Mice infected with Trypanosoma congolense developed a severe anaemia 1 week after infection, which persisted till treatment with diminazine aceturate when the packed cell volume (PCV) recovered to pre-infection levels. This was accompanied by a marked increase in the plasma levels of the acute phase proteins (APP), serum amyloid P-component (SAP) and haptoglobin (Hp). The initial peak levels of Hp and SAP were attained 7 and 12 days post-infection (DPI), respectively. Thereafter SAP levels decreased significantly to near pre-infection levels, but later increased even after treatment to give a second peak 34 DPI after which there was a decline till the study was terminated. The Hp levels on the other hand decreased to an intermediate level after the initial peak increasing to a second peak 22 DPI. Thereafter Hp decreased significantly following diminazine aceturate treatment to reach pre-infection levels within 5 days post-treatment. This indicates that T. congolense-infected mice develop severe anaemia accompanied by an acute phase response leading to an increase in SAP and Hp but that following treatment divergent responses occurred indicating differences in the pathways for stimulation of the APP. Haptoglobin was shown to be an earlier indicator of infection and a better marker in monitoring the response to treatment.

The vision of the Government of Kenya is to facilitate ICT as a universal tool for education and training. In order to achieve this vision every educational institution, teacher, learner and the respective community should be equipped with appropriate ICT infrastructure, competencies and policies for usage and progress. It calls for recognition of the fact that ICT provides capabilities and skills needed for a knowledge-based economy. It also calls for transforming teaching and learning to incorporate new pedagogies that are appropriate for the 21st  century. The Ministry of Education�s (MOE) mission is to facilitate effective use of ICT to improve access, learning and administration in delivery education programmes and services. The principal objective will be to integrate ICT in the delivery of education and training curricula. XML:NAMESPACE PREFIX = O />  Although not exhaustive, the range of ICT that have been used in the delivery of education to improve access, teaching, learning, and administration includes: Electric Board, Audio Cassette, Radio for Interactive Radio Instructions (IRI), Video/TV-Learning, Computer, Integrated ICT infrastructure and Support Application Systems (SAS).These systems are in use, at various degrees, in most parts of Africa (Charp, 1998). This plan envisages use ofthese digital components to improve access and quality in the delivery of education in Kenya.  The major challenge in respect to this component is limited digital equipment at virtually all levels of education. While the average access rate is one computer to 15 students in most of the developed countries, the access rate in Kenya is approximately one computer to 150 students (EMIS, 2005). Whereas most secondary schools in Kenya have some computer equipment, only a small fraction is equipped with basic ICT infrastructure. In most cases equipment of schools with ICT infrastructure has been through initiatives supported by the parents, government, development agencies and the private sector, including the NEPAD E-Schools programme. Attempts to set up basic ICT infrastructure in primary schools are almost negligible.  According to ICTs in Education Options Paper, one of the main problems is limited penetration of the physical telecommunication infrastructure into rural and low-income areas. Specifically, the main challenge is limited access to dedicated phone lines and high-speed systems or connectivity to access e-mail and Internet resources. The EMIS Survey (2003/2004) indicated that over 70% of secondary schools and a much larger proportion of primary schools require functional telephones. Indeed, many parts of Kenya cannot easily get Internet services because of the poor telephone networks. About 90% of secondary schools need to establish standard Local Area Networks (LANs) in order to improve sharing of learning resources.  Alternative and appropriate technologies for access to Internet resources, including wireless systems remain quite expensive. Indeed, a small proportion of schools have direct access, through Internet Service Providers (ISPs), to high-speed data and communication systems. Furthermore, very few schools in the rural areas use wireless technology such as VSAT to access e-mail and Internet resources. Nearly all of the 6 NEPAD e-Schools are in rural areas and are expected to enjoy internet connectivity through VSAT technology.  While other countries have reported up to 41% of integration of ICT to teaching and learning, the proportion remains substantially low in Africa, Kenya included. Integration aims at the use ICT to support teaching and learning in the delivery of the various curricula to achieve improved education outcomes. Because ICT is interactive media, it facilitates students to develop diversified skills needed for industrialization and a knowledge-based economy. It also allows teachers and learners to proceed at different paces depending on the prevailing circumstances. As a first step, the Ministry of Education has initiated a major ICT project in Secondary schools meant to equip over 200 secondary schools with ICT infrastructure for integration of ICT in teaching/learning process ( KESSP, 2004). Three schools have been chosen in every district of Kenya.

The ability of Phenylbutazone and Dexamethazone to modulate post operative tempetature, limping, joint pain and joint mobility after joint surgery in calves was assessed. Intramuscular injections of 4.4mg/kg Phenylbutazone or 0.2 mg/kg Dexamethazone were given to two groups of calves. Both Dexamethazone and Phenybutazone were effective in reducing pain, limping and fever with a tendency fo Dexamethazone to be more potent than Phenylbutazone. However there was no significant difference between the ability of Dexamethazone and Phenylbitazone to module these controlled use of the anti-inflammatory drugs in the immediate post-operative period in cattle in beneficial.

Stomoxys calcitrans failed to transmitTrypanosoma (b.) evansi from infected goats to other goats or camels, but the trypanosomal infection was transmitted by needle prick from infected goats to camels.

OBJECTIVE: To assess post-surgical management of patients with breast cancer at the Kenyatta National Hospital. DESIGN: Retrospective analysis of patients treated for breast carcinoma at Kenyatta National Hospital between January 1989 and January 2000. SETTING: Kenyatta National Hospital. SUBJECTS: Three hundred and seventy-four patients who had surgery or biopsy for breast cancer at the Kenyatta National Hospital. INTERVENTION: Chemo-hormonal therapy and/or radiotherapy for adjuvant, metastatic, or palliative purposes. RESULTS: Twenty-two patients received adjuvant chemotherapy, and 21 patients received chemotherapy for metastatic disease. Forty-six patients received adjuvant radiotherapy and 53 had radiotherapy for palliative purposes. One hundred and twenty-six patients were given tamoxifen for adjuvant and metastatic purposes. The median duration of follow-up was 20 months. CONCLUSION: Chemotherapy is grossly underutilized in the treatment of breast cancer at the Kenyatta National Hospital, and radiotherapy is also underutilized. Follow-up durations are dismal and if this is used as a surrogate measure for survival then survival durations for breast cancer patients are also dismal at the Kenyatta National Hospital.

OBJECTIVES: To evaluate the frequency and severity of occurrence of vincristine-associated neurotoxicity. DESIGN: A retrospective case series study. SETTING: Hurlingham Oncology Clinic, Nairobi. SUBJECTS: Thirty-eight patients treated for various neoplasms with vincristine containing chemotherapeutic regimens. MAIN OUTCOME MEASURES: The frequency and degree of neurotoxicity when vincristine was given at the standard dose of 1.4 mg/m2. RESULTS: Five patients (13.2%) developed peripheral neuropathy, one having had it even before vincristine was started. Therefore only four (10.5%) had it attributed to vincristine. Four of the patients who developed neuropathy (80%) were HIV-positive. Neuropathy grade 2 (severe) occurred in only two patients leading to discontinuation of the drug. All the neurotoxicity resolved after discontinuation of vincristine. CONCLUSION: Vincristine induced neuropathy occurred but was rarely severe at a dose of 1.4 mg/m2. It appeared to be more frequent in HIV infected individuals, but controlled studies with bigger sample sizes are required to determine whether this may warrant routine capping of the dose at a maximum of 2 mg.

OBJECTIVE: To determine the impact on neutrophils if adriamycin is administered at 60 mg/m2 and cyclophosphamide at 600/m2 (AC 60/600); and at 50 mg/m2 and 500 mg/m2 (50/500) in the treatment of breast cancer. DESIGN: Restrospective analysis of nadir neutrophil counts in female mammary carcinoma patients treated with adriamycin/cyclophosphamide combination. SETTING: Hurlingham Oncology Clinic, Nairobi and The Nairobi Hospital between March 1995 and August 1999. SUBJECTS: Eighteen patients with breast cancer were treated either for adjuvant purposes or for metastatic disease. INTERVENTION: Chemotherapy with adriamycin and cyclophosphamide at 60/600 or 50/500. Patients were advised to avoid crowded places and given prophylactic broadspectrum antibiotics whenever grade 4 neutropenia occurred at nadir. RESULTS: Grade 3-4 neutropenia occurred in 75.5% of treatments at 60/600 and in 56.8% of the treatments at 50/500. Febrile neutropenia followed only one treatment and did not result in death. CONCLUSION: Neutropenia is frequent and severe at A/C 60/600 and need to be watched out for. Sepsis on the other hand is prevented if meticulous attention is given and corrective measures taken. A/C 50/500 was associated with less occurrences of neutropenia though still very high. Neutropenia should therefore be checked and steps be taken to prevent sepsis even at this dosage.

OBJECTIVE: To determine the impact on neutrophils if adriamycin is administered at 60 mg/m2 and cyclophosphamide at 600/m2 (AC 60/600); and at 50 mg/m2 and 500 mg/m2 (50/500) in the treatment of breast cancer. DESIGN: Restrospective analysis of nadir neutrophil counts in female mammary carcinoma patients treated with adriamycin/cyclophosphamide combination. SETTING: Hurlingham Oncology Clinic, Nairobi and The Nairobi Hospital between March 1995 and August 1999. SUBJECTS: Eighteen patients with breast cancer were treated either for adjuvant purposes or for metastatic disease. INTERVENTION: Chemotherapy with adriamycin and cyclophosphamide at 60/600 or 50/500. Patients were advised to avoid crowded places and given prophylactic broadspectrum antibiotics whenever grade 4 neutropenia occurred at nadir. RESULTS: Grade 3-4 neutropenia occurred in 75.5% of treatments at 60/600 and in 56.8% of the treatments at 50/500. Febrile neutropenia followed only one treatment and did not result in death. CONCLUSION: Neutropenia is frequent and severe at A/C 60/600 and need to be watched out for. Sepsis on the other hand is prevented if meticulous attention is given and corrective measures taken. A/C 50/500 was associated with less occurrences of neutropenia though still very high. Neutropenia should therefore be checked and steps be taken to prevent sepsis even at this dosage.

Records were available for 197 patients with malignant lymphomas (MLs) aged 13 years and above seen at Kenyatta National Hospital (KNH) between the years 1973 and 1986. There were 110 cases of Hodgkin's disease (HD) and 87 cases of non-Hodgkin's lymphomas (NHLs). The distribution of the two groups according to sex and histologic sub-types was not significantly different. HD patients were on average significantly younger than NHL patients (28.8 years versus 41.1 years). Over 70% of both HD and NHL cases presented in stages III and IV and the distribution of the groups according to stage of disease was not statistically significant. There was no significant correlation between stage of disease at diagnosis and histologic subtypes for either group. Losses to follow-up were high in both groups. Female sex was associated with longer periods of follow-up in both groups, being statistically significant for HD and not so for NHLs. Age was not correlated with duration of follow-up for NHLS whereas for HD cases, older age (above 53 years) was associated with shortened follow-up periods. The mortality rate was higher in NHLs than in HD cases.

A two-year study was conducted with an overall objective of characterising the structure and function of an arid rangeland in Kenya. A plot measuring 100 x 100m was used for this study. Data on rainfall and temperature were recorded at the plot site whereas data on evaporation rates and relative humidity were obtained from the meteorological office near the study site. Herbaceous aboveground material was sampled at monthly intervals using a rectangular 0.25m2 quadrat frame. Clipped material was separated by species and classified dead or live by physical examination. A 5cm diameter metal soil corer was used to sample belowground plant material, at monthly intervals. The sampled material was washed with running water over 2mm sieves and classified dead or live using the vital staining technique. All weights and calculations were based on organic weight. Total aboveground standing crop ranged from 84.6g m-2 to 295.4g m-2, with a mean of 162.3 60.6g m-2. Mean monthly aboveground standing crop for 1992 and 1993 was 142.8 53.8 and 178.5 63.3g m-2 respectively. The two values were significantly different (p<0.10). Aboveground biomass yield ranged from 17.7g m-2 to 242.7g m-2, with a mean of 104.3 58g m-2 and a coefficient of variation of 58%. Mean aboveground standing crop was 59 24g m-2. Monthly values ranged from 28.8g m-2 to 120g m-2, with a 38% coefficient of variation. The range for total belowground standing crop was from 83.3g m-2 to 232.7g m-2, and a mean of 155.2 46g m-2. The values had a coefficient of variation of 30%. Mean total monthly belowground plant material yield for 1992 and 1993 was 137.6 41g m-2 and 169.9 46g m-2. The coefficients of variation were 59% and 28% respectively. The mean monthly belowground biomass yield was 51.6 33g m-2 with a coefficient of variation of 64%. Mean monthly yield for belowground dead material was 103.7 32g m-2, with a coefficient of variation of 31%. There was no significant difference (p>0.01) in the mean belowground dead material yield between 1992 and 1993. In 1992, annual NPP was 439.2g m-2, giving a net primary productivity of 1.22g m-2day-1. Monthly NPP ranged from 17.2g m-2 to 90.1g m-2. In 1993, annual NPP was 944.5g m-2, equivalent to a net primary productivity of 2.62g m-2day-1. Monthly NPP was between 27.4g m-2 and 548.6g m-2. Over the 19921993 period, NPP was 1 383.7g m-2, equivalent to a productivity of 1.92g m-2day-1. Trends in monthly NPP closely followed the trend in rainfall. On the whole, herbaceous vegetation production and productivity were episodic in nature and closely linked to rainfall. The high primary productivity puts arid and semi-arid rangelands under sharp focus as CO2 sinks, whose role in the amelioration of greenhouse effect could be more important than is currently appreciated.

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The purpose of this study was to examine the feasibility and safety of ablation of idiopathic outflow tract ventricular tachycardia (OTVT) from the distal ramifications of the coronary sinus (CS).
A significant minority of patients presenting with idiopathic OTVT have an epicardial focus, the standard approach to which involves ablation from within one of the aortic valve cusps (AVCs). We describe the successful ablation of idiopathic epicardial OTVT from within the CS in the distal great cardiac vein (GCV).

Ablation from the distal GCV was performed in 5 patients with idiopathic OTVT who had unfavorable mapping, in some cases unsuccessful ablation from various endocardial and epicardial sites including the AVCs, and in 1 patient via the direct epicardial approach. An electroanatomic mapping system (Carto) was used in 3 patients, and conventional mapping was performed in 2 patients, and in 3 patients cryothermal ablation was performed.
In all patients, the first ablation lesion in the GCV successfully eliminated the arrhythmia. All patients have remained free of VT after a mean follow-up of 24 (7 to 44) months. There were no immediate or long-term complications.
Idiopathic epicardial OTVT can be successfully ablated from the distal GCV, and should be seen as an alternative to ablation from the aortic valve cusps.

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

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

Objective: To determine the pattern of breast disease at Kenyatta National Hospital (KNH) Study design:    Retrospective descriptive study Study setting:    Kenyatta National Hospital, a University teaching and National Referral Hospital Patients: Records of 1172 patients were reviewed. Results: An average 469 new patients per year or 11 new patients per clinic visit were seen at the clinic over a two and a half year period. Females predominated (98.9%) in this series. The mean age was 34.71 years (range 1 to 96 years). The average age at menarche was 14.49 years and the mean duration of symptoms was 6.86 months. Only 2.6% of 843 patients had a positive family history of breast disease. Fibroadenoma was the commonest diagnosis made (33.2%) followed by ductal carcinoma (19.7%). Gynaecomastia was the most common lesion seen in males. Two thirds of patients presenting with tumors had masses measuring more than 5cm.  Overall five conditions (fibroadenoma, ductal carcinoma, breast abscesses, fibrocystic disease and mastalgia) accounted for over 85% of all breast ailments. Surgery formed the main stay of care in over 80% of patients. Conclusions: The pattern of breast diseases at KNH closely mirrors those reported in other studies in the region and beyond. This study indicates that a large proportion of patients presenting with breast disease are treated initially by surgery. It may be wise to consider other alternative forms of therapy where appropriate. The Annals of African Surgery: 2008 June; Vol 2, pg 97-101.

Objective: To determine the pattern of breast disease at Kenyatta National Hospital (KNH) Study design:    Retrospective descriptive study Study setting:    Kenyatta National Hospital, a University teaching and National Referral Hospital Patients: Records of 1172 patients were reviewed. Results: An average 469 new patients per year or 11 new patients per clinic visit were seen at the clinic over a two and a half year period. Females predominated (98.9%) in this series. The mean age was 34.71 years (range 1 to 96 years). The average age at menarche was 14.49 years and the mean duration of symptoms was 6.86 months. Only 2.6% of 843 patients had a positive family history of breast disease. Fibroadenoma was the commonest diagnosis made (33.2%) followed by ductal carcinoma (19.7%). Gynaecomastia was the most common lesion seen in males. Two thirds of patients presenting with tumors had masses measuring more than 5cm.  Overall five conditions (fibroadenoma, ductal carcinoma, breast abscesses, fibrocystic disease and mastalgia) accounted for over 85% of all breast ailments. Surgery formed the main stay of care in over 80% of patients. Conclusions: The pattern of breast diseases at KNH closely mirrors those reported in other studies in the region and beyond. This study indicates that a large proportion of patients presenting with breast disease are treated initially by surgery. It may be wise to consider other alternative forms of therapy where appropriate. The Annals of African Surgery: 2008 June; Vol 2, pg 97-101.

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In Kenya the reported high rates of unwanted pregnancies (more than 90%), among adolescents have subsequently resulted in unsafely induced abortions with the associated high morbidity and mortality rates.
To evaluate the adolescents' behaviour regarding induced abortion.
A cross-sectional, prospective study done from July 1995 to June 1996.
Schools and health facilities in Kiambu and Nairobi districts in Kenya.
Interviews were conducted among adolescents aged 10-19 years in schools at the two districts and selected using a multi-stage random sampling procedure, as well as adolescent girls at two hospitals and two clinics in the immediate post-abortion period.
The number of adolescents health programmes, aimed at reducing the dangers of unsafely induced abortion, which are designed and subsequently implemented.
Demographic and health data, as well as data on behaviour regarding induced abortion were collected using a self-administered questionnaire.
The study sample comprised 1820 adolescents. These were 1048 school girls (SG), 580 school boys (SB) and 192 post-abortion (PA). Many adolescents were aware of abortion dangers, with the awareness being significantly lower among the SB whose girlfriends (GF) had aborted than those whose GF had not (p < 0.01). The practice of abortion was reported among 3.4% SG, 9.3% SBs' GF and 100% PA. Direct and indirect costs of abortion were heavy on the girls. Knowledge of the abortion dangers had no influence on the choice of the abortionist. Abortion encounter positively influenced approval by the adolescents, of abortion for pregnant school girls (p < 0.01).
Despite the costs and awareness of abortion dangers by adolescents, they will take risks

BACKGROUND: In Kenya the reported high rates of unwanted pregnancies (more than 90%), among adolescents have subsequently resulted in unsafely induced abortions with the associated high morbidity and mortality rates. OBJECTIVE: To evaluate the adolescents' behaviour regarding induced abortion. DESIGN: A cross-sectional, prospective study done from July 1995 to June 1996. SETTING: Schools and health facilities in Kiambu and Nairobi districts in Kenya. PARTICIPANTS: Interviews were conducted among adolescents aged 10-19 years in schools at the two districts and selected using a multi-stage random sampling procedure, as well as adolescent girls at two hospitals and two clinics in the immediate post-abortion period. MAIN OUTCOME MEASURES: The number of adolescents health programmes, aimed at reducing the dangers of unsafely induced abortion, which are designed and subsequently implemented. DATA COLLECTION: Demographic and health data, as well as data on behaviour regarding induced abortion were collected using a self-administered questionnaire. RESULTS: The study sample comprised 1820 adolescents. These were 1048 school girls (SG), 580 school boys (SB) and 192 post-abortion (PA). Many adolescents were aware of abortion dangers, with the awareness being significantly lower among the SB whose girlfriends (GF) had aborted than those whose GF had not (p < 0.01). The practice of abortion was reported among 3.4% SG, 9.3% SBs' GF and 100% PA. Direct and indirect costs of abortion were heavy on the girls. Knowledge of the abortion dangers had no influence on the choice of the abortionist. Abortion encounter positively influenced approval by the adolescents, of abortion for pregnant school girls (p < 0.01). CONCLUSION: Despite the costs and awareness of abortion dangers by adolescents, they will take risks.

BACKGROUND: In Kenya the reported high rates of unwanted pregnancies (more than 90%), among adolescents have subsequently resulted in unsafely induced abortions with the associated high morbidity and mortality rates. OBJECTIVE: To evaluate the adolescents' behaviour regarding induced abortion. DESIGN: A cross-sectional, prospective study done from July 1995 to June 1996. SETTING: Schools and health facilities in Kiambu and Nairobi districts in Kenya. PARTICIPANTS: Interviews were conducted among adolescents aged 10-19 years in schools at the two districts and selected using a multi-stage random sampling procedure, as well as adolescent girls at two hospitals and two clinics in the immediate post-abortion period. MAIN OUTCOME MEASURES: The number of adolescents health programmes, aimed at reducing the dangers of unsafely induced abortion, which are designed and subsequently implemented. DATA COLLECTION: Demographic and health data, as well as data on behaviour regarding induced abortion were collected using a self-administered questionnaire. RESULTS: The study sample comprised 1820 adolescents. These were 1048 school girls (SG), 580 school boys (SB) and 192 post-abortion (PA). Many adolescents were aware of abortion dangers, with the awareness being significantly lower among the SB whose girlfriends (GF) had aborted than those whose GF had not (p < 0.01). The practice of abortion was reported among 3.4% SG, 9.3% SBs' GF and 100% PA. Direct and indirect costs of abortion were heavy on the girls. Knowledge of the abortion dangers had no influence on the choice of the abortionist. Abortion encounter positively influenced approval by the adolescents, of abortion for pregnant school girls (p < 0.01). CONCLUSION: Despite the costs and awareness of abortion dangers by adolescents, they will take risks.

Pregnancy among adolescents is unplanned in many instances. Although some pregnant adolescents carry the pregnancy to term, abortion, in many instances unsafely induced, is a commonly sought solution in Kenya.
OBJECTIVE:
To determine adolescents' perceptions of induced abortion.
DESIGN:
A cross-sectional descriptive study carried out between July 1995 and June 1996.
SETTING:
An urban and a rural district in Kenya.
PARTICIPANTS:
Adolescents aged 10-19 years in schools in Nairobi and Kiambu districts, and a group of immediate post-abortion adolescent girls in some health facilities in Nairobi.
MAIN OUTCOME MEASURES:
The number of health programmes formulated and put into use, which are adolescent-friendly and providing information, education and communication on abortion issues.
DATA COLLECTION:
One thousand eight hundred and twenty adolescents were subjected to a self-administered questionnaire that collected demographic and health data as well as perceptions of induced abortion. Focus group discussions on perceptions of abortion were held with 12 groups of adolescents in schools and the information obtained recorded on paper and in a tape-recorder.
RESULTS:
One thousand nine hundred and fifty two adolescents, comprising of 1048 school girls (SG), 580 boys (SB), 192 post-abortion girls (PA) and 132 adolescents in the focus group discussions, formed the study sample. More than 90% were aware of induced abortion (IA). Knowledge of IA correlated positively with level of education (P < 0.01). Seventy one per cent of SG, 84% of PA and 40% of SB were aware of abortion-related complications, the most common being infections, death and infertility. Eighty three per cent of PA felt that complications were preventable by seeking care from a qualified doctor compared to one quarter each for the SB and SG. 56% PA, 69% SB and 72% SG felt that abortions were preventable. However, less than 40% proposed abstinence as a primary strategy. The most important source of information on abortion was the media followed by friends and teachers.
CONCLUSION:
Adolescents are aware of abortion and the related complications, but there is more variability in their knowledge and preventive measures.

BACKGROUND: Pregnancy among adolescents is unplanned in many instances. Although some pregnant adolescents carry the pregnancy to term, abortion, in many instances unsafely induced, is a commonly sought solution in Kenya. OBJECTIVE: To determine adolescents' perceptions of induced abortion. DESIGN: A cross-sectional descriptive study carried out between July 1995 and June 1996. SETTING: An urban and a rural district in Kenya. PARTICIPANTS: Adolescents aged 10-19 years in schools in Nairobi and Kiambu districts, and a group of immediate post-abortion adolescent girls in some health facilities in Nairobi. MAIN OUTCOME MEASURES: The number of health programmes formulated and put into use, which are adolescent-friendly and providing information, education and communication on abortion issues. DATA COLLECTION: One thousand eight hundred and twenty adolescents were subjected to a self-administered questionnaire that collected demographic and health data as well as perceptions of induced abortion. Focus group discussions on perceptions of abortion were held with 12 groups of adolescents in schools and the information obtained recorded on paper and in a tape-recorder. RESULTS: One thousand nine hundred and fifty two adolescents, comprising of 1048 school girls (SG), 580 boys (SB), 192 post-abortion girls (PA) and 132 adolescents in the focus group discussions, formed the study sample. More than 90% were aware of induced abortion (IA). Knowledge of IA correlated positively with level of education (P < 0.01). Seventy one per cent of SG, 84% of PA and 40% of SB were aware of abortion-related complications, the most common being infections, death and infertility. Eighty three per cent of PA felt that complications were preventable by seeking care from a qualified doctor compared to one quarter each for the SB and SG. 56% PA, 69% SB and 72% SG felt that abortions were preventable. However, less than 40% proposed abstinence as a primary strategy. The most important source of information on abortion was the media followed by friends and teachers. CONCLUSION: Adolescents are aware of abortion and the related complications, but there is more variability in their knowledge and preventive measures

BACKGROUND: Pregnancy among adolescents is unplanned in many instances. Although some pregnant adolescents carry the pregnancy to term, abortion, in many instances unsafely induced, is a commonly sought solution in Kenya. OBJECTIVE: To determine adolescents' perceptions of induced abortion. DESIGN: A cross-sectional descriptive study carried out between July 1995 and June 1996. SETTING: An urban and a rural district in Kenya. PARTICIPANTS: Adolescents aged 10-19 years in schools in Nairobi and Kiambu districts, and a group of immediate post-abortion adolescent girls in some health facilities in Nairobi. MAIN OUTCOME MEASURES: The number of health programmes formulated and put into use, which are adolescent-friendly and providing information, education and communication on abortion issues. DATA COLLECTION: One thousand eight hundred and twenty adolescents were subjected to a self-administered questionnaire that collected demographic and health data as well as perceptions of induced abortion. Focus group discussions on perceptions of abortion were held with 12 groups of adolescents in schools and the information obtained recorded on paper and in a tape-recorder. RESULTS: One thousand nine hundred and fifty two adolescents, comprising of 1048 school girls (SG), 580 boys (SB), 192 post-abortion girls (PA) and 132 adolescents in the focus group discussions, formed the study sample. More than 90% were aware of induced abortion (IA). Knowledge of IA correlated positively with level of education (P < 0.01). Seventy one per cent of SG, 84% of PA and 40% of SB were aware of abortion-related complications, the most common being infections, death and infertility. Eighty three per cent of PA felt that complications were preventable by seeking care from a qualified doctor compared to one quarter each for the SB and SG. 56% PA, 69% SB and 72% SG felt that abortions were preventable. However, less than 40% proposed abstinence as a primary strategy. The most important source of information on abortion was the media followed by friends and teachers. CONCLUSION: Adolescents are aware of abortion and the related complications, but there is more variability in their knowledge and preventive measures.

The controversy that has surrounded herbivory studi es in the last few decades prompted our investigati on to establish the extent to which herbivore optimisatio n hypothesis or compensatory growth evidence is rea l. We used the traditional movable cage method to collect primary productivity data on herbage, functional g roups and key individual grass species in various controlled large herbivore treatments in an east African savan na. The herbivore treatments in triplicate blocks included cattle, wild herbivores with and without mega herbi vores and combinations of cattle and wild herbivores also wit h and without mega herbivores. The findings reveale d that at herbage level, most grazed treatments (four out of five) had higher productivity than the ungrazed con trol and three showed grazing optimisation curve at sixth po lynomial degree between monthly productivity and gr azing intensity (1-g/ng). At functional group level forbs productivity was higher in the ungrazed control th an in any of the grazed treatments while at individual grass spe cies level Themeda triandra productivity was higher in all grazed treatments than in ungrazed control. We conc lude against presence of herbivore optimisation hyp othesis at herbage, functional group and species level beca use of lack of attributable grazing effect in graze d treatments that matches complex ecological effects in the ungr azed treatment.

The controversy that has surrounded herbivory studies in the last few decades prompted our investigation to establish the extent to which herbivore optimisation hypothesis or compensatory growth evidence is real. We used the traditional movable cage method to collect primary productivity data on herbage, functional groups and key individual grass species in various controlled large herbivore treatments in an east African savanna. The herbivore treatments in triplicate blocks included cattle, wild herbivores with and without mega herbivores and combinations of cattle and wild herbivores also with and without mega herbivores. The findings revealed that at herbage level, most grazed treatments (four out of five) had higher productivity than the ungrazed control and three showed grazing optimisation curve at sixth polynomial degree between monthly productivity and grazing intensity (1-g/ng). At functional group level forbs productivity was higher in the ungrazed control than in any of the grazed treatments while at individual grass species level Themeda triandra productivity was higher in all grazed treatments than in ungrazed control. We conclude against presence of herbivore optimisation hypothesis at herbage, functional group and species level because of lack of attributable grazing effect in grazed treatments that matches complex ecological effects in the ungrazed treatment.

OBJECTIVE: To find out whether frequent blood transfusions increase the risk of transfusion-related HIV infection in children with Sickle cell anaemia. METHODS: One hundred and ninety-eight children with Sickle cell anaemia were transfused 1-13 times (mean 2,4) between 1982 and 1987. In Kenya routine screening of blood banks for HIV infection began in 1987. The HIV status of these children was compared with 231 non-transfused children: 106 with Sickle cell anaemia and 125 children with haemoglobin AA. In both transfused and non-transfused children age ranges were similar and were 1-12 years. All children were tested with Wellcozyme Elisa test in duplicate. All tests were performed at least 6 months after the last transfusion. Sixty five transfused sicklers were rechecked one year later. RESULTS: All 429 children were HIV negative. CONCLUSIONS: Out findings suggest that HIV seropositivity is low in Kenyan children. Furthermore, even though blood was unscreened in 1982 - 1987 transfusion did not increase the risk of HIV infection in our study children

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The absolute configurations of two acyclic triterpenoids 1 and 2, previously isolated from the bark of Ekebergia capensis (Meliaceae) have been determined by the modified Mosher's method.

The role of pastoralist women in conflict resolution and management (study funded by SIDA though IMPACT)

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PMID: 614126 [PubMed - indexed for MEDLINE]

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Background: Marine invertebrates rely solely on innate immune mechanisms, the cellular component of which is characterized by hemocytes that phagocytize microbes and secrete soluble antimicrobial and cytotoxic substances. In this regard, marine invertebrates are a potential source of promising antimicrobial compounds with novel mechanisms of action. Objective: The objective of this study was to evaluate extracts of the gut, gonad, spines and mouth parts of the sea urchin Tripneustes gratilla for antimicrobial and haemolytic activities in vitro. Methods: Potentially bioactive metabolites were extracted using methanol and chloroform and tested for activity against Salmonella typhi, Escherichia coli, Shigella sonnei, Pseudomonas aeruginosa and Penicillium spp. using the agar disc diffusion method. Toxicity was determined by assaying for hemolysis against human red blood cells. Results: Bioactivity against the tested bacteria was observed mainly with the methanol and chloroform extracts of the gonads and gut. Higher antibacterial activity was present in the methanol extracts compared to chloroform extracts. Activity against the Penicillium spp was detected only in the methanol extracts, while the chloroform extracts showed no activity. The various extracts of the sea urchin lacked any detectable hemolytic activity against human erythrocytes. Discussion: These research findings suggest that marine echinoderms are a potential source of novel antimicrobial compounds. Key words: Tripneustes gratilla, antimicrobial activity, marine invertebrates

Clarithromycin is a 6-O-methylated semi-synthetic derivative of erythromycin A,
which is more resistant towards acid decomposition. Commercial clarithromycin
samples contain several potential impurities arising from the manufacturing process
and degradation. A simple, selective, and sensitive isocratic liquid chromatographic
method has been developed for the impurity profiling of clarithromycin bulk samples.
The method employs a XTerra RP18, 5 lm, 25064.6 mm column thermostated at
568C. The mobile phase consists of acetonitrile ± 0.2 M potassium phosphate buffer
pH 6.80 ± water (40 : 3.5 :56.5). Several peaks are of unknown identity. The method
is stability indicating.

Asiatic acid (AA) is a pentacyclic triterpene found in Centella asiatica. In the present study, the mechanism of anticancer effect of AA on skin cancer was investigated. AA decreased viability and induced apoptosis in human melanoma SK-MEL-2 cells in a time- and dose-dependent manner. AA also markedly increased intracellular reactive oxygen species (ROS) level and enhanced the expression of Bax but not Bcl-2 protein in the cells. In addition, AA-induced activation of caspase-3 activity in a dose-dependent manner. Pretreatment with Trolox, an antioxidant, significantly blocked the induction of Bax and activation of caspase-3 in AA-treated cells. Furthermore, Ac-DEVD-CHO, a specific caspase-3 inhibitor, and Trolox prevented the AA-induced apoptosis. AA did not elevate p53 nuclear protein levels that are present in a mutant form in SK-MEL-2 cells. These results suggest that AA-induced apoptosis may be mediated through generation of ROS, alteration of Bax/Bcl-2 ratio and activation of caspase-3, but p53-independent. These results further suggest that AA may be a good candidate for the therapeutic intervention of human skin cancer.

This report describes an investigation into the effect of oxamniquine on systemic clearance of theophylline in rat. Male Wister rats (N=12, 5 weeks old) were divide into 3 groups (N=4 per group) and administered buffer plus theophylline (10 mg/kg), controls, oxamniquine( 5 mg/kg), and theophylline (10 mg/kg) oxamniquine (20 mg/kg) intravenously. Theophylline clearance was estimated from a single plasma sample obtained 6 hours post drug administration. Oxamniquine had no effect on theophylline clearance compared to controls. It was concluded that clinically important interaction between oxamniquine and theophylline is unlikely to occur.

During the period 2000-2003, the Drug Analysis and Research Unit received and analyzed 33 samples of antiretroviral drugs. Locally manufactured products accounted for 57.6% of the samples, while the imported drugs constituted 42.4%. The drugs consisted of single, double and triple component preparations. They were subjected to identity, assay and dissolution tests. 30 samples (90.9%) complied with compendial specifications for these tests, while 3 failed. The results obtained show that the manufacture of quality generic antiretroviral drugs is achievable.

A study was conducted to determine the factors influencing plant-parasitic nematode occurrence, abundance and distribution in the sugarcane fields. Four sugarcane growing zones; Nzoia, Mumias, West Kenya and Busia of Kenya were selected from which 81 fields randomly selected and sampled. Soil samples were taken from sugarcane rhizospheres and nematodes extracted from 200 cm3 soil using the modified Baermann funnel technique. Nematodes were then fixed and mounted on slides and identified to genera level using identification keys. Nematodes of the genera Pratylenchus, Scutellonema and Meloidogyne were predominant in the sugarcane belt of western Kenya with mean densities of 61, 54 and 39, respectively. Nzoia, which falls in a marginal sugarcane zone harboured the highest proportion of these plant parasitic nematodes (55%), while West Kenya zone had the least proportion (4%). Soil texture influenced nematodes with more than 50% occurring in sandy soils compared to other soil types. Build-up of plant parasitic nematodes occurred with subsequent ratoon crops up to the second ratoon before declining in the third ratoon. Anthropogenic effects were significant with 70% higher numbers of plant parasitic nematodes in the out-grower farms compared to the factory-managed farms. This study has revealed the influence of soil texture, crop cycle and anthropogenic factors on abundance and distribution of plant parasitic nematodes in western Kenya sugarcane zones. It has also set the justification of further work to determine the economic importance of the nematodes

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

Innoculation of field pea is necessary in the absence of compatible rhizobial strains, when the rhizobial populations are low or symbiotically ineffective. The prevalence and efficacy of Rhizobium leguminosarum bv. viciae (the pea microsymbiont) in southern Manitoba soils is not known. Field experiments were conducted from 1998 to 2000 in multiple sites in southern Manitoba to characterize the abundance, efficacy, and diversity of indigenous R. leguminosarum bv. viciae. Uninoculated and inoculated (with and without N fertilizer) treatments of pea (Pisum sativum L.) were arranged in a randomized complete block design with four replicates in five sites (1999/2000). Pea was established in 21 sites in 1998 to trap indigenous rhizobia. Uninoculated and inoculated plants were evaluated for relative nodulation and growth. Pea and Lathyrus sp. isolates and commercial strains of R. leguminosarum bv. viciae were characterized by plasmid profile and polymerase chain reaction-restriction fragment length polymorphism of 16S-23S rDNA intergenic space analyses. Uninoculated plants were were nodulated in cultivated soils, but not in virgin soils. Inoculation had no effect on nodulation in all sites but one. Inoculated plants accumulated significantly more biomass than uninoculated plants in 1998 and in four of five sites in 2000. Out of 230 strains of R. leguminosarum bv. viciae typed, 77 distinct plasmid profiles were established. Plasmid profile diversity index (number of distinct profiles/number of isolates typed) varied from 0.2 to 0.83 in sites with 10 or more isolates. Few pea isolates from previously inoculated sites had profiles that matches those of the inoculants. Each site shared at least one profile with 3 to 18 other sites, but the number of profiles shared was independent of proximity... This research has shown that R. leguminosarum bv. viciae populations in southern Manitoba are abundant, diverse and competitive in nodulation, but may be less effective nitrogen fixers than commercial strains.

Hydro-distilled volatile oils from the leaves of Ocimum gratissimum L. (Lamiaceae) from Meru district in Eastern Kenya were analysed by gas chromatography-mass spectrometry (GC-MS) and also evaluated for antimicrobial activity. The oil was dominated by monoterpens which accounted for 92.48%. This monoterpene fraction was characterized by a high percentage of eugenol (68.8%). The other major monoterpenes were methyl eugenol (13.21%), cis-ocimene (7.47%), trans-ocimene (0.94%), β-pinene (1.10%) and camphor (0.95%). The sesquiterpenes present in fairly good amounts were germacrene D (4.25%) and trans-caryophyllene (1.69%). The minor sesquiterpenes were α-farnesene (0.85%) and β-bisabolene (0.74%). The antimicrobial activities of the essential oils were evaluated against both Gram positive (Staphylococcus aureus, Bacillus spp.) and Gram negative (Escherichia coli, Pseudomonas aeruginosae, Salmonella typhi, Klebisiella pneumoniae, Proteus mirabilis) bacteria and a pathogenic fungus Candida albicans. The oil had pronounced antibacterial and antifungal activities on all the microbes.

Hydro-distilled volatile oils from the leaves of Ocimum gratissimum L. (Lamiaceae) from Meru district in Eastern Kenya were analysed by gas chromatography-mass spectrometry (GC-MS) and also evaluated for antimicrobial activity. The oil was dominated by monoterpens which accounted for 92.48%. This monoterpene fraction was characterized by a high percentage of eugenol (68.8%). The other major monoterpenes were methyl eugenol (13.21%), cis-ocimene (7.47%), trans-ocimene (0.94%), β-pinene (1.10%) and camphor (0.95%). The sesquiterpenes present in fairly good amounts were germacrene D (4.25%) and trans-caryophyllene (1.69%). The minor sesquiterpenes were α-farnesene (0.85%) and β-bisabolene (0.74%). The antimicrobial activities of the essential oils were evaluated against both Gram positive (Staphylococcus aureus, Bacillus spp.) and Gram negative (Escherichia coli, Pseudomonas aeruginosae, Salmonella typhi, Klebisiella pneumoniae, Proteus mirabilis) bacteria and a pathogenic fungus Candida albicans. The oil had pronounced antibacterial and antifungal activities on all the microbes.

Hydro-distilled volatile oils from the leaves of Ocimum gratissimum L. (Lamiaceae) from Meru district in Eastern Kenya were analysed by gas chromatography-mass spectrometry (GC-MS) and also evaluated for antimicrobial activity. The oil was dominated by monoterpens which accounted for 92.48%. This monoterpene fraction was characterized by a high percentage of eugenol (68.8%). The other major monoterpenes were methyl eugenol (13.21%), cis-ocimene (7.47%), trans-ocimene (0.94%), β-pinene (1.10%) and camphor (0.95%). The sesquiterpenes present in fairly good amounts were germacrene D (4.25%) and trans-caryophyllene (1.69%). The minor sesquiterpenes were α-farnesene (0.85%) and β-bisabolene (0.74%). The antimicrobial activities of the essential oils were evaluated against both Gram positive (Staphylococcus aureus, Bacillus spp.) and Gram negative (Escherichia coli, Pseudomonas aeruginosae, Salmonella typhi, Klebisiella pneumoniae, Proteus mirabilis) bacteria and a pathogenic fungus Candida albicans. The oil had pronounced antibacterial and antifungal activities on all the microbes.

Hydro-distilled volatile oils from the leaves of Ocimum gratissimum L. (Lamiaceae) from Meru district in Eastern Kenya were analysed by gas chromatography-mass spectrometry (GC-MS) and also evaluated for antimicrobial activity. The oil was dominated by monoterpens which accounted for 92.48%. This monoterpene fraction was characterized by a high percentage of eugenol (68.8%). The other major monoterpenes were methyl eugenol (13.21%), cis-ocimene (7.47%), trans-ocimene (0.94%), β-pinene (1.10%) and camphor (0.95%). The sesquiterpenes present in fairly good amounts were germacrene D (4.25%) and trans-caryophyllene (1.69%). The minor sesquiterpenes were α-farnesene (0.85%) and β-bisabolene (0.74%). The antimicrobial activities of the essential oils were evaluated against both Gram positive (Staphylococcus aureus, Bacillus spp.) and Gram negative (Escherichia coli, Pseudomonas aeruginosae, Salmonella typhi, Klebisiella pneumoniae, Proteus mirabilis) bacteria and a pathogenic fungus Candida albicans. The oil had pronounced antibacterial and antifungal activities on all the microbes.

Hydro-distilled volatile oils from the leaves of Ocimum gratissimum L. (Lamiaceae) from Meru district in Eastern Kenya were analysed by gas chromatography-mass spectrometry (GC-MS) and also evaluated for antimicrobial activity. The oil was dominated by monoterpens which accounted for 92.48%. This monoterpene fraction was characterized by a high percentage of eugenol (68.8%). The other major monoterpenes were methyl eugenol (13.21%), cis-ocimene (7.47%), trans-ocimene (0.94%), β-pinene (1.10%) and camphor (0.95%). The sesquiterpenes present in fairly good amounts were germacrene D (4.25%) and trans-caryophyllene (1.69%). The minor sesquiterpenes were α-farnesene (0.85%) and β-bisabolene (0.74%). The antimicrobial activities of the essential oils were evaluated against both Gram positive (Staphylococcus aureus, Bacillus spp.) and Gram negative (Escherichia coli, Pseudomonas aeruginosae, Salmonella typhi, Klebisiella pneumoniae, Proteus mirabilis) bacteria and a pathogenic fungus Candida albicans. The oil had pronounced antibacterial and antifungal activities on all the microbes.

   

Hydro-distilled volatile oils from the leaves of Ocimum gratissimum L. (Lamiaceae) from Meru district in Eastern Kenya were analysed by gas chromatography-mass spectrometry (GC-MS) and also evaluated for antimicrobial activity. The oil was dominated by monoterpens which accounted for 92.48%. This monoterpene fraction was characterized by a high percentage of eugenol (68.8%). The other major monoterpenes were methyl eugenol (13.21%), cis-ocimene (7.47%), trans-ocimene (0.94%), β-pinene (1.10%) and camphor (0.95%). The sesquiterpenes present in fairly good amounts were germacrene D (4.25%) and trans-caryophyllene (1.69%). The minor sesquiterpenes were α-farnesene (0.85%) and β-bisabolene (0.74%). The antimicrobial activities of the essential oils were evaluated against both Gram positive (Staphylococcus aureus, Bacillus spp.) and Gram negative (Escherichia coli, Pseudomonas aeruginosae, Salmonella typhi, Klebisiella pneumoniae, Proteus mirabilis) bacteria and a pathogenic fungus Candida albicans. The oil had pronounced antibacterial and antifungal activities on all the microbes.

Twenty variceal banding sessions were performed in eight patients between February 1995 and September 1996. A total of 69 rings were used to band the varices and at each session between two to six rings were used. Two of the eight had active bleeding and both underwent variceal banding to successfully arrest their bleeding as inpatients. Sixteen other variceal banding sessions were performed on an outpatient basis to obliterate their varices. Four of the eight patients had had sclerotherapy before and varices were still present. No acute or long term complications were noted. In one patient, variceal banding could not be performed as he developed stridor upon placement of the overtube. All the patients had advanced varices (Grade III or IV) and extended for more than 15 cms in the oesophagus. Endoscopic variceal obliteration remains the treatment of choice for patients with portal hypertension with variceal bleeding. Variceal banding is associated with a superior outcome when compared with sclerotherapy; the variceal kill time is shorter, infective complications less, rebleeding occurs less commonly and transfusion requirements are lower.

Twenty variceal banding sessions were performed in eight patients between February 1995 and September 1996. A total of 69 rings were used to band the varices and at each session between two to six rings were used. Two of the eight had active bleeding and both underwent variceal banding to successfully arrest their bleeding as inpatients. Sixteen other variceal banding sessions were performed on an outpatient basis to obliterate their varices. Four of the eight patients had had sclerotherapy before and varices were still present. No acute or long term complications were noted. In one patient, variceal banding could not be performed as he developed stridor upon placement of the overtube. All the patients had advanced varices (Grade III or IV) and extended for more than 15 cms in the oesophagus. Endoscopic variceal obliteration remains the treatment of choice for patients with portal hypertension with variceal bleeding. Variceal banding is associated with a superior outcome when compared with sclerotherapy; the variceal kill time is shorter, infective complications less, rebleeding occurs less commonly and transfusion requirements are lower.

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;} The research sought to find out the extent to which mobile phone users were aware about safe disposal of mobile phones. In addition the research went ahead to establish the avenues available to mobile phone manufacturers and users in order to enhance safe mobile disposal through a survey.  The research revealed that there was the need for the mobile manufacturers to manufacture handsets from recyclable materials. The manufacturers should also avail information on handset disposal at the point of sale and do a follow-up using the available media. The mobile services providers can also play an important role on mobile phone disposal by availing the information on the face of the scratch cards. In addition they can notify the subscribers on the available disposal channels through text messages. The government through the designated agencies such as the Communications Commission of Kenya (CCK) and National Environmental Management Authority (NEMA) needs to be more assertive in mobile phone disposal measures. Key words: Recycle, Disposal; Mobile Phone; handsets; Environment; Design; Kenya

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The present studies were designed and carried out to determine if hydrogen peroxide (H2O2) is involved in the regulation of erythropoietin (Epo) gene expression and stimulation of Epo production in the hepatocellular (Hep 3B) cells. Hep 3B cells were incubated with varying concentrations of H2O2 for periods of 6 hours or 24 hours. In other experiments Hep 3B cells were incubated for 24 hours with or without increasing concentrations of catalase and in the presence of H2O2. Culture medium levels of Epo were determined and quantitation of Epo mRNA was also made. The results indicate that H2O2 increases the levels of Epo mRNA and Epo hormone production in Hep 3B cells, and that catalase, the specific scavenger of hydrogen peroxide, inhibits Epo production in these cells. Based on these findings, it is concluded that H2O2 takes part in the signal transduction mechanisms in Epo production. It is recommended that further studies be undertaken to find out the source of the hydrogen peroxide in the hepatocellular carcinoma cells.

This paper reports on a prospective study conducted between June 1990 and June 1992 to determine method acceptability, user satisfaction and continuation rates for three highly effective and reversible contraceptive methods currently available in Kenya: the CuT 380A (IUCD), the injectable, Depo-Provera and the low-dose oral contraceptive pill, Microgynon. A non-randomised sample of volunteer participants was used. One thousand and seventy-six users were followed up for a period of one year or up to the time of discontinuation of the method, whichever came earlier. Analysis revealed method specific differences in users' characteristics. The OC users were younger and had fewer children than the IUCD or Depo-Provera users. The Depo-Provera users were older, and had the largest family sizes. Many OC users (almost 40%) were single, while almost three-quarters of IUCD and Depo-Provera users were married. IUCD users were also more educated compared to OC and Depo-Provera users. Survival analysis was used to calculate cumulative life table discontinuation rates by method for the 12 month period. Discontinuation rates were highest for OC users (80%) and lowest for IUCD users (20%) and intermediate for Depo-Provera users (39%). Ninety percent of OC and Depo-Provera users and 86% of IUCD users said they were satisfied with their respective methods. While OCs are among the most popular family planning methods in Kenya, they are also one of the most problematic, while IUCD has the fewest compliance problems. Service providers need to address the issue of high discontinuation rates among the young OC users.
PIP:
This paper reports on a prospective study conducted between June 1990 and June 1992 to determine method acceptability, user satisfaction, and continuation rates for three highly effective and reversible contraceptive methods currently available in Kenya: the CuT 380A IUD; the injectable Depo-Provera; and the low-dose oral contraceptive Microgynon. A nonrandomized sample of volunteer participants was used. 1076 users were followed up for a period of 1 year or up to the time of discontinuation of the method, whichever came earlier. Analysis revealed method-specific differences in users' characteristics. The OC users were younger and had fewer children than the IUD or Depo-Provera users. The Depo-Provera users were older and had the largest family sizes. Many OC users (almost 40%) were single, while almost three-quarters of the IUD and Depo-Provera users were married. IUD users were also more educated compared to OC and Depo-Provera users. Survival analysis was used to calculate cumulative life table discontinuation rates by method for the 12-month period. Discontinuation rates were highest for OC users (80%), lowest for IUD users (20%), and intermediate for Depo-Provera users (39%). 90% of OC and Depo-Provera users and 86% of IUD users said they were satisfied with their respective methods. While OCs are among the most popular family planning methods in Kenya, they are also one of the most problematic, while IUDs have shown the fewest compliance problems. Service providers need to address the issue of high discontinuation rates among young OC users

Mucosal specimens are essential to evaluate compartmentalized immune responses to HIV vaccine candidates and other mucosally targeted investigational products. We studied the acceptability and feasibility of repeated mucosal sampling in East African clinical trial participants at low risk of HIV and other sexually transmitted infections.

Ogutu EO. A 10-year (1976-1986) retrospective study was done on 30 cases with histological diagnosis of pancreatic carcinoma. The male to female ratio was 1.3:1 and the peak incidence was in the 6th and 7th decades. The head of the pancreas was involved in 96% of cases while solid adenocarcinoma of duct cell origin accounted for 73.3% of cases, followed by anaplastic carcinoma (23.3%). The commonest complications were distinct metastasis (86.6%), obstructive jaundice (73.3%) and upper gastrointestinal bleed (13.6%).

This paper reports on a prospective study conducted between June 1990 and June 1992 to determine method acceptability, user satisfaction and continuation rates for three highly effective and reversible contraceptive methods currently available in Kenya: the CuT 380A (IUCD), the injectable, Depo-Provera and the low-dose oral contraceptive pill, Microgynon. A non-randomised sample of volunteer participants was used. One thousand and seventy-six users were followed up for a period of one year or up to the time of discontinuation of the method, whichever came earlier. Analysis revealed method specific differences in users' characteristics. The OC users were younger and had fewer children than the IUCD or Depo-Provera users. The Depo-Provera users were older, and had the largest family sizes. Many OC users (almost 40%) were single, while almost three-quarters of IUCD and Depo-Provera users were married. IUCD users were also more educated compared to OC and Depo-Provera users. Survival analysis was used to calculate cumulative life table discontinuation rates by method for the 12 month period. Discontinuation rates were highest for OC users (80%) and lowest for IUCD users (20%) and intermediate for Depo-Provera users (39%). Ninety percent of OC and Depo-Provera users and 86% of IUCD users said they were satisfied with their respective methods. While OCs are among the most popular family planning methods in Kenya, they are also one of the most problematic, while IUCD has the fewest compliance problems. Service providers need to address the issue of high discontinuation rates among the young OC users.
PIP:
This paper reports on a prospective study conducted between June 1990 and June 1992 to determine method acceptability, user satisfaction, and continuation rates for three highly effective and reversible contraceptive methods currently available in Kenya: the CuT 380A IUD; the injectable Depo-Provera; and the low-dose oral contraceptive Microgynon. A nonrandomized sample of volunteer participants was used. 1076 users were followed up for a period of 1 year or up to the time of discontinuation of the method, whichever came earlier. Analysis revealed method-specific differences in users' characteristics. The OC users were younger and had fewer children than the IUD or Depo-Provera users. The Depo-Provera users were older and had the largest family sizes. Many OC users (almost 40%) were single, while almost three-quarters of the IUD and Depo-Provera users were married. IUD users were also more educated compared to OC and Depo-Provera users. Survival analysis was used to calculate cumulative life table discontinuation rates by method for the 12-month period. Discontinuation rates were highest for OC users (80%), lowest for IUD users (20%), and intermediate for Depo-Provera users (39%). 90% of OC and Depo-Provera users and 86% of IUD users said they were satisfied with their respective methods. While OCs are among the most popular family planning methods in Kenya, they are also one of the most problematic, while IUDs have shown the fewest compliance problems. Service providers need to address the issue of high discontinuation rates among young OC users

A total of 138 households were interviewed on various aspects of camel milk and camel milk products using a single-visit multiple-subject diagnostic survey in Garisa, Wajir and Eastleigh the main urban centres with high camel milk consumption. 75% of the respondents generally take camel milk or milk products every day. Raw and sour milk are the most popular products. The most important purchasing criterion for raw camel milk was taste (19 and18%) while packaging was more important for pasteurized milk (18, 18 and 16%) for Wajir, Garisa and Eastleigh respectively. For Yoghurt, the most important purchasing criteria were taste (18%) and aroma (19%). The taste of sour milk is the most important attribute in both Garisa (30%) and Eastleigh (24%). To enhance marketing of camel milk, the appropriate attributes demanded by customers needs to be seriously addressed. Promotion of camel milk and products to non conventional consumers should be done in order to increase their consumption.

A total of 138 households were interviewed on various aspects of camel milk and camel milk products using a single-visit multiple-subject diagnostic survey in Garisa, Wajir and Eastleigh the main urban centres with high camel milk consumption. 75% of the respondents generally take camel milk or milk products every day. Raw and sour milk are the most popular products. The most important purchasing criterion for raw camel milk was taste (19 and18%) while packaging was more important for pasteurized milk (18, 18 and 16%) for Wajir, Garisa and Eastleigh respectively. For Yoghurt, the most important purchasing criteria were taste (18%) and aroma (19%). The taste of sour milk is the most important attribute in both Garisa (30%) and Eastleigh (24%). To enhance marketing of camel milk, the appropriate attributes demanded by customers needs to be seriously addressed. Promotion of camel milk and products to non conventional consumers should be done in order to increase their consumption.

A new impetus is emerging with regard to the potential role that agricultural producer associations might play in improving rural economies. For this study, the use of cereal banking to improve accessibility to premium markets was assessed and the factors influencing farmers' decisions to join them were evaluated. The methodology involved a baseline survey of 213 smallholder maize producers in Bungoma district, western Kenya, plus a logit model analysis to predict the probabilities of farmers joining a cereal bank. Membership of other local community-based organizations and the actual harvests achieved strongly influence farmers' decisions to join a cereal bank.

Introduction: In South Sudan few women have heard about the HIV. The prevalence of HIV infection in the country is 2.6%. Post abortion care (PAC) accounts for over 50% of all gynaecological admissions at the Juba Teaching Hospital (JTH). HIV testing is not routinely offered as part of PAC services.

Objective: To determine factors associated with acceptability of HIV testing among women receiving PAC at JTH.

Methods: This was a cross-sectional study, conducted at the Gynaecological Unit of JTH. Three hundred and forty patients were interviewed using a structured questionnaire.

Results: The mean age of the participants was 24.7 years with 50.5% aged <25years, 31.5% were employed, and 31.8% had no formal education. Acceptability of HIV testing was 70.9% and the prevalence of HIV was 2.7%. The most common reason for not accepting, was the belief, based on previous results, that they were HIV negative. Patients aged ≥25 years and those with primary and secondary education were twice as likely to accept HIV testing than those <25 years and those with no formal education, respectively. Employment status, religion and marital status were not statistically associated with acceptability of HIV testing. Patients previously tested for HIV were more likely to accept testing.

Conclusion: Routine HIV testing should be integrated into PAC services with efforts to increase awareness of HIV and importance of testing

Key words: HIV, abortion, post-abortion care, South Sudan

The factors responsible for the explosive spread of human immunodeficiency virus type 1 (HIV-1) in sub-Saharan Africa continue to be identified and debated. One of the most controversial factors has been male circumcision. This cross-sectional study was conducted to measure the association between circumcision status and infection with HIV-1 among men with genital ulcer disease. Eight hundred and ten men participated in the study, of whom 190 (23%) were HIV-1-positive. A logistic regression model adjusted for behavioral and historical showed that HIV-1 positivity was independently associated with being uncircumcised (adjusted odds ratio [OR], 4.8; 95% confidence interval [CI], 3.3-7.2) and with a history of urethral discharge (adjusted OR, 2.0; 95% CI, 1.4-2.8). This association could not be explained by measures of sexual exposure to HIV-1 among this population. Male circumcision should be considered as an intervention strategy for AIDS control.

Invasive cervical cancer (ICC) is common in areas where human immunodeficiency virus (HIV) is also prevalent. Currently, HIV seroprevalence as well as acceptability of HIV testing in ICC patients in Kenya is unknown. The objective of this study was to determine the acceptability of HIV testing among patients with ICC. Women with histologically verified ICC at Kenyatta National Hospital participated in the study. A structured questionnaire was administered to patients who gave informed consent. HIV pre- and posttesting counseling was done. Blood was tested for HIV using enzyme-linked immunosorbent assay. Overall, 11% of ICC patients were HIV seropositive. The acceptance rate of HIV testing was 99%; yet, 5% of the patients did not want to know their HIV results. Patients less than 35 years old were two times more likely to refuse the result of the HIV test (odds ratio [OR] 2.2). Patients who did not want to know their HIV results were three times more likely to be HIV seropositive (OR 3.1). Eighty four percent of the patients were unaware of their HIV seropositive status. The HIV-1 seroprevalence in ICC patients was comparable to the overall seroprevalence in Kenya. ICC patients were interested in HIV testing following pretest counseling. Offering routine HIV testing is recommended in ICC patients.

Invasive cervical cancer (ICC) is common in areas where human immunodeficiency virus (HIV) is also prevalent. Currently, HIV seroprevalence as well as acceptability of HIV testing in ICC patients in Kenya is unknown. The objective of this study was to determine the acceptability of HIV testing among patients with ICC. Women with histologically verified ICC at Kenyatta National Hospital participated in the study. A structured questionnaire was administered to patients who gave informed consent. HIV pre- and posttesting counseling was done. Blood was tested for HIV using enzyme-linked immunosorbent assay. Overall, 11% of ICC patients were HIV seropositive. The acceptance rate of HIV testing was 99%; yet, 5% of the patients did not want to know their HIV results. Patients less than 35 years old were two times more likely to refuse the result of the HIV test (odds ratio [OR] 2.2). Patients who did not want to know their HIV results were three times more likely to be HIV seropositive (OR 3.1). Eighty four percent of the patients were unaware of their HIV seropositive status. The HIV-1 seroprevalence in ICC patients was comparable to the overall seroprevalence in Kenya. ICC patients were interested in HIV testing following pretest counseling. Offering routine HIV testing is recommended in ICC patients.

Invasive cervical cancer (ICC) is common in areas where human immunodeficiency virus (HIV) is also prevalent. Currently, HIV seroprevalence as well as acceptability of HIV testing in ICC patients in Kenya is unknown. The objective of this study was to determine the acceptability of HIV testing among patients with ICC. Women with histologically verified ICC at Kenyatta National Hospital participated in the study. A structured questionnaire was administered to patients who gave informed consent. HIV pre- and posttesting counseling was done. Blood was tested for HIV using enzyme-linked immunosorbent assay. Overall, 11% of ICC patients were HIV seropositive. The acceptance rate of HIV testing was 99%; yet, 5% of the patients did not want to know their HIV results. Patients less than 35 years old were two times more likely to refuse the result of the HIV test (odds ratio [OR] 2.2). Patients who did not want to know their HIV results were three times more likely to be HIV seropositive (OR 3.1). Eighty four percent of the patients were unaware of their HIV seropositive status. The HIV-1 seroprevalence in ICC patients was comparable to the overall seroprevalence in Kenya. ICC patients were interested in HIV testing following pretest counseling. Offering routine HIV testing is recommended in ICC patients.

Invasive cervical cancer (ICC) is common in areas where human immunodeficiency virus (HIV) is also prevalent. Currently, HIV seroprevalence as well as acceptability of HIV testing in ICC patients in Kenya is unknown. The objective of this study was to determine the acceptability of HIV testing among patients with ICC. Women with histologically verified ICC at Kenyatta National Hospital participated in the study. A structured questionnaire was administered to patients who gave informed consent. HIV pre- and posttesting counseling was done. Blood was tested for HIV using enzyme-linked immunosorbent assay. Overall, 11% of ICC patients were HIV seropositive. The acceptance rate of HIV testing was 99%; yet, 5% of the patients did not want to know their HIV results. Patients less than 35 years old were two times more likely to refuse the result of the HIV test (odds ratio [OR] 2.2). Patients who did not want to know their HIV results were three times more likely to be HIV seropositive (OR 3.1). Eighty four percent of the patients were unaware of their HIV seropositive status. The HIV-1 seroprevalence in ICC patients was comparable to the overall seroprevalence in Kenya. ICC patients were interested in HIV testing following pretest counseling. Offering routine HIV testing is recommended in ICC patients.

Oyieke H.A. and Misra A.K:

Abstract

We studied the acceptability of isoniazid preventive therapy (IPT) in newly human immunodeficiency virus (HIV) infected Ugandan women. Women were followed in an out-patient clinic where they received HIV care including IPT. Of 52 women who were purified protein derivative-positive, 48 were eligible for IPT and 39 (81%) completed therapy. This completion rate was higher than reported in similar observational studies.

The prevalence of sexually transmitted infections (STIs) among female sex workers (FSWs) in sub-Saharan Africa remains high. Providing treatment to the affected FSWs is a challenge, and more so to their stable sexual partners. There is scanty research information on acceptance of STI treatment for stable sexual partners by FSWs. We conducted a study to assess acceptance of STI treatment for stable sexual partners by FSWs, and to identify factors associated with acceptance.

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On attainment of political independence in 1963, the Government of Kenya (GoK), households and the private sector collectively endeavoured to enhance the development of education in the country. The rapid development of education and training in Kenya was an aftermath of the Sessional Paper No. 10 of 1965 on African Socialism and its Application to Planning in Kenya, which emphasized combating ignorance, disease and poverty. It was based on two long-standing concerns that: (i) every Kenyan child, irrespective of gender, religion and ethnicity, has the inalienable right to access basic welfare provision, including education; and (ii) the GoK has an obligation to provide opportunity to all citizens to fully participate in socio-economic and political development of the country and also to empower the people to improve their welfare. Development of education since independence has been marked by various changes and challenges. For nearly four decades therefore, the sector has undergone several reviews by special commissions and working parties appointed by the government, with the aim of improving efficiency and effectiveness of the education provision.

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The identification of five novel compounds, pseudo-erythromycin A-6,9-hemiketal, 8,9-anhydro-pseudo-erythromycin A-6,9-hemiketal, 8,9-anhydro-pseudo-N-demethylerythromycin A-6,9-hemiketal, 5-O-beta-D-desosaminylerythronolide A and 15-nor-erythromycin C, in mother liquor concentrates of Streptomyces erythraeus is described. The pseudo-erythromycin derivatives are characterized by a 12-membered macrocyclic ring as a result of C13––C11 trans-lactonization. The five compounds have very little antimicrobial activity.

The increasing land scarcity and the worsening trend of poverty in Kenya in recent years have raised concerns about the focus on land-based agriculture as the basis of growth in the rural areas. This paper combines two complementary data sets obtained from two locations in Kenya, drawn against distinctively different land availability patterns, to examine the diverse rural asset base and key sources of livelihood in the rural areas. The analysis reveals that while access to productive land is still an important determinant of livelihoods in the rural areas, even where land holdings are very small, growth in farm productivity alone may not guarantee households sufficient incomes to escape poverty. We find evidence to suggest that growth of non-farm sector is necessary and may be much more important in reducing risks and vulnerability to poverty and should be equally emphasized if households in such regions are to escape poverty. Off-farm earnings accounted for at least 50 percent of total household incomes in the two research locations. The study further revealed existence of significant barriers to entry to remunerative livelihoods both at farm and off-farm level. The study advocates for expansion of educational services, infrastructure and strengthening of rural institutions to spur broad-based development in the rural areas.

The increasing land scarcity and the worsening trend of poverty in Kenya in recent years have raised concerns about the focus on land-based agriculture as the basis of growth in the rural areas. This paper combines two complementary data sets obtained from two locations in Kenya, drawn against distinctively different land availability patterns, to examine the diverse rural asset base and key sources of livelihood in the rural areas. The analysis reveals that while access to productive land is still an important determinant of livelihoods in the rural areas, even where land holdings are very small, growth in farm productivity alone may not guarantee households sufficient incomes to escape poverty. We find evidence to suggest that growth of non-farm sector is necessary and may be much more important in reducing risks and vulnerability to poverty and should be equally emphasized if households in such regions are to escape poverty. Off-farm earnings accounted for at least 50 percent of total household incomes in the two research locations. The study further revealed existence of significant barriers to entry to remunerative livelihoods both at farm and off-farm level. The study advocates for expansion of educational services, infrastructure and strengthening of rural institutions to spur broad-based development in the rural areas.

The increasing land scarcity and the worsening trend of poverty in Kenya in recent years have raised concerns about the focus on land-based agriculture as the basis of growth in the rural areas. This paper combines two complementary data sets obtained from two locations in Kenya, drawn against distinctively different land availability patterns, to examine the diverse rural asset base and key sources of livelihood in the rural areas. The analysis reveals that while access to productive land is still an important determinant of livelihoods in the rural areas, even where land holdings are very small, growth in farm productivity alone may not guarantee households sufficient incomes to escape poverty. We find evidence to suggest that growth of non-farm sector is necessary and may be much more important in reducing risks and vulnerability to poverty and should be equally emphasized if households in such regions are to escape poverty. Off-farm earnings accounted for at least 50 percent of total household incomes in the two research locations. The study further revealed existence of significant barriers to entry to remunerative livelihoods both at farm and off-farm level. The study advocates for expansion of educational services, infrastructure and strengthening of rural institutions to spur broad-based development in the rural areas.

No abstract available.

No abstract available.

Access, sources and value of new medical information: views of final year medical students at the University of Nairobi.
Gituma A, Masika M, Muchangi E, Nyagah L, Otieno V, Irimu G, Wasunna A, Ndiritu M, English M
OBJECTIVE: To evaluate final year medical students' access to new medical information.
METHOD: Cross-sectional survey of final year medical students at the University of Nairobi using anonymous, self-administered questionnaires.
RESULTS: Questionnaires were distributed to 85% of a possible 343 students and returned by 44% (152). Half reported having accessed some form of new medical information within the previous 12 months, most commonly from books and the internet. Few students reported regular access; and specific, new journal articles were rarely accessed. Absence of internet facilities, slow internet speed and cost impeded access to literature; and current training seems rarely to encourage students to seek new information.
CONCLUSION: Almost half the students had not accessed any new medical information in their final year in medical school. This means they are ill prepared for a career that may increasingly demand life-long, self-learning.

Trop Med Int Health. 2009 Jan;14(1):118-22. doi: 10.1111/j.1365-3156.2008.02209.x.

To evaluate final year medical students' access to new medical information.

Patients who have an accessory pathway (AP) of atrioventricular (AV) conduction may develop circus movement tachycardia otherwise known as atrioventricular re-entrant tachycardia (AVRT). Orthodromic AVRT is the most common form. It occurs as a result of antegrade conduction through the normal AV conduction system and retrograde conduction to the atria via the AP. Less commonly, conduction occurs in the opposite direction resulting in antidromic AVRT. Tachycardia may also involve multiple APs which may provide both antegrade and retrograde conduction and may alternate antegradely or retrogradely. Tachycardia may occur in which the AP simply acts as a bystander, and does not participate in the tachycardia mechanism. When atrial fibrillation is conducted to the ventricles via and AP, the resultant ventricular rate may be extremely rapid, placing the patient at risk of developing ventricular fibrillation and cardiac arrest. This paper reviews the anatomical and physiological substrates involved in the pathogenesis of AVRT. The acute and long-term management of patients who suffer from these arrhythmias will then be discussed. The normal AV annulus is composed exclusively of electrically inert fibrous tissue. The AV node and His bundle normally act as the sole route of electrical conduction. Accessory pathways occur at all points along the AV ring, and usually occur as isolated abnormalities, although a proportion of patients have associated congenital abnormalities. This is particularly true of right-sided APs. Most APs exhibit non-decremental conduction properties, and conduct faster than normal AV conduction tissue. In many patients with APs the surface ECG reveals clear evidence of pre-excitation, and a good idea of pathway localization is possible using one or more of several algorithms which have been developed. Patients with latent pre-excitation, intermittent pre-excitation, and patients with concealed APs have not evidence of pre-excitation on a proportion or all of Their surface ECGs. Patients present with a history of paroxysmal palpitations, often with associated symptoms such as chest discomfort Syncope is a rare presenting symptom. Unless bundle branch block is present, patients with orthodromic AVRT exhibit a narrow complex tachycardia on the surface ECG. Patients with pre-excited tachycardia including antidromic AVRT, and other forms of SVT in which the AP conducts to the ventricles as a bystander but does not participate in the tachycardias mechanism, present as broad complex tachycardias on the surface ECG which may be difficult to distinguish from ventricular tachycardia. Adenosine is increasingly used for this purpose since it is highly efficacious and has an extremely short half-life. Adenosine is also very useful in the diagnosis of broad-complex tachycardia, and in unmasking latent pre-excitation during sinus rhythm. Electrophysiology study in these patients is frequently performed at the same time as an attempt at catheter ablation; it aims to diagnose, localize and determine the functional characteristics of an AP, and to characterize the role of the pathway in tachycardia. AVRT can be reliably terminated by effective AV nodal blockade. Drug therapy for the prevention of AVRT is useful for temporary control whilst awaiting more definitive measures and in certain cases as long-term management. No class of drug stands out as 'therapy of choice', and physician preference, pro-arrhythmic effects and associated conditions need to be taken into account such that an individual choice can be made in each patient. The management of patients with AVRT has been revolutionized in recent years with the advent of catheter-based techniques for their cure. Whilst this method of treatment is highly effective and has low complication rates, pathways in particular locations such as the septal region remain challenging.

No abstract available.

Detailed information on the situation of youth in Africa is not available. There is increasing concern that large sections of young people have become marginalized or are excluded from education, healthcare, housing, leadership and even promotion of talent based activities such as arts and sports which has great potential in shaping up their livelihood status and their dignity.

For the poor youth in Africa, doing nothing is not an option at times of acute basic needs such as food, housing and clothing. Capitalistic nature and lack of supportive welfare systems in urban areas is compounding the survival of the youth. Most Government are now recognizing the important role played by youth. Sports and entertainment sector is becoming a beacon of hope for alleviating challenges facing the youth.

The Paper uses ethnographic approach- whose intent is provision of a detailed, in-depth description of youth in everyday life and practice.

Paper Presented in College Des Benardins in Paris, France on 23rd/8/2011. Proceedings of Paris 2011-Homeless World Cup Symposium.

In 2002 the Danish Minister of Environment initiated a process to investigate the possibilities of establishing national parks in Denmark. For this purpose experts were mobilised to investigate the status and potentials of the areas in question. The national park process was extensive in scope and complex, and in theory such complexity is assumed to make it difficult for non-experts to understand all the relevant aspects of policy. This exclusion of non-experts may lead to scientification of politics. Furthermore politicisation of science might occur as experts might advocate political interests disguised as objective science, and policy-makers might select results that further their own interests. As a result policy-makers risk losing a source of legitimacy, scientists risk losing credibility and the citizens risk losing the possibility to hold policy-makers accountable for their decisions, which puts democracy at risk. This paper examines the accountability relationships that experts were a part of in the national park process. These include accountability towards the employer, towards the buyer and towards the general public. The purpose is to determine if these relationships were adequate to circumvent the problems associated with scientification of politics and to discuss how accountability relationships and thereby democracy could be strengthened. The empirical analysis shows that in the national park process experts were mainly accountable towards the National Forest and Nature Agency. There were formal accountability relationships between the experts and the local steering committees and the national advisory group, but these relationships were less significant. Moreover, despite the fact that the process was deemed unusually open to the public by the participants, the relationship between experts and the public cannot be characterised as an accountability relationship and could have been improved by including experts in the deliberative fora of the process.

Despite multiple efforts to strengthen health systems in low and middle income countries, intended sustainable improvements in health outcomes have not been shown. To date most priority setting initiatives in health systems have mainly focused on technical approaches involving information derived from burden of disease statistics, cost effectiveness analysis, and published clinical trials. However, priority setting involves value-laden choices and these technical approaches do not equip decision-makers to address a broader range of relevant values - such as trust, equity, accountability and fairness - that are of concern to other partners and, not least, the populations concerned. A new focus for priority setting is needed. Accountability for Reasonableness (AFR) is an explicit ethical framework for legitimate and fair priority setting that provides guidance for decision-makers who must identify and consider the full range of relevant values. AFR consists of four conditions: i) relevance to the local setting, decided by agreed criteria; ii) publicizing priority-setting decisions and the reasons behind them; iii) the establishment of revisions/appeal mechanisms for challenging and revising decisions; iv) the provision of leadership to ensure that the first three conditions are met. REACT - "REsponse to ACcountable priority setting for Trust in health systems" is an EU-funded five-year intervention study started in 2006, which is testing the application and effects of the AFR approach in one district each in Kenya, Tanzania and Zambia. The objectives of REACT are to describe and evaluate district-level priority setting, to develop and implement improvement strategies guided by AFR and to measure their effect on quality, equity and trust indicators. Effects are monitored within selected disease and programme interventions and services and within human resources and health systems management. Qualitative and quantitative methods are being applied in an action research framework to examine the potential of AFR to support sustainable improvements to health systems performance. This paper reports on the project design and progress and argues that there is a high need for research into legitimate and fair priority setting to improve the knowledge base for achieving sustainable improvements in health outcomes.

Ogutu EO. A 10-year (1976-1986) retrospective study was done on 30 cases with histological diagnosis of pancreatic carcinoma. The male to female ratio was 1.3:1 and the peak incidence was in the 6th and 7th decades. The head of the pancreas was involved in 96% of cases while solid adenocarcinoma of duct cell origin accounted for 73.3% of cases, followed by anaplastic carcinoma (23.3%). The commonest complications were distinct metastasis (86.6%), obstructive jaundice (73.3%) and upper gastrointestinal bleed (13.6%).

Journal of the Institute of Certified Public Accountants of Kenya. (pages 13-15)

Journal of the Institute of Certified Public Accountants of Kenya. (pages 13-15)

No abstract available

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Journal of the Institute of Certified Public Accountants of Kenya. (pages 13-15)

Journal of the Institute of Certified Public Accountants of Kenya. (pages 13-15)

Journal of the Institute of Certified Public Accountants of Kenya. (pages 13-15)

Journal of the Institute of Certified Public Accountants of Kenya. (pages 13-15)

Journal of the Institute of Certified Public Accountants of Kenya. (pages 13-15)

Journal of the Institute of Certified Public Accountants of Kenya. (pages 13-15)

Journal of the Institute of Certified Public Accountants of Kenya. (pages 13-15)

Journal of the Institute of Certified Public Accountants of Kenya. (pages 13-15)

No abstract available

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Journal of the Institute of Certified Public Accountants of Kenya. (pages 13-15)

Journal of the Institute of Certified Public Accountants of Kenya. (pages 13-15)

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Fluoride in plant and vegetable samples has beendetermined using the ion selective electrode.The analysis was carried out after ashingthe samples onan open flame, adding perchloric acid and allowing the hydrogen fluoride to diffuse into a sodium hydroxide layer. The results obtained show that kale and pumpkins can accumulate more than ten times their normal values of fluoridewhile plants were found to accumulate upto 100 ug/g fluoride when exposed to high levels of fluoride in water or soil.

Accumulation, distribution and metabolism of ring labelled, "C-1,1,1, - trichloro-2,2-bis(p-chlorophenyl)ethane (p,p'-DDT) in a model marine aquatic ecosystem consisting of sea water, sediment, oysters (Isognomonon alatus) and Humbug fish (Dascillus aruanus) were studied in the laboratory. "C-p,p'-DDT distributes rapidly in the ecosystem immediately after application on the water surface with reduction of its concentration in the water phase from 1.18 ng g"1 to 0.71 ng g'after 2 hours and an increase in its content in the sediment and oysters. The bioconcentration factor reached a maximum of 19x 10* in oysters, and 1657 in Humbug fish after 24 hours. The sediment concentration reached 117 ng g"1 after 168 hours from start of application. A peak bioconcentration factor of 111 x 103 was calculated after 120 hours when 0.24 mg kg"1 of '^>p,p'-DDT was maintained through dosing every 24 hours with 0.002 mg kg' of a mixture of labelled and non-labelled pesticide. The rate of depuration of accumulated "C-p,p'-DDT sediment residues was up to 78.3% after 24 hours while oysters lost only 14.0% during the same period. The loss in Humbug fish was only 22.2% in three days. Volatilisation and sorption losses from seawater alone (without sediment/biota) were found to be very high in the range of 73.8 - 91.5% over 24 h for p,p'-DDT in aerated and non-aerated ecosystem. Gas chromatograph and TLC analysis of water, sediment and oyster samples revealed presence of p,p'-DDT and substantial amounts of p,p'-DDE and p,p'-DDD three days after pesticide dosage.

The world is today faced with the global pandemic of HIV/AIDS that has evolved rapidly since it was first described. The pandemic has been termed the greatest development challenge for sub Saharan Africa and is rapidly evolving in the Asian continent. The pandemic ha had a significantly negative impact on individual families through loss of loved ones, communities by increasing the burden of caring for the ill, and countries through reduced productivity.     As we look forward to the 21st century, the human population is reminded that even in an age where drugs to treat most ailments are available, human behaviour and individual aspirations are critical in the control of disease. Factors that affect human and social behaviour, such as poverty, discrimination and disenfranchisement have to be addressed on a global basis if the HIV/AIDS epidemic is to be controlled. The HIV/AIDS epidemic presents special challenges and new frontiers for public health interventions and research. HIV/AIDS has revealed the gaps in the understanding of how human behaviour is motivated and how it can be changed.     In this publication we present a review of some of the programs that are specifically targeting the youth with HIV/AIDS prevention activities in the countries of   This publication records the stories of men and women in Eastern Africa, who have tremendous commitment to the work they do even with minimal resources, because they have a vision for the youth of the African continent. It is a story of innovation, creativity, determination and partnership between adults and youth, communities and governments, countries, aid agencies and NGOSs.

We tested the practical application of an anaemia scoring chart (the FAMACHA© chart) as a method for controlling Haemonchus contortus in goats kept under smallholder conditions in a sub-humid area of Central Kenya. The objectives were: (1) to test the accuracy of the FAMACHA© chart in identifying anaemic goats (PCV ≤ 18); (2) to quantify the proportion of goats left untreated at farm level when using the chart. On each of two farms, Small East African goats of various ages were allocated to two treatment groups; a FAMACHA© group (F1 (n = 34) and F2 (n = 31) on farms 1 and 2, respectively) and a control group (C1 (n = 34) and C2 (n = 30)). In F1 and F2 goats with a FAMACHA© score of 3, 4 or 5 were treated with anthelmintic after scoring. In C1 and C2 goats were treated every 4 weeks from 15 February to 20 July. Every 2 weeks all goats were scored with the FAMACHA© chart and weighed. Furthermore, faecal samples were collected for faecal egg counts (FEC) and blood samples were collected for packed cell volume (PCV) determination. H. contortus was found to be the predominant nematode on both farms. The mean FECs were higher on farm 1 compared to farm 2, while in contrast the mean PCV levels were lowest on farm 2. The latter was most likely due to the presence of Fasciola spp., flea and tick infections on farm 2. The accuracy of the chart was evaluated by using PCV as the gold standard for anaemia (PCV ≤ 18%). The mean percentage of false-negative scorings per sampling was 0.7% on farm 1 and 1.6% on farm 2, while the mean percentage of false-positive scorings was 9.7% and 21.4%, respectively. It is most likely that the accuracy of the chart was negatively affected by the concurrent parasite infections on farm 2. The mean proportion of untreated goats per sampling was 89% and 77% on farm 1 and farm 2. It was concluded that the FAMACHA© chart can be a valuable tool for decision-making in control of H. contortus in goats kept under smallholder conditions, without morbidity or mortality unacceptable to the farmer. The application may further reduce the risk of development of anthelmintic resistance by increasing refugia. However, caution should be taken under conditions where other anaemia-causing parasites are present (e.g. Fasciola spp. and ecto-parasites), since this possibly decreases the accuracy of the FAMACHA© chart

Abstract:
We tested the practical application of an anaemia scoring chart (the FAMACHA© chart) as a method for controlling Haemonchus contortus in goats kept under smallholder conditions in a sub-humid area of Central Kenya. The objectives were: (1) to test the accuracy of the FAMACHA© chart in identifying anaemic goats (PCV ≤ 18); (2) to quantify the proportion of goats left untreated at farm level when using the chart. On each of two farms, Small East African goats of various ages were allocated to two treatment groups; a FAMACHA© group (F1 (n = 34) and F2 (n = 31) on farms 1 and 2, respectively) and a control group (C1 (n = 34) and C2 (n = 30)). In F1 and F2 goats with a FAMACHA© score of 3, 4 or 5 were treated with anthelmintic after scoring. In C1 and C2 goats were treated every 4 weeks from 15 February to 20 July. Every 2 weeks all goats were scored with the FAMACHA© chart and weighed. Furthermore, faecal samples were collected for faecal egg counts (FEC) and blood samples were collected for packed cell volume (PCV) determination. H. contortus was found to be the predominant nematode on both farms. The mean FECs were higher on farm 1 compared to farm 2, while in contrast the mean PCV levels were lowest on farm 2. The latter was most likely due to the presence of Fasciola spp., flea and tick infections on farm 2. The accuracy of the chart was evaluated by using PCV as the gold standard for anaemia (PCV ≤ 18%). The mean percentage of false-negative scorings per sampling was 0.7% on farm 1 and 1.6% on farm 2, while the mean percentage of false-positive scorings was 9.7% and 21.4%, respectively. It is most likely that the accuracy of the chart was negatively affected by the concurrent parasite infections on farm 2. The mean proportion of untreated goats per sampling was 89% and 77% on farm 1 and farm 2. It was concluded that the FAMACHA© chart can be a valuable tool for decision-making in control of H. contortus in goats kept under smallholder conditions, without morbidity or mortality unacceptable to the farmer. The application may further reduce the risk of development of anthelmintic resistance by increasing refugia. However, caution should be taken under conditions where other anaemia-causing parasites are present (e.g. Fasciola spp. and ecto-parasites), since this possibly decreases the accuracy of the FAMACHA© chart.

This study aimed to estimate the level of relatedness within Ankole cattle herds using autosomal microsatellite markers and to assess the accuracy of relationship assignment based on farmers' memory. Eight cattle populations (four from each of two counties in Mbarara district in Uganda) were studied. Cattle in each population shared varying degrees of relatedness (first-, second- and third-degree relatives and unrelated individuals). Only memory-based kinship assignments which farmers knew with some confidence were tested in this experiment. DNA isolated from the blood of a subsample of 304 animals was analysed using 19 microsatellite markers. Average within population relatedness coefficients ranged from 0.010 ± 0.005 (Nshaara) to 0.067 ± 0.004 (Tayebwa). An exclusion probability of 99.9% was observed for both sire-offspring and dam-offspring relationships using the entire panel of 19 markers. Confidence from likelihood tests performed on 292 dyads showed that first-degree relatives were more easily correctly assigned by farmers than second-degree ones (p < 0.01), which were also easier to assign than third-degree relatives (p < 0.01). Accuracy of kinship assignment by the farmers was 91.9% ± 5.0 for dam-offspring dyads, 85.5% ± 3.4 for sire-offspring dyads, 75.6% ± 12.3 for half-sib and 60.0% ± 5.0 for grand dam-grand offspring dyads. Herd size, number of dyads assigned and length of time spent by the herder with their cattle population did not correlate with error in memorizing relationships. However, herd size strongly correlated with number of dyads assigned by the herder (r = 0.967, p < 0.001). Overall, we conclude that memorized records of pastoralists can be used to trace relationships and for pedigree reconstruction within Ankole cattle populations, but with the awareness that herd size constrains the number of kinship assignments remembered by the farmer.

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This paper investigates the possibilities of applying emerging management theories and techniques to constitutionally created offices in Kenya and East African region. The benefits from application of these theories, particularly in the judicial services are highlighted.