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

No abstract available.

No abstract available.

Kamau RK, Osoti AO, Njuguna EM. Department of Obstetrics and Gynaecology, College of Health Sciences, University of Nairobi, P.O. Box 1%76-00202, Nairobi, Kenya. BACKGROUND: Cancer of the uterine cervix is the most common female cancer in Kenya. Despite being preventable, it is often diagnosed when it is already late. For this reason, only palliative therapy is provided. Hence, it is expected that their daily routines and that of their caregivers are severely disrupted. OBJECTIVES: To determine the extent to which diagnosis and treatment of inoperable cervical carcinoma affects quality of life (QOL). DESIGN: Cross-sectional descriptive study. Setting Radiotherapy Department at the Kenyatta National Hospital. SUBJECTS: Women undergoing radiotherapy for inoperable cervical cancer. RESULTS: There is high prevalence of profound disruptions in nearly all domains of QOL. In the social domain, between 33% and 44% had the perception that family members and friends had withdrawn social support. Reduction in various economic facets was reported by 47.4%-52.6%, with 44.7% reporting a fall in the overall living standards. There were significant changes in the sexual domain, as a result in which 28.3% reported marital discordance. In the personality domain, decreased self-esteem and self-projection in life occurred in 30.9% and 36.2% respectively. On functional outcomes (EORTC QLQ-C30), only 32%-41% reported not being affected in the various facets of emotional function. Physical functions were affected in 19%-79%, role functions in 69%-75%; symptoms in 49%-80%; cognitive functions in 46%-56%; social functions in 63%-71% and financial aspects by 63%. On global QOL, 53% and 47% respectively reported high level disruption in overall physical health and overall QOL. CONCLUSION: Severe deterioration of QOL occurs as a result of diagnosis of inoperable cervical cancer and subsequent therapies. For this reason there is need to establish severe disease and end-of-life research and management services that would ensure better coping with cancer for patients and for home-based caregivers. PMID: 17633581 [PubMed - indexed for MEDLINE]

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{ OBJECTIVES To compare sociodemographic profiles, child care, child feeding practices and growth indices of children born to HIV-1 seropositive and seronegative mothers. METHODS: A cohort study of 234 children (seropositive and seronegative) born to HIV-1 seropositive mothers and 139 children born to seronegative mothers in Pumwani Maternity Hospital which serves a low-income population in Nairobi, Kenya from December 1991 and January 1994. RESULTS: With few exceptions, at the time of their birth children in all three cohorts had parents with similar characteristics, lived in similar housing in similar geographical areas, had their mothers as their primary care givers, had similar feeding practices and similar growth status and patterns. However, the HIV-1 seropositive mothers were slightly younger (23.8 years vs. 25.0 years, P < 0.01), if married they were less likely to be their husband's first wife (79% vs. 91%

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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]

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.

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.

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.

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

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coming soon at the webstie

Introduction The Centre for Open and Distance Learning has been established to facilitate the Internal Faculties in launching and managing their programmes using distance mode with a view to increasing access to university education and provide equity in higher education to the learners all over the country. Operational Strategies The operational strategies that have been set up involve collaborative arrangements between the CODL and the Internal Faculties in the development of Study Materials and Learner support Services for off-campus students. The professional in open and distance learning are availed by the Centre to serve the Faculties as trainers while the Faculties provide academic expertise who are facilitated through participatory methods involving application of knowledge, skills and strategies to develop study materials in their respective subjects. Focus The Centre is currently working with Faculties of Science, Commerce and Arts. The Material development process involves training, writing, reviewing and editing followed by conversion to e-content and audio modes. Conclusion These collaborative arrangements will increase access to higher education make significant contribution in the realization of educational Millennium Goals in Kenya where only 20% of all those who qualify obtain admission in the public universities.

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PMID: 614126 [PubMed - indexed for MEDLINE]

PMID: 614126 [PubMed - indexed for MEDLINE]

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.

   

Experimentally, two hydatid cyst fluid (HCF) antigens (antigens 4 and 5) were found to be the most immunogenic antigens in HCF.  The two antigens were precipitated together from HCF.  This was done by adding 2M phosphotungstic acid and 2M magnesium chloride pollutions to clarified HCF whilte continuously stirring the mixture.  The precipitate formed was suspend in physiological saline (PS).  This antigens solutions was used to coat microtitre plates fro indirect ELISA.  Indirect ELISA was performed on 180 randomly selected bovine sera. The sensitivity of the test was found to be 98% while the specificity was 70%.  The predictive value was 89%.  Although the specificity of the test was relatively low, the test using these partially purified antigens was found to be useful because of its high sensitivity.

Antisera to thermostable muscle antigens from 13 wild animals: Buffalo, Waterbuck, Bushbuck, Eland, Oryx, Kongoni, Bushpig, Warthog, Topi, Thomson’s gazelle, Grant’s gazelle, Sheep, Pig, Horse, Camel & Dog, were raised in rabbits and/or goats. Absorptions of the antisera with copolymerized pooled serum from the 20 species and the thermostable muscle antigens rendered most of the antisera mmonospecific. It was possible to identify the species of origin of saline extracts of both cooked and fresh meat samples in immunodiffusion tests. The method is promising for use in identification of the species origin of fresh and cooked animal meats.

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

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

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

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45 Kenyan traditional healers were interviewed with respect to the diagnosis and treatment of eye diseases. Traditional management of eye diseases is based on the healers' concept of the disease causation as well as their knowledge of the herbal, animal and chemical substances that possess (or are reported to possess) remedial effect on the disease. While many of the healers interviewed failed to give a clear distinction between the various eye conditions, diseases such as cataract, foreign bodies and injuries were recognized easily. In almost all cases the medicinal substances were first diluted in water before they were applied to the eyes. Human milk, blood and the white of the egg were the animal substances listed as medicinal to various eye conditions. A solution of sugar was one of the chemical substances used in the treatment of specific eye conditions. Given correct information, some of these healers could f

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

Kenya Nurs J. 1981 Jun;10(1):21-2.
Opening speech to Coast Branch N.N.A.K. AGM on team work and nurses welfare.
Ngugi EN.

PMID:
6913629
[PubMed - indexed for MEDLINE]

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Destroy user interface controlMeSH Terms

Kenya Nurs J. 1981 Dec;10(2):13-5.
Setting the pace: new approaches in nursing practice: paper presented to the International Council of Nurses Congress at the 17th ICN Quadrennial Congress held in Los Angeles in June, 1981.
Ngugi EN.
PMID:
6921385
[PubMed - indexed for MEDLINE]

An unusual case of ophthalmomyiasis is reported, in which two living fly larvae were observed inside the patient's eye. One larva was removed from the anterior chamber by paracentesis; the other was destroyed on the retina by photocoagulation. The mode of infestation, clinical picture and treatment are discussed in brief.

Thirty-six Friesian and Friesian cross-bred cattle about 11 months old were fed to grow at the rates of 0·50 (low) and 1·08 (high) kg/day in a 12-week winter feeding period and then turned out on high quality pasture. For 12 weeks after turning out the ‘low’ and ‘high’ animals gained weight at 1·17 and 0·90 kg/day respectively. There was a negative correlation (– 0·57, P < 0·01) between winter and grazing live-weight gain. On two occasions herbage intake was estimated. Average intake of ‘low’ animals was 12% higher than of ‘high’ animals although herbage digestibility, estimated from faecal N, was similar for the two treatments. Differences in live-weight gain on pasture between treatments were largely accounted for by differences in intake. The low rate of winter growth did not have any significant effects on age at slaughter, carcass weights or grades attained by the restricted animals.

This is a combined prospective and retrospective
review 'study of empyema thoracis. Twenty patients admitted
to Kenyatta National Hospital wards between November, 1980
and April 1981 were studied prospectively. Seventy nine patients admitted between January 1975 and October 1980 were
studied retrospectively. Both groups have been reviewed
to highlight various aspects of this disease, particularly
its potentially crippling effect on the respiratory system
and the fact that this is a preventable situation which is
not yet fully appreciated in our country.
Pulmonary disease was the most prevalent underlying
aetiology in this series. Mycobacteria and Staph. Aureus
were the most frequent causative organism followed by
various gram negative bacteria. Culture was negative in 21%
of all cases reviewed. The tendency of children under
10 years of age to have staphylococcal and multibacterial
infection was noted.
The ever increasing pneumonectomy rate on the background
of inadequate initial. treatment coupled with
scarcity of surgical beds and theatre time is highlighted.
Finally paediatric age and presence of underlying disea were shown to have positive relationship with increased
mortality, while traumatic and tuberculous aetiologies
were found to have a higher risk of eventual pneumonectomy.

The different factors affecting the stability of adrenaline
in solution have been examined with a view to producing a
pharmaceutically active eye drop prep~ration of adrenaline. It
was important that such a formulation should be simple enough to

enable preperation using the available facilities in this country_
A preformu1ation screening of antioxidants in the
pH
absence of adrenaline showed that at low/values (around pH 3.0)
sodium sulphite was superior to either sodium metabisu1phite or
ascorbic acid. Accelerated stability studies showed that the
pH of maximum stability for aqueous solutions of adrenaline was
approximately pH 3.7. Accelerated stability tests at this pH

confirmed the superiority of sodium sulphite over a combination
of sodium metabisu1phite and ascorbic acid as antioxidants.
Accelerated stability studies also confirmed the
important role of boric acid in enhancing the stability of adrenaline
in aqueous solutions.
An investigation of four sterilization procedures
showed that the immediate loss of adrenaline was negligible
after either sterilization by filtration or by heating at 980c
for 30 minutes. Higher sterilization temperatures caused
substantial loss of adrenaline and discolouration of the solut
ions ,
For reasons of comfort to the patient on instillation
- 131 -
into the eye and for clarity of the solution in presence of the
preservative used (Benzalkonium Chloride), a final formulation of
adrenaline eye drops was prepared in borate buffer at pH 5.8,
with sodium sulphite as the antioxidant. Accelerated stability
studies and long term storage studies at ambient temperatures
showed that the final preparation was reasonably stable. Clinical
testing of the preparation on hospitalized glaucoma patients
showed that the preparation compared favourably with commercial
and other preparations used in the management of raised intraocular
pressures.

This is a retrospective study of 105 patients with herediatry haemorrhagic disorders seen at the Kenyatta National Hospital (KNH), between March 1975 and July 1980. Haemophilia forms 63% of the cases, Christmas disease 22% and von Willebrarid's disease (VWD) 9.5%. Rarer disorders encountered are factors X and VIII deficiency and one case of Glauzmann's disease. The study includes 3 subjects of Asian descent. Haernophilia co-existed witlt B-thalassaemia trait in 2 of the Asian subjects. Co-existing Christmas disease' and sickle cell anaemia was seen in one case. The clinical picture and course ' of the disorders are very similar to what is described elsewhere in the literature. It is. noted that although complications of replacement therapy in bleeding disorders are well documented elsewhere, only one of these patients' showed clinical evidence of such complications. There is now ample evidence that haemophilia is quite common in Africans, contrary to some reports in the past. This report serves as further evidence that haemophilia is not uncommon in Kenya and adds on to the already documented cases of hereditary haemorrhagic diseases in Kenya (1). With improving diagnostic and therapeutic facilities and increased use of hospital services more of these cases will be diagnosed

This is a retrospective study of 105 patients with herediatry haemorrhagic disorders seen at the Kenyatta National Hospital (KNH), between March 1975 and July 1980. Haemophilia forms 63% of the cases, Christmas disease 22% and von Willebrarid's disease (VWD) 9.5%. Rarer disorders encountered are factors X and VIII deficiency and one case of Glauzmann's disease. The study includes 3 subjects of Asian descent. Haernophilia co-existed witlt B-thalassaemia trait in 2 of the Asian subjects. Co-existing Christmas disease' and sickle cell anaemia was seen in one case. The clinical picture and course ' of the disorders are very similar to what is described elsewhere in the literature. It is. noted that although complications of replacement therapy in bleeding disorders are well documented elsewhere, only one of these patients' showed clinical evidence of such complications. There is now ample evidence that haemophilia is quite common in Africans, contrary to some reports in the past. This report serves as further evidence that haemophilia is not uncommon in Kenya and adds on to the already documented cases of hereditary haemorrhagic diseases in Kenya (1). With improving diagnostic and therapeutic facilities and increased use of hospital services more of these cases will be diagnosed

The dimension of the lower tarsus diminishes with aging. Changes in the number and size of the meibomian glands and in the character of intermingling fibroconnective tissues are thought to be responsible. Furthermore, such alterations of the structural integrity play an important role in the pathogenesis of entropion encountered commonly in the elderly. We have advocated the use of an autogenous cartilage graft harvested from the ear to correct the deformity, especially in instances where the conventional methods of correction have failed.

Valepotriates, mainly isovaltrate and valtrate, have been separated and quantitatively estimated by reversed-phase HPLC in the leaves, flowers, stems and rhizomes of Valeriana kilimandascharica. The isovaltrate/valtrate concentration reaches a maximum of 5.89% in the leaves, 3.84% in the flowers, 3.17% in the stems and 5.15% in the rhizomes.

he distribution of cathinone and d-norpseudoephedrine in Catha edit/is plants from 2 different geographical localities has been investigated. There was no difference in the chemical constituents of Catha material from 2 locali-ties. D-norpseudoephedrine was present in all parts of the plant examined except the root but cathinone was only detected in the young shoots and bran-chlets. It is concluded that the psychostinaulant effect following chewing of young Catha shoots is due to both cathinone and d-norpseudoephedrine with the cathinone being more important since it is 7-10 times more potent than d-norpseudoephedrine.

The basic problem of farming in developing countries is the lack of proper incentives for farmers. Prices paid for farmers' produce are too low, even to cover operational costs. The horticultural crops are much affected due to an unstructured market, and the Horticultural Crops Development Authority (HCDA) has not effectively assisted small-scale farmers. This paper evaluates the marketing systems for horticultural crops in relation to major ingredients affecting marketing. These variables are: the products to be marketed such as french beans, avocados, pineapples, mangoes; the place of the market and the prices to be paid. Some policies which could be adopted to improve the marketing of horticultural crops are considered.

he distribution of cathinone and d-norpseudoephedrine in Catha edit/is plants from 2 different geographical localities has been investigated. There was no difference in the chemical constituents of Catha material from 2 locali-ties. D-norpseudoephedrine was present in all parts of the plant examined except the root but cathinone was only detected in the young shoots and bran-chlets. It is concluded that the psychostinaulant effect following chewing of young Catha shoots is due to both cathinone and d-norpseudoephedrine with the cathinone being more important since it is 7-10 times more potent than d-norpseudoephedrine.

ere is great heterogeneity in the way individuals and populations respond to medications in terms of both host toxicity and efficacy. It is now well recognized that genetic differences in drug metabolism and disposition as well in drug target receptors could have an even greater influence on the efficacy and toxicity of medications. A Wide range of drug metabolizing enzymes (DME) are subject to genetic polymorphism. The genotype-phenotype relationship is particularly important for drugs with narrow therapeutic index where slight changes in plasma levels can result in serious toxicity or lack of efficacy. While Caucasian and oriental populations have benefited from the intense interest in the field of pharmacogenomics, there still exists a wide gap in this knowledge on African populations. Hence, the main objective of this study was to investigate the occurrence and frequency of allelic variants of polymorphic DME in three major ethnic populations in Kenya.

In a nine months period,from March 1987 to November

1987, inc1usiv€, studies on p1ac21et functions, pla$ma fibrinolytic activity and coagulation screen were carried out in 40 patients (30 males and 10 females) with the nephrotic syndrome and 40 matches controls at the Kenyatta
National Hospital. The age range was S-Sl years, mean + SD

20.5+11.6.

patients had unchanged platelet counts and clot retraction compared to controls (p>O.OS), whereas platelet adhesiveness and platelet agg~egation to adenosine diphosphate U",DP) were significantly reduced among patients (P0.05) as well as between plasma fibrinogen concentration and total cholesterol (r=0.25, P>0.05).
It is concluded that our patients have a degree of hype-rcoagulability. Whether the factors for and against hypercoagulabiJ .ity compensate f cr each other in the causation of complications need to be verified. A larger populatibn and more detailed haemostatic study will in future be needed to cover more nephrotic patients in different areas of the country. It is also necessary to folIo w up ou r pat ient s f or complicat ions resul ting from
this hypercoagulable state, like thromboembolic events and

is.c!haemic heart diseas.e to find ou.t.. their pre...lence .

and

contr.ibutionto morbidity and mortality among Africans with

nephrotic syndrome.

We have studied metabolism of glucose by infective forms of Trypanosoma brucei brucei isolated from tsetse fly salivary glands and grown in continuous culture for more than 700 days. The end products of glucose metabolism under aerobic conditions were found to be pyruvate and glycerol in the ratio 3:1. this changed to equimolar formation of pyruvate and glycerol when glucose was metabolized under aerobic conditions in the presence of 1.5 mM salicylhydroxamic acid (SHAM), a situation analogous to anaerobiosis. The respiration of the parasites was insensitive to cyanide inhibition but SHAM inhibited it completely. In the presence of SHAM, formation of pyruvate and glycerol from glucose metabolism was inhibited by 60% and 45% respectively. These findings indicate that the infective trypanosomes grown in vitro for about 2 yr have a peculiar glycolytic pathway which can be exploited to elucidate the mechanism of energy production of bloodstream form trypanosomes during anaerobic glycolysis

A survey of proprietary pharmaceutical products used in self-medication, in Kenya, has been undertaken. Out of 472 products covered in the survey, 32% were those used for gastrointestinal disorders and 18% for respiratory disorders. The significance and limitations of self•medication as they relate to management of minor health problems are discussed.

Cathinone, a potent psychostimulant isolated from young shoots of Catha edulis was given to four human volunteers. Examination of urine collected from the volunteers at predetermined intervals showed the presence of unchanged cathinone, d-norpseudoephedrine, and two unidentified basic substances. The observed biotransformation of cathinone to the less potent psychostimulant, d-norpseudoephedrine involves reduction of a ketone group to alcohol, a common metabolic pathway in humans.

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.

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.

Introduction to Philosophy of Religion, University of Nairobi, 1988

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

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.

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

45 Kenyan traditional healers were interviewed with respect to the diagnosis and treatment of eye diseases. Traditional management of eye diseases is based on the healers' concept of the disease causation as well as their knowledge of the herbal, animal and chemical substances that possess (or are reported to possess) remedial effect on the disease. While many of the healers interviewed failed to give a clear distinction between the various eye conditions, diseases such as cataract, foreign bodies and injuries were recognized easily. In almost all cases the medicinal substances were first diluted in water before they were applied to the eyes. Human milk, blood and the white of the egg were the animal substances listed as medicinal to various eye conditions. A solution of sugar was one of the chemical substances used in the treatment of specific eye conditions. Given correct information, some of these healers could f

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J. M. Khalagai,  held in Nairobi, Kenya in

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he distribution of cathinone and d-norpseudoephedrine in Catha edit/is plants from 2 different geographical localities has been investigated. There was no difference in the chemical constituents of Catha material from 2 locali-ties. D-norpseudoephedrine was present in all parts of the plant examined except the root but cathinone was only detected in the young shoots and bran-chlets. It is concluded that the psychostinaulant effect following chewing of young Catha shoots is due to both cathinone and d-norpseudoephedrine with the cathinone being more important since it is 7-10 times more potent than d-norpseudoephedrine.

The effect of acqueous extract of the tuber of Adenia globosa on the isolated preparation of the rat uterus was determined. The crude drug caused a dose-dependent contraction of the tissue preparation. This action was enhanced by a small dose of oxytocin. The results are discussed in relation to the traditional uses of this plant.

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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.

Joint exhibition of paintings and sculptures

The existing structure of the division of labour between men and women and the changing roles of women in Kenya are at once rooted in cultural norms and institutions and reinforced by structural arrangements. The Kenyan economy is primarily dependent on the agricultural sector. The great majority of the small farms are worked by family labour, and women provide the bulk of the labour force. Differences in male and female labour contributions to production and reproduction and the rewards associated with such roles constitute a basis for gender inequality. Changes in the historical processes and in the structure of the division of labour have conjointly led to the expansion of female roles, intensification of women's workload, and their economic and social marginality. This paper speaks to these issues and details the ways in which cultural and structural forces interact to define and perpetuate the role and subordinate status of women in Western Kenya.

The existing structure of the division of labour between men and women and the changing roles of women in Kenya are at once rooted in cultural norms and institutions and reinforced by structural arrangements. The Kenyan economy is primarily dependent on the agricultural sector. The great majority of the small farms are worked by family labour, and women provide the bulk of the labour force. Differences in male and female labour contributions to production and reproduction and the rewards associated with such roles constitute a basis for gender inequality. Changes in the historical processes and in the structure of the division of labour have conjointly led to the expansion of female roles, intensification of women's workload, and their economic and social marginality. This paper speaks to these issues and details the ways in which cultural and structural forces interact to define and perpetuate the role and subordinate status of women in Western Kenya.

No abstract available.

Introduction The Centre for Open and Distance Learning has been established to facilitate the Internal Faculties in launching and managing their programmes using distance mode with a view to increasing access to university education and provide equity in higher education to the learners all over the country. Operational Strategies The operational strategies that have been set up involve collaborative arrangements between the CODL and the Internal Faculties in the development of Study Materials and Learner support Services for off-campus students. The professional in open and distance learning are availed by the Centre to serve the Faculties as trainers while the Faculties provide academic expertise who are facilitated through participatory methods involving application of knowledge, skills and strategies to develop study materials in their respective subjects. Focus The Centre is currently working with Faculties of Science, Commerce and Arts. The Material development process involves training, writing, reviewing and editing followed by conversion to e-content and audio modes. Conclusion These collaborative arrangements will increase access to higher education make significant contribution in the realization of educational Millennium Goals in Kenya where only 20% of all those who qualify obtain admission in the public universities.

Introduction The Centre for Open and Distance Learning has been established to facilitate the Internal Faculties in launching and managing their programmes using distance mode with a view to increasing access to university education and provide equity in higher education to the learners all over the country. Operational Strategies The operational strategies that have been set up involve collaborative arrangements between the CODL and the Internal Faculties in the development of Study Materials and Learner support Services for off-campus students. The professional in open and distance learning are availed by the Centre to serve the Faculties as trainers while the Faculties provide academic expertise who are facilitated through participatory methods involving application of knowledge, skills and strategies to develop study materials in their respective subjects. Focus The Centre is currently working with Faculties of Science, Commerce and Arts. The Material development process involves training, writing, reviewing and editing followed by conversion to e-content and audio modes. Conclusion These collaborative arrangements will increase access to higher education make significant contribution in the realization of educational Millennium Goals in Kenya where only 20% of all those who qualify obtain admission in the public universities.

Small-intestinal function was studied in 10 patients with visceral leishmaniasis. Vitamin-A absorption was impaired in 7 and d-xylose in 1. In 5 of the 10 patients Leishmania were demonstrated in biopsy specimens of intestinal mucosa. Parasitised macrophages were present in villous tips and less commonly in the lamina propria and submucosa; a moderate inflammatory infiltrate was composed of lymphocytes and plasma cells. 2 patients had partial villous atrophy. There was no correlation between intensity of parasitisation and severity of malabsorption. After treatment with sodium stibogluconate there was a significant improvement in absorption of vitamin A and d-xylose, and biopsy specimens became normal. In 1 patient visceral leishmaniasis was thought to be the cause of chronic diarrhoea.

JASPA Working Paper, ILO, Addis Ababa

Although early diagnosis and treatment are key factors in the effective control of human African trypanosomiasis (HAT), many cases of the disease delay taking appropriate action, leading to untold suffering. As a better understanding of treatment-seeking behaviour should help in identifying the obstacles to early diagnosis and effective treatment, the treatment pathways followed by 203 former HAT cases in western Kenya and eastern Uganda have recently been explored. About 86% of the HAT cases had utilized more than two different healthcare options before being correctly diagnosed for HAT, with about 70% each using more than three different health facilities. Only about 8% of the cases reported that they had been correctly diagnosed the first time they sought treatment. Just over half (51%) of the HAT cases had been symptomatic for >2 months before being correctly diagnosed for HAT, and such time lags in diagnosis contributed to 72% of the cases receiving their first appropriate treatment only in the late stage of the disease. The likelihood of a correct diagnosis increased with the time the case had been symptomatic. These observations indicate an urgent need to build the diagnostic capacity of the primary healthcare facilities in the study area, so that all HAT cases can be identified and treated in the early stage of the disease.

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

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

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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.

This paper describes the methodology and presents preliminary results of an economic appraisal of a community based health care project in Kenya. Community health workers, trained for 12 weeks and deployed in two locations in Kenya's Western Province, act as first contact providers of basic health care and promoters of selected health, sanitation and nutrition practices. A Cost Benefit Analysis has been undertaken using the Willingness to Pay approach to compare the costs of the project and its benefits. The benefits are in the form of more easily accessible basic health care and are measured as consumer surplus accruing to the community. Gain in consumer surplus is consequent on the fall of average user costs and rise in utilisation of the project established points of first contact with primary health care. The argument for the economic viability of the project is validated by the large Net Present Value and Benefit Cost Ratio obtained for the whole of the project area and for the two locations separately. Although the evaluation technique used faces the problem of valuation of community time, aggregation of health care services at all points of first contact and the partial nature of cost benefit analysis evaluations, the results are strongly in favour of decentralisation of primary health care on similar lines in the rest of the country.

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.

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

 Journal of Civil Engineering, Jomo Kenyatta University of Agriculture and Technology Vol.7 PP

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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.

SUMMARY LIII)' lIIorpllOlogiClI changcs ill the goat ,csris after:. sillgle illlraperilOlieal injec,ioll of ethalle ,lillie' I.:lIIeslll"llOnarc (EI )S) werc investigatcd mint; (1Orh liglH alld deCll'On microscopy. The (olllpolind was ;almillistered at two dose Icvels: 75 mgll

SUMMARY LIII)' lIIorpllOlogiClI changcs ill the goat ,csris after:. sillgle illlraperilOlieal injec,ioll of ethalle ,lillie' I.:lIIeslll"llOnarc (EI )S) werc investigatcd mint; (1Orh liglH alld deCll'On microscopy. The (olllpolind was ;almillistered at two dose Icvels: 75 mgll

Mean ages of eruption of the permanent teeth (except 3rd molars) in African and Asian children were derived from a cross-sectional study of 2847 children aged 4-14 years, in selected nursery and primary schools in Nairobi, Kenya. Except for the premolars, the mandibular teeth erupted earlier than the maxillary ones in both races. The mandibular incisors and canines erupted earlier by 0.9-1.1 yr in Africans and 0.6-0.8 yr in Asians, and the molar by 0.2-0.4 yr in both races. The maxillary premolars were ahead of mandibular premolars by 0.1-0.2 yr in both races. The females were ahead of males in both races. Compared with the Asians, the African permanent teeth erupted earlier by 0.2-0.7 yr. The most frequent order of eruption in Africans is Mand I1, Mand M1, Max M1, Mand I2, and Max I1 between 5-7 years, while in the Asians the most frequent order is Mand M1, Mand I1, or Max M1, Max I1 and Mand I2 between 6-8 years. The incidence of Cusp of Carabelli in Africans and Asians is about 19-25%.

Eruption data for permanent teeth, obtained from a previous cross-sectional study of 2847 African and Asian school children aged 4-14 years in Nairobi, Kenya, were used to calculate the median age and the 10th-90th percentile range of age, for a given number of teeth present. For a limited period (5-13 years) up to the time of eruption of second molars, the total number of permanent teeth erupted can be used to estimate the age of a child, with an error which increases with the number of teeth present. The range of this error is about 18-30% of the median age for African males, 21-29% for African females, 15-33% for Asian males and 18-33% for Asian females, with a 1 in 5 chance that the error may exceed these limits.

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This chapter attempts to re-evaluate the history of the East African coast and the Comores between the seventh and eleventh centuries. This is being done with a view to correcting the false picture painted by historians and/or archaeologists of the colonial school of thought, who presented rather a history of foreign traders and colonizers credited with the civilization of the coast. The role of outsiders in the early history of the East African coast cannot be denied, but it is one thing to be part of a process of change and completely another to claim responsibility for the process. Recent research, however, is slowly but surely making it very clear that the history of the East African coast is the history of indigenous African populations and their interaction with the environment

This chapter attempts to re-evaluate the history of the East African coast and the Comores between the seventh and eleventh centuries. This is being done with a view to correcting the false picture painted by historians and/or archaeologists of the colonial school of thought, who presented rather a history of foreign traders and colonizers credited with the civilization of the coast. The role of outsiders in the early history of the East African coast cannot be denied, but it is one thing to be part of a process of change and completely another to claim responsibility for the process. Recent research, however, is slowly but surely making it very clear that the history of the East African coast is the history of indigenous African populations and their interaction with the environment

Families in Kenya. In Handbook of World Families, edited by B.N. Adams and J. Trest. Sage Publication, 2005.

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JASPA Working Paper, ILO, Addis Ababa

JASPA Working Paper, ILO, Addis Ababa