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.

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

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

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

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

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

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

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Rajab J.A. Unit 4: Safe blood transfusion module 4 STI control and prevention manual for postgraduate diploma in the control and management of sexually transmitted infections by distance learning. Ministry of Health and the Belgian Development Cooperation, 1999.

OBJECTIVE: To study re-association pattern of human placental eluate immunoglobulins with acid treated isologous and third party trophoblast derived placental microvesicles. DESIGN: Laboratory based experimentation. SETTING: Biological Sciences Department and Discipline for Reproductive Medicine University of Newcastle, Australia and the Department of Biochemistry, University of Nairobi, Kenya. RESULTS: Placental eluate immunoglobulins re-associated with isologous and third party acidified microvesicles in three distinct patterns. I: eluate immunoglobulins re-associated more strongly with isologous and third party acid treated placental microvesicles, II: eluate immunoglobulins re-associated strongly with isologous but weakly with third party acid treated placental microvesicles, III: eluate immunoglobulins did not show preferential re-association with isologous and third party acid treated placental microvesicles. CONCLUSION: Two types of antigenic epitopes I and II may be expressed on the human placentae. Type I antigens may be present on all human placentae while type II epitopes may be paternally derived hence unique to each pregnancy. Also, immunoglobulins produced to placental microvesicle antigens may be directed to some but not all antigenic epitopes expressed on the human placental trophoblast.

A mini review of contamination routes and limitations to effective control. Japanesegricultural Quarterly Journal 2010; 44 (1) 7-16.

A description is given of a novel liquid phase immunoassay for the measurement of testosterone in peripheral venous plasma from men and women. The procedure involves: (i) competitive binding of the analyte and tritiated antigen to specific antibodies; (ii) enzymatic conjugation of the free ligand with glucuronic acid; and (iii) separation of the antibody-bound and free ligand by partition of the reactants into an organic and aqueous phase. The technique has been called ligand differentiation immunoassay (LIDIA). The mean sensitivity was 5 pg/tube (equivalent to 0.35 nmol/l female plasma; 0.87 nmol/l male plasma). The mean reagent blank (+/- SD) was 0.24 (0.12) nmol/l female plasma; 0.61 (0.30) nmol/l male plasma. A precision profile gave values less than 50%; the within batch variation was less than 8.3% and the between batch variation over three months was 12.3%. An accuracy profile between the second and penultimate points on the calibration curve gave values between 77 and 103%. The correlation coefficient 'r' between LIDIA and a heterogeneous radioimmunoassay was 0.92 when applied to plasma from men and 0.95 to samples from women.

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

Rhabdomyosarcomas are the most common soft tissue sarcomas in childhood. The botryoid variant arises in infancy from the vagina or urinary bladder and extremely rarely from the uterine cervix. Treatment regimes range from local excision of the tumour to radical hysterectomy with adjuvant multidrug therapy and/or radiotherapy. In cases of minimal cervical invasion, the less invasive local excision in combination with adjuvant chemotherapy has resulted in excellent survival rates with complete functional preservation of the bladder, rectum, vagina, and ovaries. We present here a 30-year literature review and a case report of a cervical sarcoma botryoides in a 5-year-old girl. CONCLUSION: based on the literature review and our own observation, we recommend minor surgical approaches in combination with chemotherapy as the treatment of choice for early stage I cervical rhabdomyosarcoma. Copyright 2004 Springer-Verlag

Surgical significance of brachial arterial variants in a Kenyan population
A Pulei, M Obimbo, K Ongeti, P Kitunguu, M Inyimili, J Ogeng’o

Abstract

Background: Knowledge of the variant anatomy of the brachial artery is important in radial arterial grafts for coronary bypass, percutaneous trans-radial approach to coronary angiography, angioplasty and flap surgery. These variations show ethnic differences but data from black populations are scarce. This study therefore describes the course in relation with median nerve, level and pattern of termination of brachial artery in a black Kenyan population.
Methods: This was a cadaveric dissection study of 162 upper limbs at the Department of Human Anatomy University of Nairobi, Kenya. The brachial artery was exposed entirely from the lower border of teres major to its point of termination. The course in relation to the median nerve and the level of termination were recorded. The results were analyzed using SPSS version 17.0 for Windows.
Results: 72.2% of the brachial arteries followed the classical pattern described in Gray’s Anatomy. Superfi cial brachioradial and superficial brachial arteries were present in 12.3% and 6.1% of the cases respectively. Brachial artery terminated at the radial neck in 79% of the cases, radial tuberosity (8.6%), and proximal arm (11.1%), mid arm (1.2%). Pattern of termination was either a bifurcation into the radial and ulnar arteries (90.1%) or trifurcation into radial, ulnar and common interosseous arteries (9.3%). We also report a case of trifurcation of the brachial artery into the profunda brachii, radial and ulnar arteries (0.6%).
Conclusion: Variations of the brachial artery in its relationship with the median nerve, level and pattern of termination are common. These may complicate arm surgical exposures, fl ap and vascular surgery. Pre-operative angiographic evaluation is recommended.

Keywords: brachial artery, bifurcation, trifurcation, superficial brachioradial artery

Department of Obstetrics and Gynecology, Justus-Liebig-University of Giessen, Giessen, Germany. BACKGROUND: Vulvar melanoma represents a rare group of malignancies and is the second most common vulvar malignancy. Treatment options range from local excision of the tumor and sentinel lymph node dissection to radical resection involving en bloc vulvectomy and inguinofemoral lymphanedectomy. Vulvar melanomas have an overall poor prognosis, and there is lack of consensus in the published literature regarding treatment options. OBJECTIVE: To discuss the management of vulvar melanomas through review of the actual literature. METHODS: Identification of studies through computerized searches (January 2006) was conducted using MEDLINE (1966 to present), the Cochrane Central Register of Controlled Trials, the National Research Register and the Medical Research Council's Clinical Trials Register. The medical subject headings and text words used were: vulvar melanoma, malignant, management, case report, and therapy. The literature review was done over the past 36 years. RESULT: Results of these primary retrospective series have shown no improvement in the overall recovery or disease survival rates. CONCLUSION: Patients with malignant melanoma are often diagnosed at 70 years of age with multiple comorbidities. Less radical surgery presents a more realistic option for many patients without decreasing their survival rates. Surgery is still the gold standard of treatment and offers the best available treatment for controlling and potential curing of malignant melanomas. However, the whole concept of therapy should be tailored to meet the specific needs of individual patients.

Recurrent pregnancy loss has been associated with autoimmune responses to membrane phospholipids and alloimmune reactions against paternally derived molecules on the trophoblast. The problem is psychologically and economically stressful as it undermines the capacity of some couples to reproduce and participate effectively in the day-to-day economic activities. This article reviews the adoption of intravenous immunoglobulin as a form of therapy for the clinical management of recurrent pregnancy loss and of selected autoimmune disorders. Side effects, contraindications and safety of use are discussed.

OBJECTIVE: To study re-association pattern of human placental eluate immunoglobulins with acid treated isologous and third party trophoblast derived placental microvesicles. DESIGN: Laboratory based experimentation. SETTING: Biological Sciences Department and Discipline for Reproductive Medicine University of Newcastle, Australia and the Department of Biochemistry, University of Nairobi, Kenya. RESULTS: Placental eluate immunoglobulins re-associated with isologous and third party acidified microvesicles in three distinct patterns. I: eluate immunoglobulins re-associated more strongly with isologous and third party acid treated placental microvesicles, II: eluate immunoglobulins re-associated strongly with isologous but weakly with third party acid treated placental microvesicles, III: eluate immunoglobulins did not show preferential re-association with isologous and third party acid treated placental microvesicles. CONCLUSION: Two types of antigenic epitopes I and II may be expressed on the human placentae. Type I antigens may be present on all human placentae while type II epitopes may be paternally derived hence unique to each pregnancy. Also, immunoglobulins produced to placental microvesicle antigens may be directed to some but not all antigenic epitopes expressed on the human placental trophoblast.

Steady state concentrations of three anticonvulsant drugs (phenobarbitone, phenytoin and carbamazepine) were measured in plasma samples from fifteen patients (eight males and seven females; ages: 13-49 years; body weights: 44-70 kg), attending the outpatient Neurology Clinic at Kenyatta National Hospital. In addition, total protein and albumin levels were measured in plasma from patients taking phenytoin. Total protein levels were normal (range: 6.3-7.6 g/dl) in all patients except in one patient (10.7 g/dl). Albumin levels were also normal (range: 3.7-4.1 g/dl) in all patients except one (25.4 g/dl). One patient on phenobarbitone and three patients on phenytoin had no detectable drug levels in their plasma. In the remainder, phenobarbitone, phenytoin and carbamazepine steady state concentrations were 8.7-21.1 mg/L (N = 8), 9.3-27.3 mg/L (N = 6) and 10-19.7 mg/L (N = 5), respectively. The unbound fraction of phenytoin in plasma (fu) was normal(approximately 0.1) in six patients, but relatively high (0.2) in one patient. Most patients in the study complied with the prescribed treatment and their epilepsy was controlled. Cases where drug levels were undetectable probably arose from a lack of money to purchase all prescribed medicines rather than deliberate non-compliance. Routine monitoring of anticonvulsant drug levels may improve management of epileptic patients

   

Knowledge of the variant vascular anatomy of the subhepatic region is important for hepatobiliary surgeons in limiting operative complications due to unexpected bleeding. The pattern of arterial blood supply of 102 gallbladders was studied by gross dissection. The cystic artery originated from the right hepatic artery in 92.2% of cases. The rest were aberrant and originated from the proper hepatic artery. Accessory arteries were observed to originate from proper hepatic artery (n = 5), left hepatic artery (n = 2), and right hepatic artery (n = 1). Most of the arteries approached the gallbladder in relation to the common hepatic duct (anterior 45.1%, posterior, 46.1%). The other vessels passed anterior to common bile duct (2.9%), posterior to common bile duct (3.9%), or were given off in Calot's triangle. Cystic arteries in this data set show wide variations in terms of relationship to the duct systems. In about one tenth of patients, an accessory cystic artery may need to be ligated or clipped during cholecystectomy. 2007 Wiley-Liss, Inc

   

 

 

A study that devised a modified method of reporting antibiotic sensitivity results was undertaken. Enterobacteriaceae and Gram positive cocci were tested for drug sensitivity by a disc diffusion method. Zones of bacterial growth inhibition were measured, dividing the isolates into four groups: the highly sensitive, the moderately sensitive, the slightly sensitive and the resistant ones. The slightly sensitive isolates were taken as indicators of antibiotic resistance acquisition. By that system, when more than 50% of the isolates fell into the slightly and resistant groups, that meant that the antibiotic concerned would be discontinued for some time until the bacteria reverted to being moderately sensitive. The study also provided a method of making antibiotic discs from local blotting papers, and a sample of a form on which antibiotic sensitivity results could be recorded was presented. The method is considered to be easy and very appropriate for developing countries in detecting gradual and abrupt acquisition of antibiotic resistance by bacteria.

A retrospective study of 42 patients with perforations of the oesophagus during the period 1981-1987 indicated that 57.1% of the perforations were iatrogenic. Diseases of the oesophagus and in contiguous structures and foreign bodies in the oesophagus caused perforations in 31% of the cases. Perforations in 35.7% of the patients were located in the middle third of the oesophagus. The lower and upper thirds were affected in 31% of the patients in each site. The presenting physical signs included tachycardia (78.6%), fever (76.2%) and dyspnoea (59.5%). The main accompanying symptoms were chest pain and coughs in 100% and in 50% of the patients respectively. Radiographic findings showed hydropneumothorax in 40.5% of the cases and consolidation in 38.1% of the patients. Oesophagoscopy was positive in 78% of cases tested while thoracocentesis was positive in all cases that were tested.

A study that devised a modified method of reporting antibiotic sensitivity results was undertaken. Enterobacteriaceae and Gram positive cocci were tested for drug sensitivity by a disc diffusion method. Zones of bacterial growth inhibition were measured, dividing the isolates into four groups: the highly sensitive, the moderately sensitive, the slightly sensitive and the resistant ones. The slightly sensitive isolates were taken as indicators of antibiotic resistance acquisition. By that system, when more than 50% of the isolates fell into the slightly and resistant groups, that meant that the antibiotic concerned would be discontinued for some time until the bacteria reverted to being moderately sensitive. The study also provided a method of making antibiotic discs from local blotting papers, and a sample of a form on which antibiotic sensitivity results could be recorded was presented. The method is considered to be easy and very appropriate for developing countries in detecting gradual and abrupt acquisition of antibiotic resistance by bacteria.

This article reveals that the concept of education as a process of growth is a difficult one. Philosophers are, therefore, justified in being weary when pondering over its meaning, both in theory and practice. By way of conclusion, the article appreciates the complexities inherent in the growth theory of education, summarizing its major strength and weaknesses. Then it cautions educational planners and practitioners to be weary when, and if, they translate the theory into practice, so that they utilize the strengths inherent in the theory whilst paying attention to the dangers of its inherent weaknesses.

OBJECTIVE: To determine the bacteriology and antibiotic sensitivity of the bacterial isolates in chronic maxillary sinusitis patients seen at the Kenyatta National Hospital. DESIGN: Cross-sectional study. SETTING: Kenyatta National Hospital, ENT department. SUBJECTS AND METHODS: Seventy-three patients had bilateral sntral washout done and the lavage submitted for culture and anti-microbial sensitivity between January and June 1996. RESULTS: Antral lavage yielded secretions in 63% of patients but bacteria were cultured in only 28.8% of the specimens. The isolates included Streptococcus pneumonia (22.2%), Staphylocococus albus (18.5%), Staphylocococus aureus (11.1%) and Enterobactericiae (11.1%). Anaerobic bacteria were cultured in 22.2% of the specimens. Of the commonly used antibiotics, there was high sensitivity to erythromycin, cefadroxyl, chloramphenicol and amoxicillin and poor sensitivity to ampicillin, cotrimoxazole and perfloxacin. CONCLUSION: The bacteriology of chronic maxillary sinusitis at Kenyatta National Hospital is generally similar to that found elsewhere. The bacteria are susceptible to relatively affordable antibiotics like amoxicillin, erythromycin and cefadroxyl.

Knowledge of the variant vascular anatomy of the subhepatic region is important for hepatobiliary surgeons in limiting operative complications due to unexpected bleeding. The pattern of arterial blood supply of 102 gallbladders was studied by gross dissection. The cystic artery originated from the right hepatic artery in 92.2% of cases. The rest were aberrant and originated from the proper hepatic artery. Accessory arteries were observed to originate from proper hepatic artery (n = 5), left hepatic artery (n = 2), and right hepatic artery (n = 1). Most of the arteries approached the gallbladder in relation to the common hepatic duct (anterior 45.1%, posterior, 46.1%). The other vessels passed anterior to common bile duct (2.9%), posterior to common bile duct (3.9%), or were given off in Calot's triangle. Cystic arteries in this data set show wide variations in terms of relationship to the duct systems. In about one tenth of patients, an accessory cystic artery may need to be ligated or clipped during cholecystectomy. 2007 Wiley-Liss, Inc

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A study that devised a modified method of reporting antibiotic sensitivity results was undertaken. Enterobacteriaceae and Gram positive cocci were tested for drug sensitivity by a disc diffusion method. Zones of bacterial growth inhibition were measured, dividing the isolates into four groups: the highly sensitive, the moderately sensitive, the slightly sensitive and the resistant ones. The slightly sensitive isolates were taken as indicators of antibiotic resistance acquisition. By that system, when more than 50% of the isolates fell into the slightly and resistant groups, that meant that the antibiotic concerned would be discontinued for some time until the bacteria reverted to being moderately sensitive. The study also provided a method of making antibiotic discs from local blotting papers, and a sample of a form on which antibiotic sensitivity results could be recorded was presented. The method is considered to be easy and very appropriate for developing countries in detecting gradual and abrupt acquisition of antibiotic resistance by bacteria.

A clinical, radiological, histological, and geographical study of carcinoma of the esophagus in Kenya is reported. It was found that this cancer is diagnosed more often in males than in females, with a ration of 8:1 (Kenya Cancer Registry). The most common age in males and females is 50 to 59 years. The regions of the esophagus most commonly involved are the middle and lower thirds, in almost equal proportions. An unexplained tendency for the tumor to be poorly differentiated towards the lower third is noted. In addition a review on the possible etiological factors is presented.

A study that devised a modified method of reporting antibiotic sensitivity results was undertaken. Enterobacteriaceae and Gram positive cocci were tested for drug sensitivity by a disc diffusion method. Zones of bacterial growth inhibition were measured, dividing the isolates into four groups: the highly sensitive, the moderately sensitive, the slightly sensitive and the resistant ones. The slightly sensitive isolates were taken as indicators of antibiotic resistance acquisition. By that system, when more than 50% of the isolates fell into the slightly and resistant groups, that meant that the antibiotic concerned would be discontinued for some time until the bacteria reverted to being moderately sensitive. The study also provided a method of making antibiotic discs from local blotting papers, and a sample of a form on which antibiotic sensitivity results could be recorded was presented. The method is considered to be easy and very appropriate for developing countries in detecting gradual and abrupt acquisition of antibiotic resistance by bacteria.

OBJECTIVE: To determine the bacteriology and antibiotic sensitivity of the bacterial isolates in chronic maxillary sinusitis patients seen at the Kenyatta National Hospital. DESIGN: Cross-sectional study. SETTING: Kenyatta National Hospital, ENT department. SUBJECTS AND METHODS: Seventy-three patients had bilateral sntral washout done and the lavage submitted for culture and anti-microbial sensitivity between January and June 1996. RESULTS: Antral lavage yielded secretions in 63% of patients but bacteria were cultured in only 28.8% of the specimens. The isolates included Streptococcus pneumonia (22.2%), Staphylocococus albus (18.5%), Staphylocococus aureus (11.1%) and Enterobactericiae (11.1%). Anaerobic bacteria were cultured in 22.2% of the specimens. Of the commonly used antibiotics, there was high sensitivity to erythromycin, cefadroxyl, chloramphenicol and amoxicillin and poor sensitivity to ampicillin, cotrimoxazole and perfloxacin. CONCLUSION: The bacteriology of chronic maxillary sinusitis at Kenyatta National Hospital is generally similar to that found elsewhere. The bacteria are susceptible to relatively affordable antibiotics like amoxicillin, erythromycin and cefadroxyl.

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A study that devised a modified method of reporting antibiotic sensitivity results was undertaken. Enterobacteriaceae and Gram positive cocci were tested for drug sensitivity by a disc diffusion method. Zones of bacterial growth inhibition were measured, dividing the isolates into four groups: the highly sensitive, the moderately sensitive, the slightly sensitive and the resistant ones. The slightly sensitive isolates were taken as indicators of antibiotic resistance acquisition. By that system, when more than 50% of the isolates fell into the slightly and resistant groups, that meant that the antibiotic concerned would be discontinued for some time until the bacteria reverted to being moderately sensitive. The study also provided a method of making antibiotic discs from local blotting papers, and a sample of a form on which antibiotic sensitivity results could be recorded was presented. The method is considered to be easy and very appropriate for developing countries in detecting gradual and abrupt acquisition of antibiotic resistance by bacteria.

 

 

Background: Prolapsed intervertebral disk (PID) disease can be managed conservatively or surgically with different reported outcomes.Objective: The present study aimed at assessing the management and outcomes of slipped intervertebral disk disease at the Kenyatta National hospital.Study Design: A retrospective cross-sectional study.Setting: Kenyatta National Hospital (KNH) a referral and teaching Hospital in Kenya.Patients and Methods: Consecutive files of all cases of slipped intervertebral disk disease from January1997 to December 2007 were retrieved from the Medical records at the Kenyatta National Hospital. The biodata, management methods and the outcomes of the procedures were recorded. The collecteddata was analyzed using the SPSS 17.0 for Windows.Results: Six hundred and three cases were reviewed. All patients received analgesics and bed rest.Five percent of the patients were put on bilateral traction for two weeks while 4% of the patients had corsets. Thirty five per cent of the patients were surgically managed. Over a third of the surgically managed patients had laminectomies. Microdiscectomy was increasingly popular in the latter half ofthe study period. Of the managed patients 95% reported improvement while 92% were complication free. The rate of reherniation and reoperation was 1.5% and 1.2% respectively.Conclusion: The management of PID at Kenyatta National Hospital is largely successful with few cases of complications. In selected patients both conservative and surgical care are used in tandem. Microdiscectomy is an increasingly popular surgical procedure at the KNH.

   

 

 

A study that devised a modified method of reporting antibiotic sensitivity results was undertaken. Enterobacteriaceae and Gram positive cocci were tested for drug sensitivity by a disc diffusion method. Zones of bacterial growth inhibition were measured, dividing the isolates into four groups: the highly sensitive, the moderately sensitive, the slightly sensitive and the resistant ones. The slightly sensitive isolates were taken as indicators of antibiotic resistance acquisition. By that system, when more than 50% of the isolates fell into the slightly and resistant groups, that meant that the antibiotic concerned would be discontinued for some time until the bacteria reverted to being moderately sensitive. The study also provided a method of making antibiotic discs from local blotting papers, and a sample of a form on which antibiotic sensitivity results could be recorded was presented. The method is considered to be easy and very appropriate for developing countries in detecting gradual and abrupt acquisition of antibiotic resistance by bacteria.

A retrospective study of 42 patients with perforations of the oesophagus during the period 1981-1987 indicated that 57.1% of the perforations were iatrogenic. Diseases of the oesophagus and in contiguous structures and foreign bodies in the oesophagus caused perforations in 31% of the cases. Perforations in 35.7% of the patients were located in the middle third of the oesophagus. The lower and upper thirds were affected in 31% of the patients in each site. The presenting physical signs included tachycardia (78.6%), fever (76.2%) and dyspnoea (59.5%). The main accompanying symptoms were chest pain and coughs in 100% and in 50% of the patients respectively. Radiographic findings showed hydropneumothorax in 40.5% of the cases and consolidation in 38.1% of the patients. Oesophagoscopy was positive in 78% of cases tested while thoracocentesis was positive in all cases that were tested.

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A study that devised a modified method of reporting antibiotic sensitivity results was undertaken. Enterobacteriaceae and Gram positive cocci were tested for drug sensitivity by a disc diffusion method. Zones of bacterial growth inhibition were measured, dividing the isolates into four groups: the highly sensitive, the moderately sensitive, the slightly sensitive and the resistant ones. The slightly sensitive isolates were taken as indicators of antibiotic resistance acquisition. By that system, when more than 50% of the isolates fell into the slightly and resistant groups, that meant that the antibiotic concerned would be discontinued for some time until the bacteria reverted to being moderately sensitive. The study also provided a method of making antibiotic discs from local blotting papers, and a sample of a form on which antibiotic sensitivity results could be recorded was presented. The method is considered to be easy and very appropriate for developing countries in detecting gradual and abrupt acquisition of antibiotic resistance by bacteria.

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Towers are typical structures that can be found in many urban and rural landscapes the world over. From their basic design, they are usually exposed to severe environmental loads. It is therefore prudent to carry out periodic maintenance that includes checking that they are correctly aligned. This paper describes a method that was used for the re-alignment of a guyed tower in Limuru, Kenya. Angular and distance observations, made from two observation points detected a vertical misalignment that was larger than the acceptable tolerance of l/400. An iterative re-alignment procedure was then applied, resulting in an acceptable final misalignment of 1 / 520.

The effects of niobium doping (for doping concentrations: 0.02 – 0.06 at. % Nb5+) on the crystal structure of
TiO2 prepared by high temperature diffusion method were investigated. The samples were characterized using
energy dispersive X-ray fluorescence (EDXRF) and X- ray diffraction (XRD) spectroscopy to investigate the
chemical compositions, phase compositions and crystallinity of the thin films respectively. Despite the expected
high reutilization at high temperatures (>600oC), XRD results confirmed a significant suppression of anatase to
rutile phase transformation at even a higher synthesis (850oC) temperature. Grain growth retardation was also
observed in niobium doped TiO2, results which were attributed to Nb5+ substitution of lattice Ti4+.
Key words: Anatase, rutile, phase transformation, grain growth

21) S. Derese, A. Yenesew, J.O. Midiwo, Heydenreich and M.G. Peter. (). ..

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Background: Quality pharmaceutical services are an integral part of primary healthcare and a key determinant of patient outcomes. The study focuses on pharmaceutical service delivery among private healthcare facilities serving informal settlements within Nairobi County, Kenya and aims at understanding the drug procurement practices, task-shifting and ethical issues associated with drug brand preference, competition and disposal of expired drugs. Methods: Forty-five private facilities comprising of hospitals, nursing homes, health centres, medical centres, clinics and pharmacies were recruited through purposive sampling. Structured electronic questionnaires were administered to 45 respondents working within the study facilities over an 8-week period.
Results: About 50% of personnel carrying out drug procurement belonged to non-pharmaceutical cadres namely; doctors, clinical officers, nurses and pharmacy assistants. Drug brand preferences among healthcare facilities and patients were mainly pegged on perceived quality and price. Unethical business competition practices were recorded, including poor professional demeanour and waiver of consultation fees veiled to undercut colleagues. Government subsidized drugs were sold at 100% profit in fifty percent of the facilities stocking them. In 44% of the facilities, the disposal of expired drugs was not in conformity to existing government regulatory guidelines. Conclusions: There is extensive task-shifting and delegation of pharmaceutical services to non-pharmaceutical cadres and poor observance of ethical guidelines in private facilities. Strict enforcement of regulations is required for optimal practices.

Summary:
Methods that reduce the cost and time involved in detecting defective or nonconformal members of a large population have been explored extensively in the quality control literature.
These methods have also found extensive application in insect-vector, rodent-bacterium and blood screening. Group-screening designs are plans that identity defect factors in a large population by initially pooling factors together and then classifying each pool as nonconformal (NC) or conformal (C). Individual testing is then carried only amongst individual factors in pool that are found to be nonconformal. A modifications of this strategy, suggested by Sterrett (1957), proposes a reversion to a group test, in a group declared defective, upon detection of the first nonconformal factor and then carrying out individuals testing only if the new group is nonconformal. This procedure is referred to as the Dorfman-Sterrett procedure in the literature.
The statistical properties of the restricted Dorfman-Sterrett procedure, where the number of reversion to a group test is predetermined, has found little discussion in the literature. This study uses a testing of hypothesis approach to compare the performance of the Dorfman-Sterrett procedure with the Dorfman procedure assuming that factors or groups can be misclassified. Under the testing of hypothesis approach, using a 2g fractional factorial design, cost functions which are linear functions of expected total number of incorrect decisions and the expected.

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Increasing numbers of HIV-infected adults in Africa need hospital care. It remains unclear what impact this has on health care services or on how hospitals respond. The aim of this study was to describe the effects of a rising case load of adult HIV-related disease by comparing results from a prospective cross-sectional study of acute adult medical admissions to a government hospital in Nairobi conducted in 1992 with results from a previous study done in 1988 and 1989 in the same hospital, using the same study design and protocol. Data on age, gender, number admitted, length of stay, HIV status, clinical AIDS, final diagnosis, case mix, and outcome were compared. In 1992, 374 consecutive patients were admitted in 15 24-hour periods (24.9 patients/period) compared with the 1988 to 1989 study, which enrolled 506 patients in 22 24-hour periods (23.0 patients/period). Patients' age, gender, and length of hospital stay were similar in both studies. In 1992, 39% of patients were HIV-positive compared with 19% in 1988 to 1989 (p < 10(-6)); whereas seropositive admissions rose 123% between the two periods (p < .0001), HIV-negative admissions declined 18% (p < .05). Clinical surveillance for AIDS consistently identified <40% of HIV-positive patients. Irrespective of HIV status, tuberculosis and pneumococcal pneumonia were the leading diagnoses in both surveys. No change was found in the diagnoses recorded for HIV-positive patients, but in HIV-negative patients, reductions were significant in the case mix (p < .00001) and range of diagnoses (p < .001) seen in 1992. Outcome remained unchanged for HIV-positive patients with approximately 35% mortality in both surveys. Outcome significantly worsened, in relative and absolute terms, for HIV-negative patients: in 1992, mortality was 23%, compared with 13.9% in 1988 to 1989 (p < .005), with 3.5 deaths per 24-hour period in 1992 compared with 2.6 deaths per 24-hour period in 1988 to 1989 (p < .05, one-tailed). These data suggest that increasing selection for admission is taking place as demand for care increases because of HIV/AIDS. This process appears to favor HIV-positive patients at the expense of HIV-negative patients who seem to be crowded out and, once admitted, experience higher mortality rates. The true social costs of the HIV epidemic are underestimated by not including the effects on HIV-negative people. PIP: The impact of the escalating demand for HIV/AIDS-related care on hospital services in Nairobi, Kenya, was investigated in two prospective cross-sectional studies conducted at Kenyatta National Hospital. Data on age, gender, number of admissions, length of stay, HIV status, clinical AIDS, final diagnosis, case mix, and outcome were compared in a 1988-89 study that enrolled 506 consecutive patients in a total of 22 24-hour periods and in a 1992 study of 374 patients admitted in 15 24-hour periods. 18.7% of hospital patients in 1988-89 were HIV-positive compared with 38.5% in 1992, with a concomitant decline of 18% in the number of HIV-negative admissions. Clinical surveillance for AIDS consistently identified less than 40% of HIV-positive patients. Tuberculosis and pneumococcal pneumonia were the leading diagnoses in both surveys among HIV-positive and HIV-negative patients. Diagnoses recorded for HIV-positive patients did not change over time; however, among HIV-negative patients, there was a significant narrowing in the range of diagnoses seen. Mortality among HIV-positive patients remained constant at 35% in both surveys. Among HIV-negative patients, mortality increased from 13.9% in 1988-89 to 23% in 1992 (2.6 and 3.5 deaths per 24-hour period, respectively). These findings suggest that increasing demand for hospital care by HIV-positive patients has been accompanied by deteriorating conditions for HIV-negative patients, especially an admissions selection process that favors HIV/AIDS patients. Recommended to address the worsening crisis in health care delivery are general guidelines on admission criteria that neither crowd out HIV-negative patients nor discriminate against those with HIV/AIDS.

4-Aminoantipyrine (4AAP) is widely used in the pharmaceutical industry, biochemical experiments and environmental monitoring. However, residual amounts of 4AAP in the environment may pose a threat to human health. To provide basic data that can be used to extract or eliminate 4AAP from the environment, the proton-transfer complexes of 4AAP with quinol (QL) and picric acid (PA) were synthesized and spectroscopically investigated. The interactions afforded two new proton-transfer salts named 1,5-dimethyl-3-oxo-2-phenyl-2,3-dihydro-1H-pyrazol-4-aminium-4-hydroxyphenolate and 1,5-dimethyl-3-oxo-2-phenyl-2,3-dihydro-1H-pyrazol-4-aminium-2,4,6-trinitrophenolate for QL and PA, respectively, via a 1:1 stoichiometry. Elemental analysis (CHN), electronic absorption, spectrophotometric titration, IR, Raman, (1)H NMR and X-ray diffraction were used to characterize the new products. The thermal stability of the synthesized CT complexes was investigated using thermogravimetric (TG) analyses, and the morphology and particle size of these complexes were obtained from scanning electron microscopy (SEM). It was found that PA and 4AAP immediately formed a yellow precipitate with a remarkable sponge-like morphology and good thermal stability up to 180°C. Finally, the biological activities of the newly synthesized CT complexes were tested for their antibacterial and antifungal activities. The results indicated that the [(4AAP)(QL)] complex exhibited strong antimicrobial activities against various bacterial and fungal strains compared with standard drugs.

Increasing numbers of HIV-infected adults in Africa need hospital care. It remains unclear what impact this has on health care services or on how hospitals respond. The aim of this study was to describe the effects of a rising case load of adult HIV-related disease by comparing results from a prospective cross-sectional study of acute adult medical admissions to a government hospital in Nairobi conducted in 1992 with results from a previous study done in 1988 and 1989 in the same hospital, using the same study design and protocol. Data on age, gender, number admitted, length of stay, HIV status, clinical AIDS, final diagnosis, case mix, and outcome were compared. In 1992, 374 consecutive patients were admitted in 15 24-hour periods (24.9 patients/period) compared with the 1988 to 1989 study, which enrolled 506 patients in 22 24-hour periods (23.0 patients/period). Patients' age, gender, and length of hospital stay were similar in both studies. In 1992, 39% of patients were HIV-positive compared with 19% in 1988 to 1989 (p < 10(-6)); whereas seropositive admissions rose 123% between the two periods (p < .0001), HIV-negative admissions declined 18% (p < .05). Clinical surveillance for AIDS consistently identified <40% of HIV-positive patients. Irrespective of HIV status, tuberculosis and pneumococcal pneumonia were the leading diagnoses in both surveys. No change was found in the diagnoses recorded for HIV-positive patients, but in HIV-negative patients, reductions were significant in the case mix (p < .00001) and range of diagnoses (p < .001) seen in 1992. Outcome remained unchanged for HIV-positive patients with approximately 35% mortality in both surveys. Outcome significantly worsened, in relative and absolute terms, for HIV-negative patients: in 1992, mortality was 23%, compared with 13.9% in 1988 to 1989 (p < .005), with 3.5 deaths per 24-hour period in 1992 compared with 2.6 deaths per 24-hour period in 1988 to 1989 (p < .05, one-tailed). These data suggest that increasing selection for admission is taking place as demand for care increases because of HIV/AIDS. This process appears to favor HIV-positive patients at the expense of HIV-negative patients who seem to be crowded out and, once admitted, experience higher mortality rates. The true social costs of the HIV epidemic are underestimated by not including the effects on HIV-negative people. PIP: The impact of the escalating demand for HIV/AIDS-related care on hospital services in Nairobi, Kenya, was investigated in two prospective cross-sectional studies conducted at Kenyatta National Hospital. Data on age, gender, number of admissions, length of stay, HIV status, clinical AIDS, final diagnosis, case mix, and outcome were compared in a 1988-89 study that enrolled 506 consecutive patients in a total of 22 24-hour periods and in a 1992 study of 374 patients admitted in 15 24-hour periods. 18.7% of hospital patients in 1988-89 were HIV-positive compared with 38.5% in 1992, with a concomitant decline of 18% in the number of HIV-negative admissions. Clinical surveillance for AIDS consistently identified less than 40% of HIV-positive patients. Tuberculosis and pneumococcal pneumonia were the leading diagnoses in both surveys among HIV-positive and HIV-negative patients. Diagnoses recorded for HIV-positive patients did not change over time; however, among HIV-negative patients, there was a significant narrowing in the range of diagnoses seen. Mortality among HIV-positive patients remained constant at 35% in both surveys. Among HIV-negative patients, mortality increased from 13.9% in 1988-89 to 23% in 1992 (2.6 and 3.5 deaths per 24-hour period, respectively). These findings suggest that increasing demand for hospital care by HIV-positive patients has been accompanied by deteriorating conditions for HIV-negative patients, especially an admissions selection process that favors HIV/AIDS patients. Recommended to address the worsening crisis in health care delivery are general guidelines on admission criteria that neither crowd out HIV-negative patients nor discriminate against those with HIV/AIDS.

Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} A study was conducted to determine weight loss and moisture regain properties of silk cocoon shells, shell layers and degummed fibers of the four African wild silkmoths Anaphe panda, Argema mimosae, Epiphora bauhiniae and Gonometa postica and compare "with the industry standard mulberry silkmoth, Bombyx mori. No. significant difference was observed between the moisture regain of the wild silk fibers after degumming. However, there were significant differences in weight loss and moisture regain between cocoon shells as well as shell layers. E. bauhiniae had the lowest weight loss and moisture regain of 23.19 and 5.64%, respectively while G. postica had the highest weight loss and moisture regain, 56.84 and 9.05%, respectively. The SEM micrographs also showed the presence of remnant sericin gum on the fibers surface. In both A. panda and E. bauhiniae, the outer shell layers had the lowest moisture regain and highest weight loss while the inner layer of E. bauhiniae and middle layer of A. panda lost the least weight. The physical structure and chemical composition ofthe cocoon shells and fibers contribute towards the variation in the moisture regain and weight loss and these features may have commercial implications due to their direct effect on the resulting fabric

Vulnerability to climate change impact is the most pressing issues for less developed countries whose economy mainly depends on the agricultural sector. The demand for food is growing swiftly whereas impacts of climate change on the global food production are increasing. More area specific research outputs and evidences-based policy directions are needed to tackle the ever changing climate and to reduce its impacts on the agricultural production. The aim of this study was to investigate subsistence farmer household’s vulnerability level to climate change impacts and its associations with household’s agricultural production. Then primary data was collected from 400 households from Kolla Temben District, Tigray Regional State, North Ethiopia. Multistage sampling techniques were applied to select households for interview from the district. In the first stage, 4 Kebelles (Kebelle - administration unit) were selected randomly out of 27 Kebelles and then400 households were selected for interview through systematic random sampling techniques (Figure 1). Multiple regressions were used to examine the associations between household’s vulnerability to climate change impacts and agricultural production. Grounded theory and content analysis techniques were use to analyze data from key informant interviews and focus group discussions. For every single unit increase in household vulnerability to climate change impacts, there was an average agricultural production decrease between 16.99 and 25.83 (Table 4). For single unit increase in household’s vulnerability to climate change impact, there was a decrease of total crop production, Total income, total livestock, total food consumption and food consumption per adult equivalent. Rainfall decrease, small farmland ownership, steep topography, frequent flood occurrences and large family size are among the major factors that negatively affect household’s agricultural production and total income. The more the vulnerable the households, the less in total annual crop production, total livestock size, total income from agricultural production and the more dependent on food aid). There is a negative association between household’s vulnerability level to climate change impacts and agricultural production (crop production, total livestock ownerships and total income from crop production). More access to irrigation and agricultural fertilizers, improved varieties of crops, small family size, improve farmland ownership size, more access to education and Agricultural Extension services are an effective areas of intervention to improve household’s resilient, reduce households vulnerability level to climate change impacts and increase household’s total agricultural production.

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This article seeks to identify some of the factors underlying regional variation in child mortality in Kenya. The data drawn from the 1988/89 Kenya Demographic and Health Survey are used for the purpose. Logistic regression is used to analyse the data. On the basis of child mortality estimates obtained, provinces were grouped into two mortality groups: High (HLM) and Low (LMP). The results show that the values of explanatory variables in LMP were significantly high than in the high mortality region. However, their differences did not explain much of the differences in the variation in child mortality between the two regions. Decomposing the results revealed that the differences were largely due to nature or structure of relations between mortality and explanatory variables.

Abstract
Anaesthetic agents used locally can be toxic especially if given as an inappropriate dose or route. Lipid infusion has been demonstrated in several animal models to successfully resuscitate bupivacaine induced toxicity. We present a case of successful use of 26% lipid infusion to resuscitate a paediatric patient with a presumed subcutaneous injection of bupivacaine and lignocaine which led to neurological and cardiologic consequences.

Abstract
OBJECTIVE:
To determine the seroprevalence of varicella zoster in paediatric patients at a high risk of developing complications.
DESIGN:
A cross-sectional study.
SETTING:
Paediatric general wards at Kenyatta National Hospital.
SUBJECTS:
Children with malignancies, severe malnutrition and were HIV positive.
INTERVENTIONS:
The sample size was calculated at 147 subjects. Venous samples were tested for varicella zoster virus (VZV) antibodies using enzyme immunosorbent assay (ELISA) technique at Kenya Medical Research Institute (KEMRI) laboratories, The data were analysed using the SPSS software and presented in form of tables and graphs. The prevalence of VZV antibodies was determined and 95% confidence interval computed.
RESULTS:
The overall seroprevalence of VZV antibodies in the three groups of children studied was 23.6% (95% CI = 17.4, 29.8). The seroprevalence of VZV antibodies in those with malignancies and severe malnutrition was 24.1 and 25.0% respectively. About 22% of HIV positive children had protective levels of VZV antibodies. Though the seroprevalence increased with age, it was not significantly associated with area of residence, size of residence, family size or income.
CONCLUSIONS:
The low prevalence of protective VZV antibodies among children with severe malnutrition, malignancies and HIV infection children at Kenyatta National Hospital warrants routine immunisation of the high-risk population

From roots of Peddiea volkensii (Thymelaeaceae) the irritant factors and and from roots of P. africana
the irritant factor Aj were isolated. Their structures are the 9,13,14-ort/io-(2,4,6-decatrienoates) of 5/8-
hydroxyresiniferonol-6a,7a-oxide (Vi) and of 5^,12iS-dihydroxyresiniferonol-6a,7a-oxide (Aj) and the 12-0-acetate of the latter (Vj). Factors V i and do not exhibit tumour-promoting activity in the standard initiation-promotion protocol on mouse skin, although is a moderate irritant.

Energy is important to life, and the amount of energy consumed per capita by a country is indicative of the level of development of that nation. There exist different sources of energy with solar energy as the primary source on our planet. The sun’s energy is inexhaustible, unlimited (by geographical boundaries), and non-polluting. Tapping and utilizing this energy efficiently- even with 10 to 20% efficiency- can solve the threat of climate change caused by the global warming, and also contribute towards the easing of the demand for fossil-fuel. In the developing countries a large proportion of the population is poor and not connected to the national electricity grid. This group of people is weighed down with the high cost, high risks and low benefits of the traditional fuels, candles, paraffin, and dry battery cells. Addressing their energy needs, particularly with clean energy from the renewable sources, will not only result in tangible developmental benefits but also social and environmental benefits. In this article we consider only the direct energy from the sun, and its conversion to heat or electrical forms- the energy carriers of choice.

Nanoscience and nanotechnology deal with the study, manipulation, and the design of materials and devices at the atomic scale. Whereas nanoscience focuses on the new properties, nanotechnology focuses on new devices. The nanoscale science and technology is multidisciplinary and trans-disciplinary. We thus see that nanoscience and nanotechnology bridge the gap between molecular scale and the macroscale. It is now recognized that science founded on the unified concepts on matter at the nanoscale is the new basis for knowledge creation, innovation, and technology integration.
Given the current and anticipated impacts of nanotechnology in work efficiency, ways of life and the environment, national (e.g. Kenya’s) efforts should be focused on how nanotechnology can improve efficiency in manufacturing, energy resources and utilization, reduce environmental impacts of industry and transportation, enhance healthcare, produce better pharmaceuticals, improve agriculture and food production, and expand the capabilities of information technologies. This requires synergistic relationships amongst all the stakeholders right from the beginning of the research and development processes.
A study of the Kenya’s situation reveals minimal understanding of what nanoscience and nanotechnology, and what their potential benefits are. The teaching of and research in these areas and the accompanying infrastructure are weak and disjointed. Moreover, there are almost nonexistent/weak specific regulatory tools and policies governing this important but emerging technology and discipline. Gaps presently exist in our scientific knowledge, and coupled with inadvertent outcomes witnessed in other technological advances there are reasons enough for nanotechnology industries and relevant government agencies to invest in understanding possible risks and neutralize them prior to putting the products into the market.

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.

Antagonistic fungi are continuously attracting a lot of attention as alternatives to chemical control of root-knot nematodes. The egg-pathogenic fungus Paecilomyces lilacinus, particularly strain 251 has shown promising potential as a biological control agent against various plant-parasitic nematodes. Strain 251 of P. lilacinus (PL251) and Arthrobotrys conoides (Melodogone) were tested for their efficacy against Meloidogyne spp. in tomato and cucumber under greenhouse conditions. The study aimed at determining the application rates and timing of application of the fungi. Both pre-planting and at planting application of PL251 were found to reduce nematode populations and root galling in both tomato and cucumber. Pre-planting soil treatment (0.4g/10 L of soil) reduced final nematode populations by 69% and 73% in the roots and soil, respectively, compared to the non-inoculated control in tomato. However, soil treatment at planting recorded reduction level of 54% and 74% in the roots and soil, respectively. Use of A. conoides showed lower nematode control in cucumber. Only 28% and 21% reduction levels were recorded in the roots and soil when the fungus was applied at planting, respectively. This study has demonstrated that PL251 has a promising potential that could be exploited in the management of Meloidogyne spp. in vegetable production systems.

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Drought is a recurring hazard in many countries of Africa, and Kenya is thus no exception. In the majority of the countries
in the continent, drought affects agriculture, since it is predominantly rain-fed and is the mainstay of the economies in
these countries. Various socioeconomic activities are highly prone to the impacts of drought. Since drought will always
occur, there is and will always be need for understanding its various manifestations to ensure that the effects associated
with its occurrence are managed in a sustainable manner. This study examined the spatial characteristics of drought
duration and severity in the Upper Tana Basin (UTB) of Kenya using discharge records from twenty two river gauge
stations (RGSs) in the basin. Drought duration and severity data were extracted from the discharge records using the runs
analysis technique and the data series subjected to principal components analysis (PCA) from which common factors for
the two drought events were examined. Results showed that drought duration and severity had distinct spatial patterns in
the basin. The two drought events were explained using four significant principal factors that cumulatively explained
nearly 59 percent variance for drought duration and 56 percent of variance for drought severity in the basin. The spatial
patterns of the factor loadings for drought duration showed large meridional patterns with anomalies confined to the
eastern and southeast parts of the basin. For drought severity, the spatial patterns of the factor loadings portrayed a zonal
pattern reflecting differences in the relief features between the western and eastern parts of the basin. The spatial
characteristics of the drought events may be used to plan for different land use activities in the basin.

This paper reports the detailed results of a study of the impact of the Health Workers for Change (HWFC) workshop series on clients' perceptions of health services, relationships within the health centre and relations between the health facility and the district health system. The study was carried out in three stages: baseline, intervention and evaluation over a period of 20 months. Data, both qualitative and quantitative, were collected at three levels: client, facility and system. Results indicate that relations between health workers and clients improved a great deal after the intervention while those between the facility and the system remained to a large extent unchanged. The paper concludes that, with external support and help, especially from the health system level, health workers can work towards improving health services and their job satisfaction, which can lead to better health worker-client relations.

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

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

OBJECTIVE: To determine the prevalence of Xerophthalmia among Kenyan children aged four to seven years in high risk using Conjuctival Impression Cytology and transfer. DESIGN: A cross sectional community based study. SETTING: Mathare slum in Nairobi and Tiva/Ithiani area of Kitui. SUBJECTS: Children aged four to seven years residing in the above areas were assessed for both clinical and cytological features of vitamin A deficiency. RESULTS: Of the 342 children included in this study, 316 (92.0%) were normal, five (1.5%) had XN, 19 (5.9% had XIA and two (0.6%) had XIB. No signs of corneal Xerophthalmia were seen in this study. Conjuctival impression cytology and transfer (CICT) was used to asses for squamous metaplastic changes associated with Vitamin A deficiency (VAD). Seventy five (23.1%) of the children were normal by CICT while 249 (76.9%) were abnormal. In comparing the two areas of study, only 13.2% of the children in Mathare had normal CICT compared to 50% in Kitui. For each of the age groups studied there was significant difference between the two areas with children from Mathare being more deficient than those from Kitui. CONCLUSION: VAD is a significant health problem in the high risk areas assessed by CICT in this study.

Stride lengths and stride frequencies of primates have been observed or collected from the literature. Data for Galago, various monkeys and apes, and man have been collected. The quadrupedal primates take longer strides, at any particular speed, than would be predicted for non-primates. When they gallop they use lower stride frequencies than non-primates of equal mass.

Omowunmi A. Sadik, Austin O. Aluoch, Ailing Zhou The use of nanoscale materials (e.g. nanoparticles, nanowires, & nanorods) for electrochemical biosensing has seen explosive growth in recent years following the discovery of carbon nanotubes by Suomo Ijima in 1991. Although the resulting label-free sensors could potentially simplify the molecular recognition process; there are several important hurdles to be overcome. These include issues of validating the biosensor on statistically large population of real samples rather than the commonly reported relatively short synthetic oligonucleotides, pristine laboratory standards or bioreagents; multiplexing the sensors to accommodate high-throughput, multianalyte detection as well as application in complex clinical and environmental samples. This article reviews the status of biomolecular recognition using electrochemical detection by analyzing the trends, limitations, challenges and commercial devices in the field of electrochemical biosensors. It provides a survey of recent advances in electrochemical biosensors including integrated microelectrode arrays with microfluidic technologies, commercial multiplex electrochemical biosensors, aptamer-based sensors, and metal-enhanced electrochemical detection (MED), with limits of detection in the attomole range. Novel applications are also reviewed for cancer monitoring, detection of food pathogens, as well as recent advances in electrochemical glucose biosensors

Omowunmi A. Sadik, Samuel K. Kallavi and Austin Aluoch The specificity, simplicity, and inherent miniaturization afforded by advances in modern electronics have allowed electrochemical sensors to rival the most advanced optical protocols. One major obstacle in implementing electrochemistry for studying biomolecular reaction is its inadequate sensitivity. Recent reports however showed unprecedented sensitivities for biomolecular recognition using enhanced electronic amplification provided by new classes of electrode materials (e.g. carbon nanotubes, metal nanoparticles, and quantum dots). Biosensor technology is one area where recent advances in nanomaterials are pushing the technological limits of electrochemical sensitivities, thus allowing for the development of new sensor chemistries and devices. This work focuses on our recent work, based on metal-enhanced electrochemical detection, and those of others in combining advanced nanomaterials with electrochemistry for the development of smart sensors for proteins, nucleic acids, drugs and cancer cells

Aluoch, A., Tatini, R., Parsons, D. M., Sadik, O. A. A simple, rapid, and reproducible analytical procedure has been developed for the assay of risedronate in pharmaceutical dosage forms. The method is based on ion-pair liquid chromatography with UV detection. 2 Separation is performed on an Eclipse XDB C-18 (4.6 x 150 mm(2), 3.5 mum particles) column, using 5 mM tetrabutylammonium phosphate as counter-ion in the mobile phase. The proposed method was extensively validated according to ICH guidelines for the assay determination. A linear relationship was found in the concentration range studied from 50 to 150 mug risedronate sodium per 25 muL injection. The method precision was below 1.2% relative standard deviation (RSD) (n = 9). The mean recovery of risedronate from commercial tablets was found to be in the range of 99.3-100.6%. The limit of detection (LOD) and limit of quantification (LOQ) of risedronate were found to be 30 and 100 ng, respectively. Since the method is stability indicating, it is also well suited for shelf-life studies of risedronate pharmaceutical preparations.

Omowunmi A. Sadik, Samuel K. Kallavi and Austin Aluoch The specificity, simplicity, and inherent miniaturization afforded by advances in modern electronics have allowed electrochemical sensors to rival the most advanced optical protocols. One major obstacle in implementing electrochemistry for studying biomolecular reaction is its inadequate sensitivity. Recent reports however showed unprecedented sensitivities for biomolecular recognition using enhanced electronic amplification provided by new classes of electrode materials (e.g. carbon nanotubes, metal nanoparticles, and quantum dots). Biosensor technology is one area where recent advances in nanomaterials are pushing the technological limits of electrochemical sensitivities, thus allowing for the development of new sensor chemistries and devices. This work focuses on our recent work, based on metal-enhanced electrochemical detection, and those of others in combining advanced nanomaterials with electrochemistry for the development of smart sensors for proteins, nucleic acids, drugs and cancer cells

Simulated Annealing (SA), a stochastic optimization method, is applied to aerodynamic
shape design in which at least one CFD solve is required for each evaluation of the
objective function. A simple, short algorithm, SA is used as an outer loop and calls the CFD
solvers. It is found that objective functions which involve CFD in shape design, have small-
scale roughness due to discretization errors and incomplete convergence. SA is more robust
than the gradient-based methods, in the sense that the roughness creates difficulties for …

COMPUTATIONAL FLUID DYNAMICS (CFD) has be-gun to play an increasingly important
role in the aircraft industry because of its ability to produce detailed insights into complex
flow phenomena and its ease of parameterization, which can help identify the cause of weak
aerodynamic performance. Some of the earlier uses of CFD in the design process were
based on the cut-and-try approach. Here the designer iteratively modifies and evaluates a
design. 1 While considerable gains in aerodynamic performance can be achieved by this …

The global increase in vector borne diseases has been linked to climate change. Seasonal vegetation changes are known to influence disease vector population. However, the relationship is more theoretical than quantitatively defined. There is a growing demand for understanding and prediction of climate sensitive vector borne disease risks especially in regions where meteorological data are lacking. This study aimed at analyzing and quantitatively assessing the seasonal and year-to-year association between climatic factors (rainfall and temperature) and vegetation cover, and its implications for malaria risks in Baringo County, Kenya. Remotely sensed temperature, rainfall, and vegetation data for the period 2004–2015 were used. Poisson regression was used to model the association between malaria cases and climatic and environmental factors for the period 2009–2012, this being the period for which all datasets overlapped. A strong positive relationship was observed between the Normalized Difference Vegetation Index (NDVI) and monthly total precipitation. There was a strong negative relationship between NDVI and minimum temperature. The total monthly rainfall (between 94 -181mm), average monthly minimum temperatures (between 16–21°C) and mean monthly NDVI values lower than 0.35 were significantly associated with malaria incidence rates. Results suggests that a combination of climatic and vegetation greenness thresholds need to be met for malaria incidence to be significantly increased in the county. Planning for malaria control can therefore be enhanced by incorporating these factors in malaria risk mapping.

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Towers are typical structures that can be found in many urban and rural landscapes the world over. From their basic design, they are usually exposed to severe environmental loads. It is therefore prudent to carry out periodic maintenance that includes checking that they are correctly aligned. This paper describes a method that was used for the re-alignment of a guyed tower in Limuru, Kenya. Angular and distance observations, made from two observation points detected a vertical misalignment that was larger than the acceptable tolerance of l/400. An iterative re-alignment procedure was then applied, resulting in an acceptable final misalignment of 1 / 520.

SURGICAL ANATOMY OF THE PROFUNDA BRACHII ARTERY Anne Pulei, Kevin Ongeti, Martin Inyimili, Julius Ogeng’o
Correspondence: Dr. Anne Naipanoi Pulei, Department of Human Anatomy, University of Nairobi. P.O. Box 30197 00100 Nairobi, Kenya. Email: anmunkush@yahoo.com
SUMMARY
Variations in the origin and termination of the profunda brachii artery (PBA) are rarely described in literature. Knowledge of this unusual anatomy is important during brachial artery catheterization and harvesting of lateral arm flaps. One hundred and forty four arms from 72 cadavers of black Kenyans were dissected and examined for the origin and termination of PBA at the Department of Human Anatomy, University of Nairobi, Kenya. The patterns of origin and termination of the PBA were observed and recorded. The PBA was present in all the cases. It arose from the brachial, axillary and a common stem with the superior ulnar collateral arteries in 96.9%, 1.4% and 1.7% of the cases respectively. It displayed duplication and early branching in 11.1% and 16.7% of the cases respectively. The high incidence of duplication and early branching makes it vulnerable to inadvertent injury during fractures of the humerus, brachial artery catheterization and may complicate lateral arm flaps. Preoperative angiographic evaluation is therefore recommended.
Key words: Profunda brachii arteries, variations.

http://ow.ly/i4y930hzLU0.

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HIV rapid tests (RT) are a quick and non-technically demanding means to perform HIV voluntary counselling and testing (VCT) but understanding their limitations is vital to delivering quality VCT. Objective: To determine the sensitivity and specificity of HIV rapid tests used for research and voluntary counselling and testing at four sites in East Africa. Design: Cross-sectional study. Setting: Masaka District, Uganda; a sugar plantation in Kakira, Uganda; Coastal Villages in the Kilifi District of Kenya; and the Urban slum of Kangemi located West of Nairobi, Kenya. Subjects: Six thousands two hundred and fifty five consenting volunteers were enrolled into the study, and 675 prevalent HIV infections were identified. Results: The RT sensitivity tended to be high for all assays at all sites (97.63-100%) with the exception of the Uni-Gold assay (90.24% in Kangemi, 96.58% in Kilifi). Twenty four RT results were recorded as ‘weak positives’, 22 (92%) of which were negative by ELISA. There was a high rate of RT false positives in Uganda (positive predictive values ranging from 45.70% to 86.62%). Conclusions: The sensitivity and specificity of the RT varied significantly across sites. The rate of RT misclassification in Uganda suggests that a multiple test algorithm may be preferable to a single test as screener for HIV VCT.

HIV rapid tests (RT) are a quick and non-technically demanding means to perform HIV voluntary counselling and testing (VCT) but understanding their limitations is vital to delivering quality VCT. Objective: To determine the sensitivity and specificity of HIV rapid tests used for research and voluntary counselling and testing at four sites in East Africa. Design: Cross-sectional study. Setting: Masaka District, Uganda; a sugar plantation in Kakira, Uganda; Coastal Villages in the Kilifi District of Kenya; and the Urban slum of Kangemi located West of Nairobi, Kenya. Subjects: Six thousands two hundred and fifty five consenting volunteers were enrolled into the study, and 675 prevalent HIV infections were identified. Results: The RT sensitivity tended to be high for all assays at all sites (97.63-100%) with the exception of the Uni-Gold assay (90.24% in Kangemi, 96.58% in Kilifi). Twenty four RT results were recorded as ‘weak positives’, 22 (92%) of which were negative by ELISA. There was a high rate of RT false positives in Uganda (positive predictive values ranging from 45.70% to 86.62%). Conclusions: The sensitivity and specificity of the RT varied significantly across sites. The rate of RT misclassification in Uganda suggests that a multiple test algorithm may be preferable to a single test as screener for HIV VCT.

To determine the occurrence of L. pneumophila among pneumonia patients at Kenyatta National Hospital and any association with possible risk factors. Design: A cross- sectional descriptive study. Setting: The study was conducted from March to June 2007, at the medical ward of Kenyatta National Hospital. Analysis of samples was done at the University of Nairobi Institute of Tropical and Infectious Diseases (UNITID) serology laboratories. Subjects: All adult patients who were admitted to the medical ward of the hospital with a provisional diagnosis of pneumonia. Results: The study indicated that up to 9.2% (11 out of 120) of the pneumonia patients admitted at the hospital were infected with L.pneumophila. At a confidence limit of 0.05, there was statistical significance in the number of pneumonia patients infected with L. pneumophila and exposure to air conditioners (p= 0.003). Twenty two point five eight per cent of patients who were exposed to air conditioners were positive for L. pneumophila urinary antigen. There was a statistical significance between exposure to air conditioners and location of work area (p= 0.001)). Thirty eight point four six per cent of those who worked indoors were exposed to air conditioners at their places of work. There was also statistical significance in the number of pneumonia patients infected with L. pneumophila and a history of a past or concurrent respiratory illness (p= 0.021). Conclusion: Exposure to air conditioners and a history of past or concurrent respiratory illness were found to predispose one to infection. This should raise the index of suspicion among clinicians as they obtain a patient’s medical history. Most of those exposed to air conditioners are exposed at their places of work in urban centres, hence the need for health education and public awareness on routine inspection and maintenance of such facilities. There is need for a larger multi-centre study on the prevalence of infection by L. pneumophila in pneumonia patients (both community acquired and nosocomial), existence of co- infection and the antibiotic susceptibility of isolated organisms

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This study investigated strategic management practices within large, private manufacturing companies in Kenya. A total of 73 companies (both local and foreign) were surveyed. Personal interviews were conducted with top managers in all these companies. The findings revealed that large manufacturing companies had adopted strategic management. However, there were variations in the practices. Foreign companies were more involved and committed to strategic management than the local ones. The local companies (especially family ones) exhibited heavy financial orientation in their plans (cash flow projections and extended budgeting). Differences in organizational factors were cited as explanations for the observed
variations in strategic management practices.
Key words: Strategic Management, Firms, Development, Planning, Kenya

Configurations are composed of organizational elements that render certain outcomes collectively rather than individually. This study set out to establish the implications of strategy and resource configurations on performance of Nongovernmental organizations. We tested for strategy with the sub variables of resources as predictors of performance in the tangible and intangible sub domains. Using interaction terms, results revealed that different configuration settings rendered into various performance outcomes. Strategy –tangible resource models had high coefficients but were not significant in predicting tangible, intangible and main performance. On the contrary strategy – intangible resources were significant with other domains save with intangible performance. The three way interaction term was not significant although with high prediction power across the performance variables. We conclude that configuration approach offers promise in better understanding of the performance of NGOs. The study outcomes have rich insights for both scholars and practitioners. We recommend further empirical examinations of strategy elements in the NGO sector.
Key words: Strategy, Resources, Configurations, Performance, Nongovernmental organizations, Intangible
resources, Tangible resources

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A total of 152 strains of Campylobacter jejuni, C. coli, C. laridis and C. fetus subsp. fetus were tested for haemolysis on blood agar plates. Distinct haemolysis was detected in 92.% (96/104) of strains of C. jejuni and 21.7% (5/23) of strains of C. coli on sheep blood heart infusion agar after incubation for 4 d microacrobically at 42°C. Haemolysis was also detected on horse blood heart infusion agar. Haemolysis was not detected at 37°C except with one of 50 strains of C. jejuni tested at this temperature, which was weakly positive. Campylobacter laridis was not haemolytic; C. fetus subsp. fetus, which does not grow at 42°C, showed no haemolysis at 37°C. Blood agar (Oxoid, BA Base No. 2) was not suitable for testing for haemolysis by these organisms. A microaerobic gas mixture containing hydrogen is better than that containing nitrogen because the medium has a brighter colour, making haemolysis casier to detect. There was no synergistic haemolysis with Staphylococcus aureus or Streptococcus agalactiae. The plate haemolysis test as described here may aid differentiation within the thermophilic campylobacters

A study of differentials causing flu-like symptoms (malaria, typhoid, streptococcal infections and rheumatoid arthritis) in 488 patients from a pastoralist area is presented. The potential usefulness of clinical signs, symptoms and diagnostic tests in ruling-in or ruling-out these diseases was investigated in the District hospital and three outlying health dispensaries. For each patient a detailed clinical history plus diagnostic tests for brucellosis, typhoid, streptococcal infections and rheumatoid arthritis, and for some patients, malaria were conducted. Incidence levels of these diseases were estimated using laboratory test results; brucellosis, 13%: typhoid, 40%: streptococcal infections, 6%: malaria, 9%: and rheumatoid arthritis, 10%. Brucellosis could not be differentiated clinically from the other flu-like diseases but rheumatoid arthritis could.