Objective: To establish ocular fi ndings in Kenyan children with HIV/AIDS. Design: Hospital-based cross sectional study . Setting: Mbagathi District Hospital (Nairobi) MSF-Belgium HIV clinic support center and paediatric ward. Subjects: HIV infected children. Results: A total of 208 HIV infected children were examined. The overall prevalence of ocular fi ndings was 67.3% (140 patients). 113 patients (54.3%) of the patients were on ARV therapy. The most common finding was adnexal lesions observed in 40.9% of the patients, followed by posterior segment findings in 31.3%. Conjunctival microvasculopathy (30 patients,14.4%), allergic conjunctivitis (27 patients, 13.0%) and molluscum contagiosum 12 patients, 5.8%) were the main adnexal findings. Five cases (2.4%) of infectious conjunctivitis, 4 cases (1.9%) of herpes zoster ophthalmicus (HZO) and conjunctival growth were also recorded. Keratoconjunctivitis (6 patients, 2.9%), anterior uveitis (6 patients, 2.9%), and corneal ulcer (3 patients, 1.4%) were the main anterior segment findings. Peripheral retinal perivasculitis (28 patients, 13.5%) was the commonest posterior segment finding, followed by cotton wool spots (18 patients, 8.7%) and presumed retinal pigment epitheliopathy (18 patients, 8.7%) . Two cases of white retinal infiltrate associated with frosted branch vasculitis and 2 cases of focal retinal haemorrhages were also observed. Tuberculosis was the major systemic finding (93 patients, 44.7%). This study found that ocular findings are directly related to the duration of exposure to HIV infection (age), to the severity of clinical state of the disease (WHO clinical staging)and to the severity of immune suppression (CD4 count). Conclusion: The results of this study suggest a high prevalence of ocular findings in Kenyan children with HIV/AIDS. Retinal perivasculitis was the commonest retinal finding observed. Further studies are needed to investigate the unusual fi ndings of retinal pigment epitheliopathy observed in this study.

n/a

Objective: To establish ocular fi ndings in Kenyan children with HIV/AIDS. Design: Hospital-based cross sectional study . Setting: Mbagathi District Hospital (Nairobi) MSF-Belgium HIV clinic support center and paediatric ward. Subjects: HIV infected children. Results: A total of 208 HIV infected children were examined. The overall prevalence of ocular fi ndings was 67.3% (140 patients). 113 patients (54.3%) of the patients were on ARV therapy. The most common finding was adnexal lesions observed in 40.9% of the patients, followed by posterior segment findings in 31.3%. Conjunctival microvasculopathy (30 patients,14.4%), allergic conjunctivitis (27 patients, 13.0%) and molluscum contagiosum 12 patients, 5.8%) were the main adnexal findings. Five cases (2.4%) of infectious conjunctivitis, 4 cases (1.9%) of herpes zoster ophthalmicus (HZO) and conjunctival growth were also recorded. Keratoconjunctivitis (6 patients, 2.9%), anterior uveitis (6 patients, 2.9%), and corneal ulcer (3 patients, 1.4%) were the main anterior segment findings. Peripheral retinal perivasculitis (28 patients, 13.5%) was the commonest posterior segment finding, followed by cotton wool spots (18 patients, 8.7%) and presumed retinal pigment epitheliopathy (18 patients, 8.7%) . Two cases of white retinal infiltrate associated with frosted branch vasculitis and 2 cases of focal retinal haemorrhages were also observed. Tuberculosis was the major systemic finding (93 patients, 44.7%). This study found that ocular findings are directly related to the duration of exposure to HIV infection (age), to the severity of clinical state of the disease (WHO clinical staging)and to the severity of immune suppression (CD4 count). Conclusion: The results of this study suggest a high prevalence of ocular findings in Kenyan children with HIV/AIDS. Retinal perivasculitis was the commonest retinal finding observed. Further studies are needed to investigate the unusual fi ndings of retinal pigment epitheliopathy observed in this study.

Sengis are testicondid endemic african mammals that constitute the order Macroscelidae. The epididymides of five male rufous sengis (Elephantulus rufescens) were studied both macroscopically and microscopically to describe the structure and possible features or adaptations making it a suitable site for sperm maturation and storage in testicondas. The epididymis had three distinct topographic regions; the caput, corpus and cauda epididymis. The caput and cauda epididymis were placed further apart; the former occuring as a longitudinal mass on dorsolateral border of the tesis while the latter occurred as a pear-shaped mass placed laterally between the rectum and the pelvic urethra, the two being connected by a slender corpus epiddidymis. The epithelium comprised of principal and basal cells with the former exhibiting numerous secretory granules and apical blebing in the caput. In the cauda, principal cells had numerous vacuoles and its lumen was densely packed with spermatozoa and occasional masses that appeaed to engulf spermatozoa. This study demonstrates that the pricipal cells of the caput of sengi produces materials either through merocrine or apocrine secretion, the latter being shown by apical blebs that are shed off as epididymosomes, which in turn transfers epididymis-secreted proteins to the plasma membrane of spermatozoa. Additionally, the study has shown that the cauda epididymis remarkably descends to a site probably cooler than the core body temperature for optimal sperm storage, and the numerous vacuoles indicating its involvement in fluid reabsortion and phagocytosis of residual bodies and damaged spermazoa.

This paper describes the experiences of physicians-in-training at a public hospital in Nairobi, Kenya, where medical professionals practice in an environment characterized by both significant lack of resources and patients with HIV/AIDS in historically unprecedented numbers. The data reported here are part of a larger study examining ethical dilemmas in medical education and practice among physicians in East Africa. A questionnaire and semi-structured interview were completed by fifty residents in four medical specialties, examining social and emotional supports, personal and professional sources of stress, emotional numbing and disengagement from patients and peers, and symptoms of post-traumatic stress and depression. The factors affecting resident well-being are found in this study to be more complex than previous interviews suggested. This study highlights the fact that as a result of working in an environment characterized by poor communication among hospital staff as well as a lack of resources and high numbers of patients with HIV/AIDS, residents' perceptions of themselves–their technical proficiency, their ability to care and feel for others and themselves, and for some their entire sense of self–are significantly affected. Also affected are the patients they work to treat.

This paper describes the experiences of physicians-in-training at a public hospital in Nairobi, Kenya, where medical professionals practice in an environment characterized by both significant lack of resources and patients with HIV/AIDS in historically unprecedented numbers. The data reported here are part of a larger study examining ethical dilemmas in medical education and practice among physicians in East Africa. A questionnaire and semi-structured interview were completed by fifty residents in four medical specialties, examining social and emotional supports, personal and professional sources of stress, emotional numbing and disengagement from patients and peers, and symptoms of post-traumatic stress and depression. The factors affecting resident well-being are found in this study to be more complex than previous interviews suggested. This study highlights the fact that as a result of working in an environment characterized by poor communication among hospital staff as well as a lack of resources and high numbers of patients with HIV/AIDS, residents' perceptions of themselves–their technical proficiency, their ability to care and feel for others and themselves, and for some their entire sense of self–are significantly affected. Also affected are the patients they work to treat.

This paper describes the experiences of physicians-in-training at a public hospital in Nairobi, Kenya, where medical professionals practice in an environment characterized by both significant lack of resources and patients with HIV/AIDS in historically unprecedented numbers. The data reported here are part of a larger study examining ethical dilemmas in medical education and practice among physicians in East Africa. A questionnaire and semi-structured interview were completed by fifty residents in four medical specialties, examining social and emotional supports, personal and professional sources of stress, emotional numbing and disengagement from patients and peers, and symptoms of post-traumatic stress and depression. The factors affecting resident well-being are found in this study to be more complex than previous interviews suggested. This study highlights the fact that as a result of working in an environment characterized by poor communication among hospital staff as well as a lack of resources and high numbers of patients with HIV/AIDS, residents' perceptions of themselves–their technical proficiency, their ability to care and feel for others and themselves, and for some their entire sense of self–are significantly affected. Also affected are the patients they work to treat.

This paper describes the experiences of physicians-in-training at a public hospital in Nairobi, Kenya, where medical professionals practice in an environment characterized by both significant lack of resources and patients with HIV/AIDS in historically unprecedented numbers. The data reported here are part of a larger study examining ethical dilemmas in medical education and practice among physicians in East Africa. A questionnaire and semi-structured interview were completed by fifty residents in four medical specialties, examining social and emotional supports, personal and professional sources of stress, emotional numbing and disengagement from patients and peers, and symptoms of post-traumatic stress and depression. The factors affecting resident well-being are found in this study to be more complex than previous interviews suggested. This study highlights the fact that as a result of working in an environment characterized by poor communication among hospital staff as well as a lack of resources and high numbers of patients with HIV/AIDS, residents' perceptions of themselves–their technical proficiency, their ability to care and feel for others and themselves, and for some their entire sense of self–are significantly affected. Also affected are the patients they work to treat.

This paper describes the experiences of physicians-in-training at a public hospital in Nairobi, Kenya, where medical professionals practice in an environment characterized by both significant lack of resources and patients with HIV/AIDS in historically unprecedented numbers. The data reported here are part of a larger study examining ethical dilemmas in medical education and practice among physicians in East Africa. A questionnaire and semi-structured interview were completed by fifty residents in four medical specialties, examining social and emotional supports, personal and professional sources of stress, emotional numbing and disengagement from patients and peers, and symptoms of post-traumatic stress and depression. The factors affecting resident well-being are found in this study to be more complex than previous interviews suggested. This study highlights the fact that as a result of working in an environment characterized by poor communication among hospital staff as well as a lack of resources and high numbers of patients with HIV/AIDS, residents' perceptions of themselves–their technical proficiency, their ability to care and feel for others and themselves, and for some their entire sense of self–are significantly affected. Also affected are the patients they work to treat.

This paper describes the experiences of physicians-in-training at a public hospital in Nairobi, Kenya, where medical professionals practice in an environment characterized by both significant lack of resources and patients with HIV/AIDS in historically unprecedented numbers. The data reported here are part of a larger study examining ethical dilemmas in medical education and practice among physicians in East Africa. A questionnaire and semi-structured interview were completed by fifty residents in four medical specialties, examining social and emotional supports, personal and professional sources of stress, emotional numbing and disengagement from patients and peers, and symptoms of post-traumatic stress and depression. The factors affecting resident well-being are found in this study to be more complex than previous interviews suggested. This study highlights the fact that as a result of working in an environment characterized by poor communication among hospital staff as well as a lack of resources and high numbers of patients with HIV/AIDS, residents' perceptions of themselves–their technical proficiency, their ability to care and feel for others and themselves, and for some their entire sense of self–are significantly affected. Also affected are the patients they work to treat.

Objective: To establish ocular fi ndings in Kenyan children with HIV/AIDS. Design: Hospital-based cross sectional study .

Setting: Mbagathi District Hospital (Nairobi) MSF-Belgium HIV clinic support center and paediatric ward.

Subjects: HIV infected children.

Results: A total of 208 HIV infected children were examined. The overall prevalence of ocular fi ndings was 67.3% (140 patients). 113 patients (54.3%) of the patients were on ARV therapy. The most common finding was adnexal lesions observed in 40.9% of the patients, followed by posterior segment findings in 31.3%. Conjunctival microvasculopathy (30 patients,14.4%), allergic conjunctivitis (27 patients, 13.0%) and molluscum contagiosum 12 patients, 5.8%) were the main adnexal findings. Five cases (2.4%) of infectious conjunctivitis, 4 cases (1.9%) of herpes zoster ophthalmicus (HZO) and conjunctival growth were also recorded. Keratoconjunctivitis (6 patients, 2.9%), anterior uveitis (6 patients, 2.9%), and corneal ulcer (3 patients, 1.4%) were the main anterior segment findings. Peripheral retinal perivasculitis (28 patients, 13.5%) was the commonest posterior segment finding, followed by cotton wool spots (18 patients, 8.7%) and presumed retinal pigment epitheliopathy (18 patients, 8.7%) . Two cases of white retinal infiltrate associated with frosted branch vasculitis and 2 cases of focal retinal haemorrhages were also observed. Tuberculosis was the major systemic finding (93 patients, 44.7%). This study found that ocular findings are directly related to the duration of exposure to HIV infection (age), to the severity of clinical state of the disease (WHO clinical staging)and to the severity of immune suppression (CD4 count).

Conclusion: The results of this study suggest a high prevalence of ocular findings in Kenyan children with HIV/AIDS. Retinal perivasculitis was the commonest retinal finding observed. Further studies are needed to investigate the unusual fi ndings of retinal pigment epitheliopathy observed in this study.

Objective: To establish ocular fi ndings in Kenyan children with HIV/AIDS. Design: Hospital-based cross sectional study .

Setting: Mbagathi District Hospital (Nairobi) MSF-Belgium HIV clinic support center and paediatric ward.

Subjects: HIV infected children.

Results: A total of 208 HIV infected children were examined. The overall prevalence of ocular fi ndings was 67.3% (140 patients). 113 patients (54.3%) of the patients were on ARV therapy. The most common finding was adnexal lesions observed in 40.9% of the patients, followed by posterior segment findings in 31.3%. Conjunctival microvasculopathy (30 patients,14.4%), allergic conjunctivitis (27 patients, 13.0%) and molluscum contagiosum 12 patients, 5.8%) were the main adnexal findings. Five cases (2.4%) of infectious conjunctivitis, 4 cases (1.9%) of herpes zoster ophthalmicus (HZO) and conjunctival growth were also recorded. Keratoconjunctivitis (6 patients, 2.9%), anterior uveitis (6 patients, 2.9%), and corneal ulcer (3 patients, 1.4%) were the main anterior segment findings. Peripheral retinal perivasculitis (28 patients, 13.5%) was the commonest posterior segment finding, followed by cotton wool spots (18 patients, 8.7%) and presumed retinal pigment epitheliopathy (18 patients, 8.7%) . Two cases of white retinal infiltrate associated with frosted branch vasculitis and 2 cases of focal retinal haemorrhages were also observed. Tuberculosis was the major systemic finding (93 patients, 44.7%). This study found that ocular findings are directly related to the duration of exposure to HIV infection (age), to the severity of clinical state of the disease (WHO clinical staging)and to the severity of immune suppression (CD4 count).

Conclusion: The results of this study suggest a high prevalence of ocular findings in Kenyan children with HIV/AIDS. Retinal perivasculitis was the commonest retinal finding observed. Further studies are needed to investigate the unusual fi ndings of retinal pigment epitheliopathy observed in this study.

OBJECTIVE: To study the pattern of occurrence of Creutzfeldt-Jakob disease (CJD) in Kenya. Study design Prospective, cross-sectional, descriptive study of clinical, encephalographic and natural history of CJD, backed by histology in as many patients as possible. METHODS: Consecutive patients presenting with the criteria laid down by WHO expert committee for diagnosis of CJD were recruited between January 1990 and May 2004. We analysed the clinical features and electroencephalography of all participants and took brain biopsies from four patients. RESULTS: There were four definite, seven probable and two possible cases. The electroencephalographic and histological features were typical of sporadic CJD. CONCLUSION: Sporadic CJD occurs in Kenya and the clinical, encephalographic and histological features were no different to those described elsewhere. Although we did not see variant, hereditary and iatrogenic forms of CJD, neurologists should not exclude these in making diagnoses

The prevalence of antibodies against Leishmania donovani in selected domestic and wild animal species in 2 villages in Sudan with active L. donovani transmission in humans was investigated. Screening of domestic animals (donkeys, cows, sheep, goats, camels and dogs) with the direct agglutination test (DAT) detected reaction rates above the cut-off titres in donkeys (68.7%), cows (21.4%) and goats (8.5%), and which were also found in wild rats (5.5%). Sera of sheep, camels and dogs had a weak agglutination reaction below the cut-off titre. Testing of the same sera by enzyme-linked immunosorbent assay (ELISA), against a lysate of L. donovani promastigotes, showed reaction rates above the cut-off optical density in cows (47.6%), goats (13.6%), and in rats (4.1%). No Leishmania parasite was isolated from spleen, liver, bone-marrow or spleen of Nile rats.

OBJECTIVE: To find out if there is any association between serum uric acid level and positional vertigo. DESIGN: A prospective, case controlled study. SETTING: A private neurological clinic. SUBJECTS: All patients presenting with vertigo. RESULTS: Ninety patients were seen in this period with 78 males and 19 females. Mean age was 47 +/- 3 years (at 95% confidence level) with a standard deviation of 12.4. Their mean uric acid level was 442 +/- 16 (at 95% confidence level) with a standard deviation of 79.6 umol/l as compared to 291 +/- 17 (at 95% confidence level) with a standard deviation of 79.7 umol/l in the control group. The P-value was less than 0.001. CONCLUSION: That there is a significant association between high uric acid and benign positional vertigo.

OBJECTIVE: To find out if there is any association between serum uric acid level and positional vertigo. DESIGN: A prospective, case controlled study. SETTING: A private neurological clinic. SUBJECTS: All patients presenting with vertigo. RESULTS: Ninety patients were seen in this period with 78 males and 19 females. Mean age was 47 +/- 3 years (at 95% confidence level) with a standard deviation of 12.4. Their mean uric acid level was 442 +/- 16 (at 95% confidence level) with a standard deviation of 79.6 umol/l as compared to 291 +/- 17 (at 95% confidence level) with a standard deviation of 79.7 umol/l in the control group. The P-value was less than 0.001. CONCLUSION: That there is a significant association between high uric acid and benign positional vertigo.

Samples of burnt clay from kilns in various parts of the country were tested for their cementatious qualities and found to have high silica contents.Results showed that additing upto 40% of the cly to portland cement produced good binders for mass concre and plaster work,particularly for low cost housing.

The pathology of calves that died from experimental water intoxication was investigated. Oedema of the brain and urinary bladder, and renal damage were significant pathological findings in these calves. The findings were attributed to positive water balance in calves suffering from water intoxication

This article reveals that the concept of education as a process of growth is a difficult one. Philosophers are, therefore, justified in being weary when pondering over its meaning, both in theory and practice. By way of conclusion, the article appreciates the complexities inherent in the growth theory of education, summarizing its major strength and weaknesses. Then it cautions educational planners and practitioners to be weary when, and if, they translate the theory into practice, so that they utilize the strengths inherent in the theory whilst paying attention to the dangers of its inherent weaknesses.

OBJECTIVE: To determine the prevalence, clinical characteristics, management methods and prognosis of testicular cancer at Kenyatta National Hospital. DESIGN: Retrospective case study of testicular cancer patients over a fifteen year period. SETTING: Kenyatta National Hospital, a referral and teaching hospital. PARTICIPANTS: All histologically confirmed testicular cancer patients recorded at the Histopathology Department of Kenyatta National Hospital between 1983 and 1997. RESULTS: The mean age was 34.8 years with a peak incidence in the 30-44 year age group. History of cryptochirdism was obtained in 10.26% of the patients. Thirty one patients (79.49%) presented with painless testicular swellings, eleven (28.08%) with pain, nine (23.08%) with scrotal heaviness, six (15.38%) with abdominal swellings and one (2.56%) each with gynaecomastia and eye swelling. On examination 32 patients (82.05%) had testicular masses, ten (25.64%) had abdominal masses, seven (17.91%) had supraclavicular and cervical lymphadenopathy, and one each (2.56%) had gynaecomastia and eye mass respectively. More than eighty nine per cent had germ cell cancers with seminoma accounting for 67.35%, teratoma 12.24%, embroyonal carcinoma 8.16%, rhabdomyosarcoma 6.12% and malignant germ cell tumour, orchioblastoma and dysgerminoma each accounted for 2.04%. Three patients (7.7%) had orchidectomy and radiotherapy and chemotherapy, sixteen (41.03%) had orchidectomy and radiotherapy, six (15.38%) had orchidectomy and chemotherapy, ten (25.64%) had radiotherapy and chemotherapy, three (7.7%) and two (5.13%) had only chemotherapy and radiotherapy respectively. No cisplastin based chemotherapy regime was used. Follow up was effected for eighteen patients (46.15%) and seven patients (38.89%) were alive after five years. CONCLUSION: Prognosis with current regimes was poor with survival of only 38.89% after five years. Cisplastin based chemotherapy with up to 90% cure rates should be included as a component of testicular cancer management at Kenyatta National Hospital. PIP: This retrospective study was undertaken to determine the prevalence, clinical characteristics, management methods and prognosis of testicular cancer at Kenyatta National Hospital, Nairobi. All histologically confirmed testicular cancer patients recorded at the Histopathology Department between 1993 and 1997 were analyzed. The mean age was 34.8 years with a peak incidence in the 30-44 year age group. About 10.26% of patients had history of cryptochirdism. The clinical symptoms presented were painless testicular swelling (n = 31, 79.49%), testicular pain (n = 11, 28.08%), scrotal heaviness (n = 9, 23.08%), abdominal swelling (n = 6, 15.38%), gynecomastia (n = 1, 2.56%), and eye swelling (n = 1, 2.56%). On examination, 32 patients (82.05%) had testicular masses, 10 (25.64%) had abdominal masses, 7 (17.91%) had supraclavicular and cervical lymphadenopathy, 1 had gynecomastia, and 1 had an orbital mass. More than 89% of patients had germ cell cancers with seminoma accounting for 67.35%, teratoma for 12.24%, embryonal carcinoma for 8.16%, rhabdomyosarcoma for 6.12%, and malignant germ cell tumor, orchioblastoma, and dysgerminoma each accounting for 2.04%. The various methods of treatment include orchidectomy and radiotherapy and chemotherapy in 3 patients (7.7%), orchidectomy and radiotherapy in 16 patients (41.03%), orchidectomy and chemotherapy in 6 patients (15.38%), and radiotherapy and chemotherapy in 10 patients (25.64%). No cisplatin-based chemotherapy was used. 18 patients were followed up, of whom 7 were alive after 5 years. Prognosis with current regimens was poor, with a 38.89% survival ratio in 5 years. Hence, cisplatin-based chemotherapy with up to 90% cure rates should be included in the testicular cancer management in this hospital.

This case report describes an outbreak of acute dermatophilosis in a large scale dairy herd and highlights that the disease in Kenya could occur in outbreak proportions and in clinically severe form as has been reported in other countries in West and central Africa.We believe that this is the 1st documented outbreak of a severe form of bovine cutaneous dermatophilosis in exotic dairy animals in Kenya.

This case report describes an outbreak of acute dermatophilosis in a large scale dairy herd and highlights that the disease in Kenya could occur in outbreak proportions and in clinically severe form as has been reported in other countries in West and central Africa.We believe that this is the 1st documented outbreak of a severe form of bovine cutaneous dermatophilosis in exotic dairy animals in Kenya.

The hydrodistilled essential oil of saw powder of Brachylaena hutchinsii Hutch
was analyzed by GC/MS. Twenty six compounds representing 94.7% of the oil
were identified. The main components of the oil were hydrocarbons
sesquiterpenes, caryophyllene (19.1010), f3-cubebene (15.5%), cls--calamenene
(10.5%) and o-copaene (9.0%). The oil exhibited antimicrobial activity, which
was comparable to that of gentamycin against Proteus mirabilis: It also showed
some activity against Bacillus cereus, Staphylococcus aureus, Staphylococcus
epidermidis, Micrococcus luteus and Enterococcus faecalis.

Forty one consecutive patients (24 males and 17 females) with AIDS had their blood assayed for HBsAg, anti-HBs and anti-HBc by Reversed Passive Haemagglutination (RPHA), Passive Haemagglutination (PHA) and Enzyme Linked Immunosorbent Assay (ELISA) techniques respectively. 5 (12.2%) were found positive for HBsAg. 10 (24.4%) for anti-HBs and 31 (75.6%) for anti-HBc. 32 (78%) out of 41 patients with AIDS had serological evidence of exposure to hepatitis B virus (HBV). The prevalence of HBsAg found in this study is not different from what has been found in the Kenyan community without AIDS, while that of anti-HBs is much lower than what has been reported in the general community.

Psychiatric morbidity among 200 medical in-patients at Kenyatta National Hospital was determined by a two-stage screening procedure, using the Self Reporting Questionnaire (SRQ) and standardized psychiatric interview (SPI). 44 (22%) of the total sample of 200 patients who were interviewed met the pre-established criteria for psychiatric morbidity; of these 59% comprised affective disorders. 4 (9%) of the psychiatric morbidity cases were referred for psychiatric evaluation. Referral seemed to be related to severity of illness and a previous history of psychiatric illness. There was no evidence in the notes that the psychiatric problems had been detected, treated or dealt with in any other way by the medical team in 34 patients out of 44 with psychiatric morbidity. Increase in the mental health input in the training of all health workers with emphasis on recognition and management of some of the commoner psychological problems is recommended.

Journal of Eastern African Literary and Cultural Studies

Journal of Eastern African Literary and Cultural Studies

Journal of Eastern African Literary and Cultural Studies

Journal of Eastern African Literary and Cultural Studies

This study was conducted in the northern part of Kenya, in Kakuma division, Turkana district. Kakuma is a semi-arid area under nomadic pastoralism as the main activity. The presence of a refugee camp has attracted many people from within the Turkana community and also the outside community. The study aimed at documenting the effects of emergent land use changes on vegetation resources and the socio-economic environment in Kakuma. Data on vegetation density and cover was collected. Socio-economic data was collected from the local Turkana population and the settlement camp. The data was analysed using SPSS computer package and descriptive statistics. There was a significant difference (P<0.05) in vegetation cover and density with increasing distance away from the settlement camp. The mean tree crown cover was low near the settlement camp (6.2%) but high away from the settlement camp (57.7%). Mean tree density was high near the settlement camp (13 individuals/ 100m2). Shrub crown cover was low (0.9%) in the areas that had settlements. The need for fencing and building materials was the main cause of low shrub cover. The density of the shrub species generally increased as one moved away from the settlement camp (17 individuals/ 16m2). Herb species cover and density was high near the settlement camp(68% and 202 individuals/ 1m2 respectively) but this comprised mostly of species unpalatable to livestock like Tribulus terrestris and Portulaca oleraceae. The study revealed that droughts and livestock raids in the previous years had set in motion social and ecological changes. The loss of livestock through raids and droughts encouraged sedenterization. This affected the cultural patterns and has had an effect on the rangeland condition. Lack of mobility concentrated livestock in specific areas, thus depleting the forage resources and creating conditions for soil erosion. Trading activities between the refugees and the Turkana had both positive and negative impact on the economic, social and cultural setup of the local community. The increase in population around Kakuma and the settlement camp has set in motion changes that have affected vegetation and social structures. The immediate social and economic returns from the exploitation of resources have overridden the long-term benefits. In regard to this there is a need for education on the impacts, both short-term and long-term, of the various activities on the vegetation, livestock resources and also the pastoral lifestyle. Key words: Pastoralism, Settlement, Land use, Environmental impact.

Department of Pharmacology and Toxicology, University of Nairobi, Kenya. The relative bioavailabilities of three carbamazepine tablet formulations available in the Kenyan market (Temporal(R), Taver(R) and Carbamazepine Lincoln) compared with the innovator formulation (Tegretol(R)) were evaluated in seven healthy African volunteers (5 males, two females; aged 22-36 years), according to a randomised fourway crossover study design, following oral administration of single 200 mg doses with a three week washout period. In vitro dissolution profiles of the tablets were also evaluated. Relative bioavailabilities ((F)rel) of Temporal(R), Taver(R) and Carbamazepine Linocoln were 101.2%, 82.2% and 71.6% respectively, compared with Tegretol(R). Percent drug content dissolved in vitro after I hour were 91.3%, 75.9% and 39.3% for Temporal(R), Taver(R) and Carbamazepine Lincoln, respectively. It was concluded that Temporal(R) was bioequivalent to Tegretol(R) while Taver(R) and Carbamazepin Lincoln were bioinequivalent to Tegretol(R). Administration of Taver(R) or Carbamazepine Lincoln might lead to poor control of epileptic seizures.

Department of Pharmacology and Toxicology, University of Nairobi, Kenya. The relative bioavailabilities of three carbamazepine tablet formulations available in the Kenyan market (Temporal(R), Taver(R) and Carbamazepine Lincoln) compared with the innovator formulation (Tegretol(R)) were evaluated in seven healthy African volunteers (5 males, two females; aged 22-36 years), according to a randomised fourway crossover study design, following oral administration of single 200 mg doses with a three week washout period. In vitro dissolution profiles of the tablets were also evaluated. Relative bioavailabilities ((F)rel) of Temporal(R), Taver(R) and Carbamazepine Linocoln were 101.2%, 82.2% and 71.6% respectively, compared with Tegretol(R). Percent drug content dissolved in vitro after I hour were 91.3%, 75.9% and 39.3% for Temporal(R), Taver(R) and Carbamazepine Lincoln, respectively. It was concluded that Temporal(R) was bioequivalent to Tegretol(R) while Taver(R) and Carbamazepin Lincoln were bioinequivalent to Tegretol(R). Administration of Taver(R) or Carbamazepine Lincoln might lead to poor control of epileptic seizures.

v:* {behavior:url(#default#VML);} o:* {behavior:url(#default#VML);} w:* {behavior:url(#default#VML);} .shape {behavior:url(#default#VML);} 12.00 Normal 0 false false false EN-GB X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman","serif";} Common nearly best linear estimates of location and scale parameters of normal and logistic distributions, which are based on complete samples, are considered. Here the population from which the samples are drawn is either normal or logistic population or a fusion of both distributions and the estimates are computed when it is not yet known which of the two populations (between the normal and logistic) is true. The problem discussed in this paper involves two possible population types in a given sample. Samples of sizes  and  are used to validate these estimates and a comparison of their variances is made with those of the best linear unbiased estimators (BLUEs) for normal and logistic distributions.

Normal 0 false false false MicrosoftInternetExplorer4 st1:*{behavior:url(#ieooui) } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Macrophytes have been shown to perform important ecological roles in Lake Naivasha. Consequently, various studies regarding the impact of biotic factors on the macrophytes have been advanced but related studies on environmental parameters have lagged behind. In an attempt to address this gap, sampling on floating species and submergents was carried out in eight sampling sites in 2003 to investigate how they were influenced by a set of environmental factors. Soil texture (sandy sediments; P < 0.05, regression coefficient = - 0.749) and wind were the most important environmental parameters influencing the distribution and abundance of floating macrophytes. Combination of soil texture and lake-bed slope explained the most (86.3%) variation encountered in the submergents. Continuous translocation of the floating dominant water hyacinth to the western parts by wind has led to displacement of the submergents from those areas. In view of these findings, the maintenance and preservation of the steep Crescent Lake basin whose substratum is dominated by sand thus hosting most submergents remain important, if the whole functional purpose of the macrophytes is to be sustained.

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The quality of brands of Sulfadoxine/pvrirnethamine tablets, from nine different
manufacturers, was assessed, by determining the content of active ingredients and their
dissolution profile. All nine brands complied with the USP requirement for the content of
sulfadoxine and pyrimethamine. However, only four brands passed the dissolution test,
which according to the USP; requires that more "than 60% of each active ingredient should
be in solution in' 30 minutes. One brand failed the dissolution test, with respect to both
active ingredients, for which only 19.9°/i, and 56.9% of pyrimethamine and sulfadoxine,
respectively, were in solution, in 30 minutes. The remaining four brands, failed with
respect to pyrimethamine, for which less than 60% was in solution in 30 minutes. These
findings clearly indicate that, in addition to parasite resistance to sulfadoxine/
pyrimethamine, failure of this drug combination to cure malaria could also be due to the
sub-standard products available on the market. It is recommended that pharmaceutical
manufacturers should ensure that their products meet the required standards by
adherence to good manufacturing practice. Statutory drug control bodies should also
ensure that each product, imported or locally manufactured, meets the required
compendial standards before being permitted to be on the market.

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According to the statements made by a number of scholars, in the 80's East African Anglophone novel, which once received a nickname of "social documentary", began to lose gradually its social commitment. Many of the writers known previously as the most active supporters of the social trend, moved their attempts to other literan areas - criminal novel ("Weapon of hunger" by Meja Mцangi, 1989), love story (Yussuf Dawood's "Off my chest", 1988), even children's literature (books for children in Gikuyu, written by Ngugi wa Thiong'o). However, in the late 80's and early 90's East African Anglophone novel stepped onto a new level of social trend, moving from "social documentary" to "social epic". The authors now are trying to sum up the historical experience of East African countries over a large time span, and to that effect appeal mostly to elaborate and spacious literary forms, such as epic novel. These authors, although chosen one and the same literary form, are showing clearly their inclinations towards different styles of writing. For example, Tanzanian author Moyez Vassanji in his novel "The gunny sack" (1989) makes a rather convincing attempt to replant on East African soil the method of "mythological writing", previously used by such author as Gabriel Garcia Marquez. The novel definitely appeals not only to local reader, but to a wider international audience; on its pages the author manages to restore not only the fate of several generations of Indian family, but even the slightest details of their mentality, using myth as one of the basic means for changing the dimensions of time and space, according to the logic of the narration. The development of Kenyan novel in the early 90's confirms also one of the main tendencies in modem literature - bridging between "elite" and popular fiction. The first attempt of an epic novel in Kenyan Anglophone literature was, oddly enough, made by the veteran of Kenyan popular fiction David Maillu in his "Broken drum" H991). The novel hardly aims the widest reading public - nevertheless, stylistically it bears distinct features of popular fiction, such as crime story, romance, etc. Popular novel in East Africa also shows certain inclination towards urgent social themes, but the authors inevitably uses the artistic means they feel most happy with - that is, the style of popular fiction. For example, the "clash of cultures" - the experience of young Africans studying abroad - is presented in the form of a picaresque ("Times beyond" by Omondi Makoloo, 1992) or love story ("The girl from Uganda" by Tengio Urrio, 1993); feministic problems are spiced with sentimentalism ("Judy the nun" by P .Waweru, 1990); the thoughts on the hardships of younger generation are guised in Bildungs roman ("The plight of succession" by a Tanzanian Prosper Rwegoshora, 1990). At the same time, some authors, who have been ploughing successfully the field of pop fiction for a few decades, show their interest in more elaborate literary forms ("Dedan Kimathi: the real story" by Samuel Kaluga, 1990). All the mentioned facts do not allow us to state that the division into popular and elite novel will disappear within the foreseeable future. However, the most interesting developments seem to take place precisely in the field of bridging between these two branches of East African fiction.

According to the statements made by a number of scholars, in the 80's East African Anglophone novel, which once received a nickname of "social documentary", began to lose gradually its social commitment. Many of the writers known previously as the most active supporters of the social trend, moved their attempts to other literan areas - criminal novel ("Weapon of hunger" by Meja Mцangi, 1989), love story (Yussuf Dawood's "Off my chest", 1988), even children's literature (books for children in Gikuyu, written by Ngugi wa Thiong'o). However, in the late 80's and early 90's East African Anglophone novel stepped onto a new level of social trend, moving from "social documentary" to "social epic". The authors now are trying to sum up the historical experience of East African countries over a large time span, and to that effect appeal mostly to elaborate and spacious literary forms, such as epic novel. These authors, although chosen one and the same literary form, are showing clearly their inclinations towards different styles of writing. For example, Tanzanian author Moyez Vassanji in his novel "The gunny sack" (1989) makes a rather convincing attempt to replant on East African soil the method of "mythological writing", previously used by such author as Gabriel Garcia Marquez. The novel definitely appeals not only to local reader, but to a wider international audience; on its pages the author manages to restore not only the fate of several generations of Indian family, but even the slightest details of their mentality, using myth as one of the basic means for changing the dimensions of time and space, according to the logic of the narration. The development of Kenyan novel in the early 90's confirms also one of the main tendencies in modem literature - bridging between "elite" and popular fiction. The first attempt of an epic novel in Kenyan Anglophone literature was, oddly enough, made by the veteran of Kenyan popular fiction David Maillu in his "Broken drum" H991). The novel hardly aims the widest reading public - nevertheless, stylistically it bears distinct features of popular fiction, such as crime story, romance, etc. Popular novel in East Africa also shows certain inclination towards urgent social themes, but the authors inevitably uses the artistic means they feel most happy with - that is, the style of popular fiction. For example, the "clash of cultures" - the experience of young Africans studying abroad - is presented in the form of a picaresque ("Times beyond" by Omondi Makoloo, 1992) or love story ("The girl from Uganda" by Tengio Urrio, 1993); feministic problems are spiced with sentimentalism ("Judy the nun" by P .Waweru, 1990); the thoughts on the hardships of younger generation are guised in Bildungs roman ("The plight of succession" by a Tanzanian Prosper Rwegoshora, 1990). At the same time, some authors, who have been ploughing successfully the field of pop fiction for a few decades, show their interest in more elaborate literary forms ("Dedan Kimathi: the real story" by Samuel Kaluga, 1990). All the mentioned facts do not allow us to state that the division into popular and elite novel will disappear within the foreseeable future. However, the most interesting developments seem to take place precisely in the field of bridging between these two branches of East African fiction.

According to the statements made by a number of scholars, in the 80's East African Anglophone novel, which once received a nickname of "social documentary", began to lose gradually its social commitment. Many of the writers known previously as the most active supporters of the social trend, moved their attempts to other literan areas - criminal novel ("Weapon of hunger" by Meja Mцangi, 1989), love story (Yussuf Dawood's "Off my chest", 1988), even children's literature (books for children in Gikuyu, written by Ngugi wa Thiong'o). However, in the late 80's and early 90's East African Anglophone novel stepped onto a new level of social trend, moving from "social documentary" to "social epic". The authors now are trying to sum up the historical experience of East African countries over a large time span, and to that effect appeal mostly to elaborate and spacious literary forms, such as epic novel. These authors, although chosen one and the same literary form, are showing clearly their inclinations towards different styles of writing. For example, Tanzanian author Moyez Vassanji in his novel "The gunny sack" (1989) makes a rather convincing attempt to replant on East African soil the method of "mythological writing", previously used by such author as Gabriel Garcia Marquez. The novel definitely appeals not only to local reader, but to a wider international audience; on its pages the author manages to restore not only the fate of several generations of Indian family, but even the slightest details of their mentality, using myth as one of the basic means for changing the dimensions of time and space, according to the logic of the narration. The development of Kenyan novel in the early 90's confirms also one of the main tendencies in modem literature - bridging between "elite" and popular fiction. The first attempt of an epic novel in Kenyan Anglophone literature was, oddly enough, made by the veteran of Kenyan popular fiction David Maillu in his "Broken drum" H991). The novel hardly aims the widest reading public - nevertheless, stylistically it bears distinct features of popular fiction, such as crime story, romance, etc. Popular novel in East Africa also shows certain inclination towards urgent social themes, but the authors inevitably uses the artistic means they feel most happy with - that is, the style of popular fiction. For example, the "clash of cultures" - the experience of young Africans studying abroad - is presented in the form of a picaresque ("Times beyond" by Omondi Makoloo, 1992) or love story ("The girl from Uganda" by Tengio Urrio, 1993); feministic problems are spiced with sentimentalism ("Judy the nun" by P .Waweru, 1990); the thoughts on the hardships of younger generation are guised in Bildungs roman ("The plight of succession" by a Tanzanian Prosper Rwegoshora, 1990). At the same time, some authors, who have been ploughing successfully the field of pop fiction for a few decades, show their interest in more elaborate literary forms ("Dedan Kimathi: the real story" by Samuel Kaluga, 1990). All the mentioned facts do not allow us to state that the division into popular and elite novel will disappear within the foreseeable future. However, the most interesting developments seem to take place precisely in the field of bridging between these two branches of East African fiction.

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

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

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

A study to evaluate alternative health interventions for the control of sarcoptic mange and gastro-intestinal nematodes in smallholder pig herds was carried out in Kikuyu Division of Kiambu District, Kenya. A total of 40 herds were randomly allocated, by a simple random strategy, to 3 treatment groups and 1 control group. Each group comprised of 10 herds. Herds in group 1 (control) were treated with a placebo, physiological saline. In group 2, control of nematodes and mange was attempted through the use of ivermectin, while in group 3, nematodes and mange were treated through the use of an anthelmintic (piperazine hydrochloride) and an acaricide (amitraz), respectively. In group 4, nematodes and mange were treated by using an anthelmintic (levamisole hydrochloride) and an acaricide (amitraz), respectively. The anthelmintic activity of ivermectin was not different (p>0.05) from that of levamisole. The proportion of pigs positive for mites was not different (p>0.05) between the ivermectin and the amitraz treatment groups. The overall costs for the treatments were US$0.50 for the ivermectin treatment, US$0.31 for the piperazine/amitraz combination treatment and US$0.26 for the levamisole/amitraz combination treatment. Amitraz/levamisole drug combination was the most cost-effective against sarcoptic mange and gastro-intestinal nematodes of pigs in the studied smallholder herds.

A longitudinal study was carried out in Kikuyu Division (a peri-urban area in central Kenyan highlands) between January 1999 and December 1999 to estimate the baseline parameters on reproductive performance of the sow, as well as health and productivity of grower and preweaning pigs of smallholder herds. Data were collected on 155 breeding pigs, 795 grower pigs and 801 preweaning piglets in 74, 50 and 40 smallholder herds, respectively, using record cards that were updated during monthly visits. The sow-level medians were: weaning-to-service interval 3 months; interfarrowing interval 6.4 months; number of live-born piglets 9.0; and number of piglets weaned per litter 7.5. The piglet crude morbidity incidence risk was 29%. The cause-specific incidence risks for the important health problems encountered in preweaned piglets were diarrhea (4.3%), pruritus (17.1%), and skin necrosis (4.2%). The estimated crude mortality incidence risk to 8 weeks of age was 18.7%. The cause-specific mortality incidence risks to 8 weeks of age for the important causes of mortality were overlying (9.9%), savaging (2.4%), unviable piglets (2.0%) and unknown (1.9%). Overall, 78.8% of the total live-born piglet mortality occurred during the first week postpartum with 69% of these deaths being caused by overlying. The grower-pig crude morbidity incidence risk was 20% and the cause-specific incidence risks of the important health problems encountered were gut edema (1.3%), pruritus (21.1%), and unknown (2.3%). The crude mortality incidence risk was 3.8% and the important causes were gut edema and unknown causes (cause-specific mortality incidence risks of 1.3 and 1.6%, respectively). The median weight:age ratio and average daily weight gain for the grower pigs were 5.1 kg/month of age and 0.13 kg/day, respectively. For preweaning pigs, the median average daily weight gain was 0.13 g/day.

According to the statements made by a number of scholars, in the 80's East African Anglophone novel, which once received a nickname of "social documentary", began to lose gradually its social commitment. Many of the writers known previously as the most active supporters of the social trend, moved their attempts to other literan areas - criminal novel ("Weapon of hunger" by Meja Mцangi, 1989), love story (Yussuf Dawood's "Off my chest", 1988), even children's literature (books for children in Gikuyu, written by Ngugi wa Thiong'o). However, in the late 80's and early 90's East African Anglophone novel stepped onto a new level of social trend, moving from "social documentary" to "social epic". The authors now are trying to sum up the historical experience of East African countries over a large time span, and to that effect appeal mostly to elaborate and spacious literary forms, such as epic novel. These authors, although chosen one and the same literary form, are showing clearly their inclinations towards different styles of writing. For example, Tanzanian author Moyez Vassanji in his novel "The gunny sack" (1989) makes a rather convincing attempt to replant on East African soil the method of "mythological writing", previously used by such author as Gabriel Garcia Marquez. The novel definitely appeals not only to local reader, but to a wider international audience; on its pages the author manages to restore not only the fate of several generations of Indian family, but even the slightest details of their mentality, using myth as one of the basic means for changing the dimensions of time and space, according to the logic of the narration. The development of Kenyan novel in the early 90's confirms also one of the main tendencies in modem literature - bridging between "elite" and popular fiction. The first attempt of an epic novel in Kenyan Anglophone literature was, oddly enough, made by the veteran of Kenyan popular fiction David Maillu in his "Broken drum" H991). The novel hardly aims the widest reading public - nevertheless, stylistically it bears distinct features of popular fiction, such as crime story, romance, etc. Popular novel in East Africa also shows certain inclination towards urgent social themes, but the authors inevitably uses the artistic means they feel most happy with - that is, the style of popular fiction. For example, the "clash of cultures" - the experience of young Africans studying abroad - is presented in the form of a picaresque ("Times beyond" by Omondi Makoloo, 1992) or love story ("The girl from Uganda" by Tengio Urrio, 1993); feministic problems are spiced with sentimentalism ("Judy the nun" by P .Waweru, 1990); the thoughts on the hardships of younger generation are guised in Bildungs roman ("The plight of succession" by a Tanzanian Prosper Rwegoshora, 1990). At the same time, some authors, who have been ploughing successfully the field of pop fiction for a few decades, show their interest in more elaborate literary forms ("Dedan Kimathi: the real story" by Samuel Kaluga, 1990). All the mentioned facts do not allow us to state that the division into popular and elite novel will disappear within the foreseeable future. However, the most interesting developments seem to take place precisely in the field of bridging between these two branches of East African fiction.

Aim of the study: This study was conducted to document herbal medicines used in the treatment of Malaria as well as the existing knowledge,attitudes and practices related to malaria recognition, control and treatment in South Coast, Kenya. Methods: Data was collected using semistructured questionnaires and interviews. A focused group discussion held with the community members, one in each of the study villages supplemented the interview and questionnaire survey. Results: The respondents were found to have a good understanding of malaria and could distinguish it from other fever types. They were also aware that malaria was spread by mosquitoes. Malaria prevalence was high, and affected individuals an average of four times a year. Community members avoided. Mosquito bites by using mosquitonets, clearing bushes around their homesteads and burning plant parts. To generate smoke. They prevented and treated malaria by taking decoctions or concoctions of traditional herbal remedies. Forty plant species in thirty-five genera distributed in twenty-four families were used as antimalarials in the study area. Five plant species, namely; Heeria insignis Del. (Anacardiaceae), Rottboelia exaltata L.F (Gramineae), Pentanisia ouranogyne S. Moore (Rubiaceae), Agathisanthenum globosum (A. Rich) Hiern (Rubiaceae), and Grewia trichocarpa Hochst ex A. Rich (Tiliaceae) are documented for the first time in South Coast, Kenya, for the treatment of malaria. Conclusions: The plants documented in the current study are a potential source for new bioactive compounds of therapeutic value in malaria treatment. The results provide data for further pharmacological and toxicological studies and development of commercial antimalarial phytotherapy products.

Aim of the study: This study was conducted to document herbal medicines used in the treatment of Malaria as well as the existing knowledge,attitudes and practices related to malaria recognition, control and treatment in South Coast, Kenya. Methods: Data was collected using semistructured questionnaires and interviews. A focused group discussion held with the community members, one in each of the study villages supplemented the interview and questionnaire survey. Results: The respondents were found to have a good understanding of malaria and could distinguish it from other fever types. They were also aware that malaria was spread by mosquitoes. Malaria prevalence was high, and affected individuals an average of four times a year. Community members avoided. Mosquito bites by using mosquitonets, clearing bushes around their homesteads and burning plant parts. To generate smoke. They prevented and treated malaria by taking decoctions or concoctions of traditional herbal remedies. Forty plant species in thirty-five genera distributed in twenty-four families were used as antimalarials in the study area. Five plant species, namely; Heeria insignis Del. (Anacardiaceae), Rottboelia exaltata L.F (Gramineae), Pentanisia ouranogyne S. Moore (Rubiaceae), Agathisanthenum globosum (A. Rich) Hiern (Rubiaceae), and Grewia trichocarpa Hochst ex A. Rich (Tiliaceae) are documented for the first time in South Coast, Kenya, for the treatment of malaria. Conclusions: The plants documented in the current study are a potential source for new bioactive compounds of therapeutic value in malaria treatment. The results provide data for further pharmacological and toxicological studies and development of commercial antimalarial phytotherapy products.

Fusarium wilt caused by Fusarium udum Butler, is an economically important disease of pigeonpea (Cajanus cajan (L.) Mill). Information on the mechanisms of resistance to this disease in pigeonpea is limited. To study the role of vascular occlusion in wilt resistance, isolates of F.udum were inoculated onto resistant and susceptible varieties of pigeonpea and observed under light and transmission electron microscopes. The presence of F. udum in wilt susceptible plants was characterized by mycelia and conidia in the xylem vessels, plugging in some vessels, disintegration of xylem parenchyma cells in the infected areas, and the formation of cavities due to heavy colonization in the pith cortex vascular bundle. Resistance to F. udum in the roots and stems of wilt resistant plants was associated with low fungal colonization and high occlusion due to tyloses and gels in the xylem vessels. There were significant differences (P = 0:05) in the number of xylem vessels occluded by tyloses in resistant and susceptible plants with a maximum of 22.5% and 8.0% occlusion, respectively. It is probable that tyloses and gels formed as a result of F. udum interaction in wilt resistant plants are part of a resistance mechanism. Key words: Fusarium wilt,cajanus cajan, resistance, tylose, vascular occlusion

The relative bloavailabilities of three carbamazepine tablet formulations available in the
Kenyan market (Temporal", Taver" and Carbamazepine Lincoln) compared with the
innovator formulation (Tegretol") were evaluated in seven healthy African volunteers (5
males, two females; aged 22-36 years), according to a randomlsed fourway crossover study
design, following oral administration of single 200mg doses with a three week washout
period. I" vitro dissolution profiles of the tablets were also evaluated. Relative bioavailabilities
(Frel) of Temporal", TaverR and Carbamazepine Linocoln were 101.2%, 82.2% and 71.6%
respectively, compared with Tegretols, Percent drug content dissolved ill vitro after I hour
were 91.3%, 75.9% and 39.3% for Temporal's, Taverb and Carbamazepine Lincoln,
respectively. It was concluded that Temporal+ was bioequivalent to TegretolR while TaverR
and Carbamazepin Lincoln were bioinequivalent to Tegre~IR. Administration ofTaverR or
Carbamazepine Lincoln might lead to poor control of epileptic seizures.

SETTING: Nairobi City Council Chest Clinic, Nairobi, Kenya. OBJECTIVE: To determine if under-reading of sputum smears is a contributing factor in the disproportionate increase in smear-negative tuberculosis in Nairobi, Kenya. METHODOLOGY: Between October 1997 and November 1998, patients fulfilling the local programme definition of smear-negative presumed pulmonary tuberculosis were enrolled in the study. Two further sputum specimens were collected for examination in a research laboratory by fluorescence microscopy. RESULTS: Of 163 adult subjects enrolled, 55% were seropositive for the human immunodeficiency virus type 1 (HIV-1). One hundred subjects had had two pre-study sputum smears assessed before recruitment and produced two further sputum specimens for re-examination in the research laboratory; of these 19 (19%) were sputum smear-positive on re-examination and a further seven (7%) became smear-positive on second re-examination. CONCLUSIONS: Of those patients with smear-negative presumed pulmonary tuberculosis by the local programme definition, 26% were smear-positive when reexamined carefully with two repeat sputum smears. This suggests that the high rates of smear-negative tuberculosis being seen may in part be due to under-reading. This is probably as a result of the overwhelming burden of tuberculosis leading to over rapid and inaccurate sputum examination. Retraining of existing technicians and training of more technicians is likely to reduce underreading and increase the yield of smear-positive tuberculosis. This finding also stresses the need for regular quality assurance.

Tala Quarrry in African Geoscience Review Vol. 9 Number 4 pp. 385-396.  

PIP: Menstrual blood loss (MBL) was evaluated in 74 nulliporous Kenyan women aged between 20 and 27 years. The hemoglobin levels were all in normal range with the mean of 13.65 +or- 0.8, 13.84 +or- 1.2 and 13.04 +or- 1.2 g/100 ml respectively in 3 populations. The MBL was comparable in the 3 populations with the mean of 35.1 +or- 12.6, 30.6 +or- 8.7 and 32.2 +or- 9.4 ml respectively. There was no difference of statistical significance between the 2 periods studied per each individual. This study objectively assesses the menstrual blood loss in 3 population groups–2 urban and 1 rural. The data can be used to evaluate menstrual blood loss before and after initiation of various contraceptives used in Kenya. Subjects were volunteers who were not on any contraception except barrier or natural rhythm methods, not under psychological stress and who exhibited normal physical female characteristics on examination. Those who wished to drop out, became pregnant or desired contraception, were excluded. The study confirms the individual constancy of the menstrual blood loss in this population. This has important practical implications since a single determination of the menstrual blood loss may be a fairly good expression for the average blood loss in a woman. The immediate effect of various treatments such as IUD insertion or oral contraceptives on the MBL may easily be evaluated quantitatively by measurements in consecutive periods using only 1 period as a control. The quick method can be easily used in evaluating pathological conditions e.g. iron-deficiency due to heavy bleeding, IUD-associated hemorrhage, menorrhagia and uterine fibroid. PMID: 12267056 [PubMed - indexed for MEDLINE]

{ Observational studies have associated vitamin A deficiency with vaginal shedding of human immunodeficiency virus (HIV) type 1-infected cells and mother-to-child HIV-1 transmission. To assess the effect of vitamin A supplementation on vaginal shedding of HIV-1, a randomized, double-blind, placebo-controlled trial of 6 weeks of daily oral vitamin A (10,000 IU of retinyl palmitate) was conducted among 400 HIV-1-infected women in Mombasa, Kenya. At follow-up, there was no statistically significant difference in the prevalence of HIV-1 DNA (18% vs. 21%

Presented here is a 16-year-old girl who was referred on 30th January 1996 with diagnosis of cord compression with spastic paraplegia with sensory level at T7/T8. CT scan myelogam confirmed soft tissue density mass displacing cord to the left with no dye being seen beyond T3. Thoracic spine decompressive laminectomy was performed on 1st January 1996 at Nairobi West Hospital extending from T3 to T6 level, which revealed a fibrous haemorrhagic tumour. Histology showed meningioma (mixed fibrous type and meningoepitheliomatous type) with many psammoma bodies. She had a stormy post-operative period, with infection and wound dehiscence. This was treated with appropriate antibiotics and wound care. She was eventually rehabilitated and was able to walk with the aid of a walking frame because of persistent spasticity of right leg. She was seen once as an outpatient by author on 6th July 1996, she was able to use the walking frame, but the right leg was still held in flexion deformity at the knee. She was thus referred to an orthopaedic surgeon for possible tenotomy. She was able to resume her studies at the University ambulating using a wheel chair and walking frame. She presented with worsening of symptoms in 2001 (five years after her first surgery). MRI scan thoracic spine revealed a left anterolateral intradural lesion extending from T3 to T5 vertebral body level compressing and displacing the spinal cord. She had a repeat surgery on 6th March 2001 at Kenyatta National Hospital; spastic paraparesis and urinary incontinenece persisted. She also developed bed sores and recurrent urinary tract infections. She was followed up by the author and other medical personnel in Mwea Mission Hospital where she eventually succumbed in 2005, nine years after her first surgery. This case is presented as a case of incompletely excised spinal meningioma to highlight some of the problems of managing spinal meningiomas when operating microscope and embolisation of tumours are not readily available. Also the family experienced financial constraint in bringing the patient for regular follow-up, and getting access to appropriate antibiotics, catheters and urine bags.

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Studies on the trypanotolerance of Orma Boran X Maasai Zebu (Orma Zebu) crossbred cattle (F1 progeny) and pure-bred Maasai Zebu contemporaries were carried out in Nguruman, south western Kenya. The two groups were monitored from birth for a period of 2 years. The incidence of trypanosomosis, parasitaemia, packed cell volume (PCV), body mass and average daily mass gain were monitored. During the study period, overall trypanosomosis incidence was low (3%).The crossbred cattle had a higher incidence of infection (61% vs 39%). The mean PCV and the mean mass gain for the crossbred cattle was higher than that of the Maasai Zebu. The mean calf body mass at weaning (8 months) for the Orma Zebu and Maasai Zebu was 72 kg and 64 kg, respectively, while at 18 months of age their mean body mass was 164 kg and 123 kg, respectively. During the rainy season significant differences in average daily mass gains were noted (p<0.05). The superior mass gain of the Orma Zebu observed during the rainy season, despite higher infection rates, indicate an enhanced trypanotolerance. Moreover, the better performance of the Orma Zebu is an attribute that could be exploited in the adoption of the trypanotolerance genotype, as a sustainable trypanosomosis control strategy.   Keywords: Cattle, productivity, Maasai Zebu, Orma Boran, Orma Zebu, trypanotolerance

Mwaura F, K M Mavuti and W N Wamicha. . :

In contrast with mammalian cells, little is known about the control of Ca2+ entry into primitive protozoans. Here we report that Ca2+ influx in pathogenic Trypanosoma brucei can be regulated by phospholipase A2 (PLA2) and the subsequent release of arachidonic acid (AA). Several PLA2 inhibitors blocked Ca2+ entry; 3-(4-octadecyl)-benzoylacrylic acid (OBAA; IC50 0.4+/-0.1 microM) was the most potent. We identified in live trypanosomes PLA2 activity that was sensitive to OBAA and could be stimulated by Ca2+, suggesting the presence of positive feedback control. The cell-associated PLA2 activity was able to release [14C]AA from labelled phospholipid substrates. Exogenous AA (5-50 microM) also initiated Ca2+ entry in a manner that was inhibited by the Ca2+ antagonist La3+ (100 microM). Ca2+ entry did not depend on AA metabolism or protein kinase activation. The cell response was specific for AA, and fatty acids with greater saturation than tetraeicosanoic acid (AA) or with chain lengths less than C20 exhibited greatly diminished ability to initiate Ca2+ influx. Myristate and palmitate inhibited PLA2 activity and also inhibited Ca2+ influx. Overall, these results demonstrate that Ca2+ entry into T. brucei can result from phospholipid hydrolysis and the release of eicosanoic acids.

OBJECTIVE–To determine the efficacy of the nonoxynol 9 contraceptive sponge in preventing sexual acquisition of the human immunodeficiency virus (HIV). DESIGN–Prospective, randomized placebo-controlled trial. SETTING–Research clinic for prostitutes in Nairobi, Kenya. PATIENTS AND INTERVENTIONS–One hundred thirty-eight HIV-seronegative women were enrolled, of whom 74 were assigned to nonoxynol 9 sponge use and 64 to placebo use. These two groups did not significantly differ with respect to demographic characteristics, sexual practices, or prevalence of genital infections at enrollment, except for a lower number of sex partners per week and a higher initial prevalence of genital ulcers among women assigned to nonoxynol 9 sponge use. Among the 116 women who returned for follow-up, the mean durations of follow-up were 14 and 17 months for the two groups, respectively. MAIN OUTCOME MEASURE–HIV seroconversion. RESULTS–Nonoxynol 9 sponge use was associated with an increased frequency of genital ulcers (relative risk [RR], 3.3; P less than .0001) and vulvitis (RR, 3.3; P less than .0001) and a reduced risk of gonococcal cervicitis (RR, 0.4; P less than .0001). Twenty-seven (45%) of 60 women in the nonoxynol 9 sponge group and 20 (36%) of 56 women in the placebo group developed HIV antibodies. The hazard ratio for the association between nonoxynol 9 sponge use and HIV seroconversion was 1.7 (95% confidence interval [CI], 0.9 to 3.0). Using multivariate analysis to control for the presence of genital ulcers at enrollment, the adjusted hazard ratio for the association between nonoxynol 9 sponge use and seroconversion was 1.6 (95% CI, 0.8 to 2.8). CONCLUSIONS–Genital ulcers and vulvitis occurred with increased frequency in nonoxynol 9 sponge users. We were unable to demonstrate that nonoxynol 9 sponge use was effective in reducing the risk of HIV infection among highly exposed women.

OBJECTIVE–To determine the efficacy of the nonoxynol 9 contraceptive sponge in preventing sexual acquisition of the human immunodeficiency virus (HIV). DESIGN–Prospective, randomized placebo-controlled trial. SETTING–Research clinic for prostitutes in Nairobi, Kenya. PATIENTS AND INTERVENTIONS–One hundred thirty-eight HIV-seronegative women were enrolled, of whom 74 were assigned to nonoxynol 9 sponge use and 64 to placebo use. These two groups did not significantly differ with respect to demographic characteristics, sexual practices, or prevalence of genital infections at enrollment, except for a lower number of sex partners per week and a higher initial prevalence of genital ulcers among women assigned to nonoxynol 9 sponge use. Among the 116 women who returned for follow-up, the mean durations of follow-up were 14 and 17 months for the two groups, respectively. MAIN OUTCOME MEASURE–HIV seroconversion. RESULTS–Nonoxynol 9 sponge use was associated with an increased frequency of genital ulcers (relative risk [RR], 3.3; P less than .0001) and vulvitis (RR, 3.3; P less than .0001) and a reduced risk of gonococcal cervicitis (RR, 0.4; P less than .0001). Twenty-seven (45%) of 60 women in the nonoxynol 9 sponge group and 20 (36%) of 56 women in the placebo group developed HIV antibodies. The hazard ratio for the association between nonoxynol 9 sponge use and HIV seroconversion was 1.7 (95% confidence interval [CI], 0.9 to 3.0). Using multivariate analysis to control for the presence of genital ulcers at enrollment, the adjusted hazard ratio for the association between nonoxynol 9 sponge use and seroconversion was 1.6 (95% CI, 0.8 to 2.8). CONCLUSIONS–Genital ulcers and vulvitis occurred with increased frequency in nonoxynol 9 sponge users. We were unable to demonstrate that nonoxynol 9 sponge use was effective in reducing the risk of HIV infection among highly exposed women.

Major histocompatibility complex (MHC) gene products are expressed on human immunodeficiency virus (HIV)-infected cells and incorporated into the lipid envelope of HIV virions. Macaques immunized with human MHC gene products are protected from simian immunodeficiency virus challenge when the virus is grown in cells expressing the same MHC alleles. To relate these findings to mother-to-child transmission of HIV-1, investigations of whether sharing HLA between mother and infant influenced the risk of transmission of HIV-1 to the child were carried out. Class I HLA concordance was independently associated with a stepwise increase in the risk of perinatal HIV-1 transmission for each additional concordant allele (odds ratio, 2.63; 95% confidence interval, 1.36-5.07; P = .003). Thus, discordant HLA may provide infants with a means of protection against HIV-1 as a result of allogeneic infant anti-maternal MHC immune responses.

To determine the effect of circumcision status on acquisition of human immunodeficiency virus (HIV) type 1 and other sexually transmitted diseases, a prospective cohort study of 746 HIV-1-seronegative trucking company employees was conducted in Mombasa, Kenya. During the course of follow-up, 43 men acquired HIV-1 antibodies, yielding an annual incidence of 3.0%. The annual incidences of genital ulcers and urethritis were 4.2% and 15.5%, respectively. In multivariate analysis, after controlling for demographic and behavioral variables, uncircumcised status was an independent risk factor for HIV-1 infection (hazard rate ratio [HRR=4.0; 95% confidence interval [CI], 1.9-8.3) and genital ulcer disease (HRR=2.5; 95% CI, 1.1-5.3). Circumcision status had no effect on the acquisition of urethral infections and genital warts. In this prospective cohort of trucking company employees, uncircumcised status was associated with increased risk of HIV-1 infection and genital ulcer disease, and these effects remained after controlling for potential confounders.

Certain HLAs may, in part, account for differences in human immunodeficiency virus type 1 (HIV-1) susceptibility by presenting conserved immunogenic epitopes for T cell recognition. The HLA supertype A2/6802 is associated with decreased susceptibility to HIV-1 among sex workers. The alleles in this supertype present the same HIV-1 peptide epitopes for T cell recognition in some cases. This study sought to determine whether the HLA A2/6802 supertype influenced HIV-1 transmission in a prospective cohort of HIV-1-infected mothers and children in Kenya. Decreased perinatal HIV-1 infection risk was strongly associated with possession of a functional cluster of related HLA alleles, called the A2/6802 supertype (odds ratio, 0.12; 95% confidence interval, 0.03-0.54; P=.006). This effect was independent of the protective effect of maternal-child HLA discordance. These data provide further evidence that HLA supertypes are associated with differential susceptibility to HIV-1 transmission.

Among 446 sera from prostitutes in Nairobi, the prevalence of antibody to human immunodeficiency virus (HIV) rose from 4% in 1981 to 61% in 1985. None of 118 men with chancroid seen in 1980 had antibody to HIV compared with 15% of 107 such men in 1985. Among pregnant women, 2.0% were seropositive in 1985 versus none of 111 in 1981. Seropositive prostitutes and women with sexually transmitted diseases (STDs) tended to have more sex partners and had a higher prevalence of gonorrhoea, and in women with STDs, significantly more seropositive women practiced prostitution. Pregnant women and men with STDs who were born in the most-western region of Kenya were more likely to have antibody to HIV than were such groups from other geographic areas. Our results indicate that the AIDS virus was recently introduced into Kenya, that HIV can rapidly disseminate in a high-risk group of heterosexuals, and that prostitutes may have significantly contributed to the spread of the virus.

{ BACKGROUND: Vitamin A is involved in normal immune function and the maintenance of mucosal integrity through complex effects on cellular differentiation. OBJECTIVE: We sought to determine whether serum vitamin A levels were associated with altered susceptibility to primary infection with HIV-1 in men with high-risk sexual behaviour and genital ulcers who presented for treatment at an STD clinic in Nairobi, Kenya. METHODS: HIV-1 seronegative men were prospectively followed. Vitamin A levels at study entry were compared among 38 men who HIV-1 seroconverted versus 94 controls who remained HIV seronegative. RESULTS: Vitamin A deficiency (retinol less than 20 microg/dl) was very common and was present in 50% of HIV-1 seroconverters versus 76% of persistent seronegatives. Seroconversion was independently associated with a retinol level greater than 20 microg/dl (HR 2.43, 95% CI 1.25-4.70

{ T cell responses against HIV-1 have been identified in a number of exposed uninfected populations. We hypothesized that the ability to mount an effective T cell response is partly determined by the human leucocyte antigens (HLA) phenotype of the individual. We examined whether certain HLA supertypes were associated with differential HIV-1 susceptibility in sexually exposed adults and in the setting of mother to child HIV-1 transmission. By multivariate analysis, decreased HIV-1 infection risk was strongly associated with possession of a cluster of closely related class I HLA alleles (A2/6802 supertype) in sexually exposed adults (Hazard ratio=0.42, 95% confidence intervals (CI): 0.22-0.81

OBJECTIVE: To compare a topical quinolone antibiotic (ciprofloxacin) with a cheaper topical antiseptic (boric acid) for treating chronic suppurative otitis media in children. DESIGN: Randomized controlled trial. SETTING AND PARTICIPANTS: A total of 427 children with chronic suppurative otitis media enrolled from 141 schools following screening of 39 841 schoolchildren in Kenya. Intervention Topical ciprofloxacin (n = 216) or boric acid in alcohol (n = 211); child-to-child treatment twice daily for 2 weeks. MAIN OUTCOME MEASURES: Resolution of discharge (at 2 weeks for primary outcome), healing of the tympanic membrane, and change in hearing threshold from baseline, all at 2 and 4 weeks. RESULTS: At 2 weeks, discharge was resolved in 123 of 207 (59%) children given ciprofloxacin, and in 65 of 204 (32%) given boric acid (relative risk 1.86; 95% CI 1.48-2.35; P < 0.0001). This effect was also significant at 4 weeks, and ciprofloxacin was associated with better hearing at both visits. No difference with respect to tympanic membrane healing was detected. There were significantly fewer adverse events of ear pain, irritation, and bleeding on mopping with ciprofloxacin than boric acid. CONCLUSIONS: Ciprofloxacin performed better than boric acid and alcohol for treating chronic suppurative otitis media in children in Kenya.

Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} Herbert O. Oburra, Tobias Sholz,  Jochen A. Werner,  Isaac M. Macharia,  Peter Masinde,  Joyce Aswani,  Anselmy Opiyo MEDICOM The African Journal of Hospital and Scientific Medicine, (2010) Vol  25: 33 - 36 Abstract Head and neck cancer occupies over 50% of in-patient beds at the Ear, Nose and Throat-Head and Neck Surgery Unit of the Kenyatta National Hospital. Laryngeal cancer is the third most common head and neck cancer after nasopharyngeal and oral cancers. Aim: To determine the demographic features, symptomatology, morbid anatomy, histology and disease stage of laryngeal cancer, and to assess the efficiency of the hospital facility in coping with initial work-up and diagnosis of the patients with laryngeal cancer from 1996 to 2001. Setting: Department of Ear, Nose and Throat/Head and Neck Surgery at The Kenyatta National Hospital Study design: Retrospective review of case notes of 100 patients admitted to the unit between 1996 and 2001. Results: Male to female ratio was 24:1. The peak age at presentation was 50 to 70 years with a mean of 60.6 years. Duration of delay between onset of symptoms and presentation to the unit was 4 to 300 weeks with a mean of 50 weeks. Long history of hoarseness of voices and respiratory stridor were the most frequent symptoms. Preoperative tracheostomy rate was 81%. Vocal cords were involved in 54% of cases, 33% supraglottic, 6% subglottic and 7% indeterminate. Delay in obtaining histological results after biopsy ranged from 1 to 71 days with a mean of 43 days. Ninety five per cent of cases had various grades of squamous cell carcinoma. GI differentiation was found in 36%, G2 in 25% and G3 carcinomas involving the vocal cords tended to be well differentiated.  

OBJECTIVE: To compare a topical quinolone antibiotic (ciprofloxacin) with a cheaper topical antiseptic (boric acid) for treating chronic suppurative otitis media in children. DESIGN: Randomized controlled trial. SETTING AND PARTICIPANTS: A total of 427 children with chronic suppurative otitis media enrolled from 141 schools following screening of 39 841 schoolchildren in Kenya. Intervention Topical ciprofloxacin (n = 216) or boric acid in alcohol (n = 211); child-to-child treatment twice daily for 2 weeks. MAIN OUTCOME MEASURES: Resolution of discharge (at 2 weeks for primary outcome), healing of the tympanic membrane, and change in hearing threshold from baseline, all at 2 and 4 weeks. RESULTS: At 2 weeks, discharge was resolved in 123 of 207 (59%) children given ciprofloxacin, and in 65 of 204 (32%) given boric acid (relative risk 1.86; 95% CI 1.48-2.35; P < 0.0001). This effect was also significant at 4 weeks, and ciprofloxacin was associated with better hearing at both visits. No difference with respect to tympanic membrane healing was detected. There were significantly fewer adverse events of ear pain, irritation, and bleeding on mopping with ciprofloxacin than boric acid. CONCLUSIONS: Ciprofloxacin performed better than boric acid and alcohol for treating chronic suppurative otitis media in children in Kenya.

OBJECTIVE: To compare a topical quinolone antibiotic (ciprofloxacin) with a cheaper topical antiseptic (boric acid) for treating chronic suppurative otitis media in children. DESIGN: Randomized controlled trial. SETTING AND PARTICIPANTS: A total of 427 children with chronic suppurative otitis media enrolled from 141 schools following screening of 39 841 schoolchildren in Kenya. Intervention Topical ciprofloxacin (n = 216) or boric acid in alcohol (n = 211); child-to-child treatment twice daily for 2 weeks. MAIN OUTCOME MEASURES: Resolution of discharge (at 2 weeks for primary outcome), healing of the tympanic membrane, and change in hearing threshold from baseline, all at 2 and 4 weeks. RESULTS: At 2 weeks, discharge was resolved in 123 of 207 (59%) children given ciprofloxacin, and in 65 of 204 (32%) given boric acid (relative risk 1.86; 95% CI 1.48-2.35; P < 0.0001). This effect was also significant at 4 weeks, and ciprofloxacin was associated with better hearing at both visits. No difference with respect to tympanic membrane healing was detected. There were significantly fewer adverse events of ear pain, irritation, and bleeding on mopping with ciprofloxacin than boric acid. CONCLUSIONS: Ciprofloxacin performed better than boric acid and alcohol for treating chronic suppurative otitis media in children in Kenya.

Serum acid phosphatase was measured in patients with enlarged benign and malignant prostate before and after rectal examination. Amongst the patients with benign glands, rectal examination did not produce any significant false elevation of the enzyme. Rectal examination, however, caused a rise in the enzyme level in a few untreated cancer patients and in cancer patients who has become refractory to hormonal therapy. This rise would help rather than mislead in the diagnosis of malignant prostate and also in the identifying treated patients who had become refractory to treatment. Thus, when serum acid phosphatase is properly determined, elevated levels should always arouse suspicion of malignant prostate or other lesions associated with high enzyme level even is such determination was preceded by rectal examination. There appears to be no merit in the teaching that the determination of serum acid phosphatase should be delayed after rectal examination.

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OBJECTIVE: To determine the bacteriology and antibiotic sensitivity of the bacterial isolates in chronic maxillary sinusitis patients seen at the Kenyatta National Hospital. DESIGN: Cross-sectional study. SETTING: Kenyatta National Hospital, ENT department. SUBJECTS AND METHODS: Seventy-three patients had bilateral sntral washout done and the lavage submitted for culture and anti-microbial sensitivity between January and June 1996. RESULTS: Antral lavage yielded secretions in 63% of patients but bacteria were cultured in only 28.8% of the specimens. The isolates included Streptococcus pneumonia (22.2%), Staphylocococus albus (18.5%), Staphylocococus aureus (11.1%) and Enterobactericiae (11.1%). Anaerobic bacteria were cultured in 22.2% of the specimens. Of the commonly used antibiotics, there was high sensitivity to erythromycin, cefadroxyl, chloramphenicol and amoxicillin and poor sensitivity to ampicillin, cotrimoxazole and perfloxacin. CONCLUSION: The bacteriology of chronic maxillary sinusitis at Kenyatta National Hospital is generally similar to that found elsewhere. The bacteria are susceptible to relatively affordable antibiotics like amoxicillin, erythromycin and cefadroxyl.

OBJECTIVE: To determine the bacteriology and antibiotic sensitivity of the bacterial isolates in chronic maxillary sinusitis patients seen at the Kenyatta National Hospital. DESIGN: Cross-sectional study. SETTING: Kenyatta National Hospital, ENT department. SUBJECTS AND METHODS: Seventy-three patients had bilateral sntral washout done and the lavage submitted for culture and anti-microbial sensitivity between January and June 1996. RESULTS: Antral lavage yielded secretions in 63% of patients but bacteria were cultured in only 28.8% of the specimens. The isolates included Streptococcus pneumonia (22.2%), Staphylocococus albus (18.5%), Staphylocococus aureus (11.1%) and Enterobactericiae (11.1%). Anaerobic bacteria were cultured in 22.2% of the specimens. Of the commonly used antibiotics, there was high sensitivity to erythromycin, cefadroxyl, chloramphenicol and amoxicillin and poor sensitivity to ampicillin, cotrimoxazole and perfloxacin. CONCLUSION: The bacteriology of chronic maxillary sinusitis at Kenyatta National Hospital is generally similar to that found elsewhere. The bacteria are susceptible to relatively affordable antibiotics like amoxicillin, erythromycin and cefadroxyl.

A model for the establishment of a four-dimensional regional geodetic reference datum is presented. Starting from the three-dimensional integrated geodetic network model, formulations for the establishment of a four-dimensional regional datum are developed. Astronomic latitudes, astronomic longitudes, gravity values, gravity potential differences, gravity differences, and GPS-vectors are considered as observables. The estimated parameters defining the datura are point coordinates, deflections of the vertical and geoidai undulations, and velocities and accelerations on the positional coordinates. The network datum is considered observed over several epochs with parameters estimated from previous epochs being introduced into later epochs as stochastic prior information parameters.

Department of Infectious Disease Epidemiology, Imperial College School of Medicine, London, UK. Previous attempts to determine the interactions between filariasis transmission intensity, infection and chronic disease have been limited by a lack of a theoretical framework that allows the explicit examination of mechanisms that may link these variables at the community level. Here, we show how deterministic mathematical models, in conjunction with analyses of standardized field data from communities with varying parasite transmission intensities, can provide a particularly powerful framework for investigating this topic. These models were based on adult worm population dynamics, worm initiated chronic disease and two major forms of acquired immunity (larval- versus adult-worm generated) explicitly linked to community transmission intensity as measured by the Annual Transmission Potential (ATP). They were then fitted to data from low, moderate and moderately high transmission communities from East Africa to determine the mechanistic relationships between transmission, infection and observed filarial morbidity. The results indicate a profound effect of transmission intensity on patent infection and chronic disease, and on the generation and impact of immunity on these variables. For infection, the analysis indicates that in areas of higher parasite transmission, community-specific microfilarial rates may increase proportionately with transmission intensity until moderated by the generation of herd immunity. This supports recent suggestions that acquired immunity in filariasis is transmission driven and may be significant only in areas of high transmission. In East Africa, this transmission threshold is likely to be higher than an ATP of at least 100. A new finding from the analysis of the disease data is that per capita worm pathogenicity could increase with transmission intensity such that the prevalences of both hydrocele and lymphoedema, even without immunopathological involvement, may increase disproportionately with transmission intensity. For lymphoedema, this rise may be further accelerated with the onset of immunopathology. An intriguing finding is that there may be at least two types of immunity operating in filariasis: one implicated in anti-infection immunity and generated by past experience of adult worms, the other involved in immune-mediated pathology and based on cumulative experience of infective larvae. If confirmed, these findings have important implications for the new global initiative to achieve control of this disease.

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A study was conducted to determine dietary characteristics of sheep and Grant's gazelles on Kapiti Ranch, Kenya. The dietary botanical composition was determined using the microhistological technique. Plant species in the diets were categorized into grass, forb and browse classes. Shannon-Wiener and Morisita's similarity indices were used to express dietary diversity and overlap respectively. Diets were simulated based on microhistology results to give 50 gm samples, then analysed for crude protein, neutral detergent fibre, acid detergent fibre, cellulose, lignin, and in vitro dry matter digestibility. Sheep were predominantly grazers during dry and wet season while Grant's gazelles were mixed feeders, with a higher preference for grasses during the wet season and an equal preference for both grasses and browse during the dry season. Diets of Grant's gazelles were more diverse than those of sheep for both seasons. Degree of dietary overlap between the animal species was highest during the wet season. There were significant differences (P<0.05) in dietary nutrient content between the animal species, within seasons. Dry matter digestibility was significantly higher (P<0.05) for both species during the wet season. Neutral detergent fibre, acid detergent fibre, lignin and cellulose were significantly higher (P<0.05) during the dry season. Sheep diets were significantly higher (P<0.05) in crude protein during the wet season, whereas it was significantly higher (P<0.05) in the diets of Grant's gazelles during the dry season. Study findings indicate that, sheep and Grant's gazelles are compatible for efficient use of vegetation on Athi Kapiti plains. Integration of the two ruminants can make unique and important contribution to food production and income generation opportunities in areas with vegetation composition similar to that of Athi Kapiti plains.

This report concerns an outbreak that occurred during July/August 1997. Ten pigs from a herd of 181 pigs in a medium-scale, semi-closed piggery in Kiambu District, Kenya, contracted the clinical disease. The main clinical findings in affected pigs included: fever (40.5-41.8 degrees C), prostration, inappetence, dog-sitting posture, abortion, erythema and raised, firm to the touch and easily palpated light pink to dark purple diamond-shaped to square/rectangular spots on the skin around the belly and the back. Based on the pathognomonic skin lesions, a clinical diagnosis of swine erysipelas was made. The diagnosis was confirmed by the isolation of Erysipelothrix rhusiopathiae organisms from the blood and skin biopsies taken from the affected pigs. Response to treatment with a combination of procaine penicillin and dihydrostreptomycin at the dosage rate of 20,000 IU/kg body weight (based on procaine penicillin) for 3 days was good and all the affected pigs recovered fully. The farm was placed under quarantine to prevent spread of the disease

Bacillus cereus strains were tested for production of diarrheal enterotoxin by the reverse passive latex agglutination test and for presence of B. cereus enterotoxin gene (bceT) by polymerase chain reaction. About 50% of 56 B. cereus strains reacted positive in broth culture in the reverse passive latex agglutination test, while the bceT gene was detected in 41.1 % of the strains. A 741 bp probe prepared from the polymerase chain reaction product detected bceT gene in all strains that were positive with the polymerase chain reaction. This study indicated a likelihood of two or more enterotoxins being produced by B. cereus which may be involved in causing diarrheal type food poisoning.

Bacillus cereus strains were tested for production of diarrheal enterotoxin by the reverse passive latex agglutination test and for presence of B. cereus enterotoxin gene (bceT) by polymerase chain reaction. About 50% of 56 B. cereus strains reacted positive in broth culture in the reverse passive latex agglutination test, while the bceT gene was detected in 41.1 % of the strains. A 741 bp probe prepared from the polymerase chain reaction product detected bceT gene in all strains that were positive with the polymerase chain reaction. This study indicated a likelihood of two or more enterotoxins being produced by B. cereus which may be involved in causing diarrheal type food poisoning.

The objective of this study was to evaluate knowledge, attitudes and beliefs (KAB) that may influence health seeking behaviour of caretakers of children with sickle cell disease (SCD). A cross-sectional survey was undertaken at Nyanza provincial hospital in Kenya between March and September 1993 to identify socio-demographic and economic factors that may influence health seeking behaviour of primary caretakers of children with SCD. All caretakers accompanying children under the age of 18 years to the Sickle Cell Clinic were eligible. Guardians accompanying children to the clinic were interviewed using pretested questionnaires. An exploratory factor analysis method was used to categorise questionnaire items into domains (knowledge, attitude and belief) and to investigate for association between certain socio-demographic factors and KAB. Seventy five per cent of the 108 respondents interviewed were mothers and 16.7% fathers. Seventy eight percent knew SCD to be hereditary while 55% knew how the disease presents in childhood. Only 42% associated SCD with increased risk of infection. Many felt severe infections are largely preventable and that prevention would reduce their anxiety and illness related costs. In factor analysis, variables loaded almost exclusively on "Attitudes" and "Beliefs" factors. Only family size was found to influence caretaker attitudes (p = 0.0095) and beliefs (p = 0.0034). Education, monthly income, occupation and religion had no significant influence. The majority of caretakers had good knowledge and positive attitudes towards SCD in children. Interventions aimed at management of SCD or prevention of its sequelae would be well accepted. Factor analysis is recommended for statistical analysis of KAB data. The effect of family size on attitudes and behaviour needs further evaluation.

The goal of classifier model training is not to learn an exact representation of the training
data itself, but rather to build a statistical model of the process which generates the data.
This is important if the classifier is to exhibit good generalization, that is, to make good
predictions for new inputs. Using the simple analogy of curve fitting using polynomials, we
should that a polynomial with too few coefficients gives poor predictions for new data, ie
poor generalization, since the polynomial function has too little flexibility.

Unilateral variations in the formation of the median nerve, with the presence of the third head of the biceps brachii entrapping the nerve are very rare. These variations were observed on the right side, of a 30 year old male cadaver during routine dissection at the Department of Human Anatomy, University of Nairobi. The median nerve was formed by the union of three contributions; two from the lateral cord and one from the medial cord. An additional head of the biceps brachii looped over the formed median nerve. On the left side the median nerve was formed classically by single contributions from the medial and the lateral cords. These variations are clinically important because symptoms of high median nerve compression arising from similar formations are often confused with more common causes such as radiculopathy and carpal tunnel syndrome.

A cross sectional study of 115 patients admitted at the Department of Orthopedics, Kenyatta National Hospital, Nairobi, Kenya was carried out to determine the prevalence and antibiotic susceptibility of Staphylococcus aureus isolated from infected wounds. The prevalence of Staphylococcus aureus was 33.0 %. The drugs tested and their corresponding sensitivity was amoxycillin (13.2 %), co-amoxyclav (39.5 %), oxacillin (55.3 %), erythromycin (44.7 %), gentamicin (60.5 %), ciprofloxacin (62.2 %), minocycline (86.8 %), cefuroxime (57.9 %), and clidamycin (84.2 %). These results show the sensitivity profile of Staphylococcus aureus and can be used to choose suitable drugs in the management of wounds for hospitalized patients.

OBJECTIVE: To determine the influence of oral hygiene habits and practices on the risk of developing oral leukoplakia. DESIGN: Case control study. SETTING: Githongo sublocation in Meru District. SUBJECTS: Eighty five cases and 141 controls identified in a house-to-house screening. RESULTS: The relative risk (RR) of oral leukoplakia increased gradually across the various brushing frequencies from the reference RR of 1.0 in those who brushed three times a day, to 7.6 in the "don't brush" group. The trend of increase was statistically significant (X2 for Trend : p = 0.001). The use of chewing stick as compared to conventional tooth brush had no significant influence on RR of oral leukoplakia. Non-users of toothpastes had a significantly higher risk of oral leukoplakia than users (RR = 1.8; 95% confidence levels (CI) = 1.4-2.5). Among tobacco smokers, the RR increased from 4.6 in those who brushed to 7.3 in those who did not brush. Among non-smokers, the RR of oral leukoplakia in those who did not brush (1.8) compared to those who brushed was also statistically significant (95% CL = 1.6-3.8). CONCLUSION: Failure to brush teeth and none use of toothpastes are significantly associated with the development of oral leukoplakia, while the choice of brushing tools between conventional toothbrush and chewing stick is not. In addition, failure to brush teeth appeared to potentiate the effect of smoking tobacco in the development of oral leukoplakia. Recommendations: Oral health education, instruction and motivation for the improvement of oral hygiene habits and practices; and therefore oral hygiene status, should be among the strategies used in oral leukoplakia preventive and control programmes.

The prevalence of oral leukoplakia and related lesions in a Kenyan rural population was determined in a systematic house to house survey of individuals aged 15 years and above. Among the 803 individuals examined, the following prevalence of lesions was observed: leukoedema (26%), melanosis (12.7%), leukoplakia (10.6%), palatal keratosis (6.4%), frictional keratosis (5.5%), pre-leukoplakia (4.1%), borderline leukoplakia (2.4%), cheek/lip biting (1.3%), and snuff dippers lesion (0.4%). 48.6% of the subjects had at least one of these lesions. Statistically significant preponderance was demonstrated for oralleukoplakia, palatalkeratosis, leukoedema and frictional keratosis among males and melanosis among females. With regard to clinical classification of oral leukoplakia, the prevalence was 10% for homogeneous and 0.6% for nonhomogeneous lesions. On the basis of aetiological classification; the prevalence was 8.3% for tobacco associated and 2.2% for idiopathic leukoplakia. 22.5% of leukoplakia lesions biopsied had evidence of epithelial dysplasia. In view of the premalignant potential of oral leukoplakia, our findings suggest a need for greater attention towards prevention and control of this lesion in the study community.

Department of Periodontology/ Community and Preventive Dentistry, School of Dental Sciences, University of Nairobi, P.O. Box 19676 - 00202, Nairobi, Kenya. OBJECTIVE: To determine the influence of oral hygiene habits and practices on the risk of developing oral leukoplakia. DESIGN: Case control study. SETTING: Githongo sublocation in Meru District. SUBJECTS: Eighty five cases and 141 controls identified in a house-to-house screening. RESULTS: The relative risk (RR) of oral leukoplakia increased gradually across the various brushing frequencies from the reference RR of 1.0 in those who brushed three times a day, to 7.6 in the "don't brush" group. The trend of increase was statistically significant (X2 for Trend : p = 0.001). The use of chewing stick as compared to conventional tooth brush had no significant influence on RR of oral leukoplakia. Non-users of toothpastes had a significantly higher risk of oral leukoplakia than users (RR = 1.8; 95% confidence levels (CI) = 1.4-2.5). Among tobacco smokers, the RR increased from 4.6 in those who brushed to 7.3 in those who did not brush. Among non-smokers, the RR of oral leukoplakia in those who did not brush (1.8) compared to those who brushed was also statistically significant (95% CL = 1.6-3.8). CONCLUSION: Failure to brush teeth and none use of toothpastes are significantly associated with the development of oral leukoplakia, while the choice of brushing tools between conventional toothbrush and chewing stick is not. In addition, failure to brush teeth appeared to potentiate the effect of smoking tobacco in the development of oral leukoplakia. Recommendations: Oral health education, instruction and motivation for the improvement of oral hygiene habits and practices; and therefore oral hygiene status, should be among the strategies used in oral leukoplakia preventive and control programmes.

Department of Periodontology/ Community and Preventive Dentistry, School of Dental Sciences, University of Nairobi, P.O. Box 19676 - 00202, Nairobi, Kenya. OBJECTIVE: To determine the influence of oral hygiene habits and practices on the risk of developing oral leukoplakia. DESIGN: Case control study. SETTING: Githongo sublocation in Meru District. SUBJECTS: Eighty five cases and 141 controls identified in a house-to-house screening. RESULTS: The relative risk (RR) of oral leukoplakia increased gradually across the various brushing frequencies from the reference RR of 1.0 in those who brushed three times a day, to 7.6 in the "don't brush" group. The trend of increase was statistically significant (X2 for Trend : p = 0.001). The use of chewing stick as compared to conventional tooth brush had no significant influence on RR of oral leukoplakia. Non-users of toothpastes had a significantly higher risk of oral leukoplakia than users (RR = 1.8; 95% confidence levels (CI) = 1.4-2.5). Among tobacco smokers, the RR increased from 4.6 in those who brushed to 7.3 in those who did not brush. Among non-smokers, the RR of oral leukoplakia in those who did not brush (1.8) compared to those who brushed was also statistically significant (95% CL = 1.6-3.8). CONCLUSION: Failure to brush teeth and none use of toothpastes are significantly associated with the development of oral leukoplakia, while the choice of brushing tools between conventional toothbrush and chewing stick is not. In addition, failure to brush teeth appeared to potentiate the effect of smoking tobacco in the development of oral leukoplakia. Recommendations: Oral health education, instruction and motivation for the improvement of oral hygiene habits and practices; and therefore oral hygiene status, should be among the strategies used in oral leukoplakia preventive and control programmes.

OBJECTIVE: To determine the range of ablative surgery and rehabilitative procedures performed on maxillofacial structures. DESIGN: A retrospective descriptive study. SETTING: University of Nairobi Dental Teaching Hospital. SUBJECTS: Patients operated on at the institutions theatre, and followed up at the University of Nairobi Dental Teaching Hospital Oral Surgery Outpatient Clinic during the period February 1996, August 1998. RESULTS: Forty four patients underwent ablative surgery during the study period. Complete records were available for 38 patients, 27 females and 11 males aged 10 to 79 years (mean 32.6 years). Surgical procedures performed included: partial mandibulectomy, marginal mandibular resection, subtotal maxillectomy, sequestrectomy and enucleation. Six (15.8%) patients who underwent mandibular resection had rigid bone plating. Five (13.2%) patients who had maxillary involvement were given surgical obturators post-operatively with one receiving a complete denture after full recovery. A total of 22 (57.9%) patients who would have reaped benefits from prostheses therapy received none. Individual patient follow-up periods ranged from seven days for two patients who had cyst enucleation to two years for three cases with ameloblastoma, and two cases with squamous cell carcinoma. CONCLUSION: It is concluded that prosthetic rehabilitation of patients undergoing extensive surgery at the University of Nairobi Dental Teaching Hospital is largely inadequate.

Department of Periodontology/ Community and Preventive Dentistry, School of Dental Sciences, University of Nairobi, P.O. Box 19676 - 00202, Nairobi, Kenya. OBJECTIVE: To determine the influence of oral hygiene habits and practices on the risk of developing oral leukoplakia. DESIGN: Case control study. SETTING: Githongo sublocation in Meru District. SUBJECTS: Eighty five cases and 141 controls identified in a house-to-house screening. RESULTS: The relative risk (RR) of oral leukoplakia increased gradually across the various brushing frequencies from the reference RR of 1.0 in those who brushed three times a day, to 7.6 in the "don't brush" group. The trend of increase was statistically significant (X2 for Trend : p = 0.001). The use of chewing stick as compared to conventional tooth brush had no significant influence on RR of oral leukoplakia. Non-users of toothpastes had a significantly higher risk of oral leukoplakia than users (RR = 1.8; 95% confidence levels (CI) = 1.4-2.5). Among tobacco smokers, the RR increased from 4.6 in those who brushed to 7.3 in those who did not brush. Among non-smokers, the RR of oral leukoplakia in those who did not brush (1.8) compared to those who brushed was also statistically significant (95% CL = 1.6-3.8). CONCLUSION: Failure to brush teeth and none use of toothpastes are significantly associated with the development of oral leukoplakia, while the choice of brushing tools between conventional toothbrush and chewing stick is not. In addition, failure to brush teeth appeared to potentiate the effect of smoking tobacco in the development of oral leukoplakia. Recommendations: Oral health education, instruction and motivation for the improvement of oral hygiene habits and practices; and therefore oral hygiene status, should be among the strategies used in oral leukoplakia preventive and control programmes.

Department of Periodontology/ Community and Preventive Dentistry, School of Dental Sciences, University of Nairobi, P.O. Box 19676 - 00202, Nairobi, Kenya. OBJECTIVE: To determine the influence of oral hygiene habits and practices on the risk of developing oral leukoplakia. DESIGN: Case control study. SETTING: Githongo sublocation in Meru District. SUBJECTS: Eighty five cases and 141 controls identified in a house-to-house screening. RESULTS: The relative risk (RR) of oral leukoplakia increased gradually across the various brushing frequencies from the reference RR of 1.0 in those who brushed three times a day, to 7.6 in the "don't brush" group. The trend of increase was statistically significant (X2 for Trend : p = 0.001). The use of chewing stick as compared to conventional tooth brush had no significant influence on RR of oral leukoplakia. Non-users of toothpastes had a significantly higher risk of oral leukoplakia than users (RR = 1.8; 95% confidence levels (CI) = 1.4-2.5). Among tobacco smokers, the RR increased from 4.6 in those who brushed to 7.3 in those who did not brush. Among non-smokers, the RR of oral leukoplakia in those who did not brush (1.8) compared to those who brushed was also statistically significant (95% CL = 1.6-3.8). CONCLUSION: Failure to brush teeth and none use of toothpastes are significantly associated with the development of oral leukoplakia, while the choice of brushing tools between conventional toothbrush and chewing stick is not. In addition, failure to brush teeth appeared to potentiate the effect of smoking tobacco in the development of oral leukoplakia. Recommendations: Oral health education, instruction and motivation for the improvement of oral hygiene habits and practices; and therefore oral hygiene status, should be among the strategies used in oral leukoplakia preventive and control programmes.

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.

FG Macigo, DL Mwaniki and SW Guthua East Afr. Med. Journal 1995, 72: 778 - 782 SUMMARY: The prevalence of oral leukoplakia and related lesions in a Kenyan rural population was determined in a systematic house to house survey of individuals aged 15 years and above. Among the 803 individual examined, the following prevalence of lesions was observed: leukoedema (26%), melanosis (12.7%), leukoplakia (10.6%), palatal keratosis (6.4%), frictional keratosis (5.5%), pre-leukoplakia (4.1%), borderline leukoplakia (2.4%), cheek/lip biting (1.3%), and snuff dippers lesion (0.4%), 48.6% of the subjects had at least one of these lesions. Statistically significant preponderance was demonstrated for oral leukoplakia, palatal keratosis, leukoedema and frictional keratosis among males and melanosis among females. With regard to clinical classification of oral leukoplakia, the prevalence was 10% for homogeneous and 0.6% for non-homogeneous lesions. On the basis of aetiological classification, the prevalence was 8.3% for tobacco associated and 2.2% for idiopathic leukoplakia, 22.5% of leukoplakia lesions biopsied had evidence of epithelial dysplasia. In view of the premalignant potential of oral leukoplakia, our findings suggest a need for greater attention towards prevention and control of this lesion in the study community.

OBJECTIVE: To determine the influence of cigarette filters and the effect of smoking Kiraiku (home processed, hand rolled tobacco) on the risk of developing oral leukoplakia among cigarette smokers. DESIGN: Case control using population-based study groups in a Kenyan rural community. MATERIALS AND METHODS: 85 cases and 141 controls identified in a cross-section house-to-house screening of subjects aged 15 years and over and matched for sex, age (+/- 3 years) and cluster origin were compared for their use of filter and non-filter cigarettes as well as their history of smoking Kiraiku. RESULTS: The relative risk (RR) of oral leukoplakia was 9.1 (95% confidence intervals (CI) = 4.1-20.2) in smokers of filter cigarettes and 9.8 (95% CI = 2.3-47.0) in smokers of non-filter cigarettes. The RR in the latter compared to the former was 1.1 and was not statistically significant. Regarding the influence of smoking Kiraiku, the RR of this lesion was 29.3 in smokers of both Kiraiku and filter cigarettes and 17.3 in smokers of both Kiraiku and non-filter cigarettes. CONCLUSIONS: There was no statistically significant difference between the influence of filter and non-filter cigarettes on the risk of developing oral leukoplakia. The effect of Kiraiku on the risk of this lesion was stronger in filter than in non-filter cigarettes. However, the confounding effect of tobacco dose response parameters could not be ruled out.

The stability of adrenaline ophthalmic solutions, at pH 5.8 and 7.4, to sterilization and storage conditions has been studied. Solutions sterilized by filtration or heating at 98 degrees C for 30 min showed no detectable degradation at either pH value, whilst sterilization at higher temperatures resulted in losses of up to 30%. Total degradation increased with increasing sterilization temperature at both pH values.

The stability of adrenaline ophthalmic solutions, at pH 5.8 and 7.4, to sterilization and storage conditions has been studied. Solutions sterilized by filtration or heating at 98 degrees C for 30 min showed no detectable degradation at either pH value, whilst sterilization at higher temperatures resulted in losses of up to 30%. Total degradation increased with increasing sterilization temperature at both pH values.

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

ABSTRACT
In a preliminary study, 135 samples of mature forages from 84 livestock farms (farm size 10 • 6000 acres) in Bungoma and Trans Nzoia districts were assessed for both macro (Co, S, Mg and P) and trace elements (Co, Cu, Se, Mo, Zn, Fe and Mn) using a variety of chemical techniques. Mean concentrations of these elements were low compared with surveys in other tropical countries. Comparison with recent estimates of the mineral requirements of cattle and sheep indicated that 70 -98 % of the forages were deficient in Co, P and Cu. Several pastures contained less Mg, S, Zn andSe than ruminants are thought to require but deficiencies of Co, Mn and Fe were rare. Re-assessment of the data for Cu availability using two derived prediction equations, one for hay: Cu (%DM)=8.9 -0.7logtMo - 2.61logc S and the other for grass: Cu (%DM) = 5.72 - 1.2975 • 2.785hgf Mo + 0.227 Mo X S showed that forage Mo and S rarely reached concentrations high enough to be antagonistic to Cu. However, Fe concentrations were sufficiently high to implicate this element as an independent Cu antagonist. Since forage mineral deficits are not synonymous with constraints upon livestock production, the possibility of such constraints should be further investigated, first through blood analysis and then by supplementation trials with grazing animals beginning with Cu.

JASPA Working Paper, ILO, Addis Ababa

This paper presents data on diversity and abundance of soil macrofauna of various land use systems in Embu, Kenya (natural forest, plantation forest, fallow, coffee, tea, napier, and maize). Each was sampled for
macrofauna using three sampling methods (monolith, transect and pitfall traps). Thirty four (34) genera/species of soil macrofauna were recorded, the highest number (27) being observed in napier. Majority of these genera/species being Coleoptera. Rényi diversity profile indicated that in terms of
species richness (α at 0), maize was the richest of all the land use systems, but plantation forest the least. It
was however not possible to clearly order or rank the land use system in terms of diversity because of the
bias of each of the two diversity indices as indicated by the numerous crossings observed for the diversity
profiles/curves. Shannon index of diversity (α = 1) indicated that coffee was the most diverse of the land
use systems followed by plantation forest > natural forest > napier > maize > tea, while fallow/pasture was
the least diverse (Figure 1). On the other hand, Simpson’s diversity (α = 2) indicated that plantation
forest was the most diverse followed by fallowed by coffee > natural forest > napier > maize >tea >
fallow/pasture. Rényi evenness profile indicated that the plantation forest was most even in terms of species
distribution followed by natural forest and coffee > napier > tea > maize but least even in the
fallow/pasture. Hymenoptera were most abundant of the macrofauna groups constituting about 45% of the
total followed by Isoptera (39%), Coleoptera (6%), Oligochaeta (5%), Orthoptera (3%) and Arenae (2%). The other groups that comprised of Hemiptera, Diptera, Phasmidae and Blattelidae each constituted
<1% of the total marofauna recorded. Highest macrofauna density (1566) was recorded in the napier
followed by fallow (1356) > coffee (1170) > natural forest (1110) > tea (755), but lowest in plantation
forest (309), although analysis of variance indicated no significant variation among the land use systems. This study however, demonstrates that quantitative changes in diversity and density of soil fauna communities occur when various land use systems are subjected to varying levels of intensification. These changes appear to be associated with management practices such as use of agrochemicals, consequent destruction of nesting habitats, modification of soil microclimate within habitats, removal of substrate, low diversity and availability of food sources for the associated macrofauna groups. The significant correlations
between some soil macrofauna groups with selected soil chemical properties shows that, soil chemical
characteristics may indirectly play a role in influencing the density, distribution and structure of macrofauna
communities.

Key words: Macrofauna; diversity; abundance; land use systems.

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PURPOSE: To demonstrate the capability of SD-OCT to measure macular retinal ganglion cell-inner plexiform layer (GCIPL) thickness and to assess its reproducibility in glaucomatous eyes. METHODS: Fifty-one glaucomatous eyes (26 mild, 11 moderate, 14 severe) of 51 patients underwent macular scanning using the Cirrus HD-OCT (Carl Zeiss Meditec, Dublin, CA) macula 200×200 acquisition protocol. Five scans were obtained on 5 days within 2 months. The ganglion cell analysis (GCA) algorithm was used to detect the macular GCIPL and to measure the thickness of the overall average, minimum, superotemporal, superior, superonasal, inferonasal, inferior, and inferotemporal GCIPL. The reproducibility of the measurements was evaluated with intraclass correlation coefficients (ICCs), coefficients of variation (COVs), and test-retest standard deviations (TRTSDs). RESULTS: Segmentation and measurement of GCIPL thickness were successful in 50 of 51 subjects. All ICCs ranged between 0.94 and 0.98, but ICCs for average and superior GCIPL parameters (0.97-0.98) were slightly higher than for inferior GCIPL parameters (0.94-0.97). All COVs were {\textless}5%, with 1.8% for average GCIPL and COVs for superior GCIPL parameters (2.2%-3.0%) slightly lower than those for inferior GCIPL parameters (2.5%-3.6%). The TRTSD was lowest for average GCIPL (1.16 μm) and varied from 1.43 to 2.15 μm for sectoral GCIPL CONCLUSIONS: The Cirrus HD-OCT GCA algorithm can successfully segment macular GCIPL and measure GCIPL thickness with excellent intervisit reproducibility. Longitudinal monitoring of GCIPL thickness may be possible with Cirrus HD-OCT for assessing glaucoma progression.

BACKGROUND: Comparative trials of ursodeoxycholic acid (UDCA), vitamin E and weight management programs among patients with nonalcoholic fatty liver disease (NAFLD) are lacking. AIM: To find an effective single agent or combination of agents for management of NAFLD. METHODS: In this retrospective study, consecutive patient with histologically confirmed NAFLD with raised ALT were included. The patients received either weight management (exercise and therapeutic lifestyle changes [TLC] diet with a target to reduce body weight 10% in 6 months) (group I) ; weight management + UDCA (300 mg BID) (group II); or weight management + UDCA + vitamin E (400 mg OD) (group III). Outcome measure was normalization of ALT. RESULTS: 42 patients (18, 12 and 12 in groups I, II and III, respectively) were included between 1996 and 2004. All patients in group III normalized their ALT levels, which was significantly higher than numbers in group I (8/18) and group II (5/12); (p=0.003). Post treatment ALT was significantly lower in group III (28.6 [9.3]) as compared to group I (59.3 [32.2]) and group II (49.0[31.8]); (p=0.01). Type of therapy received was the only factor predictive of ALT normalization. CONCLUSION: Combination regimen containing vitamin E appears to be effective in normalizing ALT among NAFLD patients.

{ AIM: To evaluate the clinical and biochemical profile of patients with non alcoholic fatty liver disease (NAFLD) and to assess their histological severity at presentation. METHODS: Consecutive patients presenting to the liver clinic of All India Institute of Medical Sciences (AIIMS) with raised transaminases to at least 1.5 times upper limit of normal, and histologically confirmed non-alcoholic fatty liver disease were included. Patients who had significant alcohol intake or positive markers of other liver diseases or who were taking drugs known to produce fatty liver were excluded. The clinical, biochemical and histological profile of this group was studied. RESULTS: Fifty-one patients with NAFLD formed the study population. Their median age and BMI were 34(17-58) years and 26.7(21.3-32.5) kg/m(2) respectively and 46 (90.1%) were males. The majority of the patients had mild inflammation, either grade 1 [32 (63%)] or grade 2 [16 (31%)] and only 3 (6%) patients had severe (grade 3) inflammation. Twenty-three (45%), 19 (37%), 8(16%) and 1(2%) patient had stage 0, 1, 2 and 3 fibrosis respectively on index biopsy and none had cirrhosis. On univariate analysis, triglyceride levels more than 150 mg % (OR = 7.1; 95% CI: 1.6-31.5

BACKGROUND: Hepatitis B virus (HBV) DNA detection and quantification are now playing an increasing role in the assessment of disease activity and response to therapy. However, viraemia levels which define various stages of HBV infection have not yet been established. AIM: To define viraemia levels which describe various stages of chronic hepatitis B virus infection. METHODS: In a retrospective study, stored sera samples of chronic hepatitis B virus (CHB) infected patients registered at AIIMS liver clinic, from January 1996 to June 2005 were subjected to competitive, quantitative PCR analysis. RESULTS: The median HBV DNA load was lowest among carriers and highest among patients with chronic hepatitis B [0 (0-8) vs. 7 (0-12) log10 copies/ml, respectively; p<0.05]. As compared to chronic hepatitis patients the DNA load was also lower among cirrhotics [7 (0-12) vs. 4.5 (0-8) log10 copies/ml, respectively; p<0.05] and hepatocellular cancer patients [ 7(0-12) vs. 0 (0-8) log10 copies/ml, respectively; p<0.05]. Patients with carriers had a DNA load which was significantly lower than e antigen negative CHB [0 (0-8) vs. 6 (0-10) log10 copies/ml; p<0.05] or e antigen positive CHB [0 (0-8) vs 8 (0-12) log10 copies/ml; p<0.05]. A threshold of 3.5 log10 copies/ml had sensitivity and specificity of 83% and 58% respectively in differentiating carriers from e antigen negative CHB. There was a strong positive correlation of HBV DNA load with inflammatory grade (R=0.334; p=0.0001), fibrosis stage (R=0.276; p=0.001) and ALT levels (R=0.378; p=0.0001). 82% (9/11) of those who lost e antigen had a decline in HBV DNA levels to <5 log10 copies/ml, whereas only 12.5% (1/8) of those who did not lose e antigen had a decline in DNA load below this level. CONCLUSIONS: HBV DNA viraemia levels correlate positively with the inflammatory grade, fibrosis stage and ALT levels. Most patients who loose e antigen have a decline in DNA load to below 5 log10 copies/ml. Further prospective studies employing repeated measurements are required to define a threshold to differentiate between HBV carriers and e antigen negative CHB.

BACKGROUND AND AIM: Detection of an asymptomatic rise in the hepatic aminotransferase (ARHA) value has become a distinct and frequent clinical problem. We evaluated a three-step diagnostic algorithm in such patients for maximum yield. METHODS: Consecutive patients with an ARHA value 1.5-fold the upper limit of normal for at least 4 weeks and who were apparently healthy were included in the study. Each patient underwent standard biochemical investigations and a stepwise investigative protocol. In the first step, serological markers for hepatitis viruses, serum ferritin, 24-h urinary copper, alpha-1-antitrypsin phenotyping, and autoimmune markers were carried out. In step two, patients who tested negative for all the above markers had polymerase chain reaction (PCR) analysis for hepatitis B virus (HBV)-DNA and hepatitis C virus (HCV)-RNA. Patients without a diagnosis despite the above investigations underwent a liver biopsy as part of step three. RESULTS: Of 105 patients with ARHA, 38 were excluded for various reasons and 67 were included for the final analysis. The mean age was 35.11 +/- 11.96 years and 56 patients were men. The mean body mass index was 24.17 +/- 3.2 kg/m(2). The stepwise diagnostic algorithm achieved a diagnosis in 65/67 (97%) patients. Non-alcoholic steatohepatitis (NASH) and chronic viral hepatitis were the most common diagnoses, in 24 (36%) patients each. Using the diagnostic algorithm a diagnosis was reached in 34% of patients with only serological and biochemical investigations, whereas PCR for HBV and HCV could further detect the presence of active HBV or HCV viremia in 21% (14/97) and a liver biopsy was necessary to establish the diagnosis in 28/67 (42%) patients. CONCLUSIONS: A stepwise diagnostic algorithm in patients with ARHA resulted in an optimal use of PCR and invasive tests such as liver biopsy. Cryptic HBV and HCV infection was frequent among these patients and PCR was necessary in such cases. NASH and chronic viral hepatitis were the most frequent causes of ARHA.

Coexistence of two illnesses in the same patient may result in atypical manifestations of either or both diseases. A case of hepatitis B virus-related cirrhosis in a patient who presented with a pharyngeal mucosal mass lesion as a manifestation of superadded Leishmania infection is presented here. The clue to the diagnosis was the origin of the patient from an area highly endemic for leishmaniasis and the presence of unexplained polyclonal hypergammaglobulinaemia. The patient responded very well to therapy with amphotericin B with complete disappearance of the mucosal lesion.

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

The Asp-derived amino acid pathway has been studied during the early stages of development in two maize genotypes, Io and F2, differing in germination efficiency and post-germination growth. In both genotypes expression of Ask2 (monofunctional Asp-kinase-2), Akh1 and Akh2 (bifunctional Asp-kinase-homo-Ser dehydrogenase-1 and 2), increased throughout germination and post-germination growth, suggesting a developmental regulation, whereas Ask1 (monofunctional Asp-kinase-1) was expressed constitutively. The major difference between Io and F2 concerned genes encoding bifunctional enzymes, particularly Akh2, the expression of which was dramatically low in F2. 15N-Asp labelling showed differences in in vivo Asp-kinase activities between the genotypes studied. Asp flux through the Met/Thr branches was higher in Io than in F2, while the latter exhibited a higher flux of Asp through the Lys branch. Physiological results, together with the higher Akh2 expression in Io, suggest that bifunctional enzyme activity, favourable to Met/Thr, was higher in Io than in F2 and that the monofunctional pathway was boosted in F2 because of the lower competition by the bifunctional pathway, thus allowing for higher flux of Asp through the Lys branch. In conclusion, it is suggested that F2 germination and post-germination growth might have been partially inhibited due to a limitation in Met and Thr availability. A negative physiological effect related to Lys accumulation in F2 is also discussed.

A case controlled study comprising 51 patients with homozygous sickle cell (HbSS) disease who complained of dyspepsia and 41 age and sex matched non-HbSS control dyspeptic patients was carried out, to look at upper gastrointestinal mucosal lesions associated with dyspepsia. Upper gastrointestinal tract (UGIT) endoscopy was performed with gastric control biopsy taken for histology. Thirty two (62.3%) of the HbSS or sickle cell anaemia (SCA) patients had upper gastrointestinal pathology at endoscopy as compared to 17 (41.5%) of controls. The difference was significant at p = 0.042. Bile reflux (47%) was the predominant abnormal morphological finding in SCA patients while duodenal ulcer was the most common morphological finding in dyspeptic controls. The prevalence of duodenal ulcer in controls (22%) though higher than in SCA patients (9.8%), was not statistically significant p = 0.18. Gastric ulcer was not found in SCA patients. Duodenal ulcer was commoner in males than females in both cases and controls with a ratio of 4:1 and 3.5:1 respectively. Only four (7.8%) SCA patients and one (2.4%) of controls had normal mucosa at histology, the rest had evidence of histological gastritis. We could not draw any correlation between non-steroidal anti-inflammatory drugs (NSAIDS) use and UGIT findings. Since the proportion of SCA cases with UGIT abnormalities was significantly high, we recommend that dyspeptic SCA patients undergo UGIT investigations including endoscopy to maximise their clinical care.

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Tala Quarrry in African Geoscience Review Vol. 9 Number 4 pp. 385-396.  

Tala Quarrry in African Geoscience Review Vol. 9 Number 4 pp. 385-396.  

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

A cross sectional study of 115 patients admitted at the Department of Orthopedics, Kenyatta National Hospital, Nairobi, Kenya was carried out to determine the prevalence and antibiotic susceptibility of Staphylococcus aureus isolated from infected wounds. The prevalence of Staphylococcus aureus was 33.0 %. The drugs tested and their corresponding sensitivity was amoxycillin (13.2 %), co-amoxyclav (39.5 %), oxacillin (55.3 %), erythromycin (44.7 %), gentamicin (60.5 %), ciprofloxacin (62.2 %), minocycline (86.8 %), cefuroxime (57.9 %), and clidamycin (84.2 %). These results show the sensitivity profile of Staphylococcus aureus and can be used to choose suitable drugs in the management of wounds for hospitalized patients.

A cross sectional study of 115 patients admitted at the Department of Orthopedics, Kenyatta National Hospital, Nairobi, Kenya was carried out to determine the prevalence and antibiotic susceptibility of Staphylococcus aureus isolated from infected wounds. The prevalence of Staphylococcus aureus was 33.0 %. The drugs tested and their corresponding sensitivity was amoxycillin (13.2 %), co-amoxyclav (39.5 %), oxacillin (55.3 %), erythromycin (44.7 %), gentamicin (60.5 %), ciprofloxacin (62.2 %), minocycline (86.8 %), cefuroxime (57.9 %), and clidamycin (84.2 %). These results show the sensitivity profile of Staphylococcus aureus and can be used to choose suitable drugs in the management of wounds for hospitalized patients.

A cross sectional study of 115 patients admitted at the Department of Orthopedics, Kenyatta National Hospital, Nairobi, Kenya was carried out to determine the prevalence and antibiotic susceptibility of Staphylococcus aureus isolated from infected wounds. The prevalence of Staphylococcus aureus was 33.0 %. The drugs tested and their corresponding sensitivity was amoxycillin (13.2 %), co-amoxyclav (39.5 %), oxacillin (55.3 %), erythromycin (44.7 %), gentamicin (60.5 %), ciprofloxacin (62.2 %), minocycline (86.8 %), cefuroxime (57.9 %), and clidamycin (84.2 %). These results show the sensitivity profile of Staphylococcus aureus and can be used to choose suitable drugs in the management of wounds for hospitalized patients.

A cross sectional study of 115 patients admitted at the Department of Orthopedics, Kenyatta National Hospital, Nairobi, Kenya was carried out to determine the prevalence and antibiotic susceptibility of Staphylococcus aureus isolated from infected wounds. The prevalence of Staphylococcus aureus was 33.0 %. The drugs tested and their corresponding sensitivity was amoxycillin (13.2 %), co-amoxyclav (39.5 %), oxacillin (55.3 %), erythromycin (44.7 %), gentamicin (60.5 %), ciprofloxacin (62.2 %), minocycline (86.8 %), cefuroxime (57.9 %), and clidamycin (84.2 %). These results show the sensitivity profile of Staphylococcus aureus and can be used to choose suitable drugs in the management of wounds for hospitalized patients.