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From the root bark of Erythrina burttii three isoflav-3-enes, 7,4′-dihydroxy-2′-methoxy-6-(1″,1″-dimethylallyl)isoflav-3-ene (trivial name, burttinol-A), 4′-hydroxy-2′-methoxy-2″,2″-dimethylpyrano[5″,6″:8,7]isoflav-3-ene (trivial name, burttinol-B), 7,4′-dihydroxy-2′-methoxy-8-(3″,3″-dimethylallyl)isoflav-3-ene (trivial name, burttinol-C), and 2-arylbenzofuran, 6,4′-dihydroxy-2′-methoxy-5-(1″,1″-dimethylallyl)-2-arylbenzofuran (trivial name, burttinol-D) were isolated. In addition, the known compounds, abyssinone V-4′-methyl ether, bidwillol A, calopocarpin, erybraedin A, erythrabyssin II, isobavachalcone, phaseollidin and phaseollin were identified. The structures were determined on the basis of spectroscopic evidence.

From the leaves of Buxus hildebrandtii three new steroidal alkaloids have been isolated and their structures determined by spectroscopic analysis. The following derived names have been suggested for these new alkaloids: O(30)-benzoyl-16-deoxybuxidienine-C, 30-hydroxybuxamine-A and 30-norbuxamine-A. In addition the known alkaloids cyclomicrobuxamine, buxamine-A, cyclobuxoviridine, moenjodaramine, buxamine-C and cyclorolfeine were also isolated.

A novel triple co-culture model of the human airway barrier was designed to simulate the cellular part of the air–blood barrier of the respiratory tract represented by macrophages, epithelial cells, and dendritic cells. When epithelial cells (A549 cells) were grown on filter inserts with pores of 3.0 m in diameter in a two-chamber system, they formed monolayers with polarization into apical and basolateral domains. The epithelial cell cultures were then supplemented with human blood monocyte–derived macrophages and dendritic cells on the apical and basal aspect, respectively. The single-cell cultures as well as the triple co-cultures were characterized in terms of a number of typical features, for example, morphology of cell types, integrity of epithelial layer, and expression of specific cell surface markers (CD14 for macrophages and CD86 for dendritic cells). The interplay of epithelial cells with macrophages and dendritic cells during the uptake of polystyrene particles (1 m in diameter) was investigated with confocal laser scanning and conventional transmission electron microscopy. Particles were found in all three cell types, although dendritic cells were not directly exposed to the particles. More investigations are needed to understand the translocation pathway

The anatomy of the domestic duck lung was studied macroscopically, by casting and by light, transmission, and scanning electron microscopy. The lung had four categories of secondary bronchi (SB), namely, the medioventral (MV, 4-5), laterodorsal (LD, 6-10), lateroventral (LV, 2-4), and posterior secondary bronchi (PO, 36-44). The neopulmonic parabronchi formed an intricate feltwork on the ventral third of the lung and inosculated those from the other SB. The lung parenchyma was organized into cylindrical parabronchi separated by thin septa containing blood vessels. Atria were shallow and well-fortified by epithelial ridges reinforced by smooth muscle bundles and gave rise to 2-6 elongate infundibulae. Air capillaries arose either directly from the atria or from infundibulae and were tubular or globular in shape with thin interconnecting branches. The newly described spatial disposition of the conducting air conduits closely resembles that of the chicken. This remarkable similarity between the categories, numbers, and 3D arrangement of the SB in the duck and chicken points to a convergence in function-oriented design. To illuminate airflow dynamics in the avian lung, precise directions of airflow in the various categories of SB and parabronchi need to be characterized.

Background: Despite constant monitoring of anticoagulation in prosthetic valve patients, haematologic complications occur. This study documented the occurrence of such complications and associated risk factors at the Kenyatta National Hospital (KNH).
Study design: Observational study reviewing 142 patients, 39 prospective and 103 retrospective.
Outcome measures: International Normalised Ratio (INR); presence of signs and symptoms of haematological complications.
Results: Forty four (31%) patients presented with bleeding tendencies, 28 grade I and 4 grade III. The most common thromboembolic complication was headache in 33 (23.2%) patients. Mean duration of anticoagulation for patients with complications was 82.9 months (± 64), compared to 60.8 months (± 43.8) in those without. Nine patients were non-compliant in taking medications, haematologic complications presenting in 8 of them.
Conclusion: A positive association was established between hematologic complications and INR levels, duration of anticoagulation therapy, non-compliance in taking of medications, and increased period between clinic visits. Of these only the duration of anticoagulation was an independent predictor for haematological complications.

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.

Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt: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","serif";} Products of gene modification have vast implications. Creating public awareness and disseminating information on the subject seeks to demystify some of the widely held falsehoods regarding genetically modified products. This is an informative, thorough and easy to understand guidebook that aims to enlighten and debunk some of the commonly held misconceptions on products of gene modification and to give the reader a better understanding of the role genetic modification will play. The review sheds light on the safety, and application of these products in medicine, the food industry and other areas, especially those where genetic modification may represent a cheap, faster, credible, viable alternative in achieving sustainable development among resource-poor communities.

PMID: 614126 [PubMed - indexed for MEDLINE]

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

No abstract available.

ABSTRACT.
Although it has been said that local symptoms are uncommon and that large goiters are oftenwell tolerated ( Sloan,1971), this is not true of our patients.Pressure effects may depend upon size and position of the the gland but asymmetry of nodular thyroid and strong anterior neck muscles and fasciamay cause severe compression or deviation of the trachea. In KNH,Nairobi, we have been truck by the frequency of the pressure symptoms caused by these goiter weighing less than 100gms
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To assess the thyroid function among Human Immunodeficiency Virus (HIV)/ Acquired Immunodeficiency Syndrome (AIDS) patients on anti-retroviral drugs: stavudine, lamivudine and nevirapine and to establish the prevalence of non-thyroid illness. Design: Laboratory based comparative cross-sectional study. Setting: Comprehensive care clinics at KNH and Mbagathi District Hospital. Subjects: Eighty four HIV-infected patients on treatment with ARVs (ARV +ve) and an ARV naive (ARV naive) group of 26 HIV-infected patients. Results: Thyroid stimulating hormone levels were not altered following treatment whereas the levels of FT4 decreased. The frequency of those with low FT4 were increasing with continued ARV use. The prevalence of non-thyroidal illness state defined by TSH within reference ranges and low FT4 was comparable among the ARV +ve and ARV naive groups (44 and 46% respectively). Conclusion: Progressive use of HAART causes decline in FT4 hormone levels. It is debatable whether interventions for low FT4 is necessary in ARV treatment but a longitudinal study would explain the progressive trend of thyroid hormones and implications with HAART treatment. The prevalence of NTI is comparable to both HAART users and non-users. Low levels of thyroid hormone (FT 4) may be an adaptive response by thyroid gland to minimize calorie utilisation as in chronic diseases

To assess the thyroid function among Human Immunodeficiency Virus (HIV)/ Acquired Immunodeficiency Syndrome (AIDS) patients on anti-retroviral drugs: stavudine, lamivudine and nevirapine and to establish the prevalence of non-thyroid illness. Design: Laboratory based comparative cross-sectional study. Setting: Comprehensive care clinics at KNH and Mbagathi District Hospital. Subjects: Eighty four HIV-infected patients on treatment with ARVs (ARV +ve) and an ARV naive (ARV naive) group of 26 HIV-infected patients. Results: Thyroid stimulating hormone levels were not altered following treatment whereas the levels of FT4 decreased. The frequency of those with low FT4 were increasing with continued ARV use. The prevalence of non-thyroidal illness state defined by TSH within reference ranges and low FT4 was comparable among the ARV +ve and ARV naive groups (44 and 46% respectively). Conclusion: Progressive use of HAART causes decline in FT4 hormone levels. It is debatable whether interventions for low FT4 is necessary in ARV treatment but a longitudinal study would explain the progressive trend of thyroid hormones and implications with HAART treatment. The prevalence of NTI is comparable to both HAART users and non-users. Low levels of thyroid hormone (FT 4) may be an adaptive response by thyroid gland to minimize calorie utilisation as in chronic diseases

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ABSTRAC
A three-year (1974-1977) retrospective study of 163 patients with goiter and signs of thyrotoxicosis was carried out.Of thesepatients, 65 (40%) had confirmed thyrotoxicosis,the rest were euthyroid.Kungu(1) reported 36 cases histologically diagnosed over a period of 5 years(1967-1971).Gitau in a six year study1968-1973) REPORTED 148 cases.This suggests that thyrotoxicosis is on the increase at KNH.One the reasons for the increase may be that the patients are becoming more aware of the disease and therefore reporting to the hospital for treatment.The second reason is that the doctors are increasingly interested in the disease.Thirdly, the introduction of iodised domestic salt may cause some patients to become toxic (iodine stimulation).The majority of patients were treated with antithyroid drugs;if they relapsed or did not respond to medical therpy, surgery or radio iodine were the next methods of treatment.

Tick-borne diseases are an important cause of morbidity and occasionally mortality, with infection usually passing zoonotically from animal hosts to humans. The nature and extent of tick-borne disease can change in distribution as a result of changes in habitat, vectors and reservoirs, as well as through host population movement and alterations in agricultural, industrial and leisure activities. The diseases are also sensitive to climate and may therefore either decrease or increase under the effects of climate change. These dynamically changing patterns of disease, along with increased international travel, mean that medical practitioners need to be aware of the potential diagnosis of tick-borne disease as there can be serious clinical consequences of misdiagnosis or delayed detection.

Description: This book describes four types of indigenous water retention structures used in East Africa. These structures are the Berkad tank, the Charco dam, sand wiers and hillside water retention ditches.

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

Time course investigation of infection with a low virulent Pasteurella multocida strain in normal and immune-suppressed 12 week-old free range chickens

P. G. Mbuthiaa, L. W. Njagia, P. N. Nyagaa, L. C. Beboraa, U. Mingab, Jens Peter Christensenc & J. E. Olsenc*

Date of publication: DOI:10.1080/03079457.2011.623298; Available online: 15 Sep 2011
Avian Pathology
Abstract
Twelve week old indigenous chickens, either immune-suppressed using dexamethasone (IS) or non-immune-suppressed (NIS), were challenged with a low virulent strain, Pasteurella multocida strain NCTC 10322T and developed clinical signs and pathological lesions typical of chronic fowl cholera. NIS birds demonstrated much more severe signs of fowl cholera than IS birds. With few exceptions, signs recorded in IS and NIS birds were of the same types, but significantly milder in the IS birds, indicating that immune-suppression does not change the course of infection, but rather the severity of signs in fowl cholera.
P. multocida signals by fluorescent in situ hybridization (FISH) were observed between 1 hr and 14 days in lungs, trachea, air sacs, liver, spleen, bursa of Fabricius and caecal tonsils, while signals from other organs mostly were observed after 24 hours. More organs had FISH signals in NIS than in IS-birds and at higher frequency per organ. Many organs were positive by FISH even 14 days post infection, and it is suggested that these organs may be likely places for long term carriage of P. multocida following infection.
This study has demonstrated the spread of P. multocida in different tissues in chickens and distribution of lesions associated with chronic fowl cholera, and pointed to a decrease of pathology in immune-suppressed birds. Since dexamethasone mostly affects heterophils, the study suggests that these cells play a role in the development of lesions associated with chronic fowl cholera in chickens.

of satellite observations is that measurements are readily collected and shared across
political boundaries. In contrast, many countries refuse to share ground-based hydrologic
measurements for socioeconomic and political reasons, whereas others simply lack the
capacity to centralize and digitize what data are collected. This impedes investigations on a
continental-to-global scale, as well as efforts to avert food and water crises. Because
satellites can monitor water resources at scales relevant to effective transboundary water
management and because data are often provided through freely accessible digital
archives, policies of international data denial may ultimately become obsolete (17).
Governments around the world are now instructing their water management agencies to
plan for the uncertain hydrologic future that satellite observations have helped reveal.

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While voluntary medical male circumcision (VMMC) has been shown to be protective against HIV-acquisition, the procedure may place men and their partners at risk of HIV infection in the period following circumcision if sex is resumed before the wound is healed. This prospective cohort study evaluates post-circumcision wound healing to determine whether the 42-day post-circumcision abstinence period, recommended by the World Health Organization and adopted by VMMC programs, is optimal. Methods and Findings Men were circumcised by forceps-guided method and their post-circumcision wounds examined weekly for seven weeks and at 12 weeks. Time to complete healing was recorded in completed weeks since circumcision, and its associations with baseline covariates were assessed by Kaplan-Meier methods and Cox Proportional Hazard Models. A total of 215 HIV-negative and 108 HIV-positive men aged 18–35 years (median 26, IQR 23–30) were enrolled. 97.1% of scheduled follow-up visits were completed. At week 4, 59.3% of HIV-positive men and 70.4% of age-matched HIV-negative men were healed. At week 6, these percentages rose to 93.4% in HIV-positive men and 92.6% in age-matched HIV-negative men. There was no difference in the hazard of healing between 108 HIV-positive and 108 age-matched HIV-negative men (HR 0.91 95% CI 0.70–1.20). Early post-operative infection was associated with delayed healing in both HIV-positive and HIV-negative men (HR 0.48 95% CI 0.23–1.00). Conclusions Our results indicate that the WHO recommendation for 42-days post-circumcision sexual abstinence should be maintained for both HIV-positive and HIV-negative men. It is important to stress condom use upon resumption of sex in all men undergoing circumcision.

Twelve-week-old indigenous chickens, either immune-suppressed using dexamethasone (IS) or non-immunesuppressed (NIS), were challenged with a low virulent strain, Pasteurella multocida strain NCTC 10322T, and developed clinical signs and pathological lesions typical of chronic fowl cholera. NIS birds demonstrated much more severe signs of fowl cholera than IS birds. With few exceptions, signs recorded in IS and NIS birds were of the same types, but significantly milder in the IS birds, indicating that immune suppression does not change the course of infection but rather the severity of signs in fowl cholera. P. multocida signals by fluorescent in situ hybridization (FISH) were observed between 1 h and 14 days in the lungs, trachea, air sacs, liver, spleen, bursa of Fabricius and caecal tonsils, while signals from other organs mostly were observed after 24 h. More organs had FISH signals in NIS birds than in IS birds and at higher frequency per organ. Many organs were positive by FISH even 14 days post infection, and it is suggested that these organs may be likely places for long-term carriage of P. multocida following infection. The present study has demonstrated the spread of P. multocida in different tissues in chickens and distribution of lesions associated with chronic fowl cholera, and pointed to a decrease of pathology in IS birds. Since dexamethasone mostly affects heterophils, the study suggests that these cells play a role in the development of lesions associated with chronic fowl cholera in chickens.

The effect of paroxetine on the day--night variations in the synthesis of 5HT was determined in the rat brain in an effort to gain an insight into the mechanism of action of this drug. This was done by determining its effect on the activity of tryptophan hydroxylase, the rate-limiting enzyme in the biosynthesis of 5HT in serotonergic neurons. The enzyme activity was determined in two brain regions, cortex and the brainstem, at two time points of 12hr light/12hr dark cycle, namely, mid-light and mid-dark. The results obtained showed that the activity of tryptophan hydroxylase was significantly greater in control animals during the dark than light phase both in the cortex and brainstem. They also demonstrate that the rate of synthesis of 5HT was affected by paroxetine in a time-dependent manner. It was therefore concluded that these time-dependent changes observed in paroxetine effect may influence the activity of serotonergic input into the suprachiasmatic nucleus and hence the regulation or expression of certain circadian rhythms. This action may help correct or compensate for abnormalities present in depressive illness.

OBJECTIVE: To define the frequency and timing of breast milk transmission of HIV-1. DESIGN: Meta-analysis of data abstracted from published literature. SUBJECTS: Participants in prospective cohort studies of MTCT of HIV-1. Cohorts were separated on the basis of breast feeding duration. INTERVENTIONS: None. MAIN OUTCOME MEASURES: HIV-1 transmission rates. RESULTS: Two thousand three hundred and seventy five HIV-1 infected women and their infants, 499 of whom breast fed, the estimated risk of breast milk HIV-1 transmission was 16% (95% CI: 9, 22%). Among breastfeeding infants, forty seven per cent of HIV-1 infections were attributable to breast feeding. Breast milk transmission risk was 21% (95% CI: 10, 33%) in cohorts with mean/median duration of breast feeding > or = 3 months and 13% (95% CI: 4, 21%) in cohorts with median duration of breast feeding < 2 months. In a separate analysis of 702 infants with prolonged duration of breast feeding, the risk of late postnatal transmission (infection occurring later than three to six months of age) was four per cent (95% CI 2, 5%). CONCLUSIONS: This analysis suggests that breast milk transmission of HIV-1 is substantial and continues throughout the postnatal period. Early cessation of breast feeding at six months would avert some but not most infant HIV-1 infections due to breast feeding. While recently published studies showing some effectiveness of antiretrovirals early during the breast feeding period are encouraging, prevention of breast milk HIV-1 transmission needs to remain a high research priority.

OBJECTIVE: To define the frequency and timing of breast milk transmission of HIV-1. DESIGN: Meta-analysis of data abstracted from published literature. SUBJECTS: Participants in prospective cohort studies of MTCT of HIV-1. Cohorts were separated on the basis of breast feeding duration. INTERVENTIONS: None. MAIN OUTCOME MEASURES: HIV-1 transmission rates. RESULTS: Two thousand three hundred and seventy five HIV-1 infected women and their infants, 499 of whom breast fed, the estimated risk of breast milk HIV-1 transmission was 16% (95% CI: 9, 22%). Among breastfeeding infants, forty seven per cent of HIV-1 infections were attributable to breast feeding. Breast milk transmission risk was 21% (95% CI: 10, 33%) in cohorts with mean/median duration of breast feeding > or = 3 months and 13% (95% CI: 4, 21%) in cohorts with median duration of breast feeding < 2 months. In a separate analysis of 702 infants with prolonged duration of breast feeding, the risk of late postnatal transmission (infection occurring later than three to six months of age) was four per cent (95% CI 2, 5%). CONCLUSIONS: This analysis suggests that breast milk transmission of HIV-1 is substantial and continues throughout the postnatal period. Early cessation of breast feeding at six months would avert some but not most infant HIV-1 infections due to breast feeding. While recently published studies showing some effectiveness of antiretrovirals early during the breast feeding period are encouraging, prevention of breast milk HIV-1 transmission needs to remain a high research priority.

OBJECTIVE: To determine the levels of both TSA and HD antibody in sera of patients with various malignancies and evaluate their potential role as diagnostic and/ or prognostic markers. DESIGN: Laboratory based analysis. SETTINGS: Kenyatta National Hospital, Kenya Medical Research Institute and the Department of Biochemistry, University of Nairobi. SUBJECTS: A total of 909 serum samples, 420 from cancer patients recruited at Kenyatta National Hospital and 509 from normal blood donors recruited at Nairobi Hospital. RESULTS: The mean age for the patients and controls was 36 and 37 years respectively. Carcinoma patients constituted 54%, sarcoma 12.1%, lymphoma 16.4% and 17.4% had other types of tumours. The mean TSA in patients was 0.86 mg/ml +/- 0.026 compared to 0.82 mg/ml +/- 0.014 in controls. The TSA level was significantly higher in patients compared to controls (Student's t-test p = 0.031 at 0.05 confidence level). The TSA increased with age in both study groups. In patient sera, both gender gave the same mean of 0.83 mg/ml while it was 0.82 mg/ml and 0.83 mg/ml in control females and in males respectively. Sarcomas had the highest amount of 0.93 mg/ml but there was no significant statistical variation between tumour types (p = 0.076). The HD antibody mean readings were 0.004 in pathologic sera compared to 0.011 in controls. The values were significantly elevated in patients (p = 0.03) with females giving a higher value for both study groups (p = 0.628). HD antibody readings was significantly higher in carcinomas (p = 0.017) compared to those of sarcomas and lymphomas. There was no association between antibody readings and age of patient (p = 0.601). CONCLUSION: Both TSA and HD antibody values were significantly elevated in patients compared to clinically healthy controls and while TSA levels increased with age and was independent of gender, HD antibody levels were independent of age, gender and also tumour type. The study demonstrates that although TSA is normally elevated in malignancy, most of the sialic acid shed is of N-acetyl type as some patients do not express HD antibody directed to the N-glycolyl sialic acid. The reason why some tumours would express Neu5Gc at any one time needs further evaluation.

Vertex epidural haematomas (VEDH) are rare and difficulties are encountered in diagnosis and management. This is a case report of a patient with a vertex epidural haematoma who presented with signs of severe head injury with upper limb decerebrate posture. We discuss the challenges of radiological investigation and neurosurgical management of VEDH.

Vertex epidural haematomas (VEDH) are rare and difficulties are encountered in diagnosis and management. This is a case report of a patient with a vertex epidural haematoma who presented with signs of severe head injury with upper limb decerebrate posture. We discuss the challenges of radiological investigation and neurosurgical management of VEDH.

A preliminary study of microbiological quality of honey was carried out using 26 samples obtained from the National Bee Keeping Research Station. Total viable counts (TVC) of aerobic bacteria, yeasts and moulds, and Clostridium species were done. Of the 26 samples, 24 (92.3%) had a TVC ranging from 3 x10 -87 x 10 colony forming units (cfu) per gram of honey. Two samples did not yield any microorganisms. Of the 24 positive samples, 9 (37.5%) were found to contain Clostridium species per gram while eight (33.3%) were positive for moulds with counts ranging from 10-100 c.f.u / g. No yeasts were detected. In addition, three samples yielded the three types of microorganisms.

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The area of nanostructured materials for dye sensitized solar cells has gained great interest by scientists, especially after a breakthrough by Gratzel and coworkers in developing a solar cell from nanostructured oxide of titania gaining an overall efficiency of about 11%. Since then research has been going on with emphasis on improvement on this achievement.

TiO2 nanofibres measuring average length 500nm and diameter 10nm have been prepared by synthesis method using 10M NaOH and dispersed in alcohol. Thin films prepared from the nanofibres had thickness varying from 4.5 – 5.5μm. The films were used to fabricate complete dye sensitised solar cells with Ruthenium complex dye as sentizer. I-V characteristics yielded Voc and Isc of 0.41V – 0.58V and 0.18mA – to 1.1mA respectively under standard illumination of 100mW/cm2 (using a halogen lamp and data acquired using Keithley 2400 Source Metre® controlled by LabVIEW® software). XRD analysis indicated strong anatase peaks with crystal orientation in the direction (101). This showed that there was no lose of crystalline structure of the TiO2 during the synthesis process. However, as the sintering temperature was raised, the percentage crystal content of anatase reduced as the rutile structure slowly formed.

The implementation of the participatory forest management (PFM) starting 2005 was meant to help in forest management and also assist the forest adjacent communities to benefit from these forest based resources through agreement with Kenya forest Service (KFS). Analysis of socio-economic reports and associated participatory forest management plan (PFMPs) undertaken between 2005 and 2013, indicate sizeable income generating projects (IGP) as part of social function of forest such as recreation have not been realised by community forest association (CFA). It is notable that several facilitating factors such as proximity to major urban areas and significant tourism circuits, necessary for development of these sites have had no impact. In some sites development of business plan did not manage to take IGP to the desired level. This failure leaves the CFA in the same status prior to the implementation of PFM in spite of huge resources invested in mapping and detailing resources potential. The CFA stakeholder’s composition, a structural weakness that failures to include more able and literate local stakeholders (business and professionals) is a major obstacle to enabling exploitation of forest ecosystems potential, thereby remaining localised and a closed unit. Thus, there is need for paradigm shift in terms CFA empowerment for exploitation of social functions of forest resources

Home Help Thesaurus Okeyo AM Advanced Search Tools Marked records Mark this record Search History Print this record Email this record Export citation Download MARC21 Record Related literature •Other articles by these authors on Google Scholar •Search Google for related articles • Order from the British Library (Artweb-registered users) •Order from the British Library (public order form) •Find this book on Amazon •Search for this title in NRC-CISTI •Add to … Tag in Delic.io.us Tag in Connotea Document details TitleAssessing stated preferences through the use of choice experiments: valuing (re)production versus aesthetics in the breeding goals of Ugandan Ankole cattle breeders. AuthorsWurzinger, M.; Ndumu, D.; Baumung, R.; Drucker, A. G.; Okeyo, A. M.; Semambo, D. K.; Sölkner, J. Book chapter; Conference paperProceedings of the 8th World Congress on Genetics Applied to Livestock Production, Belo Horizonte, Minas Gerais, Brazil, 13-18 August, 2006 2006 pp. 31-09 Conference TitleProceedings of the 8th World Congress on Genetics Applied to Livestock Production, Belo Horizonte, Minas Gerais, Brazil, 13-18 August, 2006. ISBN85-60088-01-6 URLhttp://www.wcgalp8.org.brRecord Number20063170234 Abstract In this study 240 cattle keepers in four regions in Southwestern Uganda were interviewed and a hypothetical choice experiment was conducted. Each choice-set consisted of 2 profiles with 6 attributes with 2 levels. The attributes for cows were horns, coat colour, size, fertility, milk yield and price. The attributes for bulls were horns, colour, muscularity, temperament, dam's performance and price. Each person got 6 choice-sets for bulls and 6 for cows. Differences in the production systems were reflected in the varying selection criteria. In cows production traits were very important and in bull

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Phylogenetic analysis combined with chemical ecology can contribute to the delimitation of closely related insect species, particularly in Lepidoptera. In this study, the taxonomic status of a species in the genus Busseola (Lepidoptera: Noctuidae) was discussed using morphological data, cross-mating experiments, sex pheromone chemistry, field-trapping, and molecular classification. The results of the chemical ecology experiments corroborated those from the phylogeny studies. It was concluded that several reproductive isolation components, namely host plants, geography, pheromone emission time, pheromone blend, and post-zygotic isolation factors, led to the separation of Busseola n. sp. from its closely related species B. segeta. Molecular data showed a strong difference between these two species, regardless of the marker used. The new species named Busseola nairobica was morphologically described and a hypothesis about the evolutionary history of the studied species was put forward.

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The purpose of this research is to get to the knowledge of how divorce affects the family according to the Kenyan society. It looks at the family’s life, living habits and through this, point out a few highlights of how the family is affected by divorce.
The target population is the whole Kenyan society regardless of race, religion and sex.
The data gathered will be analyzed using tables, pie charts, graphs among others. The results from this study will provide an insight on divorce among Kenyans.

Differentiation of bloodstream-form trypanosomes into procyclic (midgut) forms is an important first step in the establishment of an infection within the tsetse fly. This complex process is mediated by a wide variety of factors, including those associated with the vector itself, the trypanosomes and the bloodmeal. As part of an on-going project in our laboratory, we recently isolated and characterized a bloodmeal-induced molecule with both lectin and trypsin activities from midguts of the tsetse fly, Glossina longipennis [Osir, E.O., Abubakar, L., Imbuga, M.O., 1995. Purification and characterization of a midgut lectin-trypsin complex from the tsetse fly, Glossina longipennis. Parasitol. Res. 81, 276-281]. The protein (lectin-trypsin complex) was found to be capable of stimulating differentiation of bloodstream trypanosomes in vitro. Using polyclonal antibodies to the complex, we screened a G. fuscipes fuscipes cDNA midgut expression library and identified a putative proteolytic lectin gene. The cDNA encodes a putative mature polypeptide with 274 amino acids (designated Glossina proteolytic lectin, Gpl). The deduced amino acid sequence includes a hydrophobic signal peptide and a highly conserved N-terminal sequence motif. The typical features of serine protease trypsin family of proteins found in the sequence include the His/Asp/Ser active site triad with the conserved residues surrounding it, three pairs of cysteine residues for disulfide bridges and an aspartate residue at the specificity pocket. Expression of the gene in a bacterial expression system yielded a protein (M(r) approximately 32,500). The recombinant protein (Gpl) bound d(+) glucosamine and agglutinated bloodstream-form trypanosomes and rabbit red blood cells. In addition, the protein was found to be capable of inducing transformation of bloodstream-form trypanosomes into procyclic forms in vitro. Antibodies raised against the recombinant protein showed cross-reactivity with the alpha subunit of the lectin-trypsin complex. These results support our earlier hypothesis that this molecule is involved in the establishment of trypanosome infections in tsetse flies.

Differentiation of bloodstream-form trypanosomes into procyclic (midgut) forms is an important first step in the establishment of an infection within the tsetse fly. This complex process is mediated by a wide variety of factors, including those associated with the vector itself, the trypanosomes and the bloodmeal. As part of an on-going project in our laboratory, we recently isolated and characterized a bloodmeal-induced molecule with both lectin and trypsin activities from midguts of the tsetse fly, Glossina longipennis [Osir, E.O., Abubakar, L., Imbuga, M.O., 1995. Purification and characterization of a midgut lectin-trypsin complex from the tsetse fly, Glossina longipennis. Parasitol. Res. 81, 276-281]. The protein (lectin-trypsin complex) was found to be capable of stimulating differentiation of bloodstream trypanosomes in vitro. Using polyclonal antibodies to the complex, we screened a G. fuscipes fuscipes cDNA midgut expression library and identified a putative proteolytic lectin gene. The cDNA encodes a putative mature polypeptide with 274 amino acids (designated Glossina proteolytic lectin, Gpl). The deduced amino acid sequence includes a hydrophobic signal peptide and a highly conserved N-terminal sequence motif. The typical features of serine protease trypsin family of proteins found in the sequence include the His/Asp/Ser active site triad with the conserved residues surrounding it, three pairs of cysteine residues for disulfide bridges and an aspartate residue at the specificity pocket. Expression of the gene in a bacterial expression system yielded a protein (M(r) approximately 32,500). The recombinant protein (Gpl) bound d(+) glucosamine and agglutinated bloodstream-form trypanosomes and rabbit red blood cells. In addition, the protein was found to be capable of inducing transformation of bloodstream-form trypanosomes into procyclic forms in vitro. Antibodies raised against the recombinant protein showed cross-reactivity with the alpha subunit of the lectin-trypsin complex. These results support our earlier hypothesis that this molecule is involved in the establishment of trypanosome infections in tsetse flies.

A sample of 166 normal adult males and females was taken from different colleges of Assiut representing those living in upper Egypt. Each subject has been studied for measurements of stature (S), hand length (HL) and hand breadth (HB). The data were statistically analysed in order to assess the relationship between stature and hand measurements. The correlation matrix of the study indicates close similarity of the relationship between stature and hand measurements in both sexes and in both sides. A generalized multiple regression equation has been designed to estimate stature from values of hand length and hand breadth regardless of sex or side in the form: S = 34.5 + 5.77 HL + 2.7 HB +/- 5.1. This equation may be helpful to obtain approximate stature when there is difficulty in obtaining a direct measurement or where there is a chance print of a criminal or an amputated hand or arm.

Radiation doses received by patients during dental x-ray examinations were measured in 95 patients referred to the X-ray Department of the Teaching Dental Hospital, University of Nairobi. The mean skin dose for single periapical films was 5.96 milligray (596 millirads) with the bitewing view recording a mean dose of 5.57 milligray (mGy). During a 14-film full-mouth periapical survey, mean doses ranged from 10.3-16.2 mGy for the upper jaw and 10.1-13.5 mGy for the lower jaw, respectively, depending on the region of dentition. In these full-mouth examinations, the distribution of skin dose over different parts of the dentition showed a characteristic pattern which may be explained by the overlap of radiation fields in the aggregated series of exposure. Orthopantomography recorded lower mean skin doses of 3.26 mGy in the molar region and 2.67 mGy at the posterior midline at the level of the 2nd cervical vertebra. The relative merits of intra-oral radiography versus orthopantomography are discussed, with radiation dosage as one of the factors to be considered. Some observations are made on measures to reduce patient dose.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

Design is a common activity for most disciplines in engineering. Therefore, introductory
engineering courses are developed to include design activities as the main driver for the
curriculum. Despite this fact, however, it can not be concluded that the implementation of
design teaching is done in a way conducive to student learning. While there could be several
reasons for this, this paper specifically investigates the effect of tolerance for ambiguity on
student design performance. An analysis of the data collected for this investigation reveals the
beneficial effects of higher tolerance for ambiguity on increased efficacy, satisfaction, and
conflict resolution in the context of an open-ended, team-based, industry-sponsored engineering
design project.

Keywords: Design teams, tolerance for ambiguity, efficacy, design performance.

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

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

Field plots of sesame (Sesamum indicum) with six different levels of seed infection with Alternaria sesami were monitored for Alternaria leaf spot severity at Kibwezi, eastern Kenya. The aim of the study was to determine the effect of seed transmission of the pathogen on yield and tolerance level of the fungus in sesame seed. Increase in percentage leaf area diseased and percentage defoliation fitted the Gompertz model more closely than the logistic model. Areas under disease progress curves (AUDPC), infection and defoliation rates varied among the six infection levels. Disease severity increased with increase in seed infection and was least and most severe in plots established with seeds with 0 and 8% infection levels respectively. Yields ranged from 234.9 to 300.1 kg ha−1 compared with 312.5 kg ha−1 for the control, and losses due to seed infection ranged from 4% to 25%. Disease severity was negatively correlated with seed yield, 1000-seed weight and seeds per capsule. Alternaria leaf spot severity had a major effect on the seed weight component of yield. Tolerance level of A. sesami in sesame seed was determined to be less than 2%.

Toll-like receptors (TLR) are important in pathogen recognition and may play a role in HIV disease. We evaluated the effect of chronic untreated and treated HIV-1 infection on systemic TLR expression and TLR signalling.Together, these data indicate that chronic viraemic HIV-1 is associated with increased TLR expression and responsiveness, which may perpetuate innate immune dysfunction and activation that underlies HIV pathogenesis, and thus reveal potential new targets for therapy.

We evaluated the association of single nucleotide polymorphisms (SNPs) in TLRs with infant HIV-1 acquisition and viral control.

We evaluated the association of single nucleotide polymorphisms (SNPs) in TLRs with infant HIV-1 acquisition and viral control.

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IMPORTANCE:
Clinical features are unreliable for distinguishing ocular surface squamous neoplasia (OSSN) from benign conjunctival lesions.

OBJECTIVE:
To evaluate the adverse effects, accuracy, and interobserver variation of toluidine blue 0.05% vital staining in distinguishing OSSN, confirmed by histopathology, from other conjunctival lesions.

DESIGN, SETTING, AND PARTICIPANTS:
Cross-sectional study in Kenya from July 2012 through July 2014 of 419 adults with suspicious conjunctival lesions. Pregnant and breastfeeding women were excluded.

EXPOSURES:
Comprehensive ophthalmic slitlamp examination was conducted. Vital staining with toluidine blue 0.05% aqueous solution was performed before surgery. Initial safety testing was conducted on large tumors scheduled for exenteration looking for corneal toxicity on histology before testing smaller tumors. We asked about pain or discomfort after staining and evaluated the cornea at the slitlamp for epithelial defects. Lesions were photographed before and after staining.

MAIN OUTCOMES AND MEASURES:
Diagnosis was confirmed by histopathology. Six examiners assessed photographs from a subset of 100 consecutive participants for staining and made a diagnosis of OSSN vs non-OSSN. Staining was compared with histopathology to estimate sensitivity, specificity, and predictive values. Adverse effects were enumerated. Interobserver agreement was estimated using the κ statistic.

RESULTS:
A total of 143 of 419 participants (34%) had OSSN by histopathology. The median age of all participants was 37 years (interquartile range, 32-45 years) and 278 (66%) were female. A total of 322 of the 419 participants had positive staining while 2 of 419 were equivocal. There was no histological evidence of corneal toxicity. Mild discomfort was reported by 88 (21%) and mild superficial punctate keratopathy seen in 7 (1.7%). For detecting OSSN, toluidine blue had a sensitivity of 92% (95% CI, 87%-96%), specificity of 31% (95% CI, 25%-36%), positive predictive value of 41% (95% CI, 35%-46%), and negative predictive value of 88% (95% CI, 80%-94%). Interobserver agreement was substantial for staining (κ = 0.76) and moderate for diagnosis (κ = 0.40).

CONCLUSIONS AND RELEVANCE:
With the high sensitivity and low specificity for OSSN compared with histopathology among patients with conjunctival lesions, toluidine blue 0.05% vital staining is a good screening tool. However, it is not a good diagnostic tool owing to a high frequency of false-positives. The high negative predictive value suggests that a negative staining result indicates that OSSN is relatively unlikely.

Clinical features are unreliable for distinguishing ocular surface squamous neoplasia (OSSN) from benign conjunctival lesions.

From July 1989 to February 1990, 17 non-pregnant patients with severe falciparum malaria, aged 14 years and above received an initial intravenous quinine dihydrochloride loading dose of 20 mg/kg in 500 mls of normal saline or 5% dextrose infused over 4 hours followed by 100mg/kg infused 8 hourly for at least 24 hours. Sixteen comparable controls were similarly treated but without an initial loading dose. Oral quinine bisulfate 10mg/kg 8 hourly was substituted for a total of 7 days when patients were well enough. There was no significant difference in clinical and parasitological response between the two groups. Fever clearance time in hours was 44.00 +/- 13.92 (mean +/- SD) in the study group and 51.43 +/- 19.63 (mean +/- SD) in the control group (p > 0.05). Parasite clearance time in hours was 42.40 +/- 9.75 (mean +/- SD) in the study group and 47.05 +/- 7.69 (mean +/- SD) in the control group (p > 0.05). One patient from each group died. Mild toxic effects were common in both groups. Transient partial hearing loss occurred significantly more in the study than control group (p < 0.05). Hypoglycaemia during treatment occurred in 3 (18%) patients in the study group and 1 (6%) in the control group. The mean trough and peak plasma quinine levels in 3 patients per group was persistently higher than 9mg/L after first infusion. We conclude that though fairly well tolerated, quinine loading dose appears to have no advantage over the standard treatment for severe falciparum malaria at Kenyatta National Hospital, Nairobi, Kenya.

From July 1989 to February 1990, 17 non-pregnant patients with severe falciparum malaria, aged 14 years and above received an initial intravenous quinine dihydrochloride loading dose of 20 mg/kg in 500 mls of normal saline or 5% dextrose infused over 4 hours followed by 100mg/kg infused 8 hourly for at least 24 hours. Sixteen comparable controls were similarly treated but without an initial loading dose. Oral quinine bisulfate 10mg/kg 8 hourly was substituted for a total of 7 days when patients were well enough. There was no significant difference in clinical and parasitological response between the two groups. Fever clearance time in hours was 44.00 +/- 13.92 (mean +/- SD) in the study group and 51.43 +/- 19.63 (mean +/- SD) in the control group (p > 0.05). Parasite clearance time in hours was 42.40 +/- 9.75 (mean +/- SD) in the study group and 47.05 +/- 7.69 (mean +/- SD) in the control group (p > 0.05). One patient from each group died. Mild toxic effects were common in both groups. Transient partial hearing loss occurred significantly more in the study than control group (p < 0.05). Hypoglycaemia during treatment occurred in 3 (18%) patients in the study group and 1 (6%) in the control group. The mean trough and peak plasma quinine levels in 3 patients per group was persistently higher than 9mg/L after first infusion. We conclude that though fairly well tolerated, quinine loading dose appears to have no advantage over the standard treatment for severe falciparum malaria at Kenyatta National Hospital, Nairobi, Kenya.

Department of Cariology Endodontology Pedodontology, Academic Centre for Dentistry Amsterdam (ACTA), Louwesweg 1, 1066 EA Amsterdam, The Netherlands. The use of Chewing sticks (Miswaki) in the third world for control of dental plaque is very popular. Some of the studies that have been conducted on this subject have reported marked decrease in the incidences of dental caries and periodontal diseases in the users of Miswaki, when compared to the users of the conventional toothbrush living under similar conditions. Various mechanisms by which the Miswaki contributes to this phenomenon have been suggested. The purpose of the present study was to investigate in vitro, the anti-microbial action, the potential acid buffer capacity and fluoride content of crude aqueous extracts of eight commonly used chewing sticks from three regions in Kenya. The results obtained in the study, showed that one of the Miswaki had remarkable antibiotic activity against three stains of oral bacteria. Three of the Miswaki had significant acid buffer capacity. None of the eight Miswaki showed any significant fluoride release.

Department of Cariology Endodontology Pedodontology, Academic Centre for Dentistry Amsterdam (ACTA), Louwesweg 1, 1066 EA Amsterdam, The Netherlands. The use of Chewing sticks (Miswaki) in the third world for control of dental plaque is very popular. Some of the studies that have been conducted on this subject have reported marked decrease in the incidences of dental caries and periodontal diseases in the users of Miswaki, when compared to the users of the conventional toothbrush living under similar conditions. Various mechanisms by which the Miswaki contributes to this phenomenon have been suggested. The purpose of the present study was to investigate in vitro, the anti-microbial action, the potential acid buffer capacity and fluoride content of crude aqueous extracts of eight commonly used chewing sticks from three regions in Kenya. The results obtained in the study, showed that one of the Miswaki had remarkable antibiotic activity against three stains of oral bacteria. Three of the Miswaki had significant acid buffer capacity. None of the eight Miswaki showed any significant fluoride release.

From July 1989 to February 1990, 17 non-pregnant patients with severe falciparum malaria, aged 14 years and above received an initial intravenous quinine dihydrochloride loading dose of 20 mg/kg in 500 mls of normal saline or 5% dextrose infused over 4 hours followed by 100mg/kg infused 8 hourly for at least 24 hours. Sixteen comparable controls were similarly treated but without an initial loading dose. Oral quinine bisulfate 10mg/kg 8 hourly was substituted for a total of 7 days when patients were well enough. There was no significant difference in clinical and parasitological response between the two groups. Fever clearance time in hours was 44.00 +/- 13.92 (mean +/- SD) in the study group and 51.43 +/- 19.63 (mean +/- SD) in the control group (p > 0.05). Parasite clearance time in hours was 42.40 +/- 9.75 (mean +/- SD) in the study group and 47.05 +/- 7.69 (mean +/- SD) in the control group (p > 0.05). One patient from each group died. Mild toxic effects were common in both groups. Transient partial hearing loss occurred significantly more in the study than control group (p < 0.05). Hypoglycaemia during treatment occurred in 3 (18%) patients in the study group and 1 (6%) in the control group. The mean trough and peak plasma quinine levels in 3 patients per group was persistently higher than 9mg/L after first infusion. We conclude that though fairly well tolerated, quinine loading dose appears to have no advantage over the standard treatment for severe falciparum malaria at Kenyatta National Hospital, Nairobi, Kenya.

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Seasonal climate outlooks have become a necessary input to agricultural planning and execution of all farming activities as a form of adaptation to climate change and variability. Extended climate forecasts of 3–4 months pose a challenge to farmers as it is difficult for them to pinpoint exactly what might happen on daily, weekly or decadal time scales. In addition, such forecasts are presented in form of probability maps and in very coarse resolution, making them difficult for farmers to comprehend. Community-specific downscaled forecasts offer an opportunity for farmers to decide on what, where and when to plant, allocation of resources and on other investment options. This study evaluated various downscaling tools and procedures for seasonal forecast interpretation over the Greater Horn of Africa (GHA) region. The tools evaluated were: analogue year approach, Fact-Fit tool, Water Requirement Satisfaction Index (WRSI) and GeoCLIM tool. Analogue year approach turned out to be good but highly dependent on accuracy of the selected year; Fact-Fit tool was able to convert the seasonal probability forecasts into amounts but unable to disaggregate rainfall amounts at daily, weekly or dekadal time scales; the WRSI tool used was limited to a number of crops, seasons and regions but was necessary for monitoring seasonal progress and predicting crop performance. The current GeoCLIM software used was unable to disaggregate rainfall amounts to daily, weekly or dekadal scales but was good for suitability analysis and producing spatial distribution rainfall maps. An integrated approach is therefore desirable for producing more reliable and dependable location-specific seasonal forecasts for direct application by farmers and other agricultural practitioners. This is so important in the Horn of Africa region, where climate change is already affecting populations, and adaptation is seen as a major approach to cope with the impacts of climate change.

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

Modified glass ionomer restoratives are employed in conservation of abrasion cavities, and hence the characterisation of toothbrush abrasion is clinically important. The aim was to evaluate this parameter, for; resin, metal, and polyphosphonate modified glass ionomers, compomer, experimental composite and Perspex as control. Groups (n = 5) of cylindrical specimens (6mm

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The study of the effect of Top Management Team (TMT) diversity on organization performance produces mixed results. This study investigated the effect of involvement culture on the relationship between TMT diversity and organization performance. The target respondents were the Heads of Human Resources in all the commercial banks in Kenya and out of the 43 targeted banks, 33 responded. The questionnaire was the main
tool of data collection and the data was analyzed using regression analyses. Past studies have shown that the question as to whether diversity leads to organization performance depends of the performance measures used. Since past studies have shown mixed results on the effect of TMT diversity on organization performance, the study used
involvement culture as a moderating variable and found that it had a significant effect on the relationship between TMT diversity and organization performance. As a result, since most organizations have diversity at the TMT, they need to make deliberate efforts and invest in good management practices which enhance organization performance. Future studies can find out which other moderating variables have a
positive effect on the relationship between TMT diversity and organization
performance.

One of the major challenges in understanding the evolution of our own species is identifying the role climate change has played in the evolution of hominin species. To clarify the influence of climate, we need long and continuous high-resolution paleoclimate records, preferably obtained from hominin-bearing sediments, that are well-dated by tephro- and magnetostratigraphy and other methods. This is hindered, however, by the fact that fossil-bearing outcrop sediments are often discontinuous, and subject to weathering, which may lead to oxidation and remagnetization. To obtain fresh, unweathered sediments, the Hominin Sites and Paleolakes Drilling Project (HSPDP) collected a ∼216-meter core (WTK13) in 2013 from Early Pleistocene Paleolake Lorenyang deposits in the western Turkana Basin (Kenya). Here, we present the magnetostratigraphy of the WTK13 core, providing a first age model for upcoming HSPDP paleoclimate and paleoenvrionmental studies on the core sediments. Rock magnetic analyses reveal the presence of iron sulfides carrying the remanent magnetizations. To recover polarity orientation from the near-equatorial WTK13 core drilled at 5°N, we developed and successfully applied two independent drill-core reorientation methods taking advantage of (1) the sedimentary fabric as expressed in the Anisotropy of Magnetic Susceptibility (AMS) and (2) the occurrence of a viscous component oriented in the present day field. The reoriented directions reveal a normal to reversed polarity reversal identified as the top of the Olduvai Subchron. From this excellent record, we find no evidence for the ‘Vrica Subchron’ previously reported in the area. We suggest that outcrop-based interpretations supporting the presence of the Vrica Subchron have been affected by the oxidation of iron sulfides initially present in the sediments -as evident in the core record- and by subsequent remagnetization. We discuss the implications of the observed geomagnetic record for human evolution studies.

BACKGROUND:

Ocular surface squamous neoplasia (OSSN) is an aggressive eye tumour particularly affecting people with HIV in Africa. Primary treatment is surgical excision; however, tumour recurrence is common. We assessed the effect of fluorouracil 1% eye drops after surgery on recurrence.
METHODS:

We did this multicentre, randomised, placebo-controlled trial in four centres in Kenya. We enrolled patients with histologically proven OSSN aged at least 18 years. After standard surgical excision, participants were randomly allocated to receive either topical fluorouracil 1% or placebo four times a day for 4 weeks. Randomisation was stratified by surgeon, and participants and trial personnel were masked to assignment. Patients were followed up at 1 month, 3 months, 6 months, and 12 months. The primary outcome was clinical recurrence (supported by histological assessment where available) by 1 year, and analysed by intention to treat. The sample size was recalculated because events were more common than anticipated, and trial enrolment was stopped early. The trial was registered with Pan-African Clinical Trials Registry (PACTR201207000396219).
FINDINGS:

Between August, 2012, and July, 2014, we assigned 49 participants to fluorouracil and 49 to placebo. Four participants were lost to follow-up. Recurrences occurred in five (11%) of 47 patients in the fluorouracil group and 17 (36%) of 47 in the placebo group (odds ratio 0·21, 95% CI 0·07-0·63; p=0·01). Adjusting for passive smoking and antiretroviral therapy had little effect (odds ratio 0·23; 95% CI 0·07-0·75; p=0·02). Adverse effects occurred more commonly in the fluorouracil group, although they were transient and mild. Ocular discomfort occurred in 43 of 49 patients in the fluorouracil group versus 36 of 49 in the placebo group, epiphora occurred in 24 versus five, and eyelid skin inflammation occurred in seven versus none.
INTERPRETATION:

Topical fluorouracil after surgery substantially reduced recurrence of OSSN, was well-tolerated, and its use recommended.
FUNDING:

British Council for Prevention of Blindness and the Wellcome Trust.

Background : Openings of hepatic veins into the retrohepatic surface of the inferior vena cava (ostia venae hepatica) play a part in controlling hepatic circulation by acting as collateral channels in obstruction. Their topography and distribution must be taken into account during catheterization and liver transplantation. This anatomy is however little known among Kenyans.   Objectives: To study the position, number and distribution of ostia venae hepatica in a selected Kenyan population   Materials and methods: Eighty fresh postmortem liver specimens were obtained from the Chiromo Mortuary. The hepatic IVC was isolated from the lower border of caudate lobe to the diaphragmatic opening, with the liver in position. The vein was opened posteriorly by a vertical incision along its whole length and the lateral flaps reflected laterally. The topography of the ostia was studied using the Sahni model. The number and patterns of the ostia were also studied. The patterns of openings of the left, right and middle hepatic veins were studied as well as the distances between them.   Results : A total of 584 ostia were identified, an average of 7.3 per liver. The ostia were distributed on the lateral portions of the vein, with an avascular plane at the centre. Major veins terminated in the upper third of the hepatic inferior vena cava, with little extraparenchymal course. The mean distance between the right hepatic vein and middle hepaticvein was 1.7cm   Conclusion : The numerous ostia venae hepatica identified in these subjects offer collateral flow channels during hepatic venous obstructionin Budd-Chiari syndrome. The topography and patterns of distribution of the openings suggest the advantage of an avascular virtual plane, which is asafe dissecting path for hepatovascular surgeons.

The decision to pay out earnings or retain dividends has been a subject of debate for many scholars. The effect of dividend on the firm value and cost of capital have been covered in attempt to resolve the dividend puzzle. This research paper tests the applicability of constant dividend model by companies listed at the Nairobi stock exchange. Data was collected from annual reports and share price schedules obtained from Nairobi stock exchange and Capital market Authority for a population of 20 companies that paid dividends consistently from 2002 to 2008. The data was then analyzed by re-computing the dividends that should have been paid if the dividend constant model was applied. This recomputed figure was later compared to the dividend as paid out by the companies thought the years of study. Paired sample t-test statistic was also performed to determine whether there is a significant difference between the two dividend figures. The findings of the research established that the dividend model was not employed by the companies listed at the Nairobi stock exchange. Most firms instead adopted stable and predictable policy where a specific amount of dividend per share each year was paid periodically. In some years there was a slight adjustment of the dividend paid after an increase in earnings, but only by a sustainable amount. The study shows that the relationship between the stock market prices and the dividend paid from the constant dividend model is uneven from one year to another and where there was a relationship it was insignificant. Though a share would be highly priced, a high dividend per share was not always declared.

Topography of aortic bifurcation is important for gynaecologists, surgeons and radiologists operating in
the retroperitoneal area, in order for them to minimize vascular injury. It also influences the occurrence
of aortic-iliac atherosclerosis. It shows ethnic variations, but data from African populations are scarce.
This study therefore investigated the topography of aortic bifurcation in a black Kenyan population by
dissection of 106 cadavers. After removal of abdominal viscera, peritoneum, fibrofatty connective tissue,
inferior vena cava was removed to expose the termination of abdominal aorta. Vertebral level, angle and
asymmetry of bifurcation were recorded. Data were analysed by SPSS version 17.0 for windows and are
presented in tables and bar charts. All aortae terminated by bifurcating into 2 common iliac arteries. The
most common level of bifurcation was L4 (73.6%). It bifurcated below L4 in 22.7% of the cases. Mean
angle of bifurcation was 55.20 (range 23 – 780); 55.60 in males and 54.30 in females. Mean bifurcation
asymmetry was 4.4 (range 0 – 23). Topography of aortic bifurcation in the black Kenyan population
varies from conventional descriptions on over 20% of the individuals studied. Surgeons and radiologists
must be aware of this to avoid inadvertent vascular injury. Higher bifurcation angles and asymmetry
than those reported for Caucasian and Indo Asian populations suggest higher vulnerability to abdominal
aortic atherosclerosis. Preoperative evaluation of terminal aorta, and follow up for atherosclerosis are
recommended.

14.00 800x600 Normal 0 false false false EN-GB X-NONE X-NONE MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Calibri","sans-serif"; mso-bidi-font-family:"Times New Roman";} Variant anatomy of the superior thyroid artery is important during surgical procedures, interpretation of angiograms, and interventional radiography in the neck. Pattern of the variations shows population differences but there is no data from the Kenyan population. This study therefore investigated the variations in origin of the superior thyroid artery in a Kenyan population. Forty six necks (36 males and 10 females) from 46 cadavers of black Kenyans in Department of Human Anatomy University of Nairobi, Kenya were bilaterally dissected to expose the origin of the superior thyroid artery. Pattern of origin of the vessel was determined on both sides in males and females. It originated from the external carotid artery common carotid artery and linguo-facial trunk in 80%, 13% and 6.5% of the cadavers respectively on the right side. All but one of the superior thyroid arteries were ventral branches. There was asymmetric origin in 6.5% of cases. Origin from the common carotid artery was associated with high carotid bifurcation. Nearly 20% of superior thyroid arteries showed variant origin. Of these, 6.5% arose from the linguo-facial trunk, much higher than in the Caucasian and Oriental populations. Origin from common carotid artery is substantially lower than prevailing figures from other populations. These findings support ethnic variations. Preoperative angiographic evaluation is recommended.

Configuration and branching pattern of the posterior communicating artery influence occurrence and approaches to management of aneurysms. Distribution of the various configurations and branching patterns shows population variations but reports from Africa are scanty. Configurations observed in the Kenyan population are comparable to those reported in the Caucasian populations. From an anatomical standpoint, the two are equally predisposed to development of aneurysms. Posterior third of PComA had the least number of branches suggesting that the pterional approach to basilar tip aneurysm among Kenyans may be a safer procedure.

14.00 800x600 Normal 0 false false false EN-GB X-NONE X-NONE MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Calibri","sans-serif"; mso-bidi-font-family:"Times New Roman";} Variant anatomy of the superior thyroid artery is important during surgical procedures, interpretation of angiograms, and interventional radiography in the neck. Pattern of the variations shows population differences but there is no data from the Kenyan population. This study therefore investigated the variations in origin of the superior thyroid artery in a Kenyan population. Forty six necks (36 males and 10 females) from 46 cadavers of black Kenyans in Department of Human Anatomy University of Nairobi, Kenya were bilaterally dissected to expose the origin of the superior thyroid artery. Pattern of origin of the vessel was determined on both sides in males and females. It originated from the external carotid artery common carotid artery and linguo-facial trunk in 80%, 13% and 6.5% of the cadavers respectively on the right side. All but one of the superior thyroid arteries were ventral branches. There was asymmetric origin in 6.5% of cases. Origin from the common carotid artery was associated with high carotid bifurcation. Nearly 20% of superior thyroid arteries showed variant origin. Of these, 6.5% arose from the linguo-facial trunk, much higher than in the Caucasian and Oriental populations. Origin from common carotid artery is substantially lower than prevailing figures from other populations. These findings support ethnic variations. Preoperative angiographic evaluation is recommended.

Injury to the recurrent laryngeal nerve (RLN) is an important but avoidable complication of thyroidectomy. This complication may be avoided by the identification of the nerve facilitated by important landmarks found along its course. The setting for this work is the Human Anatomy Laboratory of the University of Nairobi. The aim of this work is to determine the topographic relationship of the RLN with the inferior thyroid artery (ITA), the tubercle of Zuckerkandl (TZ), and the ligament of Berry (LB) in a Kenyan population. The relationship between the nerve and the above landmarks was determined during dissection of 146 right and left thyroid lobes. One right side of the neck had a nonrecurrent nerve. Of the specimens where relationship was determined, the nerve was anterior to the ITA in 37% of cases and posterior in 51.4%. In relation to the LB, 45.3% were superficial (dorsolateral). The TZ was clearly delineated in 86 of the 146 specimens. No nerve traversed the tubercle. The RLN exhibited variations similar to those in other populations. The TZ when present was a reliable landmark to the nerve.

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JASPA Working Paper, ILO, Addis Ababa

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

Scrotal explorations were performed on 110 patients with clinical suspicion of testicular torsion over an eight-year period from January 1988 to January 1995 at the various government and private hospitals within Nairobi metropolis. Ninety five (86.36%) patients had testicular torsion. 14 (12.73%) patients had epididymo-orchitis and one (0.91%) patient had normal testis. The mean age was 20.5 years. Forty six (48.42%) patients were young adults of over 21 years of age. The overall salvage rate was low at 21% with an orchidectomy rate of 79%. All the patients (40%) who presented to the surgeon more than 48 hours from the onset of symptoms lost their testicles. This may be due to the fact that in this study, forty three (45.26%) patients were placed on antibiotics and analgesics without prior scrotal or external genital examination by the first doctor to examine them before eventual referral to the surgeon. Recurrent torsion was reported in four (4.21%) patients who had previous testicular fixation in the locality.

Scrotal explorations were performed on 110 patients with clinical suspicion of testicular torsion over an eight-year period from January 1988 to January 1995 at the various government and private hospitals within Nairobi metropolis. Ninety five (86.36%) patients had testicular torsion. 14 (12.73%) patients had epididymo-orchitis and one (0.91%) patient had normal testis. The mean age was 20.5 years. Forty six (48.42%) patients were young adults of over 21 years of age. The overall salvage rate was low at 21% with an orchidectomy rate of 79%. All the patients (40%) who presented to the surgeon more than 48 hours from the onset of symptoms lost their testicles. This may be due to the fact that in this study, forty three (45.26%) patients were placed on antibiotics and analgesics without prior scrotal or external genital examination by the first doctor to examine them before eventual referral to the surgeon. Recurrent torsion was reported in four (4.21%) patients who had previous testicular fixation in the locality.

Wildlife managers can only effectively manage wildlife resources for posterity using
sound scientific data. Aerial counts of large mammals are major source of these data.In
Kenya, the counts have been carried out in various ecosystems since the 1960’s
(Thoulesset al., 2008). As of 2002, Kenya Wildlife Service (KWS) began undertaking
aerial counts of elephants and other large mammals in key ecosystems (e.g., Tsavo,
Samburu-Laikipia-Marsabit, Maasai Mara, Amboseli, and Meru) after every three years
(Thoulesset al., 2008; Litorohet al., 2008; Ngeneet al., 2011; Mwangiet al., 2007; Kiambiet
al., 2010). Therefore, the 2012 aerial count of elephants, Grevy’s zebra and other large
mammals in Laikipia-Samburu-Marsabit ecosystem is part of the 3 years’ monitoring
cycle adopted by KWS.
Five factors made the 2012 aerial count in Laikipia-Samburu-Marsabit ecosystem
important. First, the impact of the 2009 severe drought needed to be assessed. Second,
there was need to establish the impact of increased poaching of elephantsbetween 2008
and 2012 on the ecosystem’s population status. Third, notably also is habitat loss
emanating from sedentary settlements around major elephant migratory corridors and
former elephant rangeswhich has compressed the elephant range. This is a key elephant
conservation and management issue in the ecosystem. Fourth, human-elephant conflict is
currently the greatest problem associated with loss of elephant range as a result of land
use change and increasing settlements in formerly unsettled areas. Fifth, currently, the
area has the second largest elephant population and the largest (about 90%) in-situ
Grevy’s Zebra population in the world. It is therefore important to continue to monitor
the population of elephants and Grevy’s Zebra in the ecosystem to provide continuous
long term data for sound management. The aerial count was undertaken by staff
(research scientists, pilots, GIS officers, research assistants, and drivers) from different
conservation agencies.
The 2012 aerial count wascarried out by staff from KWS, LewaDown Wildlife
Conservancy, Laikipia Wildlife Forum, Northern Rangeland Trust (NRT), African
Wildlife Foundation (AWF), Mpala Research Center (MRC), OlPejeta Conservancy
(OPC), Space for Giants (SG), OlJogi Game Ranch, Borana Ranch, Department of
Resource Surveys and Remote Sensing(DRSRS) andMwaluganje Elephant Sanctuary,
Tsavo Elephant Trust, International Union for Conservation of Nature (IUCN), and
Save the Elephants.