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

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

Kenya is in the process of reforming its national statistical system that has been catering to the various sectors of the economy including the building construction sub-sector. This paper evaluates opportunities that the reforms may bring for the improvement of building construction statistics. It starts by a conceptual review of the pertinent issues that generally constitute a challenge to statistical frameworks for construction. These issues are to do with:scope and coverage, institutional governance, comprehensive information system and the informal sector. The reforms to the statistical system in Kenya through the enactment of a new Statistics Act are then considered against their potential for tackling the pertinent issues in building construction statistics as listed above. The paper concludes that the reforms augur well for the improvement of building construction statistics in Kenya but more need to be done to translate the legislative provisions into actionable policy framework. Keywords: Building construction statistics; Statistical system reform; Statistics policy; Kenya

{ Mansa General Hospital, P.O. Box 710156, Chembe Road, Mansa, Luapula, Zambia. OBJECTIVES: To determine the prevalence and pattern of refractive errors among African type 2 diabetes mellitus patients and establish the relationship between baseline refractive status and degree of glycaemic control. DESIGN: A hospital based cross sectional study. SETTING: Diabetic medical and eye clinics at Kenyatta National Hospital (KNH). SUBJECTS: Ninety six type 2 diabetes mellitus patients. RESULTS: Ninety six patients aged 28 to 76 years were examined. The male to female ratio was 1:1.5 and about half of the patients (52.1%) had good glycaemic control. The prevalence of myopia was 39.5% and that of hypermetropia was 19.0%. Twenty two percent of the study patients had mild diabetic retinopathy (DR). Of the eyes with DR, 20% (15/75) were myopic, 19.4% (7/36) were hypermetropic and 26.6% (21/79) were emmetropic. There was no statistically significant correlation between baseline refractive status with DR (p = 0.358), or HBA1C (glycosylated haemoglobin) (rho = 0.130

{ Mansa General Hospital, P.O. Box 710156, Chembe Road, Mansa, Luapula, Zambia. OBJECTIVES: To determine the prevalence and pattern of refractive errors among African type 2 diabetes mellitus patients and establish the relationship between baseline refractive status and degree of glycaemic control. DESIGN: A hospital based cross sectional study. SETTING: Diabetic medical and eye clinics at Kenyatta National Hospital (KNH). SUBJECTS: Ninety six type 2 diabetes mellitus patients. RESULTS: Ninety six patients aged 28 to 76 years were examined. The male to female ratio was 1:1.5 and about half of the patients (52.1%) had good glycaemic control. The prevalence of myopia was 39.5% and that of hypermetropia was 19.0%. Twenty two percent of the study patients had mild diabetic retinopathy (DR). Of the eyes with DR, 20% (15/75) were myopic, 19.4% (7/36) were hypermetropic and 26.6% (21/79) were emmetropic. There was no statistically significant correlation between baseline refractive status with DR (p = 0.358), or HBA1C (glycosylated haemoglobin) (rho = 0.130

Objectives: To determine the prevalence and pattern of refractive errors among African type II diabetes mellitus patients and establish the relationship between baseline refractive status and degree of glycaemic control.
Design: A hospital based cross sectional study.
Setting: Diabetic medical and eye clinics at Kenyatta National Hospital (KNH).
Subjects: 96 type II diabetes mellitus patients.
Results: Ninety-six patients aged 28 to 76 years were examined. The male to female ratio was 1:1.5 and about half of the patients (52.1%) had good glycaemic control. The prevalence of myopia was 39.5% and that of hypermetropia was 19.0%. 22.6% of the study patients had mild diabetic retinopathy (DR). Of the eyes with DR, 20.0% (15/75) were myopic, 19.4% (7/36) were hypermetropic and 26.6% (21/79) were emmetropic. There was no statistically significant correlation between baseline refractive status with DR (p=0.358), or HBA1C (glycosylated haemoglobin) (rho=0.130, p-value=0.249 among myopes) or FBS (fasting blood sugar) (rho=-0.089, p-value=0.438 among myopes and rho=0.158, p-value=0.350 among hyperopes). However, there was a statistically significant correlation between baseline hypermetropic refractive status and HBA1C (rho=0.401, p-value=0.014).
Conclusions: Refractive errors were seen in 58.5% of the patients with myopia being the commonest type (39.5%) followed by hypermetropia 19.0%. There was no statistically significant relationship between baseline refractive status and indicators of glycaemic control except for hypermetropic refractive status and HBA1C.
Recommendations: According to the results of this study, it is not mandatory to ask for HBA1C or FBS results before issuing spectacle prescription to adult patients with type II diabetes mellitus who are already on treatment. However, there is need to emphasize the need for good glycaemic control to minimize the other ocular complications. A similar study should be done on young people with type I diabetes mellitus.

This article argues that the refugee problem presents one of the most pressing challenges for diplomacy and foreign policy in the Horn of Africa. It contends that the effect of the foreign policies of some of the states in the region has been to generate refugees, and that one of the biggest challeges of the foreign policies of states in the region is to address the refugee problem directly. The article examines the diplomatic context and responses to the 1969 Africa refugee regime, explores conflicts as causes of the refugee problem, and re-assesses the refugee probl;em in the region.

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.

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Regional differences in the aortic wall are important in explaining the physicomechanical properties and disease distribution in this artery. The goat is a suitable model for studying cardiovascular disease, but the regional features of its aorta are scarcely reported. The purpose of the study was therefore to describe the regional differences in the wall of its aorta. Sixteen healthy adult male domestic goats (capra hircus) were euthanised with intravenous sodium pentabarbitone and specimens obtained from the ascending, arch, each vertebral level of descending thoracic, and various segments of abdominal aorta. The specimens were fixed in 10% formaldehyde solution and routinely processed for paraffin embedding. Seven micron thick sections were stained with Mason's Trichrome and Weigert Resorcin Fuchsin stains. Light microscopic examination revealed that the aortic wall consists of tunica intima comprising endothelium, subendothelial zone and internal elastic lamina, media, and adventitia. Endothelium comprises flat and round endotheliocytes. The population of round cells declines as the internal elastic lamina increases in prominence caudally. Tunica media in ascending, arch, and proximal thoracic aorta comprises two zones: namely a luminal elastic and adventitial musculo-elastic zone, in which muscle islands interrupt some elastic lamellae. These islands progressively diminish caudally until by the eleventh thoracic vertebra they are only patchy. Beyond this point and in the abdominal aorta they are absent and tunica media consists of regular concentric elastic lamellae. Tunica adventitia, on the other hand, increases in thickness and elastic fibre content caudally. Regional variations exist in all three layers of goat aorta. The nature of these differences suggests that they are related to haemodynamic factors. Furthermore, the variations may form the basis for regional differences in physicomechanical strength and disease distribution along the aorta.

Regional differences in the aortic wall are important in explaining the physicomechanical properties and disease distribution in this artery. The goat is a suitable model for studying cardiovascular disease, but the regional features of its aorta are scarcely reported. The purpose of the study was therefore to describe the regional differences in the wall of its aorta. Sixteen healthy adult male domestic goats (capra hircus) were euthanised with intravenous sodium pentabarbitone and specimens obtained from the ascending, arch, each vertebral level of descending thoracic, and various segments of abdominal aorta. The specimens were fixed in 10% formaldehyde solution and routinely processed for paraffin embedding. Seven micron thick sections were stained with Mason's Trichrome and Weigert Resorcin Fuchsin stains. Light microscopic examination revealed that the aortic wall consists of tunica intima comprising endothelium, subendothelial zone and internal elastic lamina, media, and adventitia. Endothelium comprises flat and round endotheliocytes. The population of round cells declines as the internal elastic lamina increases in prominence caudally. Tunica media in ascending, arch, and proximal thoracic aorta comprises two zones: namely a luminal elastic and adventitial musculo-elastic zone, in which muscle islands interrupt some elastic lamellae. These islands progressively diminish caudally until by the eleventh thoracic vertebra they are only patchy. Beyond this point and in the abdominal aorta they are absent and tunica media consists of regular concentric elastic lamellae. Tunica adventitia, on the other hand, increases in thickness and elastic fibre content caudally. Regional variations exist in all three layers of goat aorta. The nature of these differences suggests that they are related to haemodynamic factors. Furthermore, the variations may form the basis for regional differences in physicomechanical strength and disease distribution along the aorta.

PMID:
21120813
[PubMed - indexed for MEDLINE]

Most HIV-1 transmission in Africa occurs among HIV-1-discordant couples (one partner HIV-1 infected and one
uninfected) who are unaware of their discordant HIV-1 serostatus. Given the high HIV-1 incidence among HIV-1 discordant couples
and to assess efficacy of interventions for reducing HIV-1 transmission, HIV-1 discordant couples represent a critical target
population for HIV-1 prevention interventions and prevention trials. Substantial regional differences exist in HIV-1 prevalence in
Africa, but regional differences in HIV-1 discordance among African couples, has not previously been reported. Methodology/
Principal Findings. The Partners in Prevention HSV-2/HIV-1 Transmission Trial (‘‘Partners HSV-2 Study’’), the first large HIV-1
prevention trial in Africa involving HIV-1 discordant couples, completed enrollment in May 2007. Partners HSV-2 Study recruitment
data from 12 sites from East and Southern Africa were used to assess HIV-1 discordance among couples accessing couples HIV-1
counseling and testing, and to correlate with enrollment of HIV-1 discordant couples. HIV-1 discordance at Partners HSV-2 Study
sites ranged from 8–31% of couples tested from the community. Across all study sites and, among all couples with one HIV-1
infected partner, almost half (49%) of couples were HIV-1 discordant. Site-specific monthly enrollment of HIV-1 discordant couples
into the clinical trial was not directly associated with prevalence of HIV-1 discordance, but was modestly correlated with national
HIV-1 counseling and testing rates and access to palliative care/basic health care (r = 0.74, p = 0.09). Conclusions/Significance.
HIV-1 discordant couples are a critical target for HIV-1 prevention in Africa. In addition to community prevalence of HIV-1
discordance, national infrastructure for HIV-1 testing and healthcare delivery and effective community outreach strategies impact
recruitment of HIV-1 discordant couples into HIV-1 prevention trials.

Most HIV-1 transmission in Africa occurs among HIV-1-discordant couples (one partner HIV-1 infected and one uninfected) who are unaware of their discordant HIV-1 serostatus. Given the high HIV-1 incidence among HIV-1 discordant couples and to assess efficacy of interventions for reducing HIV-1 transmission, HIV-1 discordant couples represent a critical target population for HIV-1 prevention interventions and prevention trials. Substantial regional differences exist in HIV-1 prevalence in Africa, but regional differences in HIV-1 discordance among African couples, has not previously been reported. Methodology/Principal Findings The Partners in Prevention HSV-2/HIV-1 Transmission Trial (“Partners HSV-2 Study”), the first large HIV-1 prevention trial in Africa involving HIV-1 discordant couples, completed enrollment in May 2007. Partners HSV-2 Study recruitment data from 12 sites from East and Southern Africa were used to assess HIV-1 discordance among couples accessing couples HIV-1 counseling and testing, and to correlate with enrollment of HIV-1 discordant couples. HIV-1 discordance at Partners HSV-2 Study sites ranged from 8–31% of couples tested from the community. Across all study sites and, among all couples with one HIV-1 infected partner, almost half (49%) of couples were HIV-1 discordant. Site-specific monthly enrollment of HIV-1 discordant couples into the clinical trial was not directly associated with prevalence of HIV-1 discordance, but was modestly correlated with national HIV-1 counseling and testing rates and access to palliative care/basic health care (r = 0.74, p = 0.09). Conclusions/Significance HIV-1 discordant couples are a critical target for HIV-1 prevention in Africa. In addition to community prevalence of HIV-1 discordance, national infrastructure for HIV-1 testing and healthcare delivery and effective community outreach strategies impact recruitment of HIV-1 discordant couples into HIV-1 prevention trials.

Most HIV-1 transmission in Africa occurs among HIV-1-discordant couples (one partner HIV-1 infected and one uninfected) who are unaware of their discordant HIV-1 serostatus. Given the high HIV-1 incidence among HIV-1 discordant couples and to assess efficacy of interventions for reducing HIV-1 transmission, HIV-1 discordant couples represent a critical target population for HIV-1 prevention interventions and prevention trials. Substantial regional differences exist in HIV-1 prevalence in Africa, but regional differences in HIV-1 discordance among African couples, has not previously been reported.

physico-mechanical properties and the basis for extent of atrial fibrillation and ablation. These features
are only scarcely reported. This study therefore aimed at describing regional differences in the mural
structure of coronary sinus among black Kenyans. This was a descriptive cross-sectional study on
coronary sinuses from fifteen hearts obtained during autopsy on adult black Kenyans at the Department
of Human Anatomy, University of Nairobi. Five-millimeter-long specimens were taken from the proximal,
middle and terminal segments of the coronary sinus and processed routinely for paraffin embedding and
sectioning. Seven-micron thick sections were stained with Masson’s Trichrome to demonstrate connective
tissue and smooth muscle while Weigert’s Resorcin Fuschin stain was used to demonstrate elastic fibres.
The slides were examined with a light microscope and photomicrographs taken with a high resolution
digital camera. The results are presented in micrographs. The wall comprised three layers namely
internal, middle and external. Regional differences were observed in the middle layer. In the proximal
segment, there were concentrically oriented smooth muscles scattered within connective tissue. The
middle and terminal segments on the other hand comprised cardiac muscle oriented both concentrically
and longitudinally. The muscle was separated by connective tissue rich in elastic fibres and abundant
vasa vasora. The external layer comprised connective tissue.
In conclusion the middle layer of the wall of the coronary sinus displays regional differences. The smooth
muscle at the proximal segment may confer contractility to enhance blood flow while the cardiac muscle
in the other segments enables it to function in synchrony with the right atrium during atrial systole. The
complex arrangement of circular and longitudinal muscle facilitates blood flow and may also constitute a
sphincter mechanism.

This study aimed at describing the structure of tunica media of the uterine artery of domestic
pig, since this structure influences the pattern of blood flow and reproductive performance.
Specimens were obtained from main trunk, broad ligament segment and the terminal portion
of twelve healthy adult domestic pigs (Sus scrofa domesticus) age range 6 – 18 months. They
were fixed in 10% formaldehyde solution, and routinely processed for paraffin embedding and
sectioning. Seven micron thick sections were stained with Hematoxylin & Eosin, Mason’s
Trichrome and Weigert resorcin fuchsin counterstained with Van Gieson stains. Tunica media
comprising predominantly smooth muscle occupied approximately fifty percent (50%) of the
volume of the entire wall with vasa vasora present deep into its inner zone. It showed zonal
and regional variation in that in the main trunk and broad ligament segments was divided into
inner two thirds having predominantly circular smooth muscle orientation while outer third
was preponderantly fibroelastic with longitudinally disposed smooth muscles. The terminal
segment had only circular layer. Density of vasa vasora declined distally. The predominantly
muscular tunica media of the uterine artery in pigs shows zonal and regional suggesting
segmental differentiation of function. The main trunk of this artery, due to its additional
longitudinal layer of smooth muscle may be involved in regulation of blood flow to the uterus
depending on the functional demands of the uterus.

Regional differences have been investigated in the probabilities of high and low river flow extremes along the river Nile basin in eastern Africa. This has been done on the basis of statistical extreme value analysis applied to about one hundred flow gauging stations spread over the basin. The statistical analysis results have been combined with physical sub-basin characteristics such as topography and land use. The research has been conducted within the framework of the FRIEND/Nile project, which focuses on regional hydrology research cooperation between the main Nile countries (Egypt, Sudan, Ethiopia, Kenya, Tanzania, Uganda) and the Flemish universities. The high- and low-flow statistics developed can be used in water engineering and civil engineering design applications. Of equal importance are the supratechnical research outputs, among which enhancement of water-related transboundary research cooperation in the Nile region. During the course of the project, trust among the researchers and water managers from the different Nile countries gradually increased, data sharing enhanced, and politically sensitive issues (on transboundary water sharing) became debatable.

Regional histomorphomery of the hepatic inferior vena cava: a possible sphincteric mechanism

The decision to pay out earnings or retain dividends has been a subject of debate for many scholars. The effect of dividend on the firm value and cost of capital have been covered in attempt to resolve the dividend puzzle. This research paper tests the applicability of constant dividend model by companies listed at the Nairobi stock exchange. Data was collected from annual reports and share price schedules obtained from Nairobi stock exchange and Capital market Authority for a population of 20 companies that paid dividends consistently from 2002 to 2008. The data was then analyzed by re-computing the dividends that should have been paid if the dividend constant model was applied. This recomputed figure was later compared to the dividend as paid out by the companies thought the years of study. Paired sample t-test statistic was also performed to determine whether there is a significant difference between the two dividend figures. The findings of the research established that the dividend model was not employed by the companies listed at the Nairobi stock exchange. Most firms instead adopted stable and predictable policy where a specific amount of dividend per share each year was paid periodically. In some years there was a slight adjustment of the dividend paid after an increase in earnings, but only by a sustainable amount. The study shows that the relationship between the stock market prices and the dividend paid from the constant dividend model is uneven from one year to another and where there was a relationship it was insignificant. Though a share would be highly priced, a high dividend per share was not always declared.

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

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

East African Publishers, Ltd.

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

A random sample survey using personal interviews was conducted in Machakos and Makueni Districts of Kenya in 1992 to estimate the level of rabies vaccination of the dog population. To substantiate the results of the interviews, a sample of the surveyed dogs 3 months old and above were bled for serum rabies antibody determination using an inhibition enzyme immunoassay (INH EIA). Of the 266 surveyed 3 months old and above, only 29% (77/266) were reportedly vaccinated against rabies. Out of the 197 dog sera titrated for rabies antibody, only 29% (57/197) had detectable antibodies and only 16% (32/197) had antibody tires equal to or greater than the threshold considered protective of 0.5 I.U/ml. There was a strong positive association between a history of previous vaccination and the detection of rabies antibodies. Of 133 dogs with no history of previous vaccination, 20% (26/133) had detectable antibodies. With the rabies incidence in Machakos and Makueni Districts still unacceptably high, the level of vaccination estimated in this survey is clearly inadequate for rabies control and measures designed to increase it are discussed.

This paper seeks to identify some the factors that underlie regional variation in infant mortality in Kenya. The data drawn from the 1988/89 Kenya Demographic and Health Survey were used for this purpose. Logistic regression is used to analyse the data. On the basis of infant mortality estimates obtained, provinces were grouped into two groups: High (HMP) and low (LMP). The results obtained show that the values of explanatory variables in LMP region than in the high mortality region. However, their differences did not explain much of the variation in infant mortality between the two mortality regions. Decomposing the results revealed that the differences were largely due to the differences in the nature or structure of relationships, as represented by logit coefficients, between mortality and explanatory variables. The results indicate that the lower average level of maternal education, higher proportion of preceding child loss, higher proportion mothers belonging to low economic status households and a lower proportion of mothers belonging to households possessing livestock and lower use of modern contraception modestly contributed to high infant mortality in the high mortality region

The linea alba (LA), a midline tendinous structure formed by the interlocking anterior abdominal wall aponeurotic fibers, acts as a passive tensile band that prevents sagging of the lower abdomen. The microstructure and the strength of these fibres would thus be expected to reflect on the forces that act on the linea alba. This study was undertaken to establish the histomorphology, morphometry and tensiometric characteristics of the linea alba of the goat so as to elucidate on the elements that are responsible for maintaining the integrity of the wall. Tissues resected from the linea alba in six male goats and prepared for routine light microscopy and stained with Weigert resorcin–fuchsin stain revealed three distinct laminae namely a superficial, intermediate and deep. The superficial lamina of goat epigastric linea alba, which was closely apposed to the overlying elastic tunica flava abdominis (deep fascia), was made up of predominantly obliquely aligned collagen bundles, an intermediate lamina comprising longitudinally aligned collagen bundles and a deep lamina consisting of transversely oriented collagen fibres. When exposed to longitudinal traction, the epigastric LA on average was the stiffest at 35 N/mm2 with an elastic coefficient 350 N/mm2 while the hypogastric LA was the weakest at 26.5 N/mm2 with an elastic coefficient 217 N/mm2 respectively. In conclusion, the epigastric LA was well suited for longitudinal load strength to support the compound stomach during grazing while the relatively elastic hypogastric LA was most suited for allowing a degree of midline sagging during browzing. The variations noted in tensiometry suggest that the hypogastric linea alba is more compliant to stretch but more predisposed to tearing than the epigastric line alba especially when exposed to sudden violent force or trauma.

The ventral rectus sheath (VRS) plays a key role in the stabilization of the ventral abdominal wall. This sheath has to be particularly strong in ruminants to accommodate the viscera and the large quantities of forage in their stomach. This study was conducted to establish the structural and the mechanical properties of the ventral rectus sheath in the goat, a browser, in order to elucidate its function. The ventral rectus sheath was formed by supercial and deep lamina consisting of obliquely aligned collagen bers derived from the external and internal oblique abdominal aponeuroses respectively. Closely apposed and intimately held to the super cial lamina was a layer of longitudinally aligned elastic bers, the ttunica ava abdominis or modi ed deep fascia. This tunica flava abdominis progressively increased in thickness from the epigastrium to the hypogastrium. On tensiometry, the epigastric ventral rectus sheath withstood about half the load (50N/mm2) required to reach yield point compared to the umbilical ventral rectus sheath (94.5N/mm2). Furthermore, the Youngs modulus showed that the umbilical ventral rectus sheath was the stiffest at 669 (SD 22.2) N/mm2 while the epigastric ventral rectus sheath was the weakest at 554 (SD 29) N/mm2 respectively when exposed to longitudinal traction. In conclusion, the progressively thickening of the tunica ava abdominis and the super cial lamina from the epigastrium to the hypogastrium may confer reversible stretch ability and strength to the ventral rectus sheath and is therefore well suited for longitudinal load strength needed to support the compound stomach during browzing.

According to the millennium assessment report, during the last century, global drylands have experienced anthropogenic induced climate changes that are predicted to continue and even to accelerate during the present century. The traditional pastoralist spatial domains are facing unprecedented changes due to population growth, urban sprawl and an appetite for land not anticipated by the planners who designated such lands as trust lands. A case in point is Kajiado district which has seen most community owned land blocks subdivided and tenure changed to private especially in areas surrounding It is therefore not only the pastoralists that are finding their roaming area constricted but also the wild animals. A recent court case to protect the migratory corridors of wild animals is a good example. In fact there are more wild animals among these communities than are confined in parks in Kenya. With the inevitable land use changes, and their impacts on livelihoods and environment, this paper explores the literature on the interaction of environmental conservation amid global warming and the potential role of biogas in mitigating the livelihood and vulnerability associated with it. Further, the technology helps manage green house gases and has potential for using the clean development mechanism to raise carbon credits which could be ploughed back in propping the livelihoods of rural communities. The paper highlights the preconditions of successful biogas interventions which include partial or complete confinement of animals in zero grazing units alongside improvement/change of animal breeds to more economically viable ones. However, this raises the greater question whether the radical change of livelihood approaches is at all viable? Key words: Global warming, livelihoods, conservation, biogas, carbon markets

This paper analyses the regional variations in contraceptive use between Central, Nyanza and Coast Provinces in Kenya among currently married, fecund women drawn from the 2008-09 Kenya Demographic and Health Survey (KDHS) data. Specifically the study examined the role of socio-economic, cultural and demographic factors in explaining these variations using both bivariate and logistic regression. The analysis confirmed the higher use of contraception in Central compared to Nyanza and Coast. Current use of modern contraceptive methods in Central is 70 percent compared with 39 percent and 37 percent for Nyanza and Coast respectively. The higher contraceptive use in Central is attributed to the better socio-economic and cultural environment compared with the other two provinces. Central Province has very few cases of women with no education, a much lower percentage in the poorest wealth (9.6) category and the highest proportion in monogamous unions (97.1). The higher socio-economic status and better cultural environment has in turn created a favourable environment for the use of contraception through the intervening variables of knowledge
on family planning and fertility preferences. The logistic regression results suggest that differences in contraceptive use between the three provinces could be narrowed by increasing the level of education in Coast and overcoming traditional practices such as polygyny in both Nyanza and Coast. Although mortality is still important, its effect has declined. However, the unexpected finding that contraceptive use is higher in rural areas of Central and Nyanza Provinces suggests further research to understand what could be responsible for the reversal.

The pattern of formation of the rectus sheath from the aponeuroses of external oblique, internal oblique, and transversus abdominis muscles shows regional variations. These variations may influence the microscopic organisation of the rectus sheath. Specimens were collected during autopsies from thirty one subjects (16 male, 15 female) aged 18-70 years old. The rectus sheath was exposed through gentle dissection of the superficial fascia of the anterior abdominal wall. Five millimeter thick sections were harvested and processed for light microscopy. Both walls of the rectus sheath were made up of three distinct zones: superficial, intermediate, and deep. The superficial and deep zones were fibroelastic while the intermediate zones comprised compact bundles of collagen fibres. In the anterior wall of the rectus sheath, these bundles above and below the arcuate line, respectively, were obliquely and transversely disposed. The bundles of the posterior wall of the rectus sheath were, however, transversely aligned. In conclusion, the microscopic organisation of the rectus sheath is determined by its pattern of formation. This sheath is mainly formed by the aponeuroses of the internal oblique and transversus abdominis.

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The pattern of formation of the rectus sheath from the aponeuroses of external oblique, internal oblique, and transversus abdominis muscles shows regional variations. These variations may influence the microscopic organisation of the rectus sheath. Specimens were collected during autopsies from thirty one subjects (16 male, 15 female) aged 18-70 years old. The rectus sheath was exposed through gentle dissection of the superficial fascia of the anterior abdominal wall. Five millimeter thick sections were harvested and processed for light microscopy. Both walls of the rectus sheath were made up of three distinct zones: superficial, intermediate, and deep. The superficial and deep zones were fibroelastic while the intermediate zones comprised compact bundles of collagen fibres. In the anterior wall of the rectus sheath, these bundles above and below the arcuate line, respectively, were obliquely and transversely disposed. The bundles of the posterior wall of the rectus sheath were, however, transversely aligned. In conclusion, the microscopic organisation of the rectus sheath is determined by its pattern of formation. This sheath is mainly formed by the aponeuroses of the internal oblique and transversus abdominis.

The pattern of formation of the rectus sheath from the aponeuroses of external oblique, internal oblique, and transversus abdominis muscles shows regional variations. These variations may influence the microscopic organisation of the rectus sheath. Specimens were collected during autopsies from thirty one subjects (16 male, 15 female) aged 18-70 years old. The rectus sheath was exposed through gentle dissection of the superficial fascia of the anterior abdominal wall. Five millimeter thick sections were harvested and processed for light microscopy. Both walls of the rectus sheath were made up of three distinct zones: superficial, intermediate, and deep. The superficial and deep zones were fibroelastic while the intermediate zones comprised compact bundles of collagen fibres. In the anterior wall of the rectus sheath, these bundles above and below the arcuate line, respectively, were obliquely and transversely disposed. The bundles of the posterior wall of the rectus sheath were, however, transversely aligned. In conclusion, the microscopic organisation of the rectus sheath is determined by its pattern of formation. This sheath is mainly formed by the aponeuroses of the internal oblique and transversus abdominis.

The objective of the study was to identify the challenges to camel production in The major causes of camel loss in the district were identified as predation (50.9%), drought (28.7%) and camel diseases (20.4%). Severe drought was reported to have occurred in the years; 1984 (12.4%), 1995 (9%), 2005 (42.1%), and 2006 (37.6%), and the livestock species most affected by the drought were cattle (98.1%), sheep (63.9%), donkeys (57.5%), goats (50.8%) and camels (31.2%). Water was reported to be inadequate in the district by 54.6% and 62.1% of the respondents respectively for livestock and human use. Herdsmen reported watering their camels from; rivers (24.6%), dry river beds (40%) and spring (7.7%). The livestock grazing area was reported to be getting smaller (45.7%), overgrazed (21.7%), and destroyed (13%), while only 13% believed that the grazing area had increased. Amongst the pastoralist who responded to the question on their source of income, 78.8% had no alternative source of income apart from livestock keeping. Conclusion; More resources should be allocated by the governments for improvement of camel production and the carrying capacity in pastoral production systems needs to be re-evaluated to ensure  optimal productivity.   Keywords; Camel, predation, drought, diseases, production

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{ Abuse of substances of dependence have risen dramatically and spawned major health problems in Kenya. We conducted a study on the effects of post-basic psychiatric training on nurses

We surveyed the phytoseid mites in four different geographical zones of Kenya: Zone I, upper highland and tropical alpine (2400-4400m): Zone II, lower highland (1800-2400m); zone III, midland (800-1800m); Zone IV, tropical, hot and humid( 0-800m ). A total of 107 species was found. In the sub family, amblyseeinae there were 14 species in the genus Neoseilus , one in Aspereroseius Chant, one in Paraphytoseius Swirski &Schechter, five in typhlodromips De Leon, five in Transeius Chant & McMurty, one in Graminaseius Chant &McMurty, 11 in Amblyseius Berlese, one in Arrenoseius Wanstein, two in Typhlodromalus muma, seven in Ueckemannseius Chant &McMurty, one in Ambylodromalus Chant &Mcmurty,, 20 in Euseius Wanstein, one in Iphiseius Berlese, one in Phytoseilus Evans and one in Gynaseius Ehara & Imano. In the subfamily Phytoseiinae Berlese there were four species in the genus Phytoseiius Ribaga. In the subfamily Typhlodrominae Wanstein, there were four species in the genus Kuzinellus Wainstein and 27 in Typhlodromus Scheuten

We surveyed the phytoseid mites in four different geographical zones of Kenya: Zone I, upper highland and tropical alpine (2400-4400m): Zone II, lower highland (1800-2400m); zone III, midland (800-1800m); Zone IV, tropical, hot and humid( 0-800m ). A total of 107 species was found. In the sub family, amblyseeinae there were 14 species in the genus Neoseilus , one in Aspereroseius Chant, one in Paraphytoseius Swirski &Schechter, five in typhlodromips De Leon, five in Transeius Chant & McMurty, one in Graminaseius Chant &McMurty, 11 in Amblyseius Berlese, one in Arrenoseius Wanstein, two in Typhlodromalus muma, seven in Ueckemannseius Chant &McMurty, one in Ambylodromalus Chant &Mcmurty,, 20 in Euseius Wanstein, one in Iphiseius Berlese, one in Phytoseilus Evans and one in Gynaseius Ehara & Imano. In the subfamily Phytoseiinae Berlese there were four species in the genus Phytoseiius Ribaga. In the subfamily Typhlodrominae Wanstein, there were four species in the genus Kuzinellus Wainstein and 27 in Typhlodromus Scheuten

Group cognitive conflicts occur when a learner in a collaborative mobile learning environment becomes aware of a discrepancy between his/her existing cognitive framework and new information or experience. The cognitive conflicts stimulate the learning process by making an individual to move from his/her learning sphere and participate with others in the learning process. However, there is a big challenge on how students handle and resolve conflicts during collaborative learning. Intelligent agents have been used in this paper to provide support for group interactions by regulating the group conflicts. An experimental design with one control group and two experimental groups (role playing and guided negotiation) is used to compare levels of group knowledge construction. The findings showed improved levels of knowledge construction where regulated conflicts were used compared to where they were not used.

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.

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Fourteen patients received oral premedication of temazepam in soft gelatin capsules before minor surgery. The plasma concentrations of temazepam and its sedative, anxiolytic and amnesic effects were measured for 24 hours. Absorption was rapid and peak concentrations occurred 49 minutes after administration. Clinical effects were evident at 30 minutes and persisted for about 4 hours. The decline in plasma concentration was biexponential with a distribution half-life of 1.24 hours. The end of the distribution phase coincided approximately with the termination of its clinical effects. A relationship between plasma concentration and effect was observed; concentrations above 300 ng/ml produced measurable changes in tests of mental function. Patients had recovered fully from the effects of temazepam after 24 hours. This dose of temazepam is reliable and effective as premedication before surgery

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1. A new procedure is described for selecting nitrogenase-derepressed mutants based on the method of Brenchley et al. (Brenchley, J.E., Prival, M.J. and Magasanik, B. (1973) J. Biol. Chem. 248, 6122-6128) for isolating histidase-constitutive mutants of a non-N2-fixing bacterium. 2. Nitrogenase levels of the new mutants in the presence of NH4+ were as high as 100% of the nitrogenase activity detected in the absence of NH4+. 3. Biochemical characterization of these nitrogen fixation (nif) derepressed mutants reveals that they fall into three classes. Three mutants (strains SK-24, 28 and 29), requiring glutamate for growth, synthesize nitrogenase and glutamine synthetase constitutively (in the presence of NH4+). A second class of mutants (strains SK-27 and 37) requiring glutamine for growth produces derepressed levels of nitrogenase activity and synthesized catalytically inactive glutamine synthetase protein, as determined immunologically. A third class of glutamine-requiring, nitrogenase-derepressed mutants (strain SK-25 and 26) synthesizes neither a catalytically active glutamine synthetase enzyme nor an immunologically cross-reactive glutamine synthetase protein. 4. F-prime complementation analysis reveals that the mutant strains SK-25, 26, 27, 37 map in a segment of the Klebsiella chromosome corresponding to the region coding for glutamine synthetase. Since the mutant strains SK-27 and SK-37 produce inactive glutamine synthetase protein, it is concluded that these mutations map within the glutamine synthetase structural gene.

Rhizobium strains of the cowpea group did not lose viability readily when added to soil, but Bdellovibrio acting on these rhizobia were found in 32 of 90 soils examined. Bdellovibrio did not initiate replication in liquid media at low host densities, but it did multiply once the Rhizohium numbers increased through growth to about 108 ml−1. From about 104 to 6 × 105 ml−1Rhizohium cells survived attack by the parasites in liquid media. In nutrient-free buffer, no significant increase in vibrio abundance was evident if the rhizobial frequency was low. whereas Rhizobium populations containing 6 × 108 cells ml−1 were lysed rapidly. Bdellovibrio did not multiply when introduced into sterile soil with small numbers of the host, but it replicated when the rhizobia were abundant because of the latter's use of soil organic matter for growth or because of the deliberate addition of 108Rhizohium g−1. Nevertheless, the host persisted in such vibrio-rich soil samples. The abundance of indigenous bdellovibrios increased appreciably in nonsterile soil if the rhizobia were introduced in large but not small numbers. It is suggested that a major reason for the lack of elimination of the host population in soil by its parasites is the need for a critical host cell frequency, large Rhizobium numbers being required for Btiellovibrio to initiate replication and low numbers of surviving hosts no longer being able to support the parasite.

Cerebral venous sinus thrombosis is an uncommon yet potentially life threatening condition which is often under-diagnosed or misdiagnosed because of the variability of the clinical signs and symptoms. The imaging findings are often subtle thus the need for a high index of suspicion. The superior sagittal and transverse sinuses are the most frequently involved. The correct diagnosis of cerebral venous thrombosis relies on neuroimaging studies. The two cases reported highlight the fact that the radiologist may be the first clinician to suspect and diagnose this condition. This ultimately affects prognosis as early diagnosis and treatment reduces morbidity and mortality.

Cerebral venous sinus thrombosis is an uncommon yet potentially life threatening condition which is often under-diagnosed or misdiagnosed because of the variability of the clinical signs and symptoms. The imaging findings are often subtle thus the need for a high index of suspicion. The superior sagittal and transverse sinuses are the most frequently involved. The correct diagnosis of cerebral venous thrombosis relies on neuroimaging studies. The two cases reported highlight the fact that the radiologist may be the first clinician to suspect and diagnose this condition. This ultimately affects prognosis as early diagnosis and treatment reduces morbidity and mortality.

Cerebral venous sinus thrombosis is an uncommon yet potentially life threatening condition which is often under-diagnosed or misdiagnosed because of the variability of the clinical signs and symptoms. The imaging findings are often subtle thus the need for a high index of suspicion. The superior sagittal and transverse sinuses are the most frequently involved. The correct diagnosis of cerebral venous thrombosis relies on neuroimaging studies. The two cases reported highlight the fact that the radiologist may be the first clinician to suspect and diagnose this condition. This ultimately affects prognosis as early diagnosis and treatment reduces morbidity and mortality.

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

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A 17 year old male patient with nodular sclerosis Hodgkin's disease had a relapse of lymphocyte depleted type ten years after entering complete remission with chemotherapy and radiotherapy. This is the first documented case in our experience of relapse after very long disease free interval. A review of the literature of late relapses in Hodgkin's disease is also presented. Relapses have been recorded from three years to twenty years, although few very late forms are registered. Long term follow up will be necessary to document the role of the different therapeutic regimen.

Prior to the acquired immunodeficiency syndrome (AIDS) epidemic, one or two cases of adult Burkitt's lymphoma (BL) were seen annually at the Kenyatta National Hospital, the national referral medical center in Nairobi, Kenya. To investigate the influence of human immunodeficiency virus (HIV) infection in adult BL in Kenya, we conducted a national prevalence survey of all patients 16 years of age and older with BL. A systematic review of medical records of all patients diagnosed with BL between 1992 and 1996 was performed. The diagnosis of BL was based and confirmed on review of pathological material from time of original diagnosis. HIV serology was confirmed by enzyme-linked immunosorbent assay (ELISA). Twenty-nine adult patients with BL were identified during the 5-year study period. Of these patients, 17 (59%) were males, 12 (41%) were females, and the median age was 26 years. Nineteen patients (66%) with BL were HIV-seropositive. The proportion of men was similar in HIV-seropositive and -seronegative patients (58% vs 60%). HIV-seropositive BL patients were significantly older than seronegatives (median 35 vs 19.5 years, p < 0.001). HIV-seropositive patients uniformly presented with constitutional or B symptoms and advanced BL accompanied by diffuse lymph node involvement, whereas the clinical presentation of HIV-seronegative patients during this time period was reminiscent of the "typical" endemic pattern of disease with complete sparing of peripheral lymph nodes. The overall survival of HIV-seropositive cases was significantly worse than that of the HIV-seronegative cases; median survival in the HIV-seropositive patients was 15 weeks. There is an approximate 3-fold increase in the incidence of adult BL during the time period of this study, which is attributable to the AIDS epidemic. In this setting, patients often present with disseminated disease, diffuse peripheral lymphadenopathy and fever, the latter two of which heretofore have been commonly associated with non-lymphoproliferative disorders such as Mycobacterium tuberculosis and sexually transmitted diseases in Kenya. These observations warrant inclusion of AIDS-related BL in the differential diagnosis of the adult patient with unexplained fever and lymphadenopathy in Kenya. The corollary is that HIV infection is virtually excluded in an adult patient without peripheral lymphadenopathy and biopsy-proven BL. Copyright 2001 Wiley-Liss, Inc.

Serum levels for sodium, potassium, calcium, inorganic phosphate, urea nitrogen and creatinine were determined in 1101 male and 181 female patients aged 50 years and above. The determinations were carried out on the SMA II (Technicon Instruments Corp. Tarrytown, NY 10591) with a view to establish the reference intervals for this age group. Quality control of the analytical methods was carried alongside with the determinations. The data collected was used to determine the reference intervals using a simple statistical method. The results indicate that sodium and calcium intervals are low with values of 131-142 mMol/L and 1.94-2.32 mMol/L respectively, in the aged Kenyan population as compared to subjects living in the temperate environment while the interval for inorganic phosphate is comparatively high with a value of 1.2-1.97 mMol/L. Reference values for urea nitrogen, potassium and creatinine were found to be similar to those quoted for caucasians.

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The external laryngeal nerve runs parallel to superior thyroid artery and later crossing the artery either above or below the upper pole of the thyroid gland. This relatively high anatomic variability demonstrates inter-population differences. However, datum among the Kenyan population is lacking. Knowledge of normal and variant anatomy of these structures is important in surgical procedures within the neck. This study therefore aimed at describing the variant anatomical relations of the superior thyroid artery and external laryngeal nerve for the Kenyan population. Twenty formalin fixed cadavers obtained from the Department of Human Anatomy, University of Nairobi were dissected to expose the thyroid gland, superior thyroid artery and external laryngeal nerve. The relation of the superior thyroid artery to the external laryngeal nerve was noted. The external laryngeal nerve crossed the superior thyroid artery within 1cm above the upper pole of the thyroid gland in 25% of cases and more than 1 cm in 75% of cases. The level at which the external laryngeal nerve crosses the superior thyroid artery displays variations among Kenyans warranting care during surgical procedures of the thyroid gland.

The spinal accessory nerve (SAN) exhibits variant anatomy in its relation to the internal jugular vein (IJV) as well as the sternocleidomastoid muscle (SCM). These variations are important in locating the nerve during surgical neck procedures to avoid its inadvertent injury. These variations, however, are not conserved among different populations and data from the Kenyan setting are partly elucidated. This study, therefore, aims to determine the variant anatomical relationship of the SAN to the SCM and IJV in a select Kenyan population. Forty cadaveric necks were studied bilaterally during routine dissection and the data collected were analyzed using SPSS version 21. Means and modes were calculated for the point of entry of the SAN into the posterior triangle of the neck as well as for its relation to the SCM. Side variations for both of these were analyzed using Student's t -test. Data relating the SAN to the IJV were represented in percentages and side variations were analyzed using the chi-square test. The SAN point of entry into the posterior triangle of the neck was 5.38 cm (3.501-8.008 cm) on the left side and 5.637 cm (3.504-9.173 cm) on the right side ( p  = 0.785) from the mastoid process. The nerve perforated the SCM in four cases (10%) on the left side and in eight cases (20%) on the right ( p  = 0.253). The SAN lay predominantly medial to the IJV on both sides of the neck, 87.5% on the left side of the neck versus 82.5% on the right ( p  = 0.831). In conclusion, the variant relation of the SAN to the IJV and SCM as observed in this setting is an important consideration during radical neck procedures and node biopsies.

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Banking agents are usually equipped with a combination of point-of-sale (POS)card reader, mobile phone, barcode scanner to scan bills for bill payment transactions, Personal Identification Number(PIN) pads, and sometimes personal computers (PCs) that connect with the bank’s server using a personal dial-up or other data connection. This research used the descriptive design method using secondary data gathered from the commercial banks in Kenya that had adopted agency banking in Kenya. The population of the study was the 10 commercial banks in Kenya that had adopted agency banking by the end of 2012 namely Equity Bank, Co-operative Bank, KCB Bank, Post Bank, Family Bank, Chase Bank ,Consolidated Bank, Diamond Trust Bank, Citibank and NIC Bank. Annual reports on individual banks’ financial performance were used to extract financial performance indicators. CBK’s annual report and supervisory reports were also used to establish the number of agents registered and the total transactional value conducted through the agents. The variable of interests were the cash withdrawal and deposit transactions done through agents, number of active agents, return on assets, cost to income ratio and staff cost to revenue ratio.
JEL classification numbers: G24
Keywords: Agency Banking, Financial Performance and Kenya.

Banking agents are usually equipped with a combination of point-of-sale (POS)card reader, mobile phone, barcode scanner to scan bills for bill payment transactions, Personal Identification Number(PIN) pads, and sometimes personal computers (PCs) that connect with the bank’s server using a personal dial-up or other data connection. This research used the descriptive design method using secondary data gathered from the commercial banks in Kenya that had adopted agency banking in Kenya. The population of the study was the 10 commercial banks in Kenya that had adopted agency banking by the end of 2012 namely Equity Bank, Co-operative Bank, KCB Bank, Post Bank, Family Bank, Chase Bank ,Consolidated Bank, Diamond Trust Bank, Citibank and NIC Bank. Annual reports on individual banks’ financial performance were used to extract financial performance indicators. CBK’s annual report and supervisory reports were also used to establish the number of agents registered and the total transactional value conducted through the agents. The variable of interests were the cash withdrawal and deposit transactions done through agents, number of active agents, return on assets, cost to income ratio and staff cost to revenue ratio. JEL classification numbers: G24
Keywords: Agency Banking, Financial Performance and Kenya.

Department of Orthopaedic Surgery, College of Health Sciences, University of Nairobi, Kenya. A case report is presented of a 53 year old man who presented with posterior dislocation of the hip after a road traffic accident. Initial management by closed reduction failed due to presence of an occult free intra-articular fragment. This fragment was not visualised on plain A-P and lateral X-ray views. The cause of the failed closed reduction was eventually detected by CT scan. Open reduction and removal of the bone fragment was done and the hip remained stable thereafter. It is concluded that plain X-rays are not adequate in the diagnosis of free intra-articular bone fragments within the hip joint and CT scanning is advised for accurate detection of such occult bine fragments.

Literature provides conflicting results on the relationship between corporate social responsibility (CSR) practice and firm financial performance with some studies showing a positive relationship (Waddock & Graves, 1997; Cheruiyot, 2010), others negative (Cordeiro & Sarkis, 1997; Wagner et al, 2002) and still others showing that there is no relationship between the two variables (McWilliams & Siegel, 2000; Aragon & Lopez, 2007). It is with this background that this study sought to establish the relationship between corporate social responsibility practice and financial performance of firms listed in the manufacturing, construction and allied sector of the Nairobi Securities Exchange. Although the study was meant to be a census survey, non-availability of complete data for some of the companies resulted in only 10 out of the 14 companies in the sector being studied. Secondary data was obtained from the audited financial reports of the companies for the period from 2007 to 2011. Corporate social responsibility score was obtained using content analysis of reports of the companies on various components of corporate social responsibility as reported in their audited financial reports. A multiple regression model was established to determine the relationship between the two variables. Control variables of manufacturing efficiency and capital intensity were also introduced in the regression model. The results indicated the existence of a relationship between the independent variables (corporate social responsibility score, manufacturing efficiency and capital intensity) used in the model and the dependent variable (return on assets) with a correlation coefficient of 0.870. The results of the study also showed that there was an insignificant positive relationship between corporate social responsibility practice and financial performance. Financial performance and manufacturing efficiency was found to have a significant linear inverse relationship.

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To date, there is no research on voluntary medical male circumcision (VMMC) catchment areas or the relationship between distance to a VMMC facility and attendance at a post-operative follow-up visit. We analyzed data from a randomly selected subset of males self-seeking circumcision at one of 16 participating facilities in Nyanza Province, Kenya between 2008 and 2010. Among 1437 participants, 46.7 % attended follow-up. The median distance from residence to utilized facility was 2.98 km (IQR 1.31-5.38). Nearly all participants (98.8 %) lived within 5 km from a facility, however, 26.3 % visited a facility more than 5 km away. Stratified results demonstrated that among those utilizing fixed facilities, greater distance was associated with higher odds of follow-up non-attendance (OR5.01-10km vs. 0-1km = 1.71, 95 % CI 1.08, 2.70, p = 0.02; OR>10km vs. 0-1 km = 2.80, 95 % CI 1.26, 6.21, p = 0.01), adjusting for age and district of residence. We found 5 km marked the threshold distance beyond which follow-up attendance significantly dropped. These results demonstrate distance is an important predictor of attending follow-up, and this relationship appears to be modified by facility type.

Purpose-This study was carried out with an aim to analyze the effect of
diversification strategies on capital structure of non-financial firms listed at NSE. The
study focused specifically on analyzing the effect of product (related and unrelated)
and geographical diversification on capital structure.
Methodology-An exploratory study design was used to collect data, with the
population of the study being 64 firms listed in NSE. Out of the 64 firms, 41 non-
financial firms were selected as the sample of the study. Data was collected from
secondary sources, NSE and capital market authority. Data collected was analyzed
through STATA by the use of panel data regression analysis.
Findings- Related product diversification had a coefficient of 21.5(p-value=0.007)
indicating that it has a significant relationship with capital structure. The study results
show that debt is the most preferred form of financing in related product
diversification strategies. Unrelated product diversification had a coefficient of 22.7(p
value =0.006) indicating that it has a significant relationship with capital structure.The
findings of this study show that debt is the most preferred form of financing in
unrelated product diversification strategies. Geographical diversification had a
coefficient of 0.178 (p-value=0.799) indicating that it doesn’t have a significant
relationship with capital structure.Geographical diversification boosts the worth of
shareholders by taking advantage of specific assets and by accelerating functioning

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