rabbit eyecup preparation. Cells were first classified by their characteristic extracellular responses to manually controlled stimuli similar to those which have been used in previous in vivo studies. Ganglion cells were then impaled, confirmed in identity by intracellular recording, and iontophoretically injected with horseradish peroxidase for staining. Twenty-two ganglion cells, which included members of all the major classes mentioned above, were recovered from the visual streak or near periphery. All recovered cells were drawn in camera lucida from flatmounted retinas and entered into a computer as two-dimensional stick figures; nearly all were three-dimensionally reconstructed to determine the level and manner of dendritic ramification in the inner plexiform layer (IPL). The location of ganglion cell dendrites in sublaminar regions of the IPL was found to be consistent with the hypothesis of a division of the IPL into excitatory On (promixal) and Off (distal) sublaminae, with some qualifications for particular classes. Each of the complex receptive field ganglion cell classes exhibited a distinctive three-dimensional dendritic arborization pattern uniquely associated with that physiological class.

Private standards initiatives (PSIs ) in agri‐food value chains raise questions of democratic governance and accountability relating to the voice and agency of those whom the standards are designed to benefit or whom they most affect. We employ the concept of ‘spaces for participation’ to analyze participation in a particular PSI, GlobalGAP, and assess how, and to what extent, it opens up a space for debate about what constitutes good practice in agri‐food chains and for whom. We draw on focus groups with smallholders, together with semi‐structured interviews and workshops held with actors at the national and international scales to examine PSIs operating in K enyan export horticulture to examine good agricultural practice (GAP ) standards. Our analysis suggests that despite public announcements that these initiatives promote the voice of the farmer, the direct participation of farmers is largely absent from these policy spaces at present. This is related to the way in which invitations to the spaces for participation are constructed, what is deemed to be appropriate subjects for discussion in PSIs as well as the practical challenges associated with the organization of farmers across spatial scales. The spaces for participation are located largely at the international and national scales with few connections to the local scale. This paper contributes to an extension of value chain analysis that re‐asserts the importance of institutional context and how value chains are embedded in particular socio‐economic and political systems.

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Aim: To evaluate the efficacy of topical prednisolone phosphate 1% eye drops in reducing recurrences after bare sclera pterygium surgery.
Design: Randomized controlled clinical trial.
Setting: Kenyatta, Nakuru, Embu, Murang’a, and Machakos eye clinics of Kenya.
Subjects: 51 eyes of 46 patients (17 males and 29 females) operated between May and November 1997 at the above eye units. The youngest was 22 years and the oldest 76 years.
Results: 24 out of 31 pterygia in the prednisolone group and 15 of 20 controls were evaluated. 16.7% of the eyes in the prednisolone group developed recurrences as compared to 53.3% in the control group (p=0.0017). All except one of the recurrences developed within 8 weeks. Recurrences were more common in younger patients. There was no statistically significant difference in the recurrence rate between males and females.
Conclusions: Topical prednisolone phosphate 1% eye drops; a cheap and easily available eye medication is an effective adjunctive treatment after bare sclera pterygium surgery.
Recommendations: Other adjunctive treatments and surgical techniques should also be explored preferably in a multi-centre setup.

The phosphorylated form of liver glycogen phosphorylase (alpha-1,4-glucan : orthophosphate alpha-glucosyl-transferase, EC 2.4.1.1) (phosphorylase a) is active and easily measured while the dephosphorylated form (phosphorylase b), in contrast to the muscle enzyme, has been reported to be essentially inactive even in the presence of AMP. We have purified both forms of phosphorylase from rat liver and studied the characteristics of each. Phosphorylase b activity can be measured with our assay conditions. The phosphorylase b we obtained was stimulated by high concentrations of sulfate, and was a substrate for muscle phosphorylase kinase whereas phosphorylase a was inhibited by sulfate, and was a substrate for liver phosphorylase phosphatase. Substrate binding to phosphorylase b was poor (KM glycogen = 2.5 mM, glucose-1-P = 250 mM) compared to phosphorylase a (KM glycogen = 1.8 mM, KM glucose-1-P = 0.7 mM). Liver phosphorylase b was active in the absence of AMP. However, AMP lowered the KM for glucose-1-P to 80 mM for purified phosphorylase b and to 60 mM for the enzyme in crude extract (Ka = 0.5 mM). Using appropriate substrate, buffer and AMP concentrations, assay conditions have been developed which allow determination of phosphorylase a and 90% of the phosphorylase b activity in liver extracts. Interconversion of the two forms can be demonstrated in vivo (under acute stimulation) and in vitro with little change in total activity. A decrease in total phosphorylase activity has been observed after prolonged starvation and in diabetes.

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{OBJECTIVE: Accumulating evidence suggests that exaggerated formation of vasa vasorum (VV) plays an important role in the pathogenesis of atherosclerosis. However, it remains unclear whether augmented angiogenesis in the adventitia could promote hyperlipidemia-induced atherosclerotic lesion formation. METHODS AND RESULTS: First, we analyzed the time course of VV development in apolipoprotein E-deficient (ApoE-/-) mice. VV proliferation was observed only after atherosclerotic lesion formation. Next, we investigated whether forced perivascular angiogenesis could promote plaque progression. Basic fibroblast growth factor (bFGF) (100 μg/body) incorporated in acid gelatin hydrogel microspheres (AGHM) (bFGF+AGHM group

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In individuals with human immunodeficiency virus type 1 (HIV-1) infection, CD4:CD8 lymphocyte ratio is often recognized as a quantitative outcome that reflects the critical role of both CD4(+) and CD8(+) T-cells in HIV-1 pathogenesis or disease progression. Our work aimed to first establish the dynamics and clinical relevance of CD4:CD8 ratio in a cohort of native Africans and then to examine its association with viral and host factors, including: (i) length of infection, (ii) demographics, (iii) HIV-1 viral load (VL), (iv) change in CD4(+) T-lymphocyte count (CD4 slope), (v) HIV-1 subtype, and (vi) host genetics, especially human leukocyte antigen (HLA) variants. Data from 499 HIV-1 seroconverters with frequent (monthly to quarterly) follow-up revealed that CD4:CD8 ratio was stable in the first 3 years of infection, with a modest correlation with VL and CD4 slope. A relatively normal CD4:CD8 ratio (>1.0) in early infection was associated with a substantial delay in disease progression to severe immunodeficiency (<350 CD4 cells/μl), regardless of other correlates of HIV-1 pathogenesis (adjusted hazards ratio (HR) = 0.43, 95% confidence interval (CI) = 0.29-0.63, P < 0.0001). Low VL (<10,000 copies/ml) and HLA-A*74:01 were the main predictors of CD4:CD8 ratio >1.0, but HLA variants (e.g., HLA-B*57 and HLA-B*81) previously associated with VL and/or CD4 trajectories in eastern and southern Africans had no obvious impact on CD4:CD8 ratio. Collectively, these findings suggest that CD4:CD8 ratio is a robust measure of immunologic health with both clinical and epidemiological implications.