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

Although military conflicts are common on the African continent, there is a paucity of data regarding bomb-blast injuries in this region and in Kenya in particular. This paper describes the pattern of maxillofacial injuries sustained after the August 1998 bomb blast that occurred in Nairobi, Kenya. A retrospective cross-sectional study was carried out using hospital-based records of 290 bomb-blast survivors admitted at the Kenyatta National Referral and Teaching Hospital in Nairobi. Using a self-designed form to record information about variables such as the sex and age of the survivors and type of location of soft- and hard-tissue injuries, it was found that of the 290 bomb-blast survivors, 78% had sustained one or more maxillofacial injuries. Soft-tissue injuries (cuts, lacerations or bruises) were the most common, constituting 61.3% of all injuries in the maxillofacial region; 27.6% had severe eye injuries, while 1.4% had fractures in the cranio-facial region. This paper concludes that the effective management of bomb-blast injuries as well as those caused by other types of disaster requires a multidisciplinary approach. The high percentage of maxillofacial injuries confirm that maxillofacial surgeons should form an integral part of this multidisciplinary team.

We describe the technique of splenic aspiration in 113 patients presenting with splenomegaly. It was used initially to establish a diagnosis, and in those patients with kala azar, to follow the response of the parasites to therapy until 'parasitological cure'. In all 671 aspirations were performed. No complications occurred in the 69 patients with active kala azar, who collectively had more than 600 aspirations. One patient in a moribund condition had a fatal haemorrhage. The aspirate suggested a lymphoma, confirmed at autopsy. In 68 of the 69 patients with active kala azar, the diagnosis was established at the first aspiration. The essentials of the technique are the use of a small calibre needle (21 G), and speed, the needle being in the spleen for less than a second, with the consequent procurement of a few drops of material only.

Objectives. To identify the changes in rheumatology service delivery across the five regions of Africa from the
impact of the COVID-19 pandemic.
Methods. The COVID-19 African Rheumatology Study Group created an online survey consisting of 40 questions
relating to the current practices and experiences of rheumatologists across Africa. The CHERRIES checklist for
reporting results of internet e-surveys was adhered to.
Results. A total of 554 completed responses were received from 20 countries, which include six in Northern
Africa, six in West Africa, four in Southern Africa, three in East Africa and one in Central Africa. Consultant grade
rheumatologists constituted 436 (78.7%) of respondents with a mean of 14.56 10.3 years of experience. A total of
77 (13.9%) rheumatologists avoided starting a new biologic. Face-to-face clinics with the use of some personal
protective equipment continued to be held in only 293 (52.9%) rheumatologists’ practices. Teleconsultation modalities
found usage as follows: telephone in 335 (60.5%), WhatsApp in 241 (43.5%), emails in 90 (16.3%) and video
calls in 53 (9.6%). Physical examinations were mostly reduced in 295 (53.3%) or done with personal protective
equipment in 128 (23.1%) practices. Only 316 (57.0%) reported that the national rheumatology society in their
country had produced any recommendation around COVID-19 while only 73 (13.2%) confirmed the availability of a
national rheumatology COVID-19 registry in their country.
Conclusion. COVID-19 has shifted daily rheumatology practices across Africa to more virtual consultations and
regional disparities are more apparent in the availability of local protocols and registries.
Key words: COVID-19, Africa, rheumatology, DMARD, rheumatic and musculoskeletal diseases, telem

n/a

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

The major problems experienced with solar air heaters are their non-reliability as their operation largely depends on weather conditions which keep on changing. This study was aimed at providing and experimentally validating a transient based model for predicting the performance of multi-pass solar air heaters operating on changing weather conditions. A transient prediction model was developed by considering the thermal capacities of the collector components and the flowing air. Differential equations were developed by considering the energy interactions and balances for the various components of the collector, and then solved nUmerically. The developed model was tested with input data of insolation, ambient temperature, wind velocity and solar time and then validated experimentally by use of a single collector which was designed to accommodate all the four flow arrangements investigated ( SPM, DMPM, DTPM and TPM). The time constant of the collector constructed was determined experimentally to be 27 minutes. The theoretical collector performance results indicated a transient behavior for changing weather conditions. This was' also confirmed by the experiment carried out whose data were recorded and plotted at intervals of two minutes Based on air temperature rise and collector efficiency both the developed theoretical model and experimental set up indicated that the triple pass mode is superior to the other modes, with the single pass mode ranked the lowest in performance. The developed ~UlputaticmaI prediction model had a standard deviational error of 1.8 to 2.1 % as compared to the experimental values which had an error of2.7 to 9.6%. The TPM had the lowest error (1.8%) while the SPM had the highest (2.1%). When compared to other models and experiments, the results were in good agreement. The developed model confirmed that air temperature rise in the collector is a function of available solar insolation and prevailing weather conditions such as; cloud cover, ambient temperature and wind. It was found that, in actual sense thermal solar collectors do expenence transient conditions and the developed transient model was necessary, and is expected to reduce the day long experiments that need to' be carried out to. acquire the performance characteristics of solar air heaters under changing weather conditions.

Urban sprawl is a phenomenon which characterizes all urban spaces both in MDCs and LDCs. Managing the problems associated with urban sprawl, especially in LDCs, is, however, mind boggling, hence, the very reason why the theme of the world urban forum held in 2008 in Beijing city, China, read: cities without sprawl. In order to manage urban sprawl in a sustainable way, there is need to understand the factors which bring it about. In an effort to contribute to that understanding, this paper seeks answers to the questions: Do patterns of urban sprawl occur the same way in every city both in MDCs and LDCs? In other words, can urban sprawl be explained by use of a single and universal theory? The review of literature has established that patterns of peri-urban formation vary depending on the city-rural relationship at the rural-urban interface. In countries where the urban land use system is integrated with that of the rural, peri-urban formation takes the form of invasion and succession along the city-rural continuum. In countries where the rural and urban land use systems are dichotomized, peri-urban dichotomy. It is concluded, however, that there is no single theory to explain all forms of urban sprawl. The general consensus; however, is that urban sprawl is undesirable. A framework to predetermining desirable/ optimum patterns of peri-urban formation is conceptualized in this paper. What constitutes a universal theory that informs a desirable/optimum model is also conceptualized in this paper and termed here in as the integrated politico-social-economic optimizing model.

Key words: theoretical underpinings, urban sprawl, universal theory, management challenge, urban fringe.

Literary scholars in Kenya have recognised that oral literature is a cultural heritage worth preserving and accessing. To this end, they have used traditional information to good effect. In today

Plasmodium falciparum parasites resistant to the combination sulfadoxine-pyrimethamine are spreading in Africa, particularly in East Africa. This is a matter of concern because there are no other affordable drugs available. This article provides the evidence indicating that sulfadoxine-pyrimethamine resistance can be reversed in vitro and discusses how this information might be exploited to extend the therapeutic lifetime of sulfadoxine-pyrimethamine in vivo

Mentorship is critical to develop effective leaders. The Afya Bora Fellowship in Global Health Leadership program, a consortium of four African and four US universities formed in 2008, has incorporated a robust dual mentorship component into its training of over 70 fellows. Each Fellow was assigned two mentors to guide professional growth over the fellowship period. Here, we evaluate 39 Fellows' experiences with their mentors between 2012 and 2014, and identify how these relationships prepare Fellows to lead major health programs

Polycrystalline In2Se3 semiconducting thin films were synthesized by chemical spray pyrolysis and their properties investigated. Strong dependence of structural and opto-electronic properties on film composition was observed. Absorption coefficient (α) at normal incidence was determined and an optimised direct optical band gap (Eg) of 1.92 eV was obtained at a substrate temperature (Tsub) of 673 K. Whereas low Tsub favoured incorporation of impurities in the films, elevated Tsub
had the effects of introducing textural and structural defects with modifications in the film properties. The crystallinity of the films increased with switch from chalcogen rich to chalcogen deficient films.

Keywords: In2Se3, Spray pyrolysis, Chalcopyrite buffers, Opto-electronic property

The effect of corchorus olitorius derived binder on the effective thermal conductivity of a kaolinite-based
refractory was investigated. Strong dependence of (effective) thermal conductivity of fired samples on the
binder concentration, temperature and porosity was noted. Comparison of experimental data with Effective
Medium Approximation (EMA) and Geometric Mean Model (GMM) theories showed that predictions from
EMA agreed better with the experimental data than those from GMM. This was attributed to the EMA model
being more rigorous and contained more microstructural information than the simpler GMM.

The effect of corchorus olitorius derived binder on the effective thermal conductivity of a kaolinite-based refractory was investigated. Strong dependence of (effective) thermal conductivity of fired samples on the binder concentration, temperature and porosity was noted. Comparison of experimental data with Effective Medium Approximation (EMA) and Geometric Mean Model (GMM) theories showed that predictions from EMA agreed better with the experimental data than those from GMM. This was attributed to the EMA model being more rigorous and contained more microstructural information than the simpler GMM.

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Clematis brachiata Thunberg (Ranunculaceae) is used in Kenya for the management of headaches, malaria and other febrile illnesses, abdominal disorders, yaws and for skin disorders.  Old stems and leaves are chewed for the management of toothaches and sore throats. 
Extracts of the plant were subjected to tests for antimalarial, antibacterial and antifungal activity.  The toxicity of the extracts was assessed using the brine shrimp lethality bioassay.
 
The root extract gave the highest in vitro antimalarial activity against a mulitidrug resistant strain, Plasmodium falciparum VI/S (IC50=39.24 mg/ml). The stem and leaf extracts had insignificant antiplasmodial activity.  The leaf, stem and root extracts had bacterial or fungal growth even at very high concentrations of 10 mg/ml. The LD50 values of the stem and leaf methanol extracts against the brine shrimp larvae was 365.60 and 66.5 mg/ml respectively.
The in vitro anti malarial activity of the root extract in part supports the ethnobotanical use of the plant to manage malaria.
 KEY WORDS
Clematis, Ranunculaceae, antimalarial, brine shrimp, antimicrobial

Energy conservation in food processing is not only important in industrialized countries. It can likewise be decisive for success or failure of a technology in developing countries. The present contribution discussed this subject using Kenyan tea processing plants as an example. Of this investigation, general conclusion may be drawn on the possibilities and limits of energy conservation in the food industry.

Thermal performance tests were carried out on four water heating flat plate solar collectors with the aim to select a suitable one to be used to provide process heat for milk pasteurisation. The collectors included three commercial solar collectors purchased from local shops in Nairobi, Kenya and one prototype collector designed and fabricated by the author. The three commercial solar collectors had effective areas of 1.67, 1.87 and 1.83 m2 while the self-made collector had an effective area of 1.60 m2. Thermal performance of the collectors was determined in terms of the Hottel-Whillier-Bliss equation, with FR(α)e and FRUL indicating how energy is absorbed and lost from the collector, respectively. The FR(α)e values were 0.76, 0.75, 0.73, and 0.82, respectively, for the commercial collectors and the self-made collector. The FRUL values were 8.33, 12.01, 9.80 and 13.77 W.m–2.C–1, respectively. The instantaneous efficiencies for the four solar collectors ranged from 12 to 87%. The solar collector with the lowest FRUL value had a special (black chrome) selective absorber surface and was also the most cost effective collector for delivering temperatures of about 80°C. This collector is the most suitable for medium temperature applications such as provision of hot water for milk pasteurisation.

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Clematis brachiata Thunberg (Ranunculaceae) is used in Kenya for the management of headaches, malaria and other febrile illnesses, abdominal disorders, yaws and for skin disorders.  Old stems and leaves are chewed for the management of toothaches and sore throats. 
Extracts of the plant were subjected to tests for antimalarial, antibacterial and antifungal activity.  The toxicity of the extracts was assessed using the brine shrimp lethality bioassay.
 
The root extract gave the highest in vitro antimalarial activity against a mulitidrug resistant strain, Plasmodium falciparum VI/S (IC50=39.24 mg/ml). The stem and leaf extracts had insignificant antiplasmodial activity.  The leaf, stem and root extracts had bacterial or fungal growth even at very high concentrations of 10 mg/ml. The LD50 values of the stem and leaf methanol extracts against the brine shrimp larvae was 365.60 and 66.5 mg/ml respectively.
The in vitro anti malarial activity of the root extract in part supports the ethnobotanical use of the plant to manage malaria.
 KEY WORDS
Clematis, Ranunculaceae, antimalarial, brine shrimp, antimicrobial

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Clematis brachiata Thunberg (Ranunculaceae) is used in Kenya for the management of headaches, malaria and other febrile illnesses, abdominal disorders, yaws and for skin disorders.  Old stems and leaves are chewed for the management of toothaches and sore throats. 
Extracts of the plant were subjected to tests for antimalarial, antibacterial and antifungal activity.  The toxicity of the extracts was assessed using the brine shrimp lethality bioassay.
 
The root extract gave the highest in vitro antimalarial activity against a mulitidrug resistant strain, Plasmodium falciparum VI/S (IC50=39.24 mg/ml). The stem and leaf extracts had insignificant antiplasmodial activity.  The leaf, stem and root extracts had bacterial or fungal growth even at very high concentrations of 10 mg/ml. The LD50 values of the stem and leaf methanol extracts against the brine shrimp larvae was 365.60 and 66.5 mg/ml respectively.
The in vitro anti malarial activity of the root extract in part supports the ethnobotanical use of the plant to manage malaria.
 KEY WORDS
Clematis, Ranunculaceae, antimalarial, brine shrimp, antimicrobial

This study investigated the effectiveness of three physical-chemical methods namely; pH adjustment, precipitation with alum and the use of polyelectrolytes. In the treatment of diary wastewater from Brookeside milk processing plant. It also investigated the drainability of the sludge produced by each of the three methods. Laboratory tests were carried out in three different batches, one for each of the three methods. In the alum method enough alum was added to the wastewater samples to cause precipitation by sweep floc. In the pH adjustment method, the pH of samples were lowered to the iso-electric point of the casein proteins of approximately pH 4.5 leading to their precipitation as a result of solubility changes. The polyelectrolytes method involved the use of two polyelectrolytes, Sudfloc 3820 and Sudfloc 3860 each of which was used to coagulate the dirty wastewater. For each of the three methods, the samples were taken in one-litre beakers and subjected to Jar tests to determine the optimum dosages. After one hour of settling the supernatants were decanted and subjected to standard Chemical Oxygen Demand (COD) tests, turbidity and pH measurements. The settled sludge was subjected to drainability studies. Results showed the treatment of dairy wastewater by the three physical-chemical methods to be effective. There were COD removals of between 60% and 90% and turbidity reduction of over 90%. The use of the sudfloc polyelectrolytes was found to be the least demanding in terms of effluent quality control as no pH adjustments of either the wastewater or the effluent was required. The use of polyelectolytes produced the least volumes of sludge and also the better drainability and solids concentration. Sudfloc 3820 was found to achieve better results than Sudfloc 3860 in terms of COD reduction and the drainability of sludge produced although both achieved the same drainability studies. This study showed that each of the three physical-chemical methods can be used effectively to remove the white colour of dairy wastewater as well as the bulk of the proteins and fats, hence, enabling the discharge of the effluents into natural waters to be of good assimilative capacity.

Abstract This paper presents the results of a combined experimental and theoretical study of microstructure and thermal shock resistance of an aluminosilicate ceramic. Shock-induced crack growth is studied in sintered structures produced from powders with different particle size ranges. The underlying crack/microstructure interactions and toughening mechanisms are elucidated via scanning electron microscopy (SEM). The resulting crack-tip shielding levels (due to viscoelastic crack bridging) are estimated using fracture mechanics concepts. The implications of the work are discussed for the design of high refractory ceramics against thermal shock.

Keywords Viscoelastic crack bridging . Crack-tip shielding . Thermal shock . Refractory ceramics

In controlled laboratory experiments the effects of ambient temperatures on thermoregulation, metabolism, heat balance, heart rate, and total evaporative water loss were studied in the Fennce fox (Fenneus Zerda) from the Sinai desert.

Drying characteristics of both naturally moist and.rew.etted grain sorghum were studied. Three varieties of Kenyan grain sorghum were used. The drying air temperature and its flow rate were varied. Relative humidity of the air and the initial moisture content of the sorghum grains were determined. Moisture content of the grains was determined at various times during the thin-layer drying process. Thin layer drying equations based on Pabis and Henderson equation and Page model were developed. Drying air temperature was the major factor affecting drying rates of sorghum grains. The difference in sorghum varieties also influenced the drying rates. The relationship between parameter k in Pabis and Henderson equation (MR=exp (-kt)) and drying air temperature iuas found to be of Arrhenius type. Parameter K in Page equation (MR=exp (-KfI)), for naturally moist grains, was expressed as an exponential function of temperature terms. But for rewetted grains, it was an exponentiaI function of temperature terms, air flow rate, relative humidity and initial moisture content. Parameter N in Page equation was expressed as and exponential function of temperature temis. Page equation fitted drying data better than Pabis and Henderson equation.

CONTEXT: Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) cause major morbidity and significant mortality in patients with diabetes mellitus. For more than 30 yr, our group, in a series of prospective, randomized clinical studies, has investigated the pathogenesis and evolving strategies of the treatment of hyperglycemic crises. This paper summarizes the results of these prospective studies on the management and pathophysiology of DKA. SETTING: Our earliest studies evaluated the comparative efficacy of low-dose vs. pharmacological amounts of insulin and the use of low-dose therapy by various routes in adults and later in children. Subsequent studies evaluated phosphate and bicarbonate therapy, lipid metabolism, ketosis-prone type 2 patients, and use of rapid-acting insulin analogs as well as leptin status, cardiac risk factors, proinflammatory cytokines, and the mechanism of activation of T lymphocytes in hyperglycemic crises. MAIN OUTCOME: The information garnered from these studies resulted in the creation of the 2001 American Diabetes Association (ADA) technical review on DKA and HHS as well as the ADA Position and Consensus Paper on the therapy for hyperglycemic crises. CONCLUSIONS: Areas of future research include prospective randomized studies to do the following: 1) establish the efficacy of bicarbonate therapy in DKA for a pH less than 6.9; 2) establish the need for a bolus insulin dose in the initial therapy of DKA; 3) determine the pathophysiological mechanisms for the absence of ketosis in HHS; 4) investigate the reasons for elevated proinflammatory cytokines and cardiovascular risk factors; and 5) evaluate the efficacy and cost benefit of using sc regular insulin vs. more expensive insulin analogs on the general ward for the treatment of DKA.

During the five-year period January 2001 to December 2005, the Drug Analysis and
Research Unit received and analyzed 394 drug samples. Samples were received from
regulatory authorities, local industry, non-governmental organizations, hospitals
and private practitioners. The samples analyzed constituted 37.8 % locally
manufactured and 62.2 % imported products. In contrast to previous years when
failure rates of over 20 % were recorded, the overall rate of failure to comply with
compendial quality specifications was 6.1 %, comprising of 8.7 % locally
manufactured and 4.5 % imported drugs.

This dissertation is a study of twentieth-century American novels which can be used in a course by Kenyan and other East African students and teachers. The selected novels can be studied as models for exemplification of the most significant developments and trends in longer American narrative fiction in the period covered by the study. Because of time limits and for purposes of presenting quality fictional works to be covered in one semester, eight novels were analyzed in this study. These are: Sister Carrie (1900) by Theodore Dreiser, The Great Gatsby (1925) by F.Scott Fitzgerald, The Sun Also Rises (1926) by Ernest Hemingway, Intruder in the Dust (1948)by J.D Salinger, Invisible Man(1952) by Ralph Ellison, Go Tell it On The Mountain(1953) by James Baldwin and Brown Girl, Brownstones(1959)by Paule Marshall. Each of the selected novels represents a component of significance in American literature during the era designated .Sister Carrie

Amoxycillin and clavulanic acid (Augmentin; Beecham Research Laboratories) was used to treat patients with bacteriologically proved chancroid in three different dose regimens. A single dose of Augmentin (amoxycillin 3 g, clavulanic acid 350 mg) was found to be ineffective. A similar dose repeated after 24 hours was equally ineffective, but a dose (amoxycillin 500 mg, clavulanic acid 250 mg) given every 8 hours for three days was found to be effective. The drug was well tolerated and no side effects were noted in any of the patients treated

From the fruits of Bulbine abyssinica three new dimeric anthracene derivatives, (P)-8,9,10,80-tetrahydroxy-3,30-dimethyl[10,70-bianthracene]-1,4,90,100-tetraone (trivial name abyquinone A), (10R)-1,4,8,10,80-pentahydroxy-3,30-dimethyl-[10,70-bianthracene]-9,90,100(10H)-trione (trivial name abyquinone B), and (10R)-30,40-dihydro-1,4,8,30,80,90-hexahydroxy-3,30-dimethyl-[10,70-bianthracene]-9,10(10H,20H)-dione (trivial name abyquinone C) were isolated. Despite their structural differences, these three compounds are connected to each other by the apparently biomimetic conversion of abyquinone
C (a preanthraquinonylanthrone with two stereogenic centers) into
B (an anthraquinonylanthrone with one stereogenic center) and finally into A (an axially chiral bianthraquinone) under mild conditions, involving a highly efficient center-to-axis chirality transfer. In addition, the known anthraquinones islandicin and chrysophanol were identified. The structures were determined on the basis of spectroscopical evidences, chemical transformations, and quantum chemical CD calculations.

Three ent-trachylobane diterpenes have been isolated from the leaf exudates of Psiadia punctulata and characterised as 6a,17,19-enttrachylobantriol; 2a,18,19-ent-trachylobantriol; and 2b,6a,18,19-ent-trachylobantetraol. The structures were determined on the basis of spectroscopic evidence.