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

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

There are four hypotheses which have been advanced to explain the pathophysiology of severe and complicated malaria such as cerebral malaria. However, none of them adequately explains all the features of cerebral malaria in man. One such hypotheses is Disseminated Intravascular Coagulation (DIC). To determine whether this condition occurs in patients with uncomplicated malaria, the authors conducted a study on fibrinogen and its degradation products, euglobulin lysis time and parasite counts in 30 cases of uncomplicated malaria. By spectrophotometric method, plasma fibrinogen in patients with uncomplicated malaria was found to be normal as compared to normal healthy adults. There were no fibrinogen degradation production (FDP) detected in either patients or healthy controls, using latex agglutination tests at a dilution of 1:5. This method for FDP estimation is significant in that a serum agglutination with 1:5 dilution indicates a concentration of FDP in the original serum in excess of 10g/ml, designated as positive results of experiment. High values of euglobulin lysis time (ELT) were noted in patients with low parasitaemia. Analysis of these results showed that disseminated intravascular coagulation did not occur in uncomplicated cases of malaria. In this study on cases of uncomplicated malaria and low parasitaemia the biochemical parameters relating to to DIC have been essentially normal, although DIC is thought to be a primary stage in the development of cerebral malaria. According to Reid, DIC is an important intermediate mechanism in the pathophysiology of severe and complicated malaria such as cerebral malaria.

Mefloquine pharmacokinetics were studied in Kenyan African normal volunteers and in patients with severe acute attack of Plasmodium falciparum malaria. Peak concentrations were achieved in both groups at 20-24 hours. The mean half-life of elimination was 385 +/- 150 hours (mean +/- SD) in normal subjects while in severe malaria it was 493 +/- 215 hours which was significantly longer (P less than or equal to 0.001). The volume of distribution was significantly smaller in severe malaria where it was 30.76 +/- 10.50 l/kg (mean +/- SD) while in the normal subjects it was 40.90 +/- 20.70 l/kg (mean +/- SD) (P less than or equal to 0.001). The total body clearance in severe malaria was 3.75 +/- 1.51 l/h (mean +/- SD). This was significantly lower than in the normal subjects where it was 5.15 +/- 1.50 l/h (mean +/- SD) (P less than or equal to 0.001).

Mefloquine pharmacokinetics were studied in Kenyan African normal volunteers and in patients with severe acute attack of Plasmodium falciparum malaria. Peak concentrations were achieved in both groups at 20-24 hours. The mean half-life of elimination was 385 +/- 150 hours (mean +/- SD) in normal subjects while in severe malaria it was 493 +/- 215 hours which was significantly longer (P less than or equal to 0.001). The volume of distribution was significantly smaller in severe malaria where it was 30.76 +/- 10.50 l/kg (mean +/- SD) while in the normal subjects it was 40.90 +/- 20.70 l/kg (mean +/- SD) (P less than or equal to 0.001). The total body clearance in severe malaria was 3.75 +/- 1.51 l/h (mean +/- SD). This was significantly lower than in the normal subjects where it was 5.15 +/- 1.50 l/h (mean +/- SD) (P less than or equal to 0.001).

There are four hypotheses which have been advanced to explain the pathophysiology of severe and complicated malaria such as cerebral malaria. However, none of them adequately explains all the features of cerebral malaria in man. One such hypotheses is Disseminated Intravascular Coagulation (DIC). To determine whether this condition occurs in patients with uncomplicated malaria, the authors conducted a study on fibrinogen and its degradation products, euglobulin lysis time and parasite counts in 30 cases of uncomplicated malaria. By spectrophotometric method, plasma fibrinogen in patients with uncomplicated malaria was found to be normal as compared to normal healthy adults. There were no fibrinogen degradation production (FDP) detected in either patients or healthy controls, using latex agglutination tests at a dilution of 1:5. This method for FDP estimation is significant in that a serum agglutination with 1:5 dilution indicates a concentration of FDP in the original serum in excess of 10g/ml, designated as positive results of experiment. High values of euglobulin lysis time (ELT) were noted in patients with low parasitaemia. Analysis of these results showed that disseminated intravascular coagulation did not occur in uncomplicated cases of malaria. In this study on cases of uncomplicated malaria and low parasitaemia the biochemical parameters relating to to DIC have been essentially normal, although DIC is thought to be a primary stage in the development of cerebral malaria. According to Reid, DIC is an important intermediate mechanism in the pathophysiology of severe and complicated malaria such as cerebral malaria.

There are four hypotheses which have been advanced to explain the pathophysiology of severe and complicated malaria such as cerebral malaria. However, none of them adequately explains all the features of cerebral malaria in man. One such hypotheses is Disseminated Intravascular Coagulation (DIC). To determine whether this condition occurs in patients with uncomplicated malaria, the authors conducted a study on fibrinogen and its degradation products, euglobulin lysis time and parasite counts in 30 cases of uncomplicated malaria. By spectrophotometric method, plasma fibrinogen in patients with uncomplicated malaria was found to be normal as compared to normal healthy adults. There were no fibrinogen degradation production (FDP) detected in either patients or healthy controls, using latex agglutination tests at a dilution of 1:5. This method for FDP estimation is significant in that a serum agglutination with 1:5 dilution indicates a concentration of FDP in the original serum in excess of 10g/ml, designated as positive results of experiment. High values of euglobulin lysis time (ELT) were noted in patients with low parasitaemia. Analysis of these results showed that disseminated intravascular coagulation did not occur in uncomplicated cases of malaria. In this study on cases of uncomplicated malaria and low parasitaemia the biochemical parameters relating to to DIC have been essentially normal, although DIC is thought to be a primary stage in the development of cerebral malaria. According to Reid, DIC is an important intermediate mechanism in the pathophysiology of severe and complicated malaria such as cerebral malaria.

Mefloquine pharmacokinetics were studied in Kenyan African normal volunteers and in patients with severe acute attack of Plasmodium falciparum malaria. Peak concentrations were achieved in both groups at 20-24 hours. The mean half-life of elimination was 385 +/- 150 hours (mean +/- SD) in normal subjects while in severe malaria it was 493 +/- 215 hours which was significantly longer (P less than or equal to 0.001). The volume of distribution was significantly smaller in severe malaria where it was 30.76 +/- 10.50 l/kg (mean +/- SD) while in the normal subjects it was 40.90 +/- 20.70 l/kg (mean +/- SD) (P less than or equal to 0.001). The total body clearance in severe malaria was 3.75 +/- 1.51 l/h (mean +/- SD). This was significantly lower than in the normal subjects where it was 5.15 +/- 1.50 l/h (mean +/- SD) (P less than or equal to 0.001).

The pharmacokinetics of albendazole were investigated in five children who were hospitalized at the Kenyatta National Hospital for the treatment of hydatid disease. Unchanged albendazole was below detectable level in plasma. The major metabolite present was albendazole sulphoxide. In one of the patients, the concentration of albendazole sulphone in plasma was significantly high, whereas in the other four children, only trace amounts were detected. Maximum concentrations of albendazole sulphoxide in these five children were variable and generally higher than those reported in adults by other workers. Other pharmacokinetic parameters were comparable to those found in other studies.

The pharmacokinetics of albendazole were investigated in five children who were hospitalized at the Kenyatta National Hospital for the treatment of hydatid disease. Unchanged albendazole was below detectable level in plasma. The major metabolite present was albendazole sulphoxide. In one of the patients, the concentration of albendazole sulphone in plasma was significantly high, whereas in the other four children, only trace amounts were detected. Maximum concentrations of albendazole sulphoxide in these five children were variable and generally higher than those reported in adults by other workers. Other pharmacokinetic parameters were comparable to those found in other studies.

Mefloquine pharmacokinetics were studied in Kenyan African normal volunteers and in patients with severe acute attack of Plasmodium falciparum malaria. Peak concentrations were achieved in both groups at 20-24 hours. The mean half-life of elimination was 385 +/- 150 hours (mean +/- SD) in normal subjects while in severe malaria it was 493 +/- 215 hours which was significantly longer (P less than or equal to 0.001). The volume of distribution was significantly smaller in severe malaria where it was 30.76 +/- 10.50 l/kg (mean +/- SD) while in the normal subjects it was 40.90 +/- 20.70 l/kg (mean +/- SD) (P less than or equal to 0.001). The total body clearance in severe malaria was 3.75 +/- 1.51 l/h (mean +/- SD). This was significantly lower than in the normal subjects where it was 5.15 +/- 1.50 l/h (mean +/- SD) (P less than or equal to 0.001).

Mefloquine pharmacokinetics were studied in Kenyan African normal volunteers and in patients with severe acute attack of Plasmodium falciparum malaria. Peak concentrations were achieved in both groups at 20-24 hours. The mean half-life of elimination was 385 +/- 150 hours (mean +/- SD) in normal subjects while in severe malaria it was 493 +/- 215 hours which was significantly longer (P less than or equal to 0.001). The volume of distribution was significantly smaller in severe malaria where it was 30.76 +/- 10.50 l/kg (mean +/- SD) while in the normal subjects it was 40.90 +/- 20.70 l/kg (mean +/- SD) (P less than or equal to 0.001). The total body clearance in severe malaria was 3.75 +/- 1.51 l/h (mean +/- SD). This was significantly lower than in the normal subjects where it was 5.15 +/- 1.50 l/h (mean +/- SD) (P less than or equal to 0.001).

Mefloquine pharmacokinetics were studied in Kenyan African normal volunteers and in patients with severe acute attack of Plasmodium falciparum malaria. Peak concentrations were achieved in both groups at 20-24 hours. The mean half-life of elimination was 385 +/- 150 hours (mean +/- SD) in normal subjects while in severe malaria it was 493 +/- 215 hours which was significantly longer (P less than or equal to 0.001). The volume of distribution was significantly smaller in severe malaria where it was 30.76 +/- 10.50 l/kg (mean +/- SD) while in the normal subjects it was 40.90 +/- 20.70 l/kg (mean +/- SD) (P less than or equal to 0.001). The total body clearance in severe malaria was 3.75 +/- 1.51 l/h (mean +/- SD). This was significantly lower than in the normal subjects where it was 5.15 +/- 1.50 l/h (mean +/- SD) (P less than or equal to 0.001).

Mefloquine pharmacokinetics were studied in Kenyan African normal volunteers and in patients with severe acute attack of Plasmodium falciparum malaria. Peak concentrations were achieved in both groups at 20-24 hours. The mean half-life of elimination was 385 +/- 150 hours (mean +/- SD) in normal subjects while in severe malaria it was 493 +/- 215 hours which was significantly longer (P less than or equal to 0.001). The volume of distribution was significantly smaller in severe malaria where it was 30.76 +/- 10.50 l/kg (mean +/- SD) while in the normal subjects it was 40.90 +/- 20.70 l/kg (mean +/- SD) (P less than or equal to 0.001). The total body clearance in severe malaria was 3.75 +/- 1.51 l/h (mean +/- SD). This was significantly lower than in the normal subjects where it was 5.15 +/- 1.50 l/h (mean +/- SD) (P less than or equal to 0.001).

The pharmacokinetics of albendazole were investigated in five children who were hospitalized at the Kenyatta National Hospital for the treatment of hydatid disease. Unchanged albendazole was below detectable level in plasma. The major metabolite present was albendazole sulphoxide. In one of the patients, the concentration of albendazole sulphone in plasma was significantly high, whereas in the other four children, only trace amounts were detected. Maximum concentrations of albendazole sulphoxide in these five children were variable and generally higher than those reported in adults by other workers. Other pharmacokinetic parameters were comparable to those found in other studies.

Mitogenic activities in African traditional herbal medicines were examined using protein fractions obtained from their extracts by precipitation with ammonium sulfate. Potent mitogenic activities for human and mouse lymphocytes were found in the three plants: Croton macrostachyus, Croton megalocarpus (Euphorbiaceae), and Phytolacca dodecandra (Phytolaccaceae). All the gel chromatographic patterns of these protein fractions progressed toward the smaller molecule site with pronase treatment, while their mitogenic activities decreased significantly. Protein fractions from these three plants induced mitogenesis both in human and mouse isolated T cells, but not in lymphocytes from athymic nude mice. By testing further fractionated protein fractions with gel filtration chromatography, it was found that all three plants contained several mitogens having different molecule sizes.

Mefloquine pharmacokinetics were studied in Kenyan African normal volunteers and in patients with severe acute attack of Plasmodium falciparum malaria. Peak concentrations were achieved in both groups at 20-24 hours. The mean half-life of elimination was 385 +/- 150 hours (mean +/- SD) in normal subjects while in severe malaria it was 493 +/- 215 hours which was significantly longer (P less than or equal to 0.001). The volume of distribution was significantly smaller in severe malaria where it was 30.76 +/- 10.50 l/kg (mean +/- SD) while in the normal subjects it was 40.90 +/- 20.70 l/kg (mean +/- SD) (P less than or equal to 0.001). The total body clearance in severe malaria was 3.75 +/- 1.51 l/h (mean +/- SD). This was significantly lower than in the normal subjects where it was 5.15 +/- 1.50 l/h (mean +/- SD) (P less than or equal to 0.001).

The pharmacokinetics of antipyrine were studied in 12 healthy volunteers and 10 patients of Kenya African origin with Hodgkin's lymphoma. The half-life of antipyrine was 12.2 +/- 1.3 h (mean + s.d.), while the apparent volume of distribution (V) was 0.67 +/- 0.11 l kg-1 (mean +/- s.d.) and the total body clearance was 40.7 +/- 3.2 ml kg-1 h-1 (mean +/- s.d.) in the healthy volunteers. The antipyrine half-life in the patients with advanced Hodgkin's lymphoma was 17.1 +/- 2.7 h (mean +/- s.d.). The apparent volume of distribution was 0.72 +/- 0.14 l kg-1 (mean +/- s.d.) which was larger than in healthy volunteers (P less than 0.05). The total body clearance was 30.3 +/- 9.4 ml kg-1 h-1 (mean + s.d.) and this was reduced compared with that in healthy volunteers (P less than 0.02). After cytotoxic therapy the half-life in the patients with advanced Hodgkin's lymphoma was significantly decreased to 8.3 +/- 1.3 h (mean +/- s.d.) (P less than 0.07), and the apparent volume of distribution was reduced to 0.65 +/- 0.07 l kg-1 (mean +/- s.d.) (P less than 0.05) while the total body clearance increased to 52.8 +/- 5.5 ml kg-1 h-1 (mean +/- s.d.) (P less than 0.01).

Summing multipliers is an important class of operators in the geometric theory of general Banach spaces. They are particularly useful in the study of the structure of the classical spaces. The work done by Grothendieck and Pietsch provides a good basis for the study of this class of operators. The topic of this study is Aspects on (p,q)-summing multipliers. (p,q)-summing multipliers are sequences of bounded linear operators mapping weakly p-summable sequences into strongly q-summable sequences. This study is concerned with using the concepts of absolute and p-summing multipliers to characterize the space of all (p,q)-summing multipliers. In particular we show that the space of all (p, q)-summing multipliers is complete. This is accomplished through a detailed study of the concepts of the summing operators and absolute and p-summing multipliers

A prospective study to determine the prevalence and profile of cardiovascular disease in elderly patients admitted into the medical wards, Kenyatta National Hospital, was carried out between July 1991 and January 1992. Two hundred and two patients over 60 years of age were admitted into the medical wards over this period. This formed seven per cent of the total medical admissions. Two of these refused to take part in the study. Of the 200 elderly patients evaluated for cardiovascular disease, 146 (73%) were between 60 and 75 years of age with only 26 (13%) being over 85 years. Fifty seven per cent were males. Clinical evidence of cardiovascular disease was present in 79 (39.5%) of the patients evaluated. There was no sex difference in the prevalence of cardiovascular disease as judged from clinical evaluation (37.7% males versus 41.9% females, p > 0.05). Cardiovascular diseases in our medical in-patients at Kenyatta National Hospital are common and especially so with hypertension which plays an important role in the aetiology of congestive heart failure and cerebravascular accidents. Cardiac arrhythmias are also common though not necessarily symptomatic. Rheumatic heart disease and cardiomyopathies were uncommon in our study population. A community-based survey is needed to determine the true prevalence of cardiovascular diseases in the elderly and their contribution to morbidity in this sector of the population.

The study aimed at evaluating tolerability and efficacy of the combination enalapril 20 mg with hydrochlorothiazide 12.5 mg (co-renitec) as first line therapy in black patients with mild to moderate primary hypertension. Fifty patients completed a twelve weeks of open clinical study preceded by two weeks of washout period. They were evaluated every four weeks and haematological, biochemical urine microscopy and electrocardiographic tests were undertaken before the start and after the completion of study. Pre-treatment values of mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 172.16 mm hg (+/- 20.41) and 104.38 mm hg (+/- 7.339) respectively. The usual daily dosage was one tablet which was increased to two after eight weeks in case the DBP was not normalized, i.e. less than or equal to 95 mm hg. In 44 (88%) patients, the DBP was normalised at the end of the study period; three patients (6%) were resistant to treatment and another three (6%) exhibited labile response to the treatment. Clinical tolerance was considered to be very good with only five episodes of headache, backache and anxiety, probably not related to the test drug. Biological tolerance was excellent: there was no change in the haematologic parameters; there was a decrease of 5% in mean blood urea, of 9% in the mean serum creatinine and of 4% in the mean serum uric acid and a 5% increase in plasma potassium from 3.99 to 4.28 mmol/l.(ABSTRACT TRUNCATED AT 250 WORDS)

The study aimed at evaluating tolerability and efficacy of the combination enalapril 20 mg with hydrochlorothiazide 12.5 mg (co-renitec) as first line therapy in black patients with mild to moderate primary hypertension. Fifty patients completed a twelve weeks of open clinical study preceded by two weeks of washout period. They were evaluated every four weeks and haematological, biochemical urine microscopy and electrocardiographic tests were undertaken before the start and after the completion of study. Pre-treatment values of mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 172.16 mm hg (+/- 20.41) and 104.38 mm hg (+/- 7.339) respectively. The usual daily dosage was one tablet which was increased to two after eight weeks in case the DBP was not normalized, i.e. less than or equal to 95 mm hg. In 44 (88%) patients, the DBP was normalised at the end of the study period; three patients (6%) were resistant to treatment and another three (6%) exhibited labile response to the treatment. Clinical tolerance was considered to be very good with only five episodes of headache, backache and anxiety, probably not related to the test drug. Biological tolerance was excellent: there was no change in the haematologic parameters; there was a decrease of 5% in mean blood urea, of 9% in the mean serum creatinine and of 4% in the mean serum uric acid and a 5% increase in plasma potassium from 3.99 to 4.28 mmol/l.(ABSTRACT TRUNCATED AT 250 WORDS)

A prospective study to determine the prevalence and profile of cardiovascular disease in elderly patients admitted into the medical wards, Kenyatta National Hospital, was carried out between July 1991 and January 1992. Two hundred and two patients over 60 years of age were admitted into the medical wards over this period. This formed seven per cent of the total medical admissions. Two of these refused to take part in the study. Of the 200 elderly patients evaluated for cardiovascular disease, 146 (73%) were between 60 and 75 years of age with only 26 (13%) being over 85 years. Fifty seven per cent were males. Clinical evidence of cardiovascular disease was present in 79 (39.5%) of the patients evaluated. There was no sex difference in the prevalence of cardiovascular disease as judged from clinical evaluation (37.7% males versus 41.9% females, p > 0.05). Cardiovascular diseases in our medical in-patients at Kenyatta National Hospital are common and especially so with hypertension which plays an important role in the aetiology of congestive heart failure and cerebravascular accidents. Cardiac arrhythmias are also common though not necessarily symptomatic. Rheumatic heart disease and cardiomyopathies were uncommon in our study population. A community-based survey is needed to determine the true prevalence of cardiovascular diseases in the elderly and their contribution to morbidity in this sector of the population.

The study aimed at evaluating tolerability and efficacy of the combination enalapril 20 mg with hydrochlorothiazide 12.5 mg (co-renitec) as first line therapy in black patients with mild to moderate primary hypertension. Fifty patients completed a twelve weeks of open clinical study preceded by two weeks of washout period. They were evaluated every four weeks and haematological, biochemical urine microscopy and electrocardiographic tests were undertaken before the start and after the completion of study. Pre-treatment values of mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 172.16 mm hg (+/- 20.41) and 104.38 mm hg (+/- 7.339) respectively. The usual daily dosage was one tablet which was increased to two after eight weeks in case the DBP was not normalized, i.e. less than or equal to 95 mm hg. In 44 (88%) patients, the DBP was normalised at the end of the study period; three patients (6%) were resistant to treatment and another three (6%) exhibited labile response to the treatment. Clinical tolerance was considered to be very good with only five episodes of headache, backache and anxiety, probably not related to the test drug. Biological tolerance was excellent: there was no change in the haematologic parameters; there was a decrease of 5% in mean blood urea, of 9% in the mean serum creatinine and of 4% in the mean serum uric acid and a 5% increase in plasma potassium from 3.99 to 4.28 mmol/l.(ABSTRACT TRUNCATED AT 250 WORDS)

The study aimed at evaluating tolerability and efficacy of the combination enalapril 20 mg with hydrochlorothiazide 12.5 mg (co-renitec) as first line therapy in black patients with mild to moderate primary hypertension. Fifty patients completed a twelve weeks of open clinical study preceded by two weeks of washout period. They were evaluated every four weeks and haematological, biochemical urine microscopy and electrocardiographic tests were undertaken before the start and after the completion of study. Pre-treatment values of mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 172.16 mm hg (+/- 20.41) and 104.38 mm hg (+/- 7.339) respectively. The usual daily dosage was one tablet which was increased to two after eight weeks in case the DBP was not normalized, i.e. less than or equal to 95 mm hg. In 44 (88%) patients, the DBP was normalised at the end of the study period; three patients (6%) were resistant to treatment and another three (6%) exhibited labile response to the treatment. Clinical tolerance was considered to be very good with only five episodes of headache, backache and anxiety, probably not related to the test drug. Biological tolerance was excellent: there was no change in the haematologic parameters; there was a decrease of 5% in mean blood urea, of 9% in the mean serum creatinine and of 4% in the mean serum uric acid and a 5% increase in plasma potassium from 3.99 to 4.28 mmol/l.(ABSTRACT TRUNCATED AT 250 WORDS)

The study aimed at evaluating tolerability and efficacy of the combination enalapril 20 mg with hydrochlorothiazide 12.5 mg (co-renitec) as first line therapy in black patients with mild to moderate primary hypertension. Fifty patients completed a twelve weeks of open clinical study preceded by two weeks of washout period. They were evaluated every four weeks and haematological, biochemical urine microscopy and electrocardiographic tests were undertaken before the start and after the completion of study. Pre-treatment values of mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 172.16 mm hg (+/- 20.41) and 104.38 mm hg (+/- 7.339) respectively. The usual daily dosage was one tablet which was increased to two after eight weeks in case the DBP was not normalized, i.e. less than or equal to 95 mm hg. In 44 (88%) patients, the DBP was normalised at the end of the study period; three patients (6%) were resistant to treatment and another three (6%) exhibited labile response to the treatment. Clinical tolerance was considered to be very good with only five episodes of headache, backache and anxiety, probably not related to the test drug. Biological tolerance was excellent: there was no change in the haematologic parameters; there was a decrease of 5% in mean blood urea, of 9% in the mean serum creatinine and of 4% in the mean serum uric acid and a 5% increase in plasma potassium from 3.99 to 4.28 mmol/l.(ABSTRACT TRUNCATED AT 250 WORDS)

The study aimed at evaluating tolerability and efficacy of the combination enalapril 20 mg with hydrochlorothiazide 12.5 mg (co-renitec) as first line therapy in black patients with mild to moderate primary hypertension. Fifty patients completed a twelve weeks of open clinical study preceded by two weeks of washout period. They were evaluated every four weeks and haematological, biochemical urine microscopy and electrocardiographic tests were undertaken before the start and after the completion of study. Pre-treatment values of mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 172.16 mm hg (+/- 20.41) and 104.38 mm hg (+/- 7.339) respectively. The usual daily dosage was one tablet which was increased to two after eight weeks in case the DBP was not normalized, i.e. less than or equal to 95 mm hg. In 44 (88%) patients, the DBP was normalised at the end of the study period; three patients (6%) were resistant to treatment and another three (6%) exhibited labile response to the treatment. Clinical tolerance was considered to be very good with only five episodes of headache, backache and anxiety, probably not related to the test drug. Biological tolerance was excellent: there was no change in the haematologic parameters; there was a decrease of 5% in mean blood urea, of 9% in the mean serum creatinine and of 4% in the mean serum uric acid and a 5% increase in plasma potassium from 3.99 to 4.28 mmol/l.(ABSTRACT TRUNCATED AT 250 WORDS)

Sixty patients with Diastolic Blood Pressure (DBP) of 100-110mmHg matched for age, sex and Bp levels were randomly assigned to propranolol 80mg daily or Hydroflumethiazide (HFM) 50mg daily. HFM causes a significant reduction in systolic blood pressure (SBP) and DBP within 4 weeks compared both with baseline and propranolol (SBP 143.7 +/- 12.3 vs 158.1 +/- 10.9mmHg, P < 0.05; DBP 92.0 +/- 4.5 vs 102.4 +/- 5.1mmHg, P < 0.05), (SBP 143.7 +/- 12.2 vs 152 +/- 11.0mmHg P < 0.05; DBP 92.0 +/- 4.5 vs 101.1 +/- 6.1mmHg, P < 0.05), respectively. Propranolol produced no significant difference from the baseline at 4 weeks (SBP 152.0 +/- H.0 vs 154.1 +/- 11.5mmHg NS; DBP 101.1 +/- 6.1 vs 102.2 +/- 5.6mmHg, NS). Reduction in BP by HFM was maintained after 8 and 12 weeks with further reduction but which did not achieve statistical significance. Increased dose of propranolol (160mg daily) after 4 weeks caused significant reduction in BP by 8 week (SBP 146.8 +/- 11.8 vs 152.0 +/- 11.0mmHg, P < 0.05; DBP 95.9 +/- 4.4 vs 101.1 +/- 6.1mmHg P < 0.05), which was maintained upto 12 weeks. The values however remained higher than in the HFM group. More patients in the HFM group achieved target BP (< 140/90), SBP 53.8% vs 29.6% P < 0.05, DBP 69.2% vs 14.8% P < 0.01. Incidence of side effects was similar and will be discussed. Thiazides are superior to B'blockers as initial monotherapy in black hypertensives.

Sixty patients with Diastolic Blood Pressure (DBP) of 100-110mmHg matched for age, sex and Bp levels were randomly assigned to propranolol 80mg daily or Hydroflumethiazide (HFM) 50mg daily. HFM causes a significant reduction in systolic blood pressure (SBP) and DBP within 4 weeks compared both with baseline and propranolol (SBP 143.7 +/- 12.3 vs 158.1 +/- 10.9mmHg, P < 0.05; DBP 92.0 +/- 4.5 vs 102.4 +/- 5.1mmHg, P < 0.05), (SBP 143.7 +/- 12.2 vs 152 +/- 11.0mmHg P < 0.05; DBP 92.0 +/- 4.5 vs 101.1 +/- 6.1mmHg, P < 0.05), respectively. Propranolol produced no significant difference from the baseline at 4 weeks (SBP 152.0 +/- H.0 vs 154.1 +/- 11.5mmHg NS; DBP 101.1 +/- 6.1 vs 102.2 +/- 5.6mmHg, NS). Reduction in BP by HFM was maintained after 8 and 12 weeks with further reduction but which did not achieve statistical significance. Increased dose of propranolol (160mg daily) after 4 weeks caused significant reduction in BP by 8 week (SBP 146.8 +/- 11.8 vs 152.0 +/- 11.0mmHg, P < 0.05; DBP 95.9 +/- 4.4 vs 101.1 +/- 6.1mmHg P < 0.05), which was maintained upto 12 weeks. The values however remained higher than in the HFM group. More patients in the HFM group achieved target BP (< 140/90), SBP 53.8% vs 29.6% P < 0.05, DBP 69.2% vs 14.8% P < 0.01. Incidence of side effects was similar and will be discussed. Thiazides are superior to B'blockers as initial monotherapy in black hypertensives.

Sixty patients with Diastolic Blood Pressure (DBP) of 100-110mmHg matched for age, sex and Bp levels were randomly assigned to propranolol 80mg daily or Hydroflumethiazide (HFM) 50mg daily. HFM causes a significant reduction in systolic blood pressure (SBP) and DBP within 4 weeks compared both with baseline and propranolol (SBP 143.7 +/- 12.3 vs 158.1 +/- 10.9mmHg, P < 0.05; DBP 92.0 +/- 4.5 vs 102.4 +/- 5.1mmHg, P < 0.05), (SBP 143.7 +/- 12.2 vs 152 +/- 11.0mmHg P < 0.05; DBP 92.0 +/- 4.5 vs 101.1 +/- 6.1mmHg, P < 0.05), respectively. Propranolol produced no significant difference from the baseline at 4 weeks (SBP 152.0 +/- H.0 vs 154.1 +/- 11.5mmHg NS; DBP 101.1 +/- 6.1 vs 102.2 +/- 5.6mmHg, NS). Reduction in BP by HFM was maintained after 8 and 12 weeks with further reduction but which did not achieve statistical significance. Increased dose of propranolol (160mg daily) after 4 weeks caused significant reduction in BP by 8 week (SBP 146.8 +/- 11.8 vs 152.0 +/- 11.0mmHg, P < 0.05; DBP 95.9 +/- 4.4 vs 101.1 +/- 6.1mmHg P < 0.05), which was maintained upto 12 weeks. The values however remained higher than in the HFM group. More patients in the HFM group achieved target BP (< 140/90), SBP 53.8% vs 29.6% P < 0.05, DBP 69.2% vs 14.8% P < 0.01. Incidence of side effects was similar and will be discussed. Thiazides are superior to B'blockers as initial monotherapy in black hypertensives.

A 27-year old African woman with history of regular chloroquine ingestion presented with progressive deterioration of vision, easy fatiguability, dyspnoea, dizziness progressing to syncopal attacks. Ophthalmological assessment revealed features of chloroquine retinopathy, cardiac assessment revealed features of heart failure and a complete heart block with right bundle branch block pattern. The heart block was treated by pacemaker insertion and the heart failure resolved spontaneously following chloroquine discontinuation. She however remains blind.

A prospective study to determine the prevalence and profile of cardiovascular disease in elderly patients admitted into the medical wards, Kenyatta National Hospital, was carried out between July 1991 and January 1992. Two hundred and two patients over 60 years of age were admitted into the medical wards over this period. This formed seven per cent of the total medical admissions. Two of these refused to take part in the study. Of the 200 elderly patients evaluated for cardiovascular disease, 146 (73%) were between 60 and 75 years of age with only 26 (13%) being over 85 years. Fifty seven per cent were males. Clinical evidence of cardiovascular disease was present in 79 (39.5%) of the patients evaluated. There was no sex difference in the prevalence of cardiovascular disease as judged from clinical evaluation (37.7% males versus 41.9% females, p > 0.05). Cardiovascular diseases in our medical in-patients at Kenyatta National Hospital are common and especially so with hypertension which plays an important role in the aetiology of congestive heart failure and cerebravascular accidents. Cardiac arrhythmias are also common though not necessarily symptomatic. Rheumatic heart disease and cardiomyopathies were uncommon in our study population. A community-based survey is needed to determine the true prevalence of cardiovascular diseases in the elderly and their contribution to morbidity in this sector of the population.

One hundred and twenty consecutive patients above 12 years of age with dyspepsia were studied from June 1993 to September 1994. They underwent upper gastrointestinal endoscopy to find the mucosal lesions which were associated with their dyspeptic symptoms. At endoscopy gastric mucosal biopsies were taken in order to identify Helicobacter pylori (H. pylori) using three different techniques: culture, histology and the rapid urease test. Normal looking mucosa was the commonest single endoscopic finding, accounting for 34.2%, followed by gastritis 31.7% and duodenal ulcer 29.2%. However, when duodenal ulcers and gastric ulcers were put together, then peptic ulcer was the most prevalent finding accounting for 38.4%. Peptic ulcer was the most prevalent pathological finding in both young (less than 50 years) and older patients (50 years and above). Duodenal ulcer was more prevalent than gastric ulcer in the younger age group with a ratio of 5.8:1, however, the ratio in the older age group was 1:1. Gastric cancer was only found in patients aged 50 years and above, accounting for 17.4% of dyspeptic symptoms in this age group. Females were found to have more normal endoscopic findings than males (59.6%, versus 17.8% respectively). The difference being statistically significant (p < 0.001). All our cases of peptic ulcer disease had evidence of H. pylori infection while dyspeptic patients with normal endoscopic mucosal findings had H. pylori in 80.5% of cases. The difference in prevalence of H. pylori in the two groups was statistically significant (p < 0.001). Surprisingly, evidence of H. pylori in gastric cancer cases was very low in this study, being found in only 25% of patients.

Summing multipliers is an important class of operators in the geometric theory of general Banach spaces. They are particularly useful in the study of the structure of the classical spaces. The work done by Grothendieck and Pietsch provides a good basis for the study of this class of operators. The topic of this study is Aspects on (p,q)-summing multipliers. (p,q)-summing multipliers are sequences of bounded linear operators mapping weakly p-summable sequences into strongly q-summable sequences. This study is concerned with using the concepts of absolute and p-summing multipliers to characterize the space of all (p,q)-summing multipliers. In particular we show that the space of all (p, q)-summing multipliers is complete. This is accomplished through a detailed study of the concepts of the summing operators and absolute and p-summing multipliers

Summing multipliers is an important class of operators in the geometric theory of general Banach spaces. They are particularly useful in the study of the structure of the classical spaces. The work done by Grothendieck and Pietsch provides a good basis for the study of this class of operators. The topic of this study is Aspects on (p,q)-summing multipliers. (p,q)-summing multipliers are sequences of bounded linear operators mapping weakly p-summable sequences into strongly q-summable sequences. This study is concerned with using the concepts of absolute and p-summing multipliers to characterize the space of all (p,q)-summing multipliers. In particular we show that the space of all (p, q)-summing multipliers is complete. This is accomplished through a detailed study of the concepts of the summing operators and absolute and p-summing multipliers

This report concerns an outbreak that occurred during July/August 1997. Ten pigs from a herd of 181 pigs in a medium-scale, semi-closed piggery in Kiambu District, Kenya, contracted the clinical disease. The main clinical findings in affected pigs included: fever (40.5-41.8 degrees C), prostration, inappetence, dog-sitting posture, abortion, erythema and raised, firm to the touch and easily palpated light pink to dark purple diamond-shaped to square/rectangular spots on the skin around the belly and the back. Based on the pathognomonic skin lesions, a clinical diagnosis of swine erysipelas was made. The diagnosis was confirmed by the isolation of Erysipelothrix rhusiopathiae organisms from the blood and skin biopsies taken from the affected pigs. Response to treatment with a combination of procaine penicillin and dihydrostreptomycin at the dosage rate of 20,000 IU/kg body weight (based on procaine penicillin) for 3 days was good and all the affected pigs recovered fully. The farm was placed under quarantine to prevent spread of the disease

OBJECTIVE: Screening and biochemical characterisation of trypanosome-lysing factor (trypanolysin) from non-vector insect, Schistocerca gregaria. DESIGN: Laboratory based experiment. SETTING: Department of Biochemistry, University of Nairobi. RESULTS: Lysis of isolated trypanosomes was demonstrated with midgut homogenates of natural vector Glossina morsitans centralis as well in non-vector insects. The highest trypanolytic activity was observed in midgut homogenate of the desert locust. Schistocerca gregaria followed by the cockroach, Periplaneta americana (L). Further studies on the S. gregaria trypanolytic factor showed its proteinaceous nature due to its sensitivity to temperatures above 40 degrees C and to proteases. Additionally, the factor showed lectin-like properties since the activity was blocked by D-glucosamine. CONCLUSION: The trypanolytic factor has the potential of being used to modulate tsetse fly vectorial capacity.

OBJECTIVE: Screening and biochemical characterisation of trypanosome-lysing factor (trypanolysin) from non-vector insect, Schistocerca gregaria. DESIGN: Laboratory based experiment. SETTING: Department of Biochemistry, University of Nairobi. RESULTS: Lysis of isolated trypanosomes was demonstrated with midgut homogenates of natural vector Glossina morsitans centralis as well in non-vector insects. The highest trypanolytic activity was observed in midgut homogenate of the desert locust. Schistocerca gregaria followed by the cockroach, Periplaneta americana (L). Further studies on the S. gregaria trypanolytic factor showed its proteinaceous nature due to its sensitivity to temperatures above 40 degrees C and to proteases. Additionally, the factor showed lectin-like properties since the activity was blocked by D-glucosamine. CONCLUSION: The trypanolytic factor has the potential of being used to modulate tsetse fly vectorial capacity.

Nonsusceptibility to Bombyx mori densovirus type 2 (BmDNV-2) is controlled by a recessive non-susceptibility gene, nsd-2 (non-susceptibility to DNV-2) in B. mori. Taking advantage of a lack of crossing over in females, reciprocal backcrossed F1 (BF1) progeny were used for linkage analysis and mapping of nsd-2 using silkworm strains C124 and 902, which are classified as being highly susceptible and non-susceptible to DNV-2, respectively. BF1 larvae were inoculated twice with DNV-2 virus at the first and second instar stages. DNA was extracted from each of the surviving fifth instar larvae and analysed by RFLP inheritance patterns using probes specific to each of the 28 linkage groups of B. mori. Our results indicated that the non-susceptibility gene was linked to linkage group 17, since all surviving larvae showed the homozygous profile of strain 902 in their genotype. The other linkage groups showed mixtures of heterozygous and homozygous genotypes, indicating an independent assortment. A linkage map of 30.6 cM was constructed for linkage group 17 with nsd-2 mapped at 24.5 cM and three closely linked cDNA markers were identified.

OBJECTIVE: Screening and biochemical characterisation of trypanosome-lysing factor (trypanolysin) from non-vector insect, Schistocerca gregaria. DESIGN: Laboratory based experiment. SETTING: Department of Biochemistry, University of Nairobi. RESULTS: Lysis of isolated trypanosomes was demonstrated with midgut homogenates of natural vector Glossina morsitans centralis as well in non-vector insects. The highest trypanolytic activity was observed in midgut homogenate of the desert locust. Schistocerca gregaria followed by the cockroach, Periplaneta americana (L). Further studies on the S. gregaria trypanolytic factor showed its proteinaceous nature due to its sensitivity to temperatures above 40 degrees C and to proteases. Additionally, the factor showed lectin-like properties since the activity was blocked by D-glucosamine. CONCLUSION: The trypanolytic factor has the potential of being used to modulate tsetse fly vectorial capacity.

The efficacy of bloodmeal digestion in teneral Glossina morsitans centralis fed on rabbits immunized with tsetse fly midgut extracts was progressively monitored over a period of 96 hours. Flies fed on immunized rabbits showed reduced rate of bloodmeal digestion as compared to the controls. Although there was insignificant difference in the rate of bloodmeal digestion upto 24 hours post-feeding in later stages of digestion there was quite a significant difference. Polyacrylamide gel electrophoretic patterns of bloodmeal drawn from the posterior sections of the midgut demonstrated that, bloodmeal is completely degraded in the midgut after 96 hours in the control flies, while substantial amount is still undigested in the experimental flies. However, not much difference in the rates of digestion was observed with bloodmeal drawn from the anterior section of the midgut. These results suggests that when flies are fed on rabbits immunized with tsetse fly midgut extract, there is an impairment on the efficiency of digestion. The anti-midgut antibodies could be interfering with either the induction or proteolytic activity of the midgut enzymes.

Separation of midgut membrane proteins from the tick, Ambylomma variegatum, using a nonionic detergent (Triton X-114), resulted in two protein fractions, namely DET (detergent) and AQ (aqueous). In immunoblotting analysis with polyclonal antibodies against these fractions, 4 proteins (Mr approximately 27,000, 67,000, 86,000 and 95,000,) and 2 proteins (M, approximately 54,000 and 67,000) were detected in the DET and AQ fractions, respectively. Three of the DET fraction proteins Mr approximately 27,000, 67,000 and 95,000 were glycosylated since they bound to the lectin, concanavalin A. In 2-dimensional gel electrophoresis, the AQ and DET fraction proteins were found to be acidic in nature. In a series of bioassay experiments, rabbits were first immunised with both DET and AQ fractions and then infested with ticks. The egg batch weights of these ticks were reduced by 50% compared to control ticks. Furthermore, there was a significant reduction in the hatchability of eggs laid by ticks fed on rabbits previously immunised with both DET (14%) and AQ (33%) fractions. Based on the egg hatchability, the reproductive capacity of ticks was reduced by 77 and 48% by DET and AQ fractions, respectively.

Separation of midgut membrane proteins from the tick, Ambylomma variegatum, using a nonionic detergent (Triton X-114), resulted in two protein fractions, namely DET (detergent) and AQ (aqueous). In immunoblotting analysis with polyclonal antibodies against these fractions, 4 proteins (Mr approximately 27,000, 67,000, 86,000 and 95,000,) and 2 proteins (M, approximately 54,000 and 67,000) were detected in the DET and AQ fractions, respectively. Three of the DET fraction proteins Mr approximately 27,000, 67,000 and 95,000 were glycosylated since they bound to the lectin, concanavalin A. In 2-dimensional gel electrophoresis, the AQ and DET fraction proteins were found to be acidic in nature. In a series of bioassay experiments, rabbits were first immunised with both DET and AQ fractions and then infested with ticks. The egg batch weights of these ticks were reduced by 50% compared to control ticks. Furthermore, there was a significant reduction in the hatchability of eggs laid by ticks fed on rabbits previously immunised with both DET (14%) and AQ (33%) fractions. Based on the egg hatchability, the reproductive capacity of ticks was reduced by 77 and 48% by DET and AQ fractions, respectively.

Separation of midgut membrane proteins from the tick, Ambylomma variegatum, using a nonionic detergent (Triton X-114), resulted in two protein fractions, namely DET (detergent) and AQ (aqueous). In immunoblotting analysis with polyclonal antibodies against these fractions, 4 proteins (Mr approximately 27,000, 67,000, 86,000 and 95,000,) and 2 proteins (M, approximately 54,000 and 67,000) were detected in the DET and AQ fractions, respectively. Three of the DET fraction proteins Mr approximately 27,000, 67,000 and 95,000 were glycosylated since they bound to the lectin, concanavalin A. In 2-dimensional gel electrophoresis, the AQ and DET fraction proteins were found to be acidic in nature. In a series of bioassay experiments, rabbits were first immunised with both DET and AQ fractions and then infested with ticks. The egg batch weights of these ticks were reduced by 50% compared to control ticks. Furthermore, there was a significant reduction in the hatchability of eggs laid by ticks fed on rabbits previously immunised with both DET (14%) and AQ (33%) fractions. Based on the egg hatchability, the reproductive capacity of ticks was reduced by 77 and 48% by DET and AQ fractions, respectively.

Separation of midgut membrane proteins from the tick, Ambylomma variegatum, using a nonionic detergent (Triton X-114), resulted in two protein fractions, namely DET (detergent) and AQ (aqueous). In immunoblotting analysis with polyclonal antibodies against these fractions, 4 proteins (Mr approximately 27,000, 67,000, 86,000 and 95,000,) and 2 proteins (M, approximately 54,000 and 67,000) were detected in the DET and AQ fractions, respectively. Three of the DET fraction proteins Mr approximately 27,000, 67,000 and 95,000 were glycosylated since they bound to the lectin, concanavalin A. In 2-dimensional gel electrophoresis, the AQ and DET fraction proteins were found to be acidic in nature. In a series of bioassay experiments, rabbits were first immunised with both DET and AQ fractions and then infested with ticks. The egg batch weights of these ticks were reduced by 50% compared to control ticks. Furthermore, there was a significant reduction in the hatchability of eggs laid by ticks fed on rabbits previously immunised with both DET (14%) and AQ (33%) fractions. Based on the egg hatchability, the reproductive capacity of ticks was reduced by 77 and 48% by DET and AQ fractions, respectively.

Nonsusceptibility to Bombyx mori densovirus type 2 (BmDNV-2) is controlled by a recessive non-susceptibility gene, nsd-2 (non-susceptibility to DNV-2) in B. mori. Taking advantage of a lack of crossing over in females, reciprocal backcrossed F1 (BF1) progeny were used for linkage analysis and mapping of nsd-2 using silkworm strains C124 and 902, which are classified as being highly susceptible and non-susceptible to DNV-2, respectively. BF1 larvae were inoculated twice with DNV-2 virus at the first and second instar stages. DNA was extracted from each of the surviving fifth instar larvae and analysed by RFLP inheritance patterns using probes specific to each of the 28 linkage groups of B. mori. Our results indicated that the non-susceptibility gene was linked to linkage group 17, since all surviving larvae showed the homozygous profile of strain 902 in their genotype. The other linkage groups showed mixtures of heterozygous and homozygous genotypes, indicating an independent assortment. A linkage map of 30.6 cM was constructed for linkage group 17 with nsd-2 mapped at 24.5 cM and three closely linked cDNA markers were identified.

Separation of midgut membrane proteins from the tick, Ambylomma variegatum, using a nonionic detergent (Triton X-114), resulted in two protein fractions, namely DET (detergent) and AQ (aqueous). In immunoblotting analysis with polyclonal antibodies against these fractions, 4 proteins (Mr approximately 27,000, 67,000, 86,000 and 95,000,) and 2 proteins (M, approximately 54,000 and 67,000) were detected in the DET and AQ fractions, respectively. Three of the DET fraction proteins Mr approximately 27,000, 67,000 and 95,000 were glycosylated since they bound to the lectin, concanavalin A. In 2-dimensional gel electrophoresis, the AQ and DET fraction proteins were found to be acidic in nature. In a series of bioassay experiments, rabbits were first immunised with both DET and AQ fractions and then infested with ticks. The egg batch weights of these ticks were reduced by 50% compared to control ticks. Furthermore, there was a significant reduction in the hatchability of eggs laid by ticks fed on rabbits previously immunised with both DET (14%) and AQ (33%) fractions. Based on the egg hatchability, the reproductive capacity of ticks was reduced by 77 and 48% by DET and AQ fractions, respectively.

Nonsusceptibility to Bombyx mori densovirus type 2 (BmDNV-2) is controlled by a recessive non-susceptibility gene, nsd-2 (non-susceptibility to DNV-2) in B. mori. Taking advantage of a lack of crossing over in females, reciprocal backcrossed F1 (BF1) progeny were used for linkage analysis and mapping of nsd-2 using silkworm strains C124 and 902, which are classified as being highly susceptible and non-susceptible to DNV-2, respectively. BF1 larvae were inoculated twice with DNV-2 virus at the first and second instar stages. DNA was extracted from each of the surviving fifth instar larvae and analysed by RFLP inheritance patterns using probes specific to each of the 28 linkage groups of B. mori. Our results indicated that the non-susceptibility gene was linked to linkage group 17, since all surviving larvae showed the homozygous profile of strain 902 in their genotype. The other linkage groups showed mixtures of heterozygous and homozygous genotypes, indicating an independent assortment. A linkage map of 30.6 cM was constructed for linkage group 17 with nsd-2 mapped at 24.5 cM and three closely linked cDNA markers were identified.

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

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

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Sulphadoxine/pyrimethamine (SP) is often administered with quinine in the treatment of severe falciparum malaria to shorten the course of quinine. The efficacy of SP alone in the treatment of non-severe malaria has been declining rapidly in East Africa, raising concerns of the usefulness of a shortened course of quinine followed SP. We audited the efficacy of quinine/SP in the treatment of severe malaria in Kenyan children. Children with severe falciparum malaria were treated with parenteral quinine followed by a single oral dose of SP. A clinical evaluation was performed 3 weeks later in which a blood sample was obtained for full haemogram, blood slide and analysis of the parasite dihydrofolate reductase (DHFR) and dihydropteroate synthase (DHPS) codons, mutations of which are associated with resistance to SP. A total of 452 children were enrolled, of whom 374 completed the study. Fifty-two (13.9%) children were parasitaemic by 3 weeks of whom 17 (4.5%) had fever as well. The treatment failure group had a significantly higher parasitaemia (129 061 vs. 43 339; P<0.001) and haemoglobin on admission, but only admission parasitaemia independently predicted treatment failure. Those with treatment failure had a significantly lower rise in haemoglobin at 3 weeks compared with treatment successes (9.0 vs. 10.0 g/dl). Of the 76 parasite isolates collected before treatment, 40 (53%) were triple mutant DHFR-double DHPS (Tp-Db), the genotype most associated with SP resistance. Three weeks after SP treatment, the proportion of Tp-Db increased to 72% (31/43). The high treatment failure rate and proportion of parasites with Tp-Db negate the use of SP to shorten the course of quinine treatment in East Africa.

The mean fasting insulin level in 30 apparently normal Kenyan Africans was determined by Radio-Immuno Assay (RIA) technique based on coat A-count. The mean value was found as 16.33 microIu/ml with a standard deviation (s.d) of 10.51 microIu/ml. The mean at 95% confidence interval (CI) for the population studied was 16.33 +/- 1.92. The findings are similar to what have been reported among the caucasians. This paper also reports on a case of insulinoma in a young female patient at Kenyatta National Hospital (KNH).

Ogutu EO. A 10-year (1976-1986) retrospective study was done on 30 cases with histological diagnosis of pancreatic carcinoma. The male to female ratio was 1.3:1 and the peak incidence was in the 6th and 7th decades. The head of the pancreas was involved in 96% of cases while solid adenocarcinoma of duct cell origin accounted for 73.3% of cases, followed by anaplastic carcinoma (23.3%). The commonest complications were distinct metastasis (86.6%), obstructive jaundice (73.3%) and upper gastrointestinal bleed (13.6%).

Department of Medicine, University of Nairobi, Kenya. Dyspepsia and intestinal worm infestation are both common clinical conditions in a developing country like Kenya and thus this study was designed to look at the correlation between the two in a referral gastroenterology clinic at Kenyatta National Hospital. One hundred and twenty five patients with dyspepsia had their stool, duodenal aspirate and duodenal biopsy analysed for evidence of intestinal parasites. Seven (5.6%) were found to have various types of intestinal parasites with giardia lamblia comprising 42.8% of worms isolated. 71.4% of patients with dyspepsia and worm infestation had their symptoms improved after deworming, but the low prevalence of intestinal parasite in dyspeptic patients makes routine deworming not cost effective. Stool examination had the best yield for intestinal parasites.

Kenyatta National Hospital, Nairobi, Kenya. OBJECTIVE: To determine the types and prevalence of colonic diseases in Kenyan African patients referred for colonoscopy with lower gastrointestinal tract symptoms. DESIGN: A cross sectional survey conducted over a two year period. SETTING: Major private hospitals in Nairobi. PATIENTS: Two hundred forty seven consecutive patients of both sexes and all ages referred for colonoscopy between January 1996 and December 1997. Only Kenyans of African origin were included. Patients were referred from all over the country though the majority of cases were from Nairobi and its surrounding districts. RESULTS: The major indications for colonoscopy were lower abdominal pain (35.6%), non-bloody diarrhoea (22.3%), constipation (21.4%) and rectal bleeding (19.8%). Nearly 53% of patients colonoscoped had abnormal mucosal findings, with the main abnormalities being: proctocolitis (20.2%), colorectal cancers (12.1%), haemorrhoids (7.3%), colorectal polyps (6.5%) and diverticulosis (5.3%). The main histological diagnosis among patients whose colonic biopsy were done included normal colonic mucosa (29%), non-specific colitis (28.5%), adenocarcinoma (18.2%), benign colonic polyp (9.7%) and ulcerative colitis (7.3%). There was one case of Crohn's colitis and five cases (3%) of infective colitis. CONCLUSION: The study shows that the African colon has a number of pathological lesions contrary to previous reported literature.

The mean fasting insulin level in 30 apparently normal Kenyan Africans was determined by Radio-Immuno Assay (RIA) technique based on coat A-count. The mean value was found as 16.33 microIu/ml with a standard deviation (s.d) of 10.51 microIu/ml. The mean at 95% confidence interval (CI) for the population studied was 16.33 +/- 1.92. The findings are similar to what have been reported among the caucasians. This paper also reports on a case of insulinoma in a young female patient at Kenyatta National Hospital (KNH).

Forty one consecutive patients (24 males and 17 females) with AIDS had their blood assayed for HBsAg, anti-HBs and anti-HBc by Reversed Passive Haemagglutination (RPHA), Passive Haemagglutination (PHA) and Enzyme Linked Immunosorbent Assay (ELISA) techniques respectively. 5 (12.2%) were found positive for HBsAg. 10 (24.4%) for anti-HBs and 31 (75.6%) for anti-HBc. 32 (78%) out of 41 patients with AIDS had serological evidence of exposure to hepatitis B virus (HBV). The prevalence of HBsAg found in this study is not different from what has been found in the Kenyan community without AIDS, while that of anti-HBs is much lower than what has been reported in the general community.

Forty one consecutive patients (24 males and 17 females) with AIDS had their blood assayed for HBsAg, anti-HBs and anti-HBc by Reversed Passive Haemagglutination (RPHA), Passive Haemagglutination (PHA) and Enzyme Linked Immunosorbent Assay (ELISA) techniques respectively. 5 (12.2%) were found positive for HBsAg. 10 (24.4%) for anti-HBs and 31 (75.6%) for anti-HBc. 32 (78%) out of 41 patients with AIDS had serological evidence of exposure to hepatitis B virus (HBV). The prevalence of HBsAg found in this study is not different from what has been found in the Kenyan community without AIDS, while that of anti-HBs is much lower than what has been reported in the general community.

Forty one consecutive patients (24 males and 17 females) with AIDS had their blood assayed for HBsAg, anti-HBs and anti-HBc by Reversed Passive Haemagglutination (RPHA), Passive Haemagglutination (PHA) and Enzyme Linked Immunosorbent Assay (ELISA) techniques respectively. 5 (12.2%) were found positive for HBsAg. 10 (24.4%) for anti-HBs and 31 (75.6%) for anti-HBc. 32 (78%) out of 41 patients with AIDS had serological evidence of exposure to hepatitis B virus (HBV). The prevalence of HBsAg found in this study is not different from what has been found in the Kenyan community without AIDS, while that of anti-HBs is much lower than what has been reported in the general community.

One hundred and twenty consecutive patients above 12 years of age with dyspepsia were studied from June 1993 to September 1994. They underwent upper gastrointestinal endoscopy to find the mucosal lesions which were associated with their dyspeptic symptoms. At endoscopy gastric mucosal biopsies were taken in order to identify Helicobacter pylori (H. pylori) using three different techniques: culture, histology and the rapid urease test. Normal looking mucosa was the commonest single endoscopic finding, accounting for 34.2%, followed by gastritis 31.7% and duodenal ulcer 29.2%. However, when duodenal ulcers and gastric ulcers were put together, then peptic ulcer was the most prevalent finding accounting for 38.4%. Peptic ulcer was the most prevalent pathological finding in both young (less than 50 years) and older patients (50 years and above). Duodenal ulcer was more prevalent than gastric ulcer in the younger age group with a ratio of 5.8:1, however, the ratio in the older age group was 1:1. Gastric cancer was only found in patients aged 50 years and above, accounting for 17.4% of dyspeptic symptoms in this age group. Females were found to have more normal endoscopic findings than males (59.6%, versus 17.8% respectively). The difference being statistically significant (p < 0.001). All our cases of peptic ulcer disease had evidence of H. pylori infection while dyspeptic patients with normal endoscopic mucosal findings had H. pylori in 80.5% of cases. The difference in prevalence of H. pylori in the two groups was statistically significant (p < 0.001). Surprisingly, evidence of H. pylori in gastric cancer cases was very low in this study, being found in only 25% of patients.

The mean fasting insulin level in 30 apparently normal Kenyan Africans was determined by Radio-Immuno Assay (RIA) technique based on coat A-count. The mean value was found as 16.33 microIu/ml with a standard deviation (s.d) of 10.51 microIu/ml. The mean at 95% confidence interval (CI) for the population studied was 16.33 +/- 1.92. The findings are similar to what have been reported among the caucasians. This paper also reports on a case of insulinoma in a young female patient at Kenyatta National Hospital (KNH).

Fifty three consecutive patients with histological evidence of gastric carcinoma were studied between June 1987 and June 1989 at Kenyatta National Hospital (KNH). The male to female ration was 3.4:1 and the peak age of occurrence was in the 7th decade with 62.3% of gastric carcinoma being at the gastric antrum. Poorly differentiated adenocarcinoma was found in 68.2% of patients while well differentiated adenocarcinoma in 4.5% of cases. Intestinal metaplasia was a rare finding. If Lauren's classification of gastric carcinoma is considered then diffuse type of gastric cancer is by far the commoner type in our environment.

Forty consecutive African patients found to have duodenogastric bile reflux at endoscopy were studied. Bile reflux was found more commonly among males than females, giving a male/female ratio of 2.3:1, with a peak age at 41-60 years. ABO blood groups had no significant influence on duodenogastric bile reflux. Flatulence and borborygmi were the most consistent symptoms other than the classical dyspeptic pain pattern. Bilious vomiting was a rare finding. Duodenogastric bile reflux was more commonly associated with endoscopic gastritis (67.5%), gastric ulcer (35%) and oesophagitis (30%) than with duodenal ulcer (22.5%), deformed pyloric ring (5%) or distorted duodenal bulb (2.5%). The dysfunction in the pyloric sphincter in people with duodenogastric bile reflux appears to be more of a physiological defect than structural.

Forty consecutive African patients found to have duodenogastric bile reflux at endoscopy were studied. Bile reflux was found more commonly among males than females, giving a male/female ratio of 2.3:1, with a peak age at 41-60 years. ABO blood groups had no significant influence on duodenogastric bile reflux. Flatulence and borborygmi were the most consistent symptoms other than the classical dyspeptic pain pattern. Bilious vomiting was a rare finding. Duodenogastric bile reflux was more commonly associated with endoscopic gastritis (67.5%), gastric ulcer (35%) and oesophagitis (30%) than with duodenal ulcer (22.5%), deformed pyloric ring (5%) or distorted duodenal bulb (2.5%). The dysfunction in the pyloric sphincter in people with duodenogastric bile reflux appears to be more of a physiological defect than structural.

Thirty consecutive patients with gastric ulcer diagnosed during upper gastrointestinal fibreoptic panendoscopy at both Kenya Medical Research Institute and Kenyatta National Hospital endoscopy rooms were studied. The male/female ratio was 5:1 with a peak prevalence in the 6th decade. 76.6% of the patients were from the Kikuyu ethnic group. Smoking habit was found in only 50% of patients with gastric ulcers. There were a total of 32 gastric ulcers in 30 patients. 84.4% of these were at the incisura angularis. All the incisural ulcers were benign. Two (6.25%) of the 32 ulcers were malignant (one at the cardia and the other at the antrum). Gastric ulcers whose diameter were greater than 30 mm had a higher tendency of being malignant. Five patients (16.7%) had both gastric (4 benign and 1 malignant) and duodenal ulcers while 4 (13.3%) patients had both gastric and pyloric ring ulcers. Apparent healing of a gastric ulcer while on an H2-antagonist does not totally exclude malignancy. Upper gastrointestinal bleed which was present in 53.3% of cases was the most frequent complication.

Thirty consecutive patients with gastric ulcer diagnosed during upper gastrointestinal fibreoptic panendoscopy at both Kenya Medical Research Institute and Kenyatta National Hospital endoscopy rooms were studied. The male/female ratio was 5:1 with a peak prevalence in the 6th decade. 76.6% of the patients were from the Kikuyu ethnic group. Smoking habit was found in only 50% of patients with gastric ulcers. There were a total of 32 gastric ulcers in 30 patients. 84.4% of these were at the incisura angularis. All the incisural ulcers were benign. Two (6.25%) of the 32 ulcers were malignant (one at the cardia and the other at the antrum). Gastric ulcers whose diameter were greater than 30 mm had a higher tendency of being malignant. Five patients (16.7%) had both gastric (4 benign and 1 malignant) and duodenal ulcers while 4 (13.3%) patients had both gastric and pyloric ring ulcers. Apparent healing of a gastric ulcer while on an H2-antagonist does not totally exclude malignancy. Upper gastrointestinal bleed which was present in 53.3% of cases was the most frequent complication.

Characteristics of 14 patients above 12 years of age with congenital polycystic liver disease attending liver clinic at KNH were analysed. The diagnosis was mainly based on ultrasonographic findings. The disease was found predominantly among the Kikuyu ethnic group with a female/male ratio of 6:1 and the peak age at presentation was in the 5th decade. The liver function tests were essentially normal in all cases with no complication directly relating to liver disease. Hypertension was found in 78.6% of cases and chronic renal failure in 35.7% of cases. There was an associated polycystic disease in at least one other abdominal organ in all cases.

OBJECTIVE: To determine the types and prevalence of colonic diseases in Kenyan African patients referred for colonoscopy with lower gastrointestinal tract symptoms. DESIGN: A cross sectional survey conducted over a two year period. SETTING: Major private hospitals in Nairobi. PATIENTS: Two hundred forty seven consecutive patients of both sexes and all ages referred for colonoscopy between January 1996 and December 1997. Only Kenyans of African origin were included. Patients were referred from all over the country though the majority of cases were from Nairobi and its surrounding districts. RESULTS: The major indications for colonoscopy were lower abdominal pain (35.6%), non-bloody diarrhoea (22.3%), constipation (21.4%) and rectal bleeding (19.8%). Nearly 53% of patients colonoscoped had abnormal mucosal findings, with the main abnormalities being: proctocolitis (20.2%), colorectal cancers (12.1%), haemorrhoids (7.3%), colorectal polyps (6.5%) and diverticulosis (5.3%). The main histological diagnosis among patients whose colonic biopsy were done included normal colonic mucosa (29%), non-specific colitis (28.5%), adenocarcinoma (18.2%), benign colonic polyp (9.7%) and ulcerative colitis (7.3%). There was one case of Crohn's colitis and five cases (3%) of infective colitis. CONCLUSION: The study shows that the African colon has a number of pathological lesions contrary to previous reported literature.

The mean fasting insulin level in 30 apparently normal Kenyan Africans was determined by Radio-Immuno Assay (RIA) technique based on coat A-count. The mean value was found as 16.33 microIu/ml with a standard deviation (s.d) of 10.51 microIu/ml. The mean at 95% confidence interval (CI) for the population studied was 16.33 +/- 1.92. The findings are similar to what have been reported among the caucasians. This paper also reports on a case of insulinoma in a young female patient at Kenyatta National Hospital (KNH).

The mean fasting insulin level in 30 apparently normal Kenyan Africans was determined by Radio-Immuno Assay (RIA) technique based on coat A-count. The mean value was found as 16.33 microIu/ml with a standard deviation (s.d) of 10.51 microIu/ml. The mean at 95% confidence interval (CI) for the population studied was 16.33 +/- 1.92. The findings are similar to what have been reported among the caucasians. This paper also reports on a case of insulinoma in a young female patient at Kenyatta National Hospital (KNH).

A 10-year (1976-1986) retrospective study was done on 30 cases with histological diagnosis of pancreatic carcinoma. The male to female ratio was 1.3:1 and the peak incidence was in the 6th and 7th decades. The head of the pancreas was involved in 96% of cases while solid adenocarcinoma of duct cell origin accounted for 73.3% of cases, followed by anaplastic carcinoma (23.3%). The commonest complications were distinct metastasis (86.6%), obstructive jaundice (73.3%) and upper gastrointestinal bleed (13.6%).

PIP: 125 black Kenyan women attending the Kenyatta National Family Welfare Clinic were randomly allocated to combined and fixed dose oral contraceptives (Eugynon: 500 mcg dl-norgestrel + 50 mcg ethinyl estradiol or Microgynon: 150 mcg levonorgestel + 30 mcg ethinyl estradiol). They were between 18-33 years of age with a mean of 25 +or- 7 years. The mean parity of this group was 3 and they had a mean education standard of 8 years. Fasting blood sampled were taken on recruitment (control cycle) and thereafter once for cycles 1, 3, 6, 9, and 12 during OC use. HDL-cholesterol was estimated in the sear. The 2 OCs elicited a significant decrease in levels of HDL-cholesterol (p0.01). author's modified

800x600 Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 /* 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:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman","serif";} Information and communication technologies (ICT) have become common place entities in all aspects of life. Across the past twenty years the use of ICT has fundamentally changed the practices and procedures of nearly all forms of endeavour within business and governance. Within education, ICT has begun to have a presence but the impact has not been as extensive as in other fields.   In this study, the researcher sought to find out how the use of ICT in education lends itself to more student-centered learning settings. The study seeks to determine the various impacts of ICT on contemporary secondary education in Kenya as well as potential challenges.   The study was conducted through survey method. The researcher sought permission from the Ministry of Education in Kenya to collect research data from the sampled schools since all of them were public secondary schools. The researcher constructed questionnaires which were used to collect data from various respondents in the sampled Nepad e-schools in Kenya. The researcher used three categories of respondents in each school namely; the administrators, the teachers and the students. The completed questionnaires were then coded, entered into the computer using Statistical Package for Social Scientists (SPSS) and then analysed.   The study revealed that both students and teachers have developed a positive attitude towards the use ICTs and related accessories in the teaching/learning process. This was reflected by the frequency of use of the facilities and the interest as indicated by the respondents. The study also found out that the schools under study were already using educational management software for various processes undertaken in the schools.  The study also revealed some challenges faced by the schools. Notable challenges included lack of funding to support the purchase of the technology to improve access, lack of training among teachers to adopt ICT as teaching tools and lack suitable e-content for various subjects.

Department of Medicine, College of Health Sciences, University of Nairobi. Characteristics of 14 patients above 12 years of age with congenital polycystic liver disease attending liver clinic at KNH were analysed. The diagnosis was mainly based on ultrasonographic findings. The disease was found predominantly among the Kikuyu ethnic group with a female/male ratio of 6:1 and the peak age at presentation was in the 5th decade. The liver function tests were essentially normal in all cases with no complication directly relating to liver disease. Hypertension was found in 78.6% of cases and chronic renal failure in 35.7% of cases. There was an associated polycystic disease in at least one other abdominal organ in all cases.

This paper studies the problem of malaria control in irrigation and non-irrigation areas in Kenya. Empirical results show that in both areas, households' level of awareness of malaria as a health problem, including its cause, was very high. However, attempts to trace the direct effects of malaria upon income or upon agricultural production were not statistically important. This does not imply that malaria has no consequence on household welfare. It is possible that the model equations were mis-specified–aggregate variables (total family size, total family income) and failure to quantify land in the production relationships may have contributed to these results. In addition, poor separation of malaria as a disease, from malaria as an infection, may have underestimated the effect of the disease on production. Thirdly, labour substitution (hiring or within-family substitution) was not measured in this early study, but was taken into account in subsequent research. Finally, labour requirements in the annual crop production schedules and the co-relation between these labour requirements and the pattern of adult morbidity were not longitudinally monitored. Cross-section data would bias the findings, particularly in those areas where the peak transmission season is short, where the crop grown does not require major labour input during this transmission season, and where acquisition of immunity would reduce the clinical impact of malaria upon adult labour. These vulnerabilities in the specification of the model and the data collected, probably affect the results obtained. Our empirical work raises a number of interesting and important questions which should be taken into account in future research

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

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

   

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

Isolated mouse interstitial cells were incubated with different concentrations of khat (Catha edulis) extract (0.06 mg/ml, 0.6 mg/ml. 6 mg/ml. 30 mg/ml and 60 mg/ml) and cell viability as well as testosterone concentration measured at 30 min intervals over a 3 h incubation period. High concentrations of khat extract (30 mg/ml and 60 mg/ml) significantly inhibited testosterone production while low concentrations (0.06 mg/ml. 0.6 mg/ml and 6 mg/ml) significantly stimulated (P < 0.05) testosterone production by mouse interstitial cells. Similarly, at concentrations of 30 mg/ml and 60 mg/ml, there was a significant decrease in interstitial cell viability, whereas at 0.06 mg/ml, 0.6 mg/ml and 6 mg/ml there was no significant decrease. There was only a weak correlation (r= 0.39) between testosterone production and viable interstitial cells. We postulate that khat extract at high concentrations may cause reproductive function impairment in the user but at low concentrations. may enhance testosterone production with accompanying effects on reproductive functions in male mice. @2006 Publishedby Elsevier Ireland Ltd. Kel'lVords: In dtro; Khat; Testosterone; Interstitial cells; Mouse

Sudden death in the young after low energy anterior chest wall impact is an under-recognised phenomenon in this country. Review of the literature yields several American references to commotio cordis, mainly in the context of sporting events. Two cases are reported of sudden death in young men as a result of blunt impact anterior chest wall trauma. It is suggested that these cases draw attention to a lethal condition of which many practitioners are unaware. J Accid Emerg Med 2000 Nov 17 (6): 421-422. PMID: 11104247 [PubMed - indexed for MEDLINE]PMCID: PMC1725482  

Sudden death in the young after low energy anterior chest wall impact is an under-recognised phenomenon in this country. Review of the literature yields several American references to commotio cordis, mainly in the context of sporting events. Two cases are reported of sudden death in young men as a result of blunt impact anterior chest wall trauma. It is suggested that these cases draw attention to a lethal condition of which many practitioners are unaware. J Accid Emerg Med 2000 Nov 17 (6): 421-422. PMID: 11104247 [PubMed - indexed for MEDLINE]PMCID: PMC1725482  

Sudden death in the young after low energy anterior chest wall impact is an under-recognised phenomenon in this country. Review of the literature yields several American references to commotio cordis, mainly in the context of sporting events. Two cases are reported of sudden death in young men as a result of blunt impact anterior chest wall trauma. It is suggested that these cases draw attention to a lethal condition of which many practitioners are unaware. J Accid Emerg Med 2000 Nov 17 (6): 421-422. PMID: 11104247 [PubMed - indexed for MEDLINE]PMCID: PMC1725482  

Sudden death in the young after low energy anterior chest wall impact is an under-recognised phenomenon in this country. Review of the literature yields several American references to commotio cordis, mainly in the context of sporting events. Two cases are reported of sudden death in young men as a result of blunt impact anterior chest wall trauma. It is suggested that these cases draw attention to a lethal condition of which many practitioners are unaware. J Accid Emerg Med 2000 Nov 17 (6): 421-422. PMID: 11104247 [PubMed - indexed for MEDLINE]PMCID: PMC1725482  

Adult female Sprague-Dawley rats were injected with corn oil or 5 mg, 20 mg, 25 mg or 30 mg per kg body weight of heptachlor solution every other day for up to 18 days. The rats were killed at the end of the experimental period, and blood samples were assayed for progesterone and oestrogen by radioimmunoassay. Ovarian cells from the rats were isolated and incubated either on their own, or in the presence of LH or FSH, and production of progesterone and oestrogen determined. Control incubations consisted of cells from corn oil-treated rats. The latter were also incubated on their own or in the presence of LH or FSH. Heptachlor significantly suppressed blood progesterone and oestradiol levels (P < 0.05 to P < 0.001), the degree of suppression depending on the dose and the stage of the oestrous cycle in which samples were obtained. Production of oestradiol by ovarian cells from heptachlor-treated rats was lower than for corn oil-treated controls. Cells from rats treated with low doses of heptachlor (5 mg per kg body weight) showed an increased production of progesterone, while high doses (> 20 mg per kg body weight) suppressed production.

OBJECTIVE: This paper aimed to characterize the resident exposure to acute general surgical conditions during a three-months rotation in a general surgical unit. SETTING: The Department of Surgery, University of Nairobi and Kenyatta National Referral and Teaching Hospital in Nairobi. METHODS: Four residents (in their first to third post-basic science year) were evaluated during a 12-week General Surgery rotation. Details assessed included number and variety of admission diagnoses logged by each resident, number and nature of surgical operations performed independently by each resident and with consultant support, and the resident involvement in the continuity of care. The experiences were compared across the residents. RESULTS: One hundred and forty five patients were admitted. The number of admissions per resident varied between 30 and 41. Fifty-eight patients had surgery. Operative experience where the resident was the principal surgeon ranged from 11 cases to 23 cases per resident. A second resident assisted in 8 out of the fifty-eight cases operated on and consultant support was infrequent. CONCLUSION: The operative experience was variable for the general surgical residents. Exposure could be improved by a policy of resident assistance at emergency surgery. The infrequent consultant support may invalidate formative assessment of resident competence.

Normal 0 false false false MicrosoftInternetExplorer4 st1:*{behavior:url(#ieooui) } /* 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-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Macrophytes have been shown to perform important ecological roles in Lake Naivasha. Consequently, various studies regarding the impact of biotic factors on the macrophytes have been advanced but related studies on environmental parameters have lagged behind. In an attempt to address this gap, sampling on floating species and submergents was carried out in eight sampling sites in 2003 to investigate how they were influenced by a set of environmental factors. Soil texture (sandy sediments; P < 0.05, regression coefficient = - 0.749) and wind were the most important environmental parameters influencing the distribution and abundance of floating macrophytes. Combination of soil texture and lake-bed slope explained the most (86.3%) variation encountered in the submergents. Continuous translocation of the floating dominant water hyacinth to the western parts by wind has led to displacement of the submergents from those areas. In view of these findings, the maintenance and preservation of the steep Crescent Lake basin whose substratum is dominated by sand thus hosting most submergents remain important, if the whole functional purpose of the macrophytes is to be sustained.

PMID: 6595111 [PubMed - indexed for MEDLINE]

PIP: 125 black Kenyan women attending the Kenyatta National Family Welfare Clinic were randomly allocated to combined and fixed dose oral contraceptives (Eugynon: 500 mcg dl-norgestrel + 50 mcg ethinyl estradiol or Microgynon: 150 mcg levonorgestel + 30 mcg ethinyl estradiol). They were between 18-33 years of age with a mean of 25 +or- 7 years. The mean parity of this group was 3 and they had a mean education standard of 8 years. Fasting blood sampled were taken on recruitment (control cycle) and thereafter once for cycles 1, 3, 6, 9, and 12 during OC use. HDL-cholesterol was estimated in the sear. The 2 OCs elicited a significant decrease in levels of HDL-cholesterol (p0.01). author's modified

No abstract available.

No abstract available.

PIP: The 1725 women presenting at Kenyatta National Hospital in 1984-86 for IUD insertion were screened for cervical Chlamydia trachomatis and Neisseria gonorrhoea before the IUD insertion. 207 (12%) cases of chlamydia trachomatis and 61 (3.5%) cases of Neisseria gonorrhoea were detected. There was no association between the ages of the women and the prevalence of these 2 sexually transmitted pathogens; however, there was a significant relationship between the prevalence of N gonorrhoea and marital status. N gonorrhoea was detected in 6.2% of never-married and 5.2% of formerly married women compared with 2.3% of currently married subjects (p0.001). Although there was no significant relationship between parity and the rate of isolation of the 2 pathogens, infection tended to be lower in women with 5 or more children. Educational attainment was significantly associated with N gonorrhoea infection: 5.1% in women who had 0-7 years of schooling compared with 3.0% in those with 8 or more years of education (p0.05). 12 women with C trachomatis infection were also positive for N gonorrhoea. There was no significant relationship between C trachomatis infection and any of the demographic variables examined. Given the finding that the greatest risk of pelvic inflammatory disease occurs in the 1st month of IUD use, it can be speculated that pathogens are inserted into the uterine cavity at the time of IUD insertion. It is therefore recommended that clients–especially the unmarried, the formerly unmarried, and those with low levels of education–be screened and treated for N gonorrhoea and C trachomatis before an IUD is inserted.

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

Almost 30 years after its introduction into the management of ovarian carcinoma, second-look laparotomy remains controversial. Although its supporters agree on its indications, there is a considerable number of conflicting reports on the actual benefits of the procedure. Diagnostic inaccuracy, invasiveness and expense are some of the reasons raised by opponents against its routine performance and their recommendations range from limited selective application to total avoidance. The role of second-look laparotomy is reviewed, with particular reference to developing countries where scarcity of resources must always be balanced against the need to provide the best care possible to the individual cancer patient. A management schedule for ovarian carcinoma, including second-look laparotomy, appropriate under these circumstances is given.

OBJECTIVE: In sub-Saharan Africa, many family planning programmes do not encourage advance provision of oral contraceptives to clients who must wait until menses to initiate pill use. Since some resistance to advance provision of pills is due to provider fears that the practice may be harmful, we conducted a study in Kenya in 1997 to compare pill-taking outcomes between 20 "advance provision" clients and 280 "standard" clients. DESIGN: Prospective observational study. SETTING: Six family planning clinics in Central and Western Kenya. SUBJECTS: Women presenting as new clients at MOH family planning clinics. INTERVENTIONS: Researchers used prospective tracking to compare indicators of pill-taking success between non-menstruating clients given pills to carry home for later use and menstruating clients who began pill use immediately. MAIN OUTCOME MEASURES: Pill-taking outcomes such as side effects, compliance, knowledge, satisfaction, and a continuation proxy. RESULTS: Among clients returning for re-supply, those receiving advance provision of pills did no worse than, and often had superior outcomes to, their counterparts who started taking pills immediately after the clinic visit. CONCLUSIONS: Advance provision of pills, already practiced worldwide, is safe and feasible. Explicit mention should be made of advance provision of pills in national family planning guidance documents and training curricula in Kenya and throughout sub-Saharan Africa.

OBJECTIVES: The objective of the study was to determine the efficacy of chloroquine in pregnant women with Plasmodium falciparum parasitemia at therapeutic doses of 25 mg/kg body weight divided over 3 days. <br>METHODS: Three-hundred pregnant women in Kilifi Hospital at the coast of Kenya were screened for malaria parasitemia using Giemsa stained thick blood smears. In vivo and in vitro parasite sensitivity to chloroquine was determined. <br>RESULTS: P. falciparum infections were present in 65 (22%) of 300 pregnant women. The in vivo tests showed that 46% of all the P. falciparum infections were resistant to chloroquine predominantly at RI and RII levels. The in vitro tests showed a resistance rate of 35%. <br>CONCLUSIONS: A large proportion of pregnant women with malaria do not respond to chloroquine therapy and alternative drugs are required.

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

Almost 30 years after its introduction into the management of ovarian carcinoma, second-look laparotomy remains controversial. Although its supporters agree on its indications, there is a considerable number of conflicting reports on the actual benefits of the procedure. Diagnostic inaccuracy, invasiveness and expense are some of the reasons raised by opponents against its routine performance and their recommendations range from limited selective application to total avoidance. The role of second-look laparotomy is reviewed, with particular reference to developing countries where scarcity of resources must always be balanced against the need to provide the best care possible to the individual cancer patient. A management schedule for ovarian carcinoma, including second-look laparotomy, appropriate under these circumstances is given.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

Adolescent sexuality has become a major problem all over the world. This review paper describes the main problems encountered in Kenya with regards to adolescent sexuality. The role of the Government and some non-governmental organisations is outlined. Factors which contribute to the problem of adolescent sexuality in Kenya are described. The paper stresses the role of research in solving these problems and finally suggests some strategies which may be adopted in order to minimise the undesirable effects of adolescent sexuality in Kenya. PIP: Kenya's population has increased from 5.4 million in 1948 to 15.3 million in 1979 and is expected to rise to 39 million by 2000. The population growth rate has risen from 2.5% in 1948 to 3.8% in 1979. Improvements in health and economic status since independence have caused significant changes from 1948-79: the fertility rate of women has increased from 6.5-7.9, the crude death rate has decreased from 25/1000-14/1000, infant mortality has decreased from 184/1000-104/1000 births, and life expectancy has increased from 35-54 years. Adolescent girls, 15-24, contribute up to 30% of total pregnancies of females, 15-49, and will form 44.2% of the reproductive age group by 2000. Between 1960 and 1979 the fertility rate of girls 15-19 has increased from 141/1000-168/1000. The age of menarche has dropped from 17 to 12-15. In 1 rural community 41.9% of the girls and 76.1% of the boys aged 12-23 had at least one sexual experience. The mean age at first coitus was 13.7 for boys and 14.9 for girls. 42% of the girls and 74.8% of the boys had more than one sexual partner. Because of the gradual change from extended families to nuclear families, education, role models, and any established activities that initiated youth into adulthood have virtually disappeared, leaving adolescents uneducated and unprepared. Only 2-6% use any form of contraception. 58.4% of rural and 64.4% of urban pregnant girls are in primary school at the time of conception. 8340-10,400 girls drop out of school due to pregnancy each year. 46.6% of girls who get pregnant are not married. Abortions among the adolescents account for 28-64% of abortions done in hospitals, but because of strict abortion laws in Kenya, most adolescents resort to criminal abortions frequently performed by inexperienced people in unsanitary conditions. Sexually transmitted diseases (STDs) are not uncommon among adolescents: 36.8% of pregnant adolescent females had at least 1 STD, compared to 16% of those aged 25 and above. Contraceptive services, education, and laws protecting the adolescent must be instituted in response to the problems of adolescent sexuality.

Adolescent sexuality has become a major problem all over the world. This review paper describes the main problems encountered in Kenya with regards to adolescent sexuality. The role of the Government and some non-governmental organisations is outlined. Factors which contribute to the problem of adolescent sexuality in Kenya are described. The paper stresses the role of research in solving these problems and finally suggests some strategies which may be adopted in order to minimise the undesirable effects of adolescent sexuality in Kenya. PIP: Kenya's population has increased from 5.4 million in 1948 to 15.3 million in 1979 and is expected to rise to 39 million by 2000. The population growth rate has risen from 2.5% in 1948 to 3.8% in 1979. Improvements in health and economic status since independence have caused significant changes from 1948-79: the fertility rate of women has increased from 6.5-7.9, the crude death rate has decreased from 25/1000-14/1000, infant mortality has decreased from 184/1000-104/1000 births, and life expectancy has increased from 35-54 years. Adolescent girls, 15-24, contribute up to 30% of total pregnancies of females, 15-49, and will form 44.2% of the reproductive age group by 2000. Between 1960 and 1979 the fertility rate of girls 15-19 has increased from 141/1000-168/1000. The age of menarche has dropped from 17 to 12-15. In 1 rural community 41.9% of the girls and 76.1% of the boys aged 12-23 had at least one sexual experience. The mean age at first coitus was 13.7 for boys and 14.9 for girls. 42% of the girls and 74.8% of the boys had more than one sexual partner. Because of the gradual change from extended families to nuclear families, education, role models, and any established activities that initiated youth into adulthood have virtually disappeared, leaving adolescents uneducated and unprepared. Only 2-6% use any form of contraception. 58.4% of rural and 64.4% of urban pregnant girls are in primary school at the time of conception. 8340-10,400 girls drop out of school due to pregnancy each year. 46.6% of girls who get pregnant are not married. Abortions among the adolescents account for 28-64% of abortions done in hospitals, but because of strict abortion laws in Kenya, most adolescents resort to criminal abortions frequently performed by inexperienced people in unsanitary conditions. Sexually transmitted diseases (STDs) are not uncommon among adolescents: 36.8% of pregnant adolescent females had at least 1 STD, compared to 16% of those aged 25 and above. Contraceptive services, education, and laws protecting the adolescent must be instituted in response to the problems of adolescent sexuality.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

In this study, a total of 519 patients were interviewed. 82.5% had incomplete abortion. The implication of abortion especially when induced is emphasised. Economic implications that are contributed by the youth are stressed. 83.6% of the patients had not used any contraception. The role of contraception in preventing unwanted pregnancy and therefore induced abortion is stressed. The role of the physician in providing contraception and appropriate contraceptive knowledge is discussed. PIP: A study of 519 consecutive women admitted to Kenyatta National Hospital with the diagnosis of abortion revealed that the majority were young and had a history of nonuse of contraception. Abortion was incomplete in 428 (83%) of cases; 60 (12%) cases involved sepsis. Women 20-24 years of age accounted for 221 (43%) of the abortions; the other two most represented age groups were 25-29 years (28%) and 14-19 years (17%). 460 (89%) of the abortion patients had never used a contraceptive method. The most frequently cited reasons for nonuse were desire for pregnancy (48%), no conscious reason (13%), procrastination in getting to a family planning clinic (8%), no knowledge of family planning (6%), and fear of side effects (6%). Of the 64 cases of failed contraception, 27 were using the pill, 25 had an IUD in place, and 8 were relying on the rhythm method. Among contraceptive users, the major sources of information about contraception were nurses (52%), radio and newspapers (19%), and other women (15%). Only 4% indicated that a physician had discussed family planning with them. Given the resource drain that treatment of incomplete abortion can place on Kenya's health care system and the risk of abortion-induced pelvic infection and subsequent infertility, Kenya's health workers should be encouraged to be more aggressive in promoting family planning use among young women.

In this study, a total of 519 patients were interviewed. 82.5% had incomplete abortion. The implication of abortion especially when induced is emphasised. Economic implications that are contributed by the youth are stressed. 83.6% of the patients had not used any contraception. The role of contraception in preventing unwanted pregnancy and therefore induced abortion is stressed. The role of the physician in providing contraception and appropriate contraceptive knowledge is discussed. PIP: A study of 519 consecutive women admitted to Kenyatta National Hospital with the diagnosis of abortion revealed that the majority were young and had a history of nonuse of contraception. Abortion was incomplete in 428 (83%) of cases; 60 (12%) cases involved sepsis. Women 20-24 years of age accounted for 221 (43%) of the abortions; the other two most represented age groups were 25-29 years (28%) and 14-19 years (17%). 460 (89%) of the abortion patients had never used a contraceptive method. The most frequently cited reasons for nonuse were desire for pregnancy (48%), no conscious reason (13%), procrastination in getting to a family planning clinic (8%), no knowledge of family planning (6%), and fear of side effects (6%). Of the 64 cases of failed contraception, 27 were using the pill, 25 had an IUD in place, and 8 were relying on the rhythm method. Among contraceptive users, the major sources of information about contraception were nurses (52%), radio and newspapers (19%), and other women (15%). Only 4% indicated that a physician had discussed family planning with them. Given the resource drain that treatment of incomplete abortion can place on Kenya's health care system and the risk of abortion-induced pelvic infection and subsequent infertility, Kenya's health workers should be encouraged to be more aggressive in promoting family planning use among young women.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

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

Almost 30 years after its introduction into the management of ovarian carcinoma, second-look laparotomy remains controversial. Although its supporters agree on its indications, there is a considerable number of conflicting reports on the actual benefits of the procedure. Diagnostic inaccuracy, invasiveness and expense are some of the reasons raised by opponents against its routine performance and their recommendations range from limited selective application to total avoidance. The role of second-look laparotomy is reviewed, with particular reference to developing countries where scarcity of resources must always be balanced against the need to provide the best care possible to the individual cancer patient. A management schedule for ovarian carcinoma, including second-look laparotomy, appropriate under these circumstances is given.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

In this study, a total of 519 patients were interviewed. 82.5% had incomplete abortion. The implication of abortion especially when induced is emphasised. Economic implications that are contributed by the youth are stressed. 83.6% of the patients had not used any contraception. The role of contraception in preventing unwanted pregnancy and therefore induced abortion is stressed. The role of the physician in providing contraception and appropriate contraceptive knowledge is discussed. PIP: A study of 519 consecutive women admitted to Kenyatta National Hospital with the diagnosis of abortion revealed that the majority were young and had a history of nonuse of contraception. Abortion was incomplete in 428 (83%) of cases; 60 (12%) cases involved sepsis. Women 20-24 years of age accounted for 221 (43%) of the abortions; the other two most represented age groups were 25-29 years (28%) and 14-19 years (17%). 460 (89%) of the abortion patients had never used a contraceptive method. The most frequently cited reasons for nonuse were desire for pregnancy (48%), no conscious reason (13%), procrastination in getting to a family planning clinic (8%), no knowledge of family planning (6%), and fear of side effects (6%). Of the 64 cases of failed contraception, 27 were using the pill, 25 had an IUD in place, and 8 were relying on the rhythm method. Among contraceptive users, the major sources of information about contraception were nurses (52%), radio and newspapers (19%), and other women (15%). Only 4% indicated that a physician had discussed family planning with them. Given the resource drain that treatment of incomplete abortion can place on Kenya's health care system and the risk of abortion-induced pelvic infection and subsequent infertility, Kenya's health workers should be encouraged to be more aggressive in promoting family planning use among young women.

In this study, a total of 519 patients were interviewed. 82.5% had incomplete abortion. The implication of abortion especially when induced is emphasised. Economic implications that are contributed by the youth are stressed. 83.6% of the patients had not used any contraception. The role of contraception in preventing unwanted pregnancy and therefore induced abortion is stressed. The role of the physician in providing contraception and appropriate contraceptive knowledge is discussed. PIP: A study of 519 consecutive women admitted to Kenyatta National Hospital with the diagnosis of abortion revealed that the majority were young and had a history of nonuse of contraception. Abortion was incomplete in 428 (83%) of cases; 60 (12%) cases involved sepsis. Women 20-24 years of age accounted for 221 (43%) of the abortions; the other two most represented age groups were 25-29 years (28%) and 14-19 years (17%). 460 (89%) of the abortion patients had never used a contraceptive method. The most frequently cited reasons for nonuse were desire for pregnancy (48%), no conscious reason (13%), procrastination in getting to a family planning clinic (8%), no knowledge of family planning (6%), and fear of side effects (6%). Of the 64 cases of failed contraception, 27 were using the pill, 25 had an IUD in place, and 8 were relying on the rhythm method. Among contraceptive users, the major sources of information about contraception were nurses (52%), radio and newspapers (19%), and other women (15%). Only 4% indicated that a physician had discussed family planning with them. Given the resource drain that treatment of incomplete abortion can place on Kenya's health care system and the risk of abortion-induced pelvic infection and subsequent infertility, Kenya's health workers should be encouraged to be more aggressive in promoting family planning use among young women.

OBJECTIVE: To determine the accuracy and sensitivity of diagnostic peritoneal lavage in the assessment of intra-abdominal injury using the dipstick method. DESIGN: Prospective study, involving the performance of diagnostic peritoneal lavage in the out patient department and surgical wards prior to surgical intervention. SETTING: Kenyatta National Hospital-General Surgical and Orthopaedic wards and outpatient department. The study was conducted over a duration of six months, starting from January 1995 to July 1995. RESULTS: Ninety six patients with penetrating (68) and blunt (28) abdominal trauma underwent diagnostic peritoneal lavage as evaluation of the severity of abdominal trauma. Dipstick (combur 9 strips) was used to evaluate lavage effluent for red blood cells, white blood cells, protein and bilirubin. Forty three patients had positive diagnostic peritoneal lavage (DPL) results, of which 40 (93%) had positive findings at laparatomy and three (7%) had negative findings at laparatomy. The remaining 53 patients had negative DPL results and were managed conservatively. One patient with a negative DPL result became symptomatic and had a positive laparatomy. Conservatively managed patients were discharged after 24 hours observations without any complications. DPL had an accuracy and sensitivity of 93% and specificity of 98%. CONCLUSION: Diagnostic peritoneal lavage is a cheap, safe and reliable method for assessment of abdominal trauma. The method is easy to perform by trained junior doctors in the OPD, or as a bedside procedure. Use of this method reduced negative laparotomy rate from 50% to 6.9% and average duration of stay from 6.5 days to 1.9 days. This method is recommended as a basic tool in the assessment of abdominal trauma patients.

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No abstract available yet.

Six susceptible Galana and five trypanotolerant Orma Boran (Bos indicus) cattle were infected experimentally with Trypanosoma vivax KETRI 2501 by cyclical transmission using Glossina morsitans during early and mid-pregnancy. Four pregnant animals, two of each Boran type were used as controls and remained uninfected throughout the study period. Three out of the six infected susceptible Galana Borans aborted, whilst one had a stillborn calf. None of the trypanotolerant Orma Boran cattle aborted and all carried their pregnancies to term. All control animals produced live calves at term. The mechanisms leading to disruption of reproductive function in susceptible Boran cattle were not clear but could involve a number of factors, including anaemia, weight loss and post-infection decline of plasma progesterone levels. It is concluded that infection with T. vivax disrupts maintenance of pregnancy in susceptible Galana Borans but does not affect maintenance of pregnancy in the Orma Boran, demonstrating their tolerance to infection with T. vivax.

A study was designed to examine the effect of infection with Trypanosoma vivax KETRI 2501 on the maintenance of pregnancy and postpartum return to reproductive function in susceptible Galana (n = 6) and trypano-tolerant Orma Boran (n = 6) heifers during the third trimester of pregnancy. Of the 12 study animals, 3 Galana and 3 Orma Boran heifers served as controls. One of 3 Galana heifers calved prematurely with subsequent perinatal loss. Of the 2 heifers that produced live calves, 1 calf died shortly after birth, while the other survived. Two of 3 Orma heifers calved prematurely and all 3 calves died shortly after birth. The 6 control heifers produced live calves at term, all of which survived. Infection with T. vivax during the third trimester of pregnancy delayed the resumption of ovarian activity after calving, with the Ormas taking a significantly (P < 0.05) shorter time from calving to ovulation. There was no clear evidence that premature birth was associated with pathological changes in reproductive organs. Results from this study demonstrated that infection with pathogenic T. vivax during late pregnancy influenced the outcome of pregnancy in both susceptible Galana and trypano-tolerant Orma Boran heifers, resulting in premature births, perinatal loss, retained placentae, low birth weights and a prolonged period to the onset of postpartum ovarian activity.

PMID: 614126 [PubMed - indexed for MEDLINE]

PMID: 614126 [PubMed - indexed for MEDLINE]

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

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

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

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

Rat bite fever has not been reported from Kenya previously. A case of 17 year old Kenyan male who was diagnosed to have rat bite fever after a bite of domestic rat is described. The history, clinical features and demonstration of spirillum like organisms from a thick blood film suggest infection due to spirillum minus. The patient recovered completely after a course of penicillin and gentamicin.

Rat bite fever has not been reported from Kenya previously. A case of 17 year old Kenyan male who was diagnosed to have rat bite fever after a bite of domestic rat is described. The history, clinical features and demonstration of spirillum like organisms from a thick blood film suggest infection due to spirillum minus. The patient recovered completely after a course of penicillin and gentamicin.

As part of a study to assess zoonotic milk-borne health risks, seasonal survey data and unpasteurized milk samples were collected between January 1999 and February 2000 from randomly selected informal milk market agents (220 and 236 samples in the dry and wet seasons, respectively) and from households purchasing raw milk (213 and 219 samples in the dry and wet seasons, respectively) in rural and urban locations in Central Kenya and screened for antibiotics, Brucella abortus (B. abortus) and presence of Escherichia coli (E. coli 0157:H7).The latter was assessed based on samples from consumer households only. Antibodies to B. abortus were screened using the indirect antibody Enzyme Linked Immunosorbent Assay (ELISA) and the Milk Ring Test (MRT). The presence of E. coli 0157:H7 was assessed by culture, biochemical characterization, serological testing for production of verocytotoxin one (VTI) and two (VT2) and polymerase chain reaction (PCR) analysis for the presence of genes encoding for the toxins.                                                                                                         The prevalence of antibodies to B.abortus varied considerably ranging from none in milk sold in small units and originating from intensive production systems to over 10% in samples that were bulked or originating from extensive production systems. E. coli 0157:H7 was isolated from two samples (0.8%), one of which produced VTI. All urban consumers (100%) and nearly all rural consumers (96%) of marketed milk boiled the milk before consumption, mainly in tea, thus reducing chances of exposure to live pathogens and potential health risks.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

As part of a study to assess zoonotic milk-borne health risks, seasonal survey data and unpasteurized milk samples were collected between January 1999 and February 2000 from randomly selected informal milk market agents (220 and 236 samples in the dry and wet seasons, respectively) and from households purchasing raw milk (213 and 219 samples in the dry and wet seasons, respectively) in rural and urban locations in Central Kenya and screened for antibiotics, Brucella abortus (B. abortus) and presence of Escherichia coli (E. coli 0157:H7).The latter was assessed based on samples from consumer households only. Antibodies to B. abortus were screened using the indirect antibody Enzyme Linked Immunosorbent Assay (ELISA) and the Milk Ring Test (MRT). The presence of E. coli 0157:H7 was assessed by culture, biochemical characterization, serological testing for production of verocytotoxin one (VTI) and two (VT2) and polymerase chain reaction (PCR) analysis for the presence of genes encoding for the toxins.                                                                                                         The prevalence of antibodies to B.abortus varied considerably ranging from none in milk sold in small units and originating from intensive production systems to over 10% in samples that were bulked or originating from extensive production systems. E. coli 0157:H7 was isolated from two samples (0.8%), one of which produced VTI. All urban consumers (100%) and nearly all rural consumers (96%) of marketed milk boiled the milk before consumption, mainly in tea, thus reducing chances of exposure to live pathogens and potential health risks.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

This report concerns an outbreak that occurred during July/August 1997. Ten pigs from a herd of 181 pigs in a medium-scale, semi-closed piggery in Kiambu District, Kenya, contracted the clinical disease. The main clinical findings in affected pigs included: fever (40.5-41.8 degrees C), prostration, inappetence, dog-sitting posture, abortion, erythema and raised, firm to the touch and easily palpated light pink to dark purple diamond-shaped to square/rectangular spots on the skin around the belly and the back. Based on the pathognomonic skin lesions, a clinical diagnosis of swine erysipelas was made. The diagnosis was confirmed by the isolation of Erysipelothrix rhusiopathiae organisms from the blood and skin biopsies taken from the affected pigs. Response to treatment with a combination of procaine penicillin and dihydrostreptomycin at the dosage rate of 20,000 IU/kg body weight (based on procaine penicillin) for 3 days was good and all the affected pigs recovered fully. The farm was placed under quarantine to prevent spread of the disease

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

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

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

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

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

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

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

A model for the establishment of a four-dimensional regional geodetic reference datum is presented. Starting from the three-dimensional integrated geodetic network model, formulations for the establishment of a four-dimensional regional datum are developed. Astronomic latitudes, astronomic longitudes, gravity values, gravity potential differences, gravity differences, and GPS-vectors are considered as observables. The estimated parameters defining the datura are point coordinates, deflections of the vertical and geoidai undulations, and velocities and accelerations on the positional coordinates. The network datum is considered observed over several epochs with parameters estimated from previous epochs being introduced into later epochs as stochastic prior information parameters.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

PIP: This research report studies several biochemical and histochemical aspects of cervical carcinoma and explores their use in follow-up of patients undergoing radiotherapy. Material came from 19 patients with invasive cervical carcinoma admitted to Kenyatta National Hospital. A control group consisted of 20 women matched for age who attended clinics at the hospital but were not suffering from any malignant disease; control tissue for histological examination was obtained from 3 women who had undergone hysterectomy for uterine fibroids. Biochemical assays for alkaline and acid phosphatases in patients with cervical carcinoma show an increase in alkaline phosphatase in carcinomatous tissue (35.7 umoles/hr/mg) as opposed to normal tissue (7.2). Acid phosphatase values were only moderately raised. Assays of the same enzymes in blood showed a less marked difference between patients and controls (ranges of 7.5-20.8 and 3-14, respectively). When examined histochemically, increased alkaline phosphatase activity was observed in connective tissue, epithelium of the glands and blood capillaries of tumor tissue. 1 section containing normal tissue bordering carcinomatous tissue demonstrated normal alkaline phosphatase activity in the normal tissue and increased activity in the tumor tissue. In summary, there is increased enzyme activity around the tumor areas, but values for serum levels show an overlap of normal and abnormal cases and are therefore not predictive. Results demonstrate a clear difference in activities of these enzymes in carcinomatous tissue and normal tissue, which may be of value in follow-up care.

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

isolated from preterm neonates during the outbreak of gastroenteritis in hospital in Nairobi, Kenya, were resistance to trimethoprin-sulfathoxaxole, Chloramphenicol, oxytetracycline and ampicilin, but only a few strains were resistant to cefazolin, cefamandole, cefataximine, amikacin and nalidixic acid. Fourteen different antimicrobial resistance patterns were observed in the 229 strains of E.coli analyzed. Eighty-two percent of the EPEC strains belonged to two resistance patterns. There was no consistent relationship between palsmid profile group and antimicrobial resistance pattern, although one resistance pattern was more frequently observed in EAF-positive strins belonging to the dominant plasmid profile group. Nine percent of the EPEC strins were resistant to gentamicin compared to 37% in the non-EPEC group. No correlation was observed between administration of gentamicin and percentage of resistant strains isolated. None of the nine neonates receiving gentamicin died during the outbreak. Gentamicin resistance was observed in E.coli strains from six out of these nine neonates. Five out of fourteen neonates who received other antimicrobials, or no antibiotic at all, died. Key words: Enteropathogenic Escherichia Coli; antimicrobial resistance;

isolated from preterm neonates during the outbreak of gastroenteritis in hospital in Nairobi, Kenya, were resistance to trimethoprin-sulfathoxaxole, Chloramphenicol, oxytetracycline and ampicilin, but only a few strains were resistant to cefazolin, cefamandole, cefataximine, amikacin and nalidixic acid. Fourteen different antimicrobial resistance patterns were observed in the 229 strains of E.coli analyzed. Eighty-two percent of the EPEC strains belonged to two resistance patterns. There was no consistent relationship between palsmid profile group and antimicrobial resistance pattern, although one resistance pattern was more frequently observed in EAF-positive strins belonging to the dominant plasmid profile group. Nine percent of the EPEC strins were resistant to gentamicin compared to 37% in the non-EPEC group. No correlation was observed between administration of gentamicin and percentage of resistant strains isolated. None of the nine neonates receiving gentamicin died during the outbreak. Gentamicin resistance was observed in E.coli strains from six out of these nine neonates. Five out of fourteen neonates who received other antimicrobials, or no antibiotic at all, died. Key words: Enteropathogenic Escherichia Coli; antimicrobial resistance;

isolated from preterm neonates during the outbreak of gastroenteritis in hospital in Nairobi, Kenya, were resistance to trimethoprin-sulfathoxaxole, Chloramphenicol, oxytetracycline and ampicilin, but only a few strains were resistant to cefazolin, cefamandole, cefataximine, amikacin and nalidixic acid. Fourteen different antimicrobial resistance patterns were observed in the 229 strains of E.coli analyzed. Eighty-two percent of the EPEC strains belonged to two resistance patterns. There was no consistent relationship between palsmid profile group and antimicrobial resistance pattern, although one resistance pattern was more frequently observed in EAF-positive strins belonging to the dominant plasmid profile group. Nine percent of the EPEC strins were resistant to gentamicin compared to 37% in the non-EPEC group. No correlation was observed between administration of gentamicin and percentage of resistant strains isolated. None of the nine neonates receiving gentamicin died during the outbreak. Gentamicin resistance was observed in E.coli strains from six out of these nine neonates. Five out of fourteen neonates who received other antimicrobials, or no antibiotic at all, died. Key words: Enteropathogenic Escherichia Coli; antimicrobial resistance;

isolated from preterm neonates during the outbreak of gastroenteritis in hospital in Nairobi, Kenya, were resistance to trimethoprin-sulfathoxaxole, Chloramphenicol, oxytetracycline and ampicilin, but only a few strains were resistant to cefazolin, cefamandole, cefataximine, amikacin and nalidixic acid. Fourteen different antimicrobial resistance patterns were observed in the 229 strains of E.coli analyzed. Eighty-two percent of the EPEC strains belonged to two resistance patterns. There was no consistent relationship between palsmid profile group and antimicrobial resistance pattern, although one resistance pattern was more frequently observed in EAF-positive strins belonging to the dominant plasmid profile group. Nine percent of the EPEC strins were resistant to gentamicin compared to 37% in the non-EPEC group. No correlation was observed between administration of gentamicin and percentage of resistant strains isolated. None of the nine neonates receiving gentamicin died during the outbreak. Gentamicin resistance was observed in E.coli strains from six out of these nine neonates. Five out of fourteen neonates who received other antimicrobials, or no antibiotic at all, died. Key words: Enteropathogenic Escherichia Coli; antimicrobial resistance;

isolated from preterm neonates during the outbreak of gastroenteritis in hospital in Nairobi, Kenya, were resistance to trimethoprin-sulfathoxaxole, Chloramphenicol, oxytetracycline and ampicilin, but only a few strains were resistant to cefazolin, cefamandole, cefataximine, amikacin and nalidixic acid. Fourteen different antimicrobial resistance patterns were observed in the 229 strains of E.coli analyzed. Eighty-two percent of the EPEC strains belonged to two resistance patterns. There was no consistent relationship between palsmid profile group and antimicrobial resistance pattern, although one resistance pattern was more frequently observed in EAF-positive strins belonging to the dominant plasmid profile group. Nine percent of the EPEC strins were resistant to gentamicin compared to 37% in the non-EPEC group. No correlation was observed between administration of gentamicin and percentage of resistant strains isolated. None of the nine neonates receiving gentamicin died during the outbreak. Gentamicin resistance was observed in E.coli strains from six out of these nine neonates. Five out of fourteen neonates who received other antimicrobials, or no antibiotic at all, died. Key words: Enteropathogenic Escherichia Coli; antimicrobial resistance;

isolated from preterm neonates during the outbreak of gastroenteritis in hospital in Nairobi, Kenya, were resistance to trimethoprin-sulfathoxaxole, Chloramphenicol, oxytetracycline and ampicilin, but only a few strains were resistant to cefazolin, cefamandole, cefataximine, amikacin and nalidixic acid. Fourteen different antimicrobial resistance patterns were observed in the 229 strains of E.coli analyzed. Eighty-two percent of the EPEC strains belonged to two resistance patterns. There was no consistent relationship between palsmid profile group and antimicrobial resistance pattern, although one resistance pattern was more frequently observed in EAF-positive strins belonging to the dominant plasmid profile group. Nine percent of the EPEC strins were resistant to gentamicin compared to 37% in the non-EPEC group. No correlation was observed between administration of gentamicin and percentage of resistant strains isolated. None of the nine neonates receiving gentamicin died during the outbreak. Gentamicin resistance was observed in E.coli strains from six out of these nine neonates. Five out of fourteen neonates who received other antimicrobials, or no antibiotic at all, died. Key words: Enteropathogenic Escherichia Coli; antimicrobial resistance;

isolated from preterm neonates during the outbreak of gastroenteritis in hospital in Nairobi, Kenya, were resistance to trimethoprin-sulfathoxaxole, Chloramphenicol, oxytetracycline and ampicilin, but only a few strains were resistant to cefazolin, cefamandole, cefataximine, amikacin and nalidixic acid. Fourteen different antimicrobial resistance patterns were observed in the 229 strains of E.coli analyzed. Eighty-two percent of the EPEC strains belonged to two resistance patterns. There was no consistent relationship between palsmid profile group and antimicrobial resistance pattern, although one resistance pattern was more frequently observed in EAF-positive strins belonging to the dominant plasmid profile group. Nine percent of the EPEC strins were resistant to gentamicin compared to 37% in the non-EPEC group. No correlation was observed between administration of gentamicin and percentage of resistant strains isolated. None of the nine neonates receiving gentamicin died during the outbreak. Gentamicin resistance was observed in E.coli strains from six out of these nine neonates. Five out of fourteen neonates who received other antimicrobials, or no antibiotic at all, died. Key words: Enteropathogenic Escherichia Coli; antimicrobial resistance;

isolated from preterm neonates during the outbreak of gastroenteritis in hospital in Nairobi, Kenya, were resistance to trimethoprin-sulfathoxaxole, Chloramphenicol, oxytetracycline and ampicilin, but only a few strains were resistant to cefazolin, cefamandole, cefataximine, amikacin and nalidixic acid. Fourteen different antimicrobial resistance patterns were observed in the 229 strains of E.coli analyzed. Eighty-two percent of the EPEC strains belonged to two resistance patterns. There was no consistent relationship between palsmid profile group and antimicrobial resistance pattern, although one resistance pattern was more frequently observed in EAF-positive strins belonging to the dominant plasmid profile group. Nine percent of the EPEC strins were resistant to gentamicin compared to 37% in the non-EPEC group. No correlation was observed between administration of gentamicin and percentage of resistant strains isolated. None of the nine neonates receiving gentamicin died during the outbreak. Gentamicin resistance was observed in E.coli strains from six out of these nine neonates. Five out of fourteen neonates who received other antimicrobials, or no antibiotic at all, died. Key words: Enteropathogenic Escherichia Coli; antimicrobial resistance;

isolated from preterm neonates during the outbreak of gastroenteritis in hospital in Nairobi, Kenya, were resistance to trimethoprin-sulfathoxaxole, Chloramphenicol, oxytetracycline and ampicilin, but only a few strains were resistant to cefazolin, cefamandole, cefataximine, amikacin and nalidixic acid. Fourteen different antimicrobial resistance patterns were observed in the 229 strains of E.coli analyzed. Eighty-two percent of the EPEC strains belonged to two resistance patterns. There was no consistent relationship between palsmid profile group and antimicrobial resistance pattern, although one resistance pattern was more frequently observed in EAF-positive strins belonging to the dominant plasmid profile group. Nine percent of the EPEC strins were resistant to gentamicin compared to 37% in the non-EPEC group. No correlation was observed between administration of gentamicin and percentage of resistant strains isolated. None of the nine neonates receiving gentamicin died during the outbreak. Gentamicin resistance was observed in E.coli strains from six out of these nine neonates. Five out of fourteen neonates who received other antimicrobials, or no antibiotic at all, died. Key words: Enteropathogenic Escherichia Coli; antimicrobial resistance;

isolated from preterm neonates during the outbreak of gastroenteritis in hospital in Nairobi, Kenya, were resistance to trimethoprin-sulfathoxaxole, Chloramphenicol, oxytetracycline and ampicilin, but only a few strains were resistant to cefazolin, cefamandole, cefataximine, amikacin and nalidixic acid. Fourteen different antimicrobial resistance patterns were observed in the 229 strains of E.coli analyzed. Eighty-two percent of the EPEC strains belonged to two resistance patterns. There was no consistent relationship between palsmid profile group and antimicrobial resistance pattern, although one resistance pattern was more frequently observed in EAF-positive strins belonging to the dominant plasmid profile group. Nine percent of the EPEC strins were resistant to gentamicin compared to 37% in the non-EPEC group. No correlation was observed between administration of gentamicin and percentage of resistant strains isolated. None of the nine neonates receiving gentamicin died during the outbreak. Gentamicin resistance was observed in E.coli strains from six out of these nine neonates. Five out of fourteen neonates who received other antimicrobials, or no antibiotic at all, died. Key words: Enteropathogenic Escherichia Coli; antimicrobial resistance;

isolated from preterm neonates during the outbreak of gastroenteritis in hospital in Nairobi, Kenya, were resistance to trimethoprin-sulfathoxaxole, Chloramphenicol, oxytetracycline and ampicilin, but only a few strains were resistant to cefazolin, cefamandole, cefataximine, amikacin and nalidixic acid. Fourteen different antimicrobial resistance patterns were observed in the 229 strains of E.coli analyzed. Eighty-two percent of the EPEC strains belonged to two resistance patterns. There was no consistent relationship between palsmid profile group and antimicrobial resistance pattern, although one resistance pattern was more frequently observed in EAF-positive strins belonging to the dominant plasmid profile group. Nine percent of the EPEC strins were resistant to gentamicin compared to 37% in the non-EPEC group. No correlation was observed between administration of gentamicin and percentage of resistant strains isolated. None of the nine neonates receiving gentamicin died during the outbreak. Gentamicin resistance was observed in E.coli strains from six out of these nine neonates. Five out of fourteen neonates who received other antimicrobials, or no antibiotic at all, died. Key words: Enteropathogenic Escherichia Coli; antimicrobial resistance;

isolated from preterm neonates during the outbreak of gastroenteritis in hospital in Nairobi, Kenya, were resistance to trimethoprin-sulfathoxaxole, Chloramphenicol, oxytetracycline and ampicilin, but only a few strains were resistant to cefazolin, cefamandole, cefataximine, amikacin and nalidixic acid. Fourteen different antimicrobial resistance patterns were observed in the 229 strains of E.coli analyzed. Eighty-two percent of the EPEC strains belonged to two resistance patterns. There was no consistent relationship between palsmid profile group and antimicrobial resistance pattern, although one resistance pattern was more frequently observed in EAF-positive strins belonging to the dominant plasmid profile group. Nine percent of the EPEC strins were resistant to gentamicin compared to 37% in the non-EPEC group. No correlation was observed between administration of gentamicin and percentage of resistant strains isolated. None of the nine neonates receiving gentamicin died during the outbreak. Gentamicin resistance was observed in E.coli strains from six out of these nine neonates. Five out of fourteen neonates who received other antimicrobials, or no antibiotic at all, died. Key words: Enteropathogenic Escherichia Coli; antimicrobial resistance;

isolated from preterm neonates during the outbreak of gastroenteritis in hospital in Nairobi, Kenya, were resistance to trimethoprin-sulfathoxaxole, Chloramphenicol, oxytetracycline and ampicilin, but only a few strains were resistant to cefazolin, cefamandole, cefataximine, amikacin and nalidixic acid. Fourteen different antimicrobial resistance patterns were observed in the 229 strains of E.coli analyzed. Eighty-two percent of the EPEC strains belonged to two resistance patterns. There was no consistent relationship between palsmid profile group and antimicrobial resistance pattern, although one resistance pattern was more frequently observed in EAF-positive strins belonging to the dominant plasmid profile group. Nine percent of the EPEC strins were resistant to gentamicin compared to 37% in the non-EPEC group. No correlation was observed between administration of gentamicin and percentage of resistant strains isolated. None of the nine neonates receiving gentamicin died during the outbreak. Gentamicin resistance was observed in E.coli strains from six out of these nine neonates. Five out of fourteen neonates who received other antimicrobials, or no antibiotic at all, died. Key words: Enteropathogenic Escherichia Coli; antimicrobial resistance;

The book is a biography of the author. He begins with fundamenbtal question whether we can determine our destiny or we are just fulfiling what has already been ordained. He then explains how he has grown over the yeas experiencing changes.  

The book is a biography of the author. He begins with fundamenbtal question whether we can determine our destiny or we are just fulfiling what has already been ordained. He then explains how he has grown over the yeas experiencing changes.  

Kindly check later

Kindly check later

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