Following treatment with a demethylating agent, 5 of 11 renal cell carcinoma (RCC) cell lines showed increased expression of hepatocyte growth factor (HGF) activator inhibitor type 2 (HAI-2/SPINT2/Bikunin), a Kunitz-type protease inhibitor that regulates HGF activity. As activating mutations in the MET proto-oncogene (the HGF receptor) cause familial RCC, we investigated whether HAI-2/SPINT2 might act as a RCC tumor suppressor gene. We found that transcriptional silencing of HAI-2 in RCC cell lines was associated with promoter region methylation and HAI-2/SPINT2 protein expression was down-regulated in 30% of sporadic RCC. Furthermore, methylation-specific PCR analysis revealed promoter region methylation in 30% (19 of 64) of clear cell RCC and 40% (15 of 38) of papillary RCC, whereas mutation analysis (in 39 RCC cell lines and primary tumors) revealed a missense substitution (P111S) in one RCC cell line. Restoration of HAI-2/SPINT2 expression in a RCC cell line reduced in vitro colony formation, but the P111S mutant had no significant effect. Increased cell motility associated with HAI-2/SPINT2 inactivation was abrogated by treatment with extracellular signal-regulated kinase (ERK)/mitogen-activated protein kinase (MAPK) and phospholipase C-gamma inhibitors, but not by an inhibitor of atypical protein kinase C. These findings are consistent with frequent epigenetic inactivation of HAI-2/SPINT2, causing loss of RCC tumor suppressor activity and implicate abnormalities of the MET pathway in clear cell and papillary sporadic RCC. This information provides opportunities to develop novel targeted approaches to the treatment of RCC.

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Following treatment with a demethylating agent, 5 of 11 renal cell carcinoma (RCC) cell lines showed increased expression of hepatocyte growth factor (HGF) activator inhibitor type 2 (HAI-2/SPINT2/Bikunin), a Kunitz-type protease inhibitor that regulates HGF activity. As activating mutations in the MET proto-oncogene (the HGF receptor) cause familial RCC, we investigated whether HAI-2/SPINT2 might act as a RCC tumor suppressor gene. We found that transcriptional silencing of HAI-2 in RCC cell lines was associated with promoter region methylation and HAI-2/SPINT2 protein expression was down-regulated in 30% of sporadic RCC. Furthermore, methylation-specific PCR analysis revealed promoter region methylation in 30% (19 of 64) of clear cell RCC and 40% (15 of 38) of papillary RCC, whereas mutation analysis (in 39 RCC cell lines and primary tumors) revealed a missense substitution (P111S) in one RCC cell line. Restoration of HAI-2/SPINT2 expression in a RCC cell line reduced in vitro colony formation, but the P111S mutant had no significant effect. Increased cell motility associated with HAI-2/SPINT2 inactivation was abrogated by treatment with extracellular signal-regulated kinase (ERK)/mitogen-activated protein kinase (MAPK) and phospholipase C-gamma inhibitors, but not by an inhibitor of atypical protein kinase C. These findings are consistent with frequent epigenetic inactivation of HAI-2/SPINT2, causing loss of RCC tumor suppressor activity and implicate abnormalities of the MET pathway in clear cell and papillary sporadic RCC. This information provides opportunities to develop novel targeted approaches to the treatment of RCC.

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Between 1976-1985, 127 cases of malignant tumours of the nose and maxillary sinus were seen at the Department of Human Pathology, Kenyatta National Hospital, Nairobi, Kenya. Cancer of the nose and maxillary sinus was a common diagnosis accounting for 0.8 per cent of all malignancies. Despite this, the incidence was low probably because the rural Kenyans have difficulty in gaining access to the oncology facilities in Nairobi. Incidence rates standardized to world population per 100,000 persons-years were 0.16 for males and 0.12 for females. Clinical information showed that malignancy should be expected in patients with swelling of the cheek and involvement of the orbit. Compared with Denmark the proportion of undifferentiated carcinomas was significantly higher in Kenya. The well known fact that anaplastic carcinoma of the postnasal space is causally associated with the Epstein Barr virus makes it tempting to suggest that anaplastic carcinoma of the nose and maxillary sinus may also be of viral aetiology.

BACKGROUND: Many visually impaired children can learn to read print with appropriate training and simple visual aids. This may allow them to attend normal schools and to be integrated into society, which has lifelong benefits. Yet, in Africa, many visually impaired children are enrolled in special schools and taught only Braille. The purpose of this analysis was to document the extent of inappropriate enrollment of visually impaired children in special schools and annexes for the blind in four African countries. METHODS: Schools were selected through a population-proportional-to-size method so that they would represent all children attending special schools in Kenya, Malawi, Tanzania and Uganda. Children were examined by ophthalmologists trained in standardised methods to determine visual acuity and the cause of decreased acuity. RESULTS: Of 1062 children examined in special schools and annexes for the blind, 361 (34%, 95% CI 31.2, 36.8) had visual acuity >or=6/60; the most common cause of visual impairment was retinal disease. Of the 120 children with normal vision (>or=6/18), 69 (57.5%) had two normal eyes, 21 (17.5%) had an obvious ocular disfigurement in the fellow eye and 10 (8.4%) had had successful cataract surgery. CONCLUSIONS: In these countries, many children are placed inappropriately in special schools and annexes for the blind. The reasons are multiple and to rectify the situation will require advocacy and cooperation between ministries of health and education.

PMID: 19460267 [PubMed - indexed for MEDLINE]

A double antibody enzyme linked immunosorbent assay for identification of thermostable muscle antigens of autoclaved meat samples is described. The assay differentiates heterologous thermostable muscle antigens from homologous at P 0.001. In model meat mixtures, the assay detects adulterants at the level of 1% at p0.001 even in phylogenetically related species such as buffalo and cattle.

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The tunica adventitia has previously been regarded as a passive connective tissue covering that offers
only nutritive and physical support to the arterial wall. Recently, however, emphasis has been given to
its role in atherosclerosis. Although the normal structure may bear the anatomical basis of these
functions, microscopic anatomy of the tunica adventitia in normal arteries is seldom reported. These
data are important in understanding disease process and potential areas of intervention. The goat is a
suitable model for studying cardiovascular disease and the aorta is frequently afflicted by
atherosclerosis. This study, therefore, aimed at describing the structure of tunica adventitia of normal
aorta in goat. Materials for the study were obtained from abdominal aorta of 6 healthy young adult
male goats (capra hircus) age range 12 – 24 months. Fresh specimens from euthanized animals were
fixed in 3% phosphate buffered glutaraldehyde, post fixed in 1% phosphate buffered osmium tetroxide
then embedded in durcupan. Ultrathin sections were stained with uranyl acetate counterstained with
lead citrate and examined with electron microscope. Some specimens were processed routinely for
paraffin embedding and sectioning. They were stained with Mason’s Trichrome and Weigert
elastic/Van Gieson stains. The tunica adventitia was fibroelastic with numerous capillaries, arterioles
and multiple cell types. The cells were active fibroblasts, phagocytic, perivascular and endothelial cells
embedded in the fibrous stroma. These findings suggest that the tunica adventitia of the goat aorta is
a metabolically active vascular compartment. These features namely microvasculature and multiple cell
populations probably enable it to maintain structural and functional integrity and appropriately respond
to vascular injury.

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This study sought to investigate if Turn of the Month effect exists at the Nairobi Securities Exchange. In carrying out the study, the days of the month were divided into two, the Turn of the Month (TOM) which included the last trading day of the month and the first three trading days of the following month. The other trading days of the month were categorized as Rest of the Month (ROM). The 20 share index was used as the sampling frame and the daily indices were used to compute the daily returns. Secondary data was obtained from the Nairobi Securities Exchange (NSE) data base. The TOM coefficient was not significant to confirm TOM effect. It is therefore concluded that there is no TOM effect at the Nairobi Securities Exchange. It is equally recommended that the findings of this study should be used cautiously by the market regulator, NSE, stock brokers, investors and listed companies. The reason being, they could have been influenced by the size of the index used to compute the returns. That no TOM effect was found at NSE is not sufficient to conclude that the market is efficient.

There is a substantial body of research literature that documents the critical role of Technical and Vocational Education and Training (TVET) institutions in manpower development especially in emergent economies. While acknowledging the challenges that accompany many a TVET programme in these regions such as low efficiency and poor quality, the current discussion explores the potential synergies that could be mapped and harnessed between TVET institutions and structures of devolved governance in Kenya and how these synergies could be channelled toward youth training and employment in Kenya. Using Chapter Eleven [Devolved Government] of the Constitution of Kenya (2010) as a backdrop, the discussion identifies gaps in training for devolved governance that TVET institutions could exploit on the basis of the functions of county governments as outlined in Fourth Schedule of the Constitution. In particular, TVET institutions could fill the gaps in training for devolved governance in agriculture, natural resource management and environmental conservation, public health and emergency services, cultural activities and the management of public entertainment and amenities, county transport and public works, animal control and welfare, trade development and regulation, county planning and development, delivery of pre-primary education and childcare facilities, management of village polytechnics and home craft centres, and control of drugs and pornography. The operationalisation of county governments as per the Constitution requires a critical mass of well trained human resources in all these areas and these human resources don't have to be trained in tertiary institutions and/or universities, or be deployed from the national government for the long term. The discussion posits that a coordinated effort by TVET institutions to develop and offer training tailored toward ensuring that county governments meet their constitutionally delegated mandate provides immense opportunities for youth training and subsequent youth employment in Kenya - and possibly elsewhere

A random sample survey using personal interviews was conducted in Machakos and Makueni Districts of Kenya in 1992 to estimate the level of rabies vaccination of the dog population. To substantiate the results of the interviews, a sample of the surveyed dogs 3 months old and above were bled for serum rabies antibody determination using an inhibition enzyme immunoassay (INH EIA). Of the 266 surveyed 3 months old and above, only 29% (77/266) were reportedly vaccinated against rabies. Out of the 197 dog sera titrated for rabies antibody, only 29% (57/197) had detectable antibodies and only 16% (32/197) had antibody tires equal to or greater than the threshold considered protective of 0.5 I.U/ml. There was a strong positive association between a history of previous vaccination and the detection of rabies antibodies. Of 133 dogs with no history of previous vaccination, 20% (26/133) had detectable antibodies. With the rabies incidence in Machakos and Makueni Districts still unacceptably high, the level of vaccination estimated in this survey is clearly inadequate for rabies control and measures designed to increase it are discussed.

The Twin Cities Care system lacks services that are most needed in the later stages of HIV disease. Services in highest demand included housing, transportation, and translation; available translations services are generally limited to Somali, Oromo, and Amharic, the languages most widely spoken by the three largest African immigrant and refugee groups in the Twin Cities. The care system is not well-integrated, and most of the work of moving clients within the system is done by case managers and care advocates. The main technical competencies identified by providers as lacking are understanding mental health from the perspective of African-born people living with HIV/AIDS (PLWH) and addressing sexual issues, especially with women. African providers with foreign certifications not recognized in the United States are not able to use their professional skills. African clients are not well-informed about HIV, and African women are more likely than men to seek and stay in care.

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Part of a detailed analysis of 864 unmarried teenage mothers delivering in Pumwani Maternity Hospital and Kenyatta National Hospital is presented. Teenage pregnancy amounted for 42.3% of all deliveries of unmarried mothers. Most teenage patients were above 16 years of age, had a religious background of wide coverage, had low quality antenatal care and low education. 94.6% were found to be primigravidas. This dominance has also been found by other workers. PIP: A prospective cross-sectional descriptive study of unmarried mothers delivering in Pumwani Maternity Hospital and Kenyatta National Hospital, Nairobi, Kenya, from December 1986-April 1987, was conducted with a pretested open-ended questionnaire: the 864 teen mothers are described here. They ranged from 13.4-19 years, most were 17-19. 49.4% were Catholic and 45% Protestant. 88.5% attended prenatal clinics once; 51.5% attended 5 times, although only 13% went to hospital clinics for specialized care. For reasons for not going for prenatal care teens stated that they were too shy to undergo a clinical exam, afraid of parents' reaction, unaware of the pregnancy or of the existence of prenatal care, they had not menstruated, or were in school, in prison, or had long work hours. Most girls had primary education, and 97.9% had dropped out of school. 34% dropped out because of pregnancy, and 32% for lack of tuition fees. Reasons for dropping out of school were tabulated, encompassing a broad range of social problems such as war, death, divorce, alcoholism or illness of parents, no tuition or uniform funds, poor grades, and running away from school. In Africa, teen pregnancy is probably increasing because of decreasing age at menarche and relaxing of traditional values.

PIP: The efficacy and complication rate of menstrual regulation with the hand-held Karman cannula was tested on 223 women with amenorrhea up to 56 days in the Dept. of Obstetrics and Gynecology, University of Nairobi, Kenya from October 1982-January 1983. 195 women had positive pregnancy tests, while menstrual regulation was done on the others because of concern over late menses. the procedures were done without anesthesia with a 50 ml vacuum syringe fitted with a self-locking plunger, a rubber adaptor and stop cock, 5-8 mm flexible plastic Karman cannula and a toothless volsellum, using hibitane solution and savlon antiseptic. The average procedure time was 7 minutes. Bleeding lasted over 1 week in 4%, total blood loss was over 50 ml in 3.1%, and immediate side effects were syncope in 1.3%, nausea and vomiting in 1.8% and pain in 5.4%. There were 2 (0.8%) cases of endometritis. In Kenya where 60% of all gynecological hospital admissions are for septic abortions, it is essential to provide safe termination as a backup for family planning method failures.

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Eukaryotic organisms with cilia or flagella typically express two non-axonemal or "cytoplasmic" dyneins, dynein-1 and dynein-2. Interestingly, we find that Leishmania mexicana is unusual and contains two distinct cytoplasmic dynein-2 heavy chain genes (designated LmxDHC2.1 and LmxDHC2.2) along with a single dynein-1 heavy chain (LmxDHC1). Disruption of LmxDHC2.2 resulted in immotile parasites that had a rounded cell body. Although they assume amastigote morphology, immunoblot analysis of these cells demonstrates protein expression consistent with the promastigote stage. Ultrastructural analysis revealed non-emergent flagella that lacked the paraflagellar rod and an axoneme with deficiencies in several components. We confirmed the absence of paraflagellar rod proteins PFR1 and PFR2. These results show that LmxDHC2.2 is required for flagellar assembly and also participates in the maintenance of promastigote cell shape. In contrast to the results with LmxDHC2.2, we were unable to generate homologous disruptions of LmxDHC2.1. This result suggests that, unlike LmxDHC2.2, LmxDHC2.1 is an essential gene in Leishmania. Together, these findings demonstrate that the two dynein-2 heavy chain isoforms in Leishmania perform distinct functions. The observation that the genomes of Leishmania major, Leishmania infantum and Trypanosoma brucei also contain two dynein-2 isoforms suggests that this unusual aspect of cytoplasmic dynein is a conserved feature of the kinetoplastids.

From the stem bark of Erythrina sacleuxii two new isoflavanones, (R)-5,7-dihydroxy-2′,4′,5′-trimethoxyisoflavanone (trivial name, (R)-2,3-dihydro-7-demethylrobustigenin) and (R)-5-hydroxy-2′,4′,5′-trimethoxy-2″,2″-dimethylpyrano[5″,6″:6,7]isoflavanone (trivial name, (R)-saclenone) were isolated. In addition the known compounds shinpterocarpin, 2,3-dehydrokievitone, abyssinone V, abyssinone V-4′-methyl ether, erythrinasinate and 4′-O-methylsigmoidin B were isolated. The structures were determined on the basis of spectroscopic evidence.

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Bioassay-guided screening of Hypoestes verticillaris whole plant CH2Cl2:MeOH (1:1) extract for anti-plasmodial activity yielded four new compounds: two lignans 2, 6-dimethoxysavinin (1), 2,6-dimethoxy-(7E)-7,8-dehydroheliobuphthalmin (2); and two fusicoccane diterpenoids: 11(12)-epoxyhypoestenone (3) and 3(11)-epoxyhypoestenone (4). The chemical structures were determined using various spectroscopic techniques: UV–vis, IR, CD, 1D, 2D and MS. Two fractions (RAO-43B and RAO-43D) and the isolated compounds were tested for activity against CQ susceptible (D6) and resistant (W2) Plasmodium falciparum parasite strains, in vitro and the IC50 values determined. While the whole extract and some resultant fractions displayed moderate activity, the isolated compounds exhibited mild anti-plasmodial activity against the both strains ranging from IC50 value of 328 μM in 1 to 93 μM in 3 against W2 strain.

Two new flavonoids from Dracaena usambarensis Engl.
Vaderament-A.Nchiozem-Ngnitedem, Leonidah Kerubo Omosa, Solomon Derese, PierreTane, Matthias Heydenreich, Michael Spiteller, Ean-Jeong Seo, Thomas Efferth

Investigations of the root extract of Dracaena usambarensis Engl. for anticancer principles led to the characterization of one new homoisoflavonoid, (3S)-3,4ʹ,5,6-tetrahydroxy-7-methoxyhomoisoflavanone (1) and a new retrodihydrochalcone, 4ʹ,4-dihydroxy-2,3-dimethoxydihydrochalcone (2) along with six previously reported compounds, including two homoisoflavonoids, 7-O-methyl-8-demethoxy-3-hydroxy-3,9-dihydropunctatin (3) and loureiriol (4); a phenolic amide, 3-(4ʹʹʹ-hydroxyphenyl)-N-[2ʹ-(4ʹʹ-hydroxyphenyl)-2ʹ-methoxyethyl]acrylamide (5); a spirostane, 25S-spirosta-1,4-dien-3-one (6) and two steroids, stigmasterol (7) and stigmasterol 3-O-β-D-glucopyranoside (8). The structures of 1-8 were determined using spectroscopic and spectrometric techniques. The absolute configurations of compounds 1 and 3 were achieved using circular dichroism spectroscopy. Using the resazurin reduction assay and doxorubicin as reference anticancer drug, 1 showed moderate cytotoxicity against drug sensitive CCRF-CEM but was inactive against all the other tested drug sensitive, resistance phenotypes and normal cells. The crude extract and 2-8 were inactive in the preliminary screening against CCRF-CEM and drug resistant CEM/ADR5000 cell lines. Interestingly, the activity of the standard drug, doxorubicin was comparable to those of inactive compounds against CEM/ADR5000 cells. Future studies should focus on structure modifications of 1-3, in order to obtain more potent analogues.

In a bid to determine the HIV-1 subtype variants in transmission in Nairobi and its possible association with clinical status, we screened 207 confirmed HIV-1 positive patients visiting HIV/AIDS laboratory at the Virus Research Centre in Nairobi between January and March 1994. We used a selfmade ELISA obtained from an established panel of HIV-1 V3 loop peptides (ANRS, France) and derived from seven isolates: MN, HXB2, SC, Z6, Z2, ELI and CDC4. Test samples were obtained from 95 blood donors and medical examination attendees, 57 patients with chronic diarrhoea, 31 confirmed pulmonary tuberculosis, 16 with pneumonia and 12 herpes zoster. Out of the total, 21.5% had antibodies against the MN strain, 19.1% had against the Z2 strain while reaction against the HXB2 strain was observed in 17.2%. SC, CDC4, Z6 and ELI had prevalences of 11.5%, 6.2%, 5.3% and 3.8% respectively. Fifteen per cent of the tested sera showed no reaction to any of the used peptides. Strong and significant associations were observed between the total number of strains a sample react to and the clinical state. We infer that both the North American consensus strains (MN and HXB2) and the African isolates (Z2 and Z6) are predominant in Nairobi. The correlation between antibody reactivity and clinical state is an interesting observation that necessitates an expanded study and, the use of strain specific peptides maybe a sensitive and easier method for use for molecular epidemiological purposes. PIP: During January-March 1994, in Nairobi, Kenya, the sera of pre-university students, suspected AIDS/advanced HIV-infection cases, and blood donors were screened for HIV-1 antibodies at the Virus Research Centre. All confirmed HIV-1 positive samples were categorized according to the patient's clinical status. A self-made ELISA was obtained from an established panel of HIV-1 V3 loop peptides and derived from seven isolates (MN and HXB2 [North American strains], SC, CDC4, Z2 and Z6 [African strains], and ELI). The sera of the 22 confirmed HIV-1 negative students were used as negative controls. There were 207 confirmed HIV-1 cases (95 blood donors and 112 suspected AIDS/advanced HIV-infection cases). 64 (31%) and 112 (54%) samples reacted to at least 3 strains and no more than 2 strains, respectively. The remaining 31 (15%) samples did not react to any of the 7 peptide strains. Samples with CD4 cell counts greater than 500 x 1 million reacted significantly to more peptide strains than those with CD4 counts below 200 x 1 million (88% vs. 7%). Reactivity to specific strains were 21.5% for MN, 19.1% for Z2, 17.2% for HXB2, 11.5% for SC, 6.2% for CDC 4, 5.5% for Z6, and 3.8% for ELI. Anti-HXB2 antibodies were more common in blood donors than suspected AIDS/advanced HIV-infection cases (22% vs. 13%). AIDS/advanced HIV-infection cases were more likely to have no antibodies than blood donors (21% vs. 7%). A significant association existed between the number of peptide strains a patient could react to and the clinical state (p 0.01). Specifically, 77% of samples with no V3 antibodies to the seven strains had AIDS or advanced HIV infection while 55% of those which had cross reactivity with three or more strains were asymptomatic. Further research is needed to better understand this correlation. These findings suggest that use of strain specific peptides may be a sensitive and easier method for use for molecular epidemiological purposes.

From the stem bark of Erythrina burttii, two new flavanones were isolated and characterised as 5,7-dihydroxy-4′-methoxy-3′,5′-di-(3-methylbut-2-enyl)flavanone (trivial name, abyssinone V-4′-methyl ether) and 5,7-dihydroxy-4′-methoxy-3′-(3-hydroxy-3-methylbut-1-enyl)-5′-(3-methylbut-2-enyl)flavanone (trivial name, burttinone). In addition, seven known compounds were identified. Structures were determined on the basis of spectroscopic evidence.

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From the stem bark of Erythrina burttii, a new isoflavone, 5,2′,4′-trihydroxy-7-methoxy-6-(3-methylbut-2-enyl)isoflavone (trivial name, 7-O-methylluteone) and a new flavanone, 5,7-dihydroxy-4′-methoxy-3′-(3-methylbutadienyl)-5′-(3-methylbut-2-enyl)flavanone (trivial name, burttinonedehydrate) along with three known isoflavonoids (8-prenylluteone, 3-O-methylcalopocarpin and genistein) were isolated. The structures were determined on the basis of spectroscopic evidence.

Phytochemistry. 2003 Jun;63(4):445-8.

Two prenylated flavonoids from the stem bark of Erythrina burttii.

Yenesew A, Irungu B, Derese S, Midiwo JO, Heydenreich M, Peter MG.

From the stem bark of Erythrina burttii, a new isoflavone, 5,2',4'-trihydroxy-7-methoxy-6-(3-methylbut-2-enyl)isoflavone (trivial name, 7-O-methylluteone) and a new flavanone, 5,7-dihydroxy-4'-methoxy-3'-(3-methylbutadienyl)-5'-(3-methylbut-2-enyl)flavanone (trivial name, burttinonedehydrate) along with three known isoflavonoids (8-prenylluteone, 3-O-methylcalopocarpin and genistein) were isolated. The structures were determined on the basis of spectroscopic evidence.

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Interest rate volatility is a major concern for emerging economies due to its crippling effects on the economy. There is wide ranging disconsensus on the effectiveness and speed of various tools. This paper proposes timely monetary policy mediation to curb interest rate volatility through the determination of the total time taken for the effects of monetary policy instruments to transmit to via the interest rate channel to market rates. A change in the Central Bank Rate (CBR) will trigger a corresponding change in intermediate variables (Treasury bill (Tbill), Repurchase agreement (REPO) and Interbank rates) in the first stage of transmission. The second stage measures the transmission from the intermediate variables to market rates. The study uses an Auto Distributed Lag (ADL) specification parameterized as an Error Correction Model (ECM) with primary data coming from Central Bank of Kenya (CBK). The results indicate it takes 7 days for monetary policy adduced shocks to transmit from CBR to REPO, 3 months from CBR to T-bill and 12 months from CBR to interbank for the l" stage. At the second stage it takes 3 months for the adduced shocks to transmit from interbank to market rates and 10 months from T-bill to market rates. The paper proposes that CBK considers alternative monetary policy transmission channels as well as adopting a hybrid approach to monetary policy control. The study is the first to measure the complete two stage interest rate pass-through in Kenya and will contribute the scarce but steadily growing pool of literature on the subject in Kenya and Sub-Saharan Africa. The study will aid economists in determining the appropriateness ofthe interest rate channel based on its speed

This paper aims at working out economic groupscreening plans to sort out defective items from a population which consists of tems with unequal a-priori probabilities of being defective. It is shown that in the case of group-screening from a population with unequal a-priori probabilities of factors being defective, the number of obseruations needed on the average is considerably smaller than that required in the case of a population with factors having the same a-priori probability of being defective. Tables at the end give some group-screening plans as illustrations.
Keywords: Group-factors, Group-Screening Plans

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-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} The crude methanol extract of the seeds of Derris trifoliata showed potent and dose dependent larvicidal activity against the 2nd instar larvae of Aedes aegypti. From this extract two unusual rotenoid derivatives, a rotenoloid (named 7a-O-methyl-12a-hydroxydeguelol) and a spirohomooxarotenoid (named spiro-13-homo-13-oxaelliptone), were isolated and characterised. In addition a rare natural chromanone (6,7-dimethoxy-4-chromanone) and the known rotenoids rotenone, tephrosin and dehydrodeguelin were identified. The structures were assigned on the basis of spectroscopic evidence. The larvicidal activity of the crude extract is mainly due to rotenone.

Abiy Yenesew; John T Kiplagat; Solomon Derese; Jacob O Midiwo; Jacques M Kabaru; Matthias Heydenreich; Martin G Peter

The crude methanol extract of the seeds of Derris trifoliata showed potent and dose dependent larvicidal activity against the 2nd instar larvae of Aedes aegypti. From this extract two unusual rotenoid derivatives, a rotenoloid (named 7a-O-methyl-12a-hydroxydeguelol) and a spirohomooxarotenoid (named spiro-13-homo-13-oxaelliptone), were isolated and characterised. In addition a rare natural chromanone (6,7-dimethoxy-4-chromanone) and the known rotenoids rotenone, tephrosin and dehydrodeguelin were identified. The structures were assigned on the basis of spectroscopic evidence. The larvicidal activity of the crude extract is mainly due to rotenone.

The crude methanol extract of the seeds of Derris trifoliata showed potent and dose dependent larvicidal activity against the 2nd instar larvae of Aedes aegypti. From this extract two unusual rotenoid derivatives, a rotenoloid (named 7a-O-methyl-12a-hydroxydeguelol) and a spirohomooxarotenoid (named spiro-13-homo-13-oxaelliptone), were isolated and characterised. In addition a rare natural chromanone (6,7-dimethoxy-4-chromanone) and the known rotenoids rotenone, tephrosin and dehydrodeguelin were identified.
The structures were assigned on the basis of spectroscopic evidence. The larvicidal activity of the crude extract is mainly due to rotenone.

Extensive research in developed countries has established that very low birth weight (VLBW) infants are particularly vulnerable to the effects of early nutritional deficiencies. There is, however, little information from poor countries on the long-term effects of these deficiencies in such infants.

Determine the association between neonatal feeding regimens and post-discharge morbidity/ mortality and neurological abnormalities at the age of two years for a cohort of VLBW infants.

One hundred and seventy five VLBW infants were recruited over a consecutive period of one year and followed up to the age of two years corrected for gestation. With neonatal feeding regimes as the exposure variable, post-discharge re-hospitalization, mortality and Saigal and Rosenbaum's functional disability assessment scores were compared as the outcome variables.

Department of Nutritional Biology, University of California, Davis, CA 95616, USA.

The high prevalence of vitamin B-12 deficiency in many regions of the world is becoming recognized as a widespread public health problem, but it is not known to what extent this deficiency results from a low intake of the vitamin or from its malabsorption from food. In rural Kenya, where a previous study identified a high prevalence of inadequate vitamin B-12 intakes, this study examined whether plasma vitamin B-12 concentrations were associated with dietary sources of the vitamin at baseline and could be increased by supplementation with animal source foods (ASF). The 4 experimental groups in 503 school children were: 1) control (no food provided); 2) githeri (a maize and bean staple with added oil); 3) githeri + meat (githeri + minced beef); or 4) githeri + milk (githeri + milk). Feedings were isocaloric. Dietary data were collected at baseline, and biochemical data at baseline and after 1 and 2 y of feeding. Baseline plasma vitamin B-12 concentration was 193.6 +/- 105.3 pmol/L and correlated with % energy from ASF (r = 0.308, P < 0.001). The odds ratio for low plasma vitamin B-12 (<148 pmol/L), which occurred in 40% of children, was 6.28 [95% CI: 3.07-12.82] for the lowest vs. highest ASF intake tertile (P < 0.001). Feeding ASF (meat or milk) greatly reduced the prevalence of low plasma vitamin B-12 (P < 0.001). The high prevalence of low plasma vitamin B-12 concentrations in these children is predicted by a low intake of ASF, and supplemental ASF improves vitamin B-12 status.

PMID: 17311959 [PubMed - indexed for MEDLINE]

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The purpose of this study was to determine the characteristics of firearm injuries (FAI) involving the cranio-maxillofacial region among patients admitted at the Kenyatta National Hospital (KNH), the largest national referral and University of Nairobi teaching hospital in Kenya. There were 42l patients admitted with FAI, 48; (11.4%) of whom had sustained a significant injury to the cranio-rnaxillofacial region. The age of those injured ranged from 5 to 56 years with a mean age of ]O.5years and the age f,lTOUp most affected was ]0-39 years (29.2%). Seven (14.58%) of the patients admitted with craniofacial injuries died of their wounds, translating to one death for every seven patients admitted with injury to the craniofacial area.

Commercial weight loss programs may contribute to efforts to reduce the prevalence of obesity, although evidence of efficacy and effects on metabolic and cardiovascular risk factors is critical in evaluating the likelihood of sustained benefits. The Jenny Craig (JC) program involves individualized diet and exercise counseling (provided either in-person at community-based sites or by telephone), prepackaged foods and a low-energy density diet. The aims of this study are (1) To test, in a multi-site randomized controlled trial, whether the JC Centre-based and/or JC Direct (telephone-based) interventions promote greater weight loss and maintenance of that loss in overweight or obese women over a 24-month period compared to usual care (UC) conditions; and (2) To describe the effect of the program (vs. UC conditions) on selected biochemical factors, cardiopulmonary fitness, quality of life (QOL) and eating attitudes and behaviors. At randomization, participants (n=442) were 44(10) (mean[SD]) yrs, with BMI 33.8(3.4) kg/m2, weight 92.1(10.7) kg, and waist circumference 108.6(9.6) cm. Two-year data are available for 91% of study participants (n=406), and weight loss is - 8.1(8.6), -6.7(9.3), and -2.2(7.4) kg for the JC Centre- based, JC Direct, and UC groups, an average weight reduction of -8.7%, -7.3%, and -2.4% of initial weight, respectively. The proportion of women at highest risk (CRP>3 mg/L) in the JC arms decreased significantly from 53% at enrollment to 33% at two years, but was unchanged in the UC arm. Interim analysis also shows the JC intervention to promote favorable changes in lipid, leptin and carotenoid levels, and improved cardiopulmonary fitness

To evaluate after two years, the survival rate of glass ionomer cement (GIC) sealants placed in primary molars of six to eight year-olds and as part of proximal atraumatic restorative treatment (ART) restoration. DESIGN: A longitudinal clinical study. SETTING: Matungulu/Kangundo rural divisions, Machakos district, Kenya. SUBJECT: A total of 804 six to eight year-olds from rural Kenya received a sealant as part of a proximal restoration placed in a primary molar using the atraumatic restorative treatment (ART) approach. RESULTS: The two-year cumulative survival of the sealants was 10.9%, and the survival of the sealants was not significantly affected by the GIC material brand and the tooth-isolation method used. However, slightly more sealants survived when Fuji IX and rubber dam tooth- isolation method were used. CONCLUSION: The two-year survival rate of the sealants was poor and was not significantly influenced by the GIC material or the tooth-isolation method used.

Objectives: To evaluate after 2 years, the survival rate of glass ionomer cement (GIC)
sealants placed in primary molars of 6-8 year-olds and as part of proximal ART
restoration.
Study design: A longitudinal clinical study.
Setting: Matungulu/Kangundo rural divisions, Machakos district.
Participants: A total of 804 six to eight year-olds from rural Kenya received sealants as
part of proximal restorations placed in primary molars using the atraumatic restorative
treatment (ART) approach. Trained operators, using the ART approach, placed the
proximal restorations and the sealants using Fuji IX, Ketac Molar Easymix and Ketac
Molar Aplicap, together with rubber dam and cotton roll tooth-isolation methods.
Evaluation to determine the survival of the sealants was done soon after placement
(within 2 hours of placing them) and after 2 years. The data were analyzed using SPSS
14.0 computer programme, and the survival results related to the materials and the
isolation-methods used.
Results: The 2-year cumulative survival of the sealants was 10.9%, and the survival of
the sealants was not significantly affected by the GIC material brand and the toothisolation method used. However, slightly more sealants survived when Fuji IX and rubber dam tooth-isolation method were used.
Conclusion: The two-year survival rate of the sealants was poor and was not
significantly influenced by the GIC material or the tooth-isolation method used.

Purpose: The purpose of this study was to investigate the influence of 3 glass ionomer cement (GIC) brands and the postrestoration meal consumed on the survival rate of proximal atraumatic restorative treatment (ART) restorations.
Methods: A total of 804 proximal restorations were placed in primary molars by trained operators and assistants using 3 GIC brands. The materials’ mixing/placement times, the room temperature and the postrestoration meal consumed by the subjects were documented. The restorations were evaluated soon after placement and after 2 years by trained and calibrated evaluators.
Results: After 2 years, approximately 31% of the restorations had survived. There were no statistically significant differences in the survival rate of the restorations in relation to the GIC brands. The postrestoration meal consumed, which was of “hard consistency,” was associated with significantly lower survival rate of the restorations.
Conclusions: The survival rate of the proximal restorations was not significantly affected by the glass ionomer cement brands used, but was significantly influenced by the consistency of the next meal consumed by each child.

Key words: cariolo gy, dental material s/biomaterial s, dental education

Ostriches of various ages, unhatched embryos and chicks found to have oedema during post-mortem examination are described here. Unhatched eggs and chicks originated from a commercial farm, where there was a complaint of poor hatchability of eggs and high chick mortality. Of 35 embryos examined, 29(82.9%) had severe subcutaneous oedema either generalized (23) or localized(6). Of 311 chicks, 232(74.6%) had oedema of varying degrees of severity. In 10 chicks, the oedema was subcutaneous and severe, in 5 it was only serous effusions in body cavities and in 217, it was manifested as wetness of subcutaneous tissues. Adult and juvenile ostriches originated from three farms, where they were kept as pets. Of 22 birds, 16(72.7%0 developed a general sickness and 10(62.3%) of them died. Post-mortem examination revealed emaciation and either subcutaneous oedema or serous effusion in body cavities. Additional lesions included combinations of steatites, haemorrhages and pneumonia. The sick birds responded to improved diets that were also supplemented with multivitamins and minerals.

A ten-year retrospective review of laboratory detection of Cryptococcus neoformans in cerebrospinal fluid was undertaken using past laboratory and clinical records at Kenyatta National Hospital. A total of 1462 India-ink tests were carried out, 76 (5.2%) of these tested positive for C. neoformans. An increasing number of clinical requests for India-ink test mirrored by increasing number of patients with immunological disorders were noted over the study period although no obvious trend emerged in the detection pattern of C. neoformans. The use of a more sensitive test such as the latex agglutination technique is suggested.

Type 2 diabetes is a heterogeneous disease with multiple causes revolving around beta cell dysfunction, insulin resistance and enhanced hepatic glucose output. Clinical judgement based on obesity status, age of onset and the clinical perception of residual beta cell insulin secretory function (hence insulin-requiring or not), has been used to determine therapeutic choices for each patient. Further laboratory testing of the clinically defined type 2 diabetes unmasks the various aetiologic types within the single clinical group. Objective: To determine the aetiological types of the clinically defined type 2 diabetic patients, their chosen therapies at recruitment and the quality of glycaemic control achieved. Design: Descriptive cross-sectional study. Setting: Diabetes out-patient clinic of Kenyatta National Hospital, Nairobi, Kenya. Results: A total of 124 patients with clinical type 2 diabetes were included, 49.2% were males. The mean duration of diabetes in males was 26.09 (20.95) months and that of females was 28.68 (20.54) months. The aetiological grouping revealed the following proportions: Type 1A-3.2%, Type lB-12.1%, LADA-5.7%, and "true" type 2 diabetes 79.0%. All the patients with Type IA were apparently, and rightly so, on "insulin-only" treatment even though they did not achieve optimal glycaemic control with HbAlc % = 9.06. However the study patients who were type IB and LADA were distributed all over the treatment groups where most of them did not achieve optimal glycaemic control, range of HhAc of 8.46 -10.6%. The patients with "true" type 2 were also distributed all over the treatment groups where only subjects on 'diet only' treatment had good HbAlc of 6.72% but those in other treatment groups did not achieve optimal glycaemic control of HbA1c, 8.07 - 9.32%. Conclusion: Type 2 diabetes is a heterogeneous disease where clinical judgement alone does not adequately tell the various aetiological types apart without additional laboratory testing of C-peptide levels and GAD antibody status. This may partly explain the inappropriate treatment choices for the various aetiological types with consequent sub-optimal glycaemic control of those patients.

Capitellar fractures of the elbow present with pain and swelling of the elbow following a fall on an outstretched arm and are rare injuries comprising 0.5-1% of all elbow fractures (1). This is a case report of an adult female who sustained this injury following a fall on her outstretched arm. CT scans revealed a Type I capitellar fracture of the right elbow. Open reduction and internal fixation was done with a functionally good result. Because of the cartilaginous nature of the capitellum humeri these injuries are easily missed on radiography. One must have a high index of suspicion especially when elbow movement is noticeably restricted. These injuries are discussed and the literature reviewed. Although controversial, treatment is mainly operative. One should carefully review radiographs of patients who present with injuries of the elbow with pain, swelling and markedly restricted joint range of motion and whose mechanism of injury(fall on an outstretched arm) is consistent with capitellar fracture. CT scans often clinch the diagnosis. Type I fractures may be treated conservatively but Type II injuries require operative intervention.

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with Gerd Antos (eds.). Series: Transferwissenschaften 7.

Enteric fever is endemic in developing countries and frequently complicates with ileal perforation. Surgical intervention for the perforation is the usual treatment but attendant rate of postoperative complications high. It is unclear what the spec- trum of enteric fever perforations is in rural hospital practice in Kenya, where the diagnosis most often in intraoperative. To describe the surgical experience of typhoid perforations at a rural district hospital in Kenya. This was a retrospective chart review of patients who underwent laparotomies for peritonitis at the Kapenguria District Hospital in Kenya between April 2007 and October 2009. Data abstracted from patient files included demographics, presenting symptom, duration of symptoms, investigations (Widal and/or stool culture), operative management, complications, length of stay, and death. Widal test was indicative when titer was 1:160 for “O” antigen or above. Antimesenteric longitudinal perforation was assumed to be a complication of enteric fever. The data were analyzed using SPSS version 16.0.The results are presented in frequency tables, bar charts and pie charts. Of the 50 files retrieved with diagnosis of peritonitis, 21(42%) were found at operation to have had ileal perforations. Of these 15(71.5%) had resection and primary anastomosis, 2(9.5%) had refreshening and anastomosis (simple anastomosis) and 4 (19%) had ileostomy. Male to female ratio was 4:1, majority were aged 6-15 years (38.1%). Wound infection was 8(38.1%), enterocutaneous fistulae were 7(33.3%), while 7(33.3%) required second laparotomy and 4(19%) were referred due to complications which could not be managed at this level. Mortality was 3(14.3%) and average length of stay was 17days. Morbidity and mortality arising from typhoid ileal perforation is high in this environment making it a major challenge in a resource poor environment. Prevention by use of protocols is highly recommended

Actinobacillosis due to Actinobacillus lignieresi, has been reported in domestic animals including cattle, sheep, goats, buffalo, horses and dogs (Carmalt et al., 1999; Kennerman et al., 2006; Muhammad et al., 2006; Brown et al., 2007). The causative agent is a gram-negative aerobic rod and a normal inhabitant of the gastrointestinal tract of ruminants (Radostits et al., 2007; Smith, 2009). The most frequent clinical presentation is granulomatous or pyogranulomatous lesion of the tongue or subcutaneous tissues in the head and neck region. A typical manifestation of the disease have been reported affecting other body tissues / organs usually associated from lacerations, dehorning, nose-rings, intravenous injections and lymphadenitis (Aslani, et al., 1995; Holzhauer and Roumen, 2002). Outbreaks of the disease have also been reported (Campbell et al., 1975; Nakazawa and Azuma 1977). This paper outlines an atypical case of actinobacillosis of soft tissue swelling of the head in a cow without any exudation from the lesion, which is a challenge to confirming the etiological agent and treatment.

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.