The effect of intravenous bicarbonate on the changes in intermediary metabolites during the initial treatment of diabetic ketoacidosis was examined in 16 patients. The results were compared with the changes seen in 16 patients receiving intravenous saline. Infusion of 150 mmol (mEq) bicarbonate significantly delayed the fall in blood lactate, lactate:pyruvate ratio, and total ketone bodies observed in the saline treated group. No difference in the rate of fall of blood glucose concentration was found. There is no metabolic indication for the use of intravenous bicarbonate in the treatment of diabetic ketoacidosis.

Using the method of retrograde labeling of ganglion cells with HRP, we studied in adult rats the plastic changes in the retinogeniculate projections due to monocular enucleations shortly after birth. Four normal and 6 neonatally enucleated rats were used. In two of the normal and 4 of the enucleated rats a small amount of HRP was injected into the dorsal lateral geniculate nucleus (LGd) and in 4 other rats massive injections were made into the optic tract near the LGd. Neonatally unilaterally eye-enucleated rats were characterized by an expanded distribution of ipsilaterally projecting ganglion cells all over the retina of the remaining eye and by a densely packed distribution of these cells in the lower temporal retina in which area these cells have only a moderate density in normal rats. On the contrary, in the lower temporal retina of monocularly enucleated rats the incidence of contralaterally projecting ganglion cells was decreased. Soma areas of ipsi- and contralaterally projecting ganglion cells were measured for the peripheral crescent in lower temporal and lower nasal retinas. As compared with normal rats, neonatally enucleated rats had a larger mean soma area of ipsilaterally projecting cells and a smaller mean soma area of contralaterally projecting cells. This result was interpreted as suggesting that after neonatal monocular enucleation medium to large cells had changed their side of axonal projection from the contralateral to ipsilateral LGd.

Using the method of retrograde labeling of ganglion cells with HRP, we studied in adult rats the plastic changes in the retinogeniculate projections due to monocular enucleations shortly after birth. Four normal and 6 neonatally enucleated rats were used. In two of the normal and 4 of the enucleated rats a small amount of HRP was injected into the dorsal lateral geniculate nucleus (LGd) and in 4 other rats massive injections were made into the optic tract near the LGd. Neonatally unilaterally eye-enucleated rats were characterized by an expanded distribution of ipsilaterally projecting ganglion cells all over the retina of the remaining eye and by a densely packed distribution of these cells in the lower temporal retina in which area these cells have only a moderate density in normal rats. On the contrary, in the lower temporal retina of monocularly enucleated rats the incidence of contralaterally projecting ganglion cells was decreased. Soma areas of ipsi- and contralaterally projecting ganglion cells were measured for the peripheral crescent in lower temporal and lower nasal retinas. As compared with normal rats, neonatally enucleated rats had a larger mean soma area of ipsilaterally projecting cells and a smaller mean soma area of contralaterally projecting cells. This result was interpreted as suggesting that after neonatal monocular enucleation medium to large cells had changed their side of axonal projection from the contralateral to ipsilateral LGd.

Spectrophotometric measurements of photoreceptors 1–6 in the blowfly demonstrate that rhodopsin undergoes a continuous renewal. This involves, in the dark, the slow degradation of rhodopsin whereas metarhodopsin is degraded at a much faster rate. The effect of light is to reduce the rate at which metarhodopsin is degraded, i.e. the rate is inversely related to the intensity of the light. Rhodopsin synthesis is dependent on the presence of 11-cis retinal which is formed via a photoreaction from all-trans retinal resulting from the breakdown of rhodopsin and/or metarhodopsin: the biosynthesis of rhodopsin is therefore a light dependent process. Light of the blue/violet spectral range was found to mediate the isomerization of all-trans retinal into the 11-cis form. It is proposed that this stereospecificity is the result of all-trans retinal being bound to a protein. On the basis of the results a visual pigment cycle is proposed.

Clinical Considerations, Surgery of the Intracranial Aneurysma and Results

In monocularly deprived (MD) cats, many cells in the lateral geniculate nucleus (LGN) but few cells in the visual cortex respond to input from the deprived eye, suggesting that the connections to visual cortex from the deprived geniculate laminae may have been disrupted. I have examined these connections in MD cats by using electron microscopic autoradiography of visual cortex after injections of tritiated lysine into single laminae of LGN. After injections into either deprived or experienced laminae, there was label over terminals that contained mitochondria and round synaptic vesicles and that made asymmetric contacts with dendritic profiles. However, the terminals of deprived afferents differed from those of experienced afferents. They were 25% smaller, contained 33% fewer mitochondria, were more likely to make synapses that were presynaptically convex (and thus, perhaps, immature), and synapsed onto smaller spines. These morphological changes were greater for afferents to upper layer IV than for afferents to lower layer IV. The geniculocortical synapses from deprived laminae were also reduced in number. To correct for variations in injection size and for a probable reduction in protein synthesis by cells in the deprived laminae, I computed the ratio of labeled synaptic terminals to labeled myelinated axons. Injections into the deprived laminae labeled 43% fewer synaptic terminals per labeled myelinated axon than did injections into the experienced lamina. The finding that the synaptic terminals of deprived afferents are both abnormal morphologically and fewer in number can help to explain the reduced effectiveness of the deprived eye in driving cortical cells.

Horseradish peroxidase was deposited in the optic nerve to retrogradely label and reveal the dendritic form of all classes of ganglion cell, or it was injected into the dorsal lateral geniculate nucleus to reveal only those classes projecting to the thalamus. The results were compared with those of the accompanying paper in which the ganglion cells projecting to the midbrain are selectively revealed. Two major classes of ganglion cells are described, the Pα and Pβ cells. For both classes dendritic field size increases with eccentricity from the fovea and there is no overlap in the two classes at any given eccentricity. Cell body size shows a similar mean difference but with a slight overlap. Both cell bodies and dendritic fields are larger along the temporal horizontal meridian than the nasal horizontal meridian, for Pα and for Pβ cells, but these differences are reduced when naso-temporal differences in ganglion cell density are taken into account, that is, size correlates closely with density. Injections restricted to the parvocellular layers of the lateral geniculate nucleus labelled almost exclusively Pβ cells, whereas injections confined to the magnocellular layers labelled almost exclusively Pα cells. As midbrain injections label no Pβ cells and few Pα cells it can be shown that about 80% of ganglion cells are Pβ cells projecting to parvocellular lateral geniculate nucleus, and that about 10% are Pα cells projecting to magnocellular layers. The coverage factor, that is the number of cells covering each point on the retina, varied from 1.9–2.3 for Pβ cells, and from 2–7 for Pα cells. Comparing the results with those of comparable investigations on cats and rabbits shows a much clearer segregation of the terminal targets of different classes of ganglion cell in monkeys, the greatest difference being the absence in the monkey of a projection to the geniculate from gamma- and epsilon-like cells. Further, axons which branch and innervate both thalamus and midbrain are rare in monkeys but common in other mammals. Comparing the results with those from physiological investigations suggests that the Pβ cells correspond to colour-opponent cells, whereas Pα cells correspond to the achromatic broad-band magnocellular cells.

n/a

PIP: Of 110 males selected for review with possible chancroid, 96 were clinically diagnosed as having chancroid, 7 as having herpetic lesions, and 7 as having syphilis. Of the 96 patients diagnosed clinically as chancroid, 76 (79.2%) were culture positive for H. ducreyi. 9 (9.4%) of these 96 patients yielded Herpes Simplex Virus (HSV). Both HSV and H. ducreyi were isolated from 5 of the patients, and from 4 of the patients HSV alone was isolated. 7 patients (6.4%) were clinically diagnosed as having herpetic ulcers. 5 of these grew HSV. Overall, 14 of the 110 patients (12.7%) yielded HSV. 1 patient, who presented with small vesicular lesions characteristic of HSV, yielded the virus on culture. The vesicles were initially negative for H. ducreyi, but 6 days later he had developed deep purulent ulcers in the same sites as the vesicular lesions and became culture positive for H. ducreyi snd HSV-negative. The possible association between HSV and chancroid is discussed in the light of these findings and comparisons made between the results of the present study and earlier findings made in Kenya and elsewhere, with suggestions being given as to the reasons for the apparent differences. The HSV isolation techniques used in this study may be less sensitive than those used in other studies, but it is highly unlikely that this possibility alone accounts for all of the observed differences. Patients with hepetic ulcers may be less likely to present early in the course of the disease, if at all, believing the infection to be minor and one that will heal on its own. It is also possible that HSV infection is less common in Kenya, either alone or as an initiator of chancroid, than in the US or Europe, becuase of a higher rate of childhood HSV infections in Kenya, which may confer a degree of immunity against genital HSV infection in this population. The lower prevalence of HSV in association with H. ducreyi reported may be at least partly the result of a much higher incidence in Kenya of chancroid which is not initiated by HSV. A higher incidence of HSV genital infection in Europe and America would also make it more likely that HSV would fortuitously be isolated more frequently from H. ducreyi positive lesions.

The main concern of this paper is to assess the marketing of horticultural produce in Kenya. In 1950 the Horticultural Cooperative Union (HCU) was organized to help mostly European farmers to market fruit and vegetables. The HCU has been faced with some financial problems, mainly due to loss in customers and inactive members. The HCU shares about 15 to 20 % of the total Kenya exports. There are some producers-exporters specialized in exporting flowers and some commodities like French beans, pineapples and capsicum. The climatical conditions and ecological zones are good, enabling many fruit and vegetables to be produced in Kenya. The major export products are flowers, pineapples, French beans, capsicum and fresh fruits. The trade channels are mainly directed to the British market, which is dominant with a share of 50.64 % in 1982 and European markets (mainly West Germany, having a market share of 15.5 % in 1982 and France with a market share of 12.20 % for the same year 1982). In 1974 the main export to West Germany was pineapple which amounted to 24.9 % of all fresh produce imported from Kenya, second was capsicums with 10.8 %. Kenya fresh fruit and vegetables show a high demand on European markets. This market is a very competitive one. The countries in the Mediterranean region and in the tropical equatorial part of the African Continent pose a challenging position to this market. There is free entry and free exit to this market. When Kenya wants to have a sizable share of this market also in the future, it has to maintain a high quality at a reasonable price. This means that quality control, proper packaging and efficient transportation to the market have to be improved. The smallholders need to be supported when entering the market and need close advisory in order to supply high quality produce. Kenya should be willing to invest in areas like market research, market intelligence and export promotion. In addition the local consumption of fruit and vegetables should be encouraged as a part of the National Food Policy Program.

The relative efficacy and the risk of producing biochemical disturbances by bendrofluazide, 10 mg once daily and slow-release frusemide (Lasix Retard) 60 mg once daily, during treatment of moderate hypertension in Kenyan negroes were compared in a double-blind randomized control study. Fifty newly diagnosed hypertensive patients entered the study which lasted for 36 wk. There were 7 drop-outs at the end of the trial. Both slow-release frusemide and bendrofluazide significantly decreased both supine and standing diastolic pressures and standing systolic pressure (P < 0.05). Bendrofluazide also showed a significant effect on supine systolic pressure (P < 0.01), which was greater than that of slow-release frusemide. Biochemical disturbances were more pronounced in patients receiving bendrofluazide than in those on slow-release frusemide. Bendrofluazide treatment resulted in significant hyperuricemia (P < 0.02), hypokalemia (P < 0.01) and a rise in blood glucose which was not statistically significant (t [test of significance] = 0.26). Slow-release frusemide produced no significant alterations in blood uric acid, K and blood glucose. Both treatment modalities produced no significant change in other biochemical and hematological indices. Compared with slow-release frusemide, bendrofluazide produced potentially serious adverse biochemical changes. The drugs were equally effective in controlling moderate hypertension although the hypotensive effect on systolic blood pressure was more pronounced with bendrofluazide.

OVER THE PAST TWO DECADES, sub-Saharan Africa experienced relatively low growth rates in the production of dairy products compared with the average for all developing countries. Total consumption of dairy products grew relatively much faster during the same period. However, available data suggest that the consumption of goat and sheep milk declined in East Africa between 1963 and 1980 and that of camel's milk stagnated. Only the consumption of cow's milk increased fairly rapidly in the whole of sub-Saharan Africa over the last two decades. During the 1970s the population of sub-Saharan Africa grew at a rate of 2.9% per annum. Over the same period dairy production grew at a rate of about 1.9% per annum, while the consumption of dairy products increased at a rate of 2.1 % per annum. The trade deficit in dairy products in sub-Saharan Africa increased alarmingly over the last two decades: while in 1963 the dairy trade deficit for the region was about US$ 39 million, the figure had risen to about US$ 81 million by 1970 and to US$ 575 million by 1980. The major components of the imports were milk and butter and to a lesser extent cheese. The systems of dairy development and dairy marketing in most countries of sub-Saharan Africa have one common feature: the dairy economy is dominated by a relatively underdeveloped dairy marketing subsystem in the traditional livestock subsector. Most countries in the region have both a formal dairy marketing subsystem, which caters primarily for urban milk supplies, and an informal marketing subsystem, which operates especially in the rural areas. There is some evidence that the informal marketing subsystems tend to be low-cost operations and that they are in a position to pay higher prices to producers. With milk production in sub-Saharan Africa being well below the effective demand for milk and milk products, the region will continue to depend on dairy imports to close the dairy deficit in the foreseeable future. Measures to improve the marketing infrastructure in order to facilitate the distribution of recombined fluid milk derived mainly from imported milk powder and butter oil, will also be needed. The need to link rural and urban areas in a more efficient milk distribution network must therefore receive top priority. Most food policies in developing countries, and especially those in sub-Saharan Africa, appear to be aimed at providing cheap food to urban populations. A strategy of dairy development through the creation of producer incentives, with producer prices and price controls as the main policy instruments, is limited chiefly by the need to strike a balance between the producer price and the retail price. The pricing problem appears to be at the core of programmes for improving dairy development and dairy marketing. Governments are often sensitive to the level of food prices, particularly for the urban poor. Variations in the quality of the products offered for sale, whereby consumer prices are differentiated, could help achieve certain nutritional objectives. For instance, the introduction of 'toned' (more expensive) and 'double-toned' (less expensive) liquid milk in India has made it possible to sell pasteurized milk to both higher-income and lower-income groups in the metropolitan areas. Generally, sub-Saharan Africa could learn from the experience of dairy development in India, where petty milk traders have been integrated into the overall milk collection and distribution system, thus creating a complementary rather than a competitive relationship in the operations of the country's dairy industry.

Neurological complications of Diabetes Mellitus were
looked for in a group of 31 patients using clinical examination
and electrophysiological tests. Clinically evident sensorimotor
neuropathy was found to be prsent in 41.9% and clinical
autonomic neuropathy in 15% of the patients. Electrophysiological
tests showed evidence of sensorimotor neuropathy in 80% and
autonomic nerve dysfunction in 35% of the same patients. Autonomic
neuropathy was found to occur always in association with
sensorimotor neuropathy.
The electrophysiological tests were found to be convenient
as they were easy, and required little cooeration from the patient.
Sensory nerve tests were found to be more sensitive than motor
nerve tests alone and the yield of anyone test was found to
increase the more nerves one examined. Electrocardiographic tests
for autonomic neuropathy ( i.e. 'beat to beat variation' of pulse
rate and the 'valsalva ratio' ) were found to be of equal
sensitivity, but the former was easier to carry out and is
therefore recommended. The use of postural blood pressure changes
to assess autonomic nerve function was found to be too insensitive
for any practical use. When postural hypotension is present, other
signs of neuropathy are usually grossly evident.

The purpose of this study was to analyze the production costs of French beans (Phaseolus vulgaris) and to assess the financial gain to farmers. The major growers in Kenya are small farmers. The French beans are grown mainly for export purpose and are produced largely near the city of Nairobi where the altitude is between 1 000 and 2 000 meters above sea level and where soil is well drained and rich in organic matter. French beans are among the major horticultural crops produced in Kenya for export. The export season of French beans is from November to April. The farmers visited used irrigation water for production. About 50 mm of water per week was applied using an overhead or furrow system of irrigation. The overhead system of irrigation, however, was comonly used. The farming of French beans is labor and capital intensive. The costing of the inputs such as fertilizers, seed, labor for land preparation and harvesting were estimated. Between 20 to 25 kg of seed per acre (49.4 – 61.8 kg/ha) was used, costing about Kshs 32 for 60 kgs; land preparation was about Kshs 500 per acre (Kshs 1 235.5/ ha). The price for fertilizer for one acre was Kshs 500 (Kshs 1 235.5/ha). The total variable cost was about Kshs 4 670 per acre (Kshs 11 539.6/ha). Gross margin per acre was 16 530 Kshs (Kshs 1 309.6/ha). The estimated labor input on large, mechanized farm for French beans amounts to 3 283 mh/ha. The harvesting, which include picking, selecting and packing approximately 1 300 cartons for export required the highest labor with 3 030 mh/ha; canning, 100 mh/ha; irrigation, 80 mh/ha with 20 applications; weeding, 35 mh/ha; spraying, 14 mh/ha; top dressing, 9 mh/ha and planting, 7 mh/ha. The average yield was between 600 to 1 000 cartons of 3 kg/acre (1 482.6 – 2 471.0 cartons/ha). The price at farm gate is Kshs 21 per carton of 3 kgs. Some of the small farmers had direct access to the export markets but the majority of them had to sell to the exporters. A good majority of the farmers estimated a profit of about 25 per cent but considered employment it provides for them and the rural people a very important benefit.

Despite the high frequency of sickle cell disease in Europe, the disease is poorly managed. Critical periods are the hospital stays during which the anaesthesiologist plays an important role. Understanding the molecular basis of polymerization processes of haemoglobin S can help to avoid triggering a crisis. Differentiation of the various haemoglobin phenotypes helps to estimate the individual perioperative risk. Knowledge of the patient's history and the actual haemoglobin S level facilitates general anaesthesia, surgery and postoperative care. Damage to liver, spleen, eyes, bones, lung and central nervous system increases the perioperative risk. Preoperative preparation includes early admission, intravenous volume substitution, continuing pain therapy and prophylactic antibiotic medication. General anaesthesia seems to be better for patients with a high-risk profile rather than regional anaesthesia. Careful perioperative and postoperative monitoring should allow hypoxaemia, hypovolaemia, hypothermia, acidosis and overtransfusion to be avoided. Effective pain therapy includes a combination of opioids with peripherally acting analgesia.

AbstractExchange reactions in antimony(III)–cysteine and –3,3-dimethyl-D-cysteine (dmc) systems have been investigated. Exchange is rapid and independent of pH with antimony(III)–cysteine systems at pH 1–3 but is slow with potassium bis(tartrato)diantimonate(III)–cysteine. Antimony(III) compounds of dmc, toluene-3,4-dithiolate, Dicyano-ethylene-1,2-dithiolate, and 2,3-Bis(thiosemicarbazono)butane have been synthesized and characterized.

Grains from a high and low tannin sorghum were reconstituted by adding distilled water at a 30% level (w/w) and stored for 20 d at 25 C with an acetic-propionic acid mixture added to deter fungal growth. Another batch of grain from the same sources was used as control (no moisture treatment). The grains treated as above were incorporated at a 75% level in soybean meal-based starter diets for pigs. Reconstitution reduced the tannin content of high tannin sorghum significantly. The weight gains and feed consumptions with untreated and treated sorghums were not different (P>.05). Feed efficiency (G/F) was better (P<.05) with reconstituted than with the untreated sorghums. Dry matter digestibility was improved (P<.05) by reconstitution. The diets containing high tannin sorghum had lower (P<.05) digestible energy than the diets containing low tannin sorghums. Reconstitution improved (P<.05) the protein digestibility of the high tannin sorghum, but not that of the low tannin sorghum.

In this paper, emphasis has been given to both the expected number of runs and the expected number of incorrect decisions and two stage group-screening designs have been obtained which minimise one fixing the other or minimise some sort of cost function which connects the two. Some group-screening plans have been given at the end as illustrations.
Keywords: group-screening plans, orthogonal main-effect plans, group-factor

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

The pharmacokinetics of cyclophisphamide have been extensively discussed in adult man.A few studies have been done to compare the pharmacokinetics of this important anticancer agent in children and adults of a comparable population

In field experiments at Katumani in 1982, cowpea cv. Katumani 80 and Vita 4 were grown in chromic luvisol soils and treated with 15N-labelled ammonium sulphate at 20 kg N/ha, with or without 70 kg P/ha. Differences in nodule DW, DM yield, P uptake and tissue N yield were detected between cv. at maturity, but P rate had no effect. Av. seed yields of Katumani 80 and Vita 4 were 1.16 and 1.05 t/ha, resp., and were unaffected by P rate.

The effect of alkaloids extracted from strychnos henningsii plant were studied on the normal mice following the intraperitoneal administration on the isolated innerverted skeletal muscles of the rat diaphragm as well as on local anatomic sites of the guinea pig skin.The alkaloids induced convulsions and paralysis characteristic of strychnine poisoning.The convulsions were reversible on the administration of pentobarbitone strychnos henningsii bases produced progressive blockade of the neuromuscular junction without initial stimulation.The blockade was not antagonised by physostigmine.Results of this work indicated strychnos henningsii alkanoids effects are similar to those of strychnine and not curare.we conclude that the commonly used appetiser strychnos henningsii decoction may be dangerous in overdose and suggest that incase of poisoning barbiturates could be used as antidote

Primary malignant lymphomas of the female breast are rare up to date such tumors have been described in the male. Majority of the malignant tumors of the breast are the well known infiltrating duct carcinoma. This is report of a mammary non-Hodgkins malignant lymphoma in a 35 year old Nigerian female. This tumor had a rapid progression terminating in death seven months after histological diagnosis. The clinical presentation, treatment, prognosis and the differential diagnosis with medullary and poorly differentiated carcinoma of the breast are discussed

Sea-level pressure over the southwest Indian Ocean has been studied for the northern summer season during the first Garp global experiment (FGGE) period. Grid point pressure values, resulting from objective analysis, at 1200 GMT for the period 15 June to 13 August 1979 were selected for this study. This period is referred to as the selected monsoon period and it lay between the Indian subcontinent monsoon onset and withdrawal periods. The space and time characteristics of sea level pressure in the region were estimated from principal component analysis and from spectral analysis respectively.

Examines the marketing of domestically produced dairy products in sub-Saharan Africa, including imported but locally reconstituted whole milk powder and butter oil, and discusses trends in the imports of other dairy products over the last two decades in order to assess the impact of various dairy development and marketing policies of governments on the production & consumption of dairy products in the region.

Skin and gonad doses have been measured in 144 adult patients undergoing barium meal and barium enema examina-tions at a University Teaching Hospital. Intrahospital variations are discussed and their implications for national dose surveys considered, It is suggested that, due to differences in leakage and scattered radiation levels, overcouch tube machines may deliver higher doses to organs outside the useful beam than undercouch units, The study also points towards increased film consumption in GIT studies, National surveys of radiation doses to patients in diagnostic radiology are restricted to selected institutions over short periods of time. Consequently, although the dose data from such exercises may provide a broad picture of a national situation, detailed studies of intrahospital and interhospital variations for anyone type of examination are made difficult by the small numbers of examinations carried out at anyone institution during national surveys. Detailed surveys of doses received in selected examinations at single institutions, or within limited regions, enable better analysis of such variations to be made. Matthews and Miller (1969) have reported the results of a regional survey in Great Britain. A large hospital with staff of varying levels of skill provides a suitable environment for studying within-hospital dose variations. When a particular type of examination is performed by several radiologists in rotation, the "personal factor" in dose variation tends to be evened out in the mean values obtained. Furthermore, the use of uniform film¬processing conditions removes another of the , traditional causes of variations. The present survey was undertaken at the University Hospital of South Manchester in Great Britain. Studies of the radiation exposure to patients in diagnostic examinations of the gastro-intestinal tract (GIT) are important because this group of investigations gives large doses to the active bone marrow as well as the gonads of the irradiated individuals. Following a sharp decline in the frequency of mass miniature chest radiography, GIT studies now probably make the largest contribution to the annual ner canut mean bone marrow dose in Great Britain. despit~ their low frequency compared to othe; diagnostic examinations. The relatively low con¬tribution of GIT studies to the genetically-significant dose (Wall et ai, 1980) is due to a combination of their low frequency and the age distribution of the patients examined (Kendall et ai, 1980). It may be possible that the somatic stochastic risks associated with this group of examinations are more important than the genetic risks. However, the computation of mean bone marrow doses, which requires a model combining data on the distribution of active bone marrow in different segments of the body with estimated radiation doses to the bone marrow in those segments, is beyond the objectives of this paper. In the present work, gonad doses in male patients, and abdominal skin doses in female patients, have been measured for larger numbers of patients than are normally achieved at individual institutions during national surveys. In female patients, ovary doses have been calculated from the skin doses. In the case of barium enema examinations the skin doses may be found useful in estimating mean bone marrow doses.

In the non-linear Rξ gauge, the W− boson field satisfies the naive Ward identity and in consequence one-loop contributions give zero neutrino charge, which they do not in the conventional Rξ gauge. Further, in this non-linear gauge, the separate diagrams contributing to the photon self-energy are transverse and their divergent parts gauge independent.

A prospective study of seventy seven patients with urethral
strictures treated at the Kenyatta National Hospital over a period
of twelve months (1982-1983) was done. The age, tribal, and
aetiological incidencies were investigated. Various aspects of the
clinical presentation, investigation and treatment were also looked
at;
Post-inflammatory strictures were significantly more than
post-traumatic and iatrogenic strictures. However, post-prostatectomy
strictures were not included with the later.
The lapse period following post-inflammatory strictures was,
about 5years on the avereqe , Orno-Dore quotes 18 years for a
Nigerian study done two decades ago for post-gonococcal strictures.
It was not possible to determine the initial cause of urethritis in this
study due to the fact that most patients had no cultures for the
organisms done at the time of infection. Some were treated at
dispensaries and previous medical records were unobtainable.
Data on tribal incidence could not be critically analysed
without bias due to the uneven distribution of the tribes around the
Nairobi area. Others live a few kilometers away and others hundreds

of kilometers.
Half of the urine cultures done were negative. The rest grew
gram negative organisms, mainly E. coli. No gonococci were isolated.
B.U.N. was elevated above normal in about one third of the patients;
Intravenous pyelograms were normal in four-fifths of the patients
investigated. Micturatingure throqrcmcdone in eleven patients showed
the majority of strictures to be in the posterior urethra.
Seventy-three percent of the patients were managed with
intermittent dilatations with good results. Urethroplasty was done in
23% and urethrotomy in 4% of the patients - urethroplasty was offered
more to the younger age group.
The need for proper health education to the public about this
'disease and its causes is emphasized. Suggestions for better management
of these patients are forwarded. Special stress on the benefits of
urethrotomy under vision for suitable patients is made. A critical review
of the various types of urethroplasty is also presented.

The efficacy of a single 2.5-g dose of thiamphenicol against infection with penicillinase-producing strains of Neisseria gonorrhoeae (PPNG) or non-penicillinase-producing strains (non-PPNG) was studied in a two-phase clinical trial in Nairobi. The first phase included men who had had a urethral discharge for less than seven days, were infected with either PPNG or non-PPNG, and had not received previous treatment. The second phase included men with PPNG infections that had not responded to treatment with penicillin. The overall cure rate (determined by follow-up examinations and cultures three and ten days after treatment) was 90.6% in the first phase of the study and 92.1% in the second phase. A second 2.5-g dose of thiamphenicol was administered to four of the six patients in the second phase whose cultures yielded gonococci after the initial dose; the infections of all four patients were cured. The results of disk diffusion tests of gonococcal isolates did not correlate well with the outcome of treatment.

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

Oral infection with Herpes Simplex Virus (HSV) is a frequent and well documented complication in immunosuppressed individuals including patients on immunosuppressive medication. We report the development of severe oral infection with HSV type 1 in a 34 year old woman with type 1 diabetes mellitus and end stage renal disease (ESRD) following cadaveric renal transplantation at the Western General Hospital, Edinburgh. The role of acyclovir in therapy and chemoprophylaxis is discussed.

A simple gas chromatographic assay utilising alkali flame ionisation detection is described for the estimation of cyclophosphamide as its trifluoroacetate derivative from plasma. Examination of five patients following intravenous cyclophosphamide gave values of 8.9 h (SD 2.7) for the half-life and 0.061 liters/h/kg (SD 0.011) for whole-body clearance of the drug.

Aminoglutethimide (AG) 500 mg was administered orally to four normal volunteers and eight patients undergoing treatment for metastatic breast cancer. In each subject the acetylator phenotype was established from the monoacetyldapsone (MADDS)/dapsone (DDS) ratio. Acetylaminoglutethimide (acetylAG) rapidly appeared in the plasma and its disposition paralleled that of AG. A close relationship (P less than 0.01) was observed between the acetyl AG/AG and MADDS/DDS ratio suggesting that AG may undergo polymorphic acetylation like DDS. AG half-life was 19.5 +/- 7.7 h in seven fast acetylators of DDS and 12.6 +/- 2.3 h in five slow acetylators and its apparent metabolic clearance was significantly (P less than 0.01) related to the acetylAG/AG ratio. Over 48 h the fast acetylators excreted 7.7 +/- 4.4% of the administered AG dose in the urine as unchanged AG as compared to 12.4 +/- 2.8% in slow acetylators. A much smaller fraction of the dose was excreted as acetylAG: 3.6 +/- 1.5% by fast and 1.9 +/- 1.0% by slow acetylators respectively. After 7 days treatment with AG at an accepted clinical dose regimen to the eight patients there were significant reductions in the half-lives of AG (P less than 0.01) and acetylAG (P less than 0.01) and a trend (0.1 greater than P greater than 0.05) towards reduction of the acetylAG/AG ratio which became significant (P less than 0.05) if the one patient on a known enzyme inducer was omitted. The mean apparent volume of distribution was not significantly (P greater than 0.1) altered but the mean apparent systemic clearance of AG was increased (P less than 0.05). These changes are attributed to auto-induction of oxidative enzymes involved in AG metabolism.

Nine patients with acute liver failure due to Plasmodium falciparum liver injury admitted to the Rajgarhia Liver Unit of the All-India Institute of Medical Sciences during 1982-84 are presented. The liver was palpable in all the patients, and eight had splenomegaly. Investigations revealed mild to moderate abnormality in liver function tests. All were negative for the markers of acute infection due to hepatitis A and B viruses. Blood film examination showed P. falciparum alone in seven and along with P. vivax in the remaining two patients. Liver histology, which was identical in all eight patients where liver biopsy was done, showed centrizonal necrosis and hyperplastic Kupffer cells loaded with malarial pigment. All the patients recovered with specific anti-malarial and supportive treatment. Our observations suggest that malaria due to P. falciparum may present as jaundice and encephalopathy which stimulates acute hepatic failure due to fulminant hepatitis.

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.

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.

This integrative review on the teaching of reading in Kenyan primary schools provides a foundation for the growing movement there to improve reading education. In gathering sources for this review, we took an inclusive historical stance. Thus, we did not dismiss research reports that lacked traditional indicators of quality such as being published in peer-reviewed journals. We used multiple methods to find relevant research and associated documents, including two trips to Kenya. The review is organized by six topics: (a) language of instruction, (b) reading instruction, (c) reading materials, (d) reading culture, (e) assessment, and (f) teacher development. The review concludes with six proposals for policymakers, educational researchers, and teacher educators for the development of reading instruction based on what we learned in reviewing the literature. The first proposals are intended specifically to address the teaching of reading in Kenya, but they may be relevant to other sub-Saharan nations. The final proposal encourages others to conduct similar reviews to make possible a handbook of reading in Africa.

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.

Department of Medical Microbiology, College of Health Sciences, University of Nairobi, Nairobi. Four hundred and thirty six pupils in two primary schools in Kibwezi, Kenya aged between seven and sixteen years and positive for S. mansoni were treated as follows: 320 pupils with a single dose of praziquantel at 40 mg/kg body weight and 116 controls with a placebo. Immediate and delayed side effects of praziquantel were observed. The main side-effects were abdominal pain (36.3%), headache (35.3%) and nausea (13.1%). There was correlation between frequencies of these side-effects and intensity of infection measured as eggs per gram of faeces. Other side-effects included dizziness (9.7%), fever (7.8%), urticaria and bloody diarrhoea. Overall, the side-effects of praziquantel were mild and transient, and did not require any intervention. For ethical reasons, all pupils who served as controls were treated with praziquantel after the study. PMID: 8898462 [PubMed - indexed for MEDLINE]

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Nine patients with acute liver failure due to Plasmodium falciparum liver injury admitted to the Rajgarhia Liver Unit of the All-India Institute of Medical Sciences during 1982-84 are presented. The liver was palpable in all the patients, and eight had splenomegaly. Investigations revealed mild to moderate abnormality in liver function tests. All were negative for the markers of acute infection due to hepatitis A and B viruses. Blood film examination showed P. falciparum alone in seven and along with P. vivax in the remaining two patients. Liver histology, which was identical in all eight patients where liver biopsy was done, showed centrizonal necrosis and hyperplastic Kupffer cells loaded with malarial pigment. All the patients recovered with specific anti-malarial and supportive treatment. Our observations suggest that malaria due to P. falciparum may present as jaundice and encephalopathy which stimulates acute hepatic failure due to fulminant hepatitis.

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

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

An in vitro study of the antinematodal action of two groups of compounds which act on the receptor complex of the inhibitory neurotransmitter, Gamma-aminobutyric acid (GABA) in mammalian systems is described. The compounds, Ivermectin and two benzodiazepines, Diazepam and a water soluble Midazolam were tested singly or in combination against two microfilarial parasites Onchocerca lienalis (closely related to Onchocerca volvulus) and Brugia pahangi. The combination of ivermectin and diazepam at a concentration of 0.1 microgram/ml and 33 micrograms/ml respectively achieved the same effect on microfilarial motility as when ivermectin was given at 1 microgram/ml alone or diazepam at 66 micrograms/ml alone. Similarly when the combination of ivermectin at 0.1 microgram/ml and midazolam at 10 micrograms/ml was used it achieved the same effect as ivermectin at 1 microgram/ml alone or midazolam at 33 micrograms/ml alone. This showed that both benzodiazepines had a synergistic effect on the activity of ivermectin. The microfilariae of B. pahangi were insensitive to both groups of compounds at all concentrations used.

The toxin produced by Clostridium botulinum type C 6813 (C-6813) was purified 1,009-fold from the culture supernatant in an overall yield of 30%. The specific toxicity was 1.1 X 10(7) mouse minimum lethal doses per mg of protein. The toxin had a molecular weight of 144,000, composed of the light and heavy chains with molecular weights of 52,000 and 92,000, respectively, linked by one or two disulfide bond(s). The purified C-6813 toxin heavy and light chains reacted strongly with anti-type D heavy chain immunoglobulin G and anti-type C1 light chain immunoglobulin G, respectively. The amino acid compositions of C-6813 toxin heavy and light chains were more similar to those of type D heavy chain and type C1 light chain than to those of type C1 heavy chain and type D light chain, respectively. These results suggest that in the toxin produced by the type C strain at least two subtypes exist.

No abstract available.

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

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PIP: Malaria is the most prevalent and devastating public health problem in Africa despite much research and control effort over the last two decades. In most parts of Africa, individuals should take 200 mg of Proguanil daily together with chloroquine 5 mg/kg per week as prophylaxis. Pregnant women and individuals with underlying disease such as sickle cell making them susceptible to severe or complicated malaria, however, should take just 200 mg Proguanil daily. In hard-core multi-drug resistance areas, mefloquine 250 mg once weekly together with chloroquine 300 mg weekly is recommended as prophylaxis. Since no anti-malarial drug confers absolute protection against infection, however, using mosquito nets impregnated with permethrin, insecticides, and mosquito repellents is also advocated for those at high risk of severe malaria. The need also exists to treat cases of malaria when prevention is unsuccessful. Chloroquine in total dose 25 mg/Kg over three days is the first choice treatment of uncomplicated malaria in 4-aminoquinoline sensitive areas. Amodiaquine 25 mg/Kg over three days is the second line treatment, while pyrimethamine/sulphonamide combinations are useful in areas where there is resistance to 4-aminoquinalines. Finally, quinine 10 mg/kg every eight hours for seven days is the treatment of choice for severe and complicated malaria.

PIP: Malaria is the most prevalent and devastating public health problem in Africa despite much research and control effort over the last two decades. In most parts of Africa, individuals should take 200 mg of Proguanil daily together with chloroquine 5 mg/kg per week as prophylaxis. Pregnant women and individuals with underlying disease such as sickle cell making them susceptible to severe or complicated malaria, however, should take just 200 mg Proguanil daily. In hard-core multi-drug resistance areas, mefloquine 250 mg once weekly together with chloroquine 300 mg weekly is recommended as prophylaxis. Since no anti-malarial drug confers absolute protection against infection, however, using mosquito nets impregnated with permethrin, insecticides, and mosquito repellents is also advocated for those at high risk of severe malaria. The need also exists to treat cases of malaria when prevention is unsuccessful. Chloroquine in total dose 25 mg/Kg over three days is the first choice treatment of uncomplicated malaria in 4-aminoquinoline sensitive areas. Amodiaquine 25 mg/Kg over three days is the second line treatment, while pyrimethamine/sulphonamide combinations are useful in areas where there is resistance to 4-aminoquinalines. Finally, quinine 10 mg/kg every eight hours for seven days is the treatment of choice for severe and complicated malaria.

PIP: Malaria is the most prevalent and devastating public health problem in Africa despite much research and control effort over the last two decades. In most parts of Africa, individuals should take 200 mg of Proguanil daily together with chloroquine 5 mg/kg per week as prophylaxis. Pregnant women and individuals with underlying disease such as sickle cell making them susceptible to severe or complicated malaria, however, should take just 200 mg Proguanil daily. In hard-core multi-drug resistance areas, mefloquine 250 mg once weekly together with chloroquine 300 mg weekly is recommended as prophylaxis. Since no anti-malarial drug confers absolute protection against infection, however, using mosquito nets impregnated with permethrin, insecticides, and mosquito repellents is also advocated for those at high risk of severe malaria. The need also exists to treat cases of malaria when prevention is unsuccessful. Chloroquine in total dose 25 mg/Kg over three days is the first choice treatment of uncomplicated malaria in 4-aminoquinoline sensitive areas. Amodiaquine 25 mg/Kg over three days is the second line treatment, while pyrimethamine/sulphonamide combinations are useful in areas where there is resistance to 4-aminoquinalines. Finally, quinine 10 mg/kg every eight hours for seven days is the treatment of choice for severe and complicated malaria.

PIP: Malaria is the most prevalent and devastating public health problem in Africa despite much research and control effort over the last two decades. In most parts of Africa, individuals should take 200 mg of Proguanil daily together with chloroquine 5 mg/kg per week as prophylaxis. Pregnant women and individuals with underlying disease such as sickle cell making them susceptible to severe or complicated malaria, however, should take just 200 mg Proguanil daily. In hard-core multi-drug resistance areas, mefloquine 250 mg once weekly together with chloroquine 300 mg weekly is recommended as prophylaxis. Since no anti-malarial drug confers absolute protection against infection, however, using mosquito nets impregnated with permethrin, insecticides, and mosquito repellents is also advocated for those at high risk of severe malaria. The need also exists to treat cases of malaria when prevention is unsuccessful. Chloroquine in total dose 25 mg/Kg over three days is the first choice treatment of uncomplicated malaria in 4-aminoquinoline sensitive areas. Amodiaquine 25 mg/Kg over three days is the second line treatment, while pyrimethamine/sulphonamide combinations are useful in areas where there is resistance to 4-aminoquinalines. Finally, quinine 10 mg/kg every eight hours for seven days is the treatment of choice for severe and complicated malaria.

PIP: Malaria is the most prevalent and devastating public health problem in Africa despite much research and control effort over the last two decades. In most parts of Africa, individuals should take 200 mg of Proguanil daily together with chloroquine 5 mg/kg per week as prophylaxis. Pregnant women and individuals with underlying disease such as sickle cell making them susceptible to severe or complicated malaria, however, should take just 200 mg Proguanil daily. In hard-core multi-drug resistance areas, mefloquine 250 mg once weekly together with chloroquine 300 mg weekly is recommended as prophylaxis. Since no anti-malarial drug confers absolute protection against infection, however, using mosquito nets impregnated with permethrin, insecticides, and mosquito repellents is also advocated for those at high risk of severe malaria. The need also exists to treat cases of malaria when prevention is unsuccessful. Chloroquine in total dose 25 mg/Kg over three days is the first choice treatment of uncomplicated malaria in 4-aminoquinoline sensitive areas. Amodiaquine 25 mg/Kg over three days is the second line treatment, while pyrimethamine/sulphonamide combinations are useful in areas where there is resistance to 4-aminoquinalines. Finally, quinine 10 mg/kg every eight hours for seven days is the treatment of choice for severe and complicated malaria.

This paper reviews some research studies on tillage methods influencing soil and moisture conservation in the eastern African countries of Kenya, Tanzania, Malawi and Ethiopia during the past four decades. Most of these studies were conducted in marginal rainfall (semi arid ) areas and on shallow soils of various textures (sandy clay loam, sandy clay, clay and loam). The studies were meant to establish the effects of tillage and residue management practices on physico-chemical soil properties (i.e. structure, bulk density, soil moisture and organic matter contents), runoff and infiltration. This review emphasizes the importance of appropriate tillage and residue management methods (contour bunds and terraces, minimum tillage, tied ridging, mulching and conventional tillage) in providing soil conditions favourable for soil moisture conservation and subsequent crop performance and yield on smallholder farms.

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