Department of Periodontology/ Community and Preventive Dentistry, School of Dental Sciences, University of Nairobi, P.O. Box 19676 - 00202, Nairobi, Kenya. OBJECTIVE: To determine the influence of oral hygiene habits and practices on the risk of developing oral leukoplakia. DESIGN: Case control study. SETTING: Githongo sublocation in Meru District. SUBJECTS: Eighty five cases and 141 controls identified in a house-to-house screening. RESULTS: The relative risk (RR) of oral leukoplakia increased gradually across the various brushing frequencies from the reference RR of 1.0 in those who brushed three times a day, to 7.6 in the "don't brush" group. The trend of increase was statistically significant (X2 for Trend : p = 0.001). The use of chewing stick as compared to conventional tooth brush had no significant influence on RR of oral leukoplakia. Non-users of toothpastes had a significantly higher risk of oral leukoplakia than users (RR = 1.8; 95% confidence levels (CI) = 1.4-2.5). Among tobacco smokers, the RR increased from 4.6 in those who brushed to 7.3 in those who did not brush. Among non-smokers, the RR of oral leukoplakia in those who did not brush (1.8) compared to those who brushed was also statistically significant (95% CL = 1.6-3.8). CONCLUSION: Failure to brush teeth and none use of toothpastes are significantly associated with the development of oral leukoplakia, while the choice of brushing tools between conventional toothbrush and chewing stick is not. In addition, failure to brush teeth appeared to potentiate the effect of smoking tobacco in the development of oral leukoplakia. Recommendations: Oral health education, instruction and motivation for the improvement of oral hygiene habits and practices; and therefore oral hygiene status, should be among the strategies used in oral leukoplakia preventive and control programmes.

The removal of arsenate and arsenite from drinking water poses challenges, especially when arsenite is present in a significant amount. The removal of arsenite by K(2)FeO(4), K(2)FeO(4)/FeCl(3), and K(2)FeO(4)/AlCl(3) salts was studied at pH 6.5 and at an initial As concentration of 500 microg As(III)L(-1). The arsenite removal in Fe(VI)/Fe(III) and Fe(VI)/Al(III) systems was also examined as a function of pH (6.0-8.0). Arsenite was first oxidized by Fe(VI) to arsenate, which was subsequently removed through adsorption by Fe(III) or mixed Fe(III)-Al(III) oxy/hydroxide phases. Fe(VI)/Al(III) salts had higher removal efficiency of arsenite than Fe(VI) and Fe(VI)/Fe(III) salts. A molar ratio of 6(3/3):1 for Fe(VI)/Al(III) to As(III) decreased arsenite concentration from 500 to 1.4 microg L(-1) at pH 6.5. Arsenite removal increased with a decrease in pH from 8.0 to 6.0 and exhibited less pH dependence in the Fe(VI)/Al(III) system than in the Fe(VI)/Fe(III) system. Aluminum chloride salts performed better than FeCl(3) and FeCl(3)/AlCl(3) salts (Fe:Al=1:1) in removing As(V) from water. Effect of anions (phosphate, silicate, bicarbonate, nitrate, and sulfate) on the arsenite removal by Fe(VI)/Al(III) salts at pH 6.5 was examined. Phosphate, silicate, and bicarbonate ions interfered with the removal of arsenite in water. Nitrate and sulfate had none to minimal effect on arsenite removal. Fe(VI)/Al(III) salts showed a potential for removing arsenite below the current drinking water standard (10 microg L(-1)).

The removal of deciduous canine tooth buds in early childhood is a practice that has been documented in Kenya and in neighboring countries. This paper describes the occurrence, rationale and method of this practice amongst rural Kenyan Maasai. In a group of 95 children aged between six months and two years, who were examined in 1991/92, 87% were found to have undergone the removal of one or more deciduous canine tooth buds. In an older age group (3-7 years of age), 72% of the 111 children examined exhibited missing mandibular or maxillary deciduous canines. It was found that the actual removal of a deciduous tooth bud is often performed by middle-aged Maasai women who enucleate the developing tooth using a pointed pen-knife. There exists a strong belief among the Maasai that diarrhoea, vomiting and other febrile illnesses of early childhood are caused by the gingival swelling over the canine region, and which is thought to contain 'worms' or 'nylon' teeth. The immediate and long-term hazards of this practice include profuse bleeding, infection and damage to the developing permanent canines. A multi-disciplinary approach involving social anthropologists in addition to dental and medical personnel, is recommend in order to discourage this harmful operation that appears to be on the increase

Description

Heavy metals’ discharge into the environment continues to pose grave concerns around the world. The efficacy of a hydrous alumino-silicate clay (AlSiM) coming obtained from some regions of Kenya to sorb heavy-metal ions from water has been evaluated in batch tests taking into account changes in adsorbent dose, pH, contact time, and temperature. Complete metal removals, from water containing up to 66 mg/L of Pb (II) was achieved using this material at pH value of 5 over a temperature range of 289–333 K. The adsorption data fitted both the Langmuir and the Dubinin-Radushkevich isotherms with R 2> 0.99. The DR adsorption energy (− 11.7 kJ/mol) indicated that chemisorption was the primary reaction in the adsorption process and the derived∆ G 0 value (− 7.45 kJ/mol) was consistent with the spontaneity of the adsorption process. The kinetic analyses indicated a film-diffusion and surface-chemisorption controlled process. Verification of the initial results on heavy metals-containing wastewaters obtained from a tannery and a leather processing industries revealed excellent adsorption efficacies of AlSiM for Cr 3+(99− 100%), Fe 3+(96− 98%), Mn 2+(85− 97%) and Zn 2+(78− 86%). The use of AlSiM as a plausible low-cost adsorbent for heavy-metal decontamination of industrial effluents has therefore been demonstrated.

Description
Heavy metals’ discharge into the environment continues to pose grave concerns around the world. The efficacy of a hydrous alumino-silicate clay (AlSiM) coming obtained from some regions of Kenya to sorb heavy-metal ions from water has been evaluated in batch tests taking into account changes in adsorbent dose, pH, contact time, and temperature. Complete metal removals, from water containing up to 66 mg/L of Pb (II) was achieved using this material at pH value of 5 over a temperature range of 289–333 K. The adsorption data fitted both the Langmuir and the Dubinin-Radushkevich isotherms with R 2> 0.99. The DR adsorption energy (− 11.7 kJ/mol) indicated that chemisorption was the primary reaction in the adsorption process and the derived∆ G 0 value (− 7.45 kJ/mol) was consistent with the spontaneity of the adsorption process. The kinetic analyses indicated a film-diffusion and surface-chemisorption controlled process. Verification of the initial results on heavy metals-containing wastewaters obtained from a tannery and a leather processing industries revealed excellent adsorption efficacies of AlSiM for Cr 3+(99− 100%), Fe 3+(96− 98%), Mn 2+(85− 97%) and Zn 2+(78− 86%). The use of AlSiM as a plausible low-cost adsorbent for heavy-metal decontamination of industrial effluents has therefore been demonstrated.

Background: The outcome of live kidney donation has been of concern since the recognition of hyperfiltration
injury post live kidney donation.
Studies on the topic have arrived at different conclusions regarding kidney function following live kidney
donation; some suggest the possibility of renal progression while others report renal function similar to that of
the general population. However, there are no studies done in a homogeneously African population to compare
with.
Beginning the year 2010 at Kenyatta National Hospital, Kenya, live kidney donation happened regularly with
an average of two live related kidney donation and transplantation per month.
The purpose of this study was to assess the impact of renal donation on renal function of live kidney donors at
Kenyatta national hospital.
Objective: To determine serum creatinine levels, eGFR, prevalence of proteinuria, and hypertension among
living kidney donors at Kenyatta National Hospital.
Study design: Cross-sectional descriptive study
Methods: Using a questionnaire, a targeted history was obtained from kidney donors. A venous blood sample
was drawn for serum creatinine measurement from which an eGFR was calculated using Cockroft-Gault
equation. A sample of urine was collected from which proteinuria was determined using a standard urinary dip
stick. Furthermore, blood pressure, height and weight were measured followed by the determination of the body
mass index of the study subjects. Patient’s pre-nephrectomy records were reviewed and blood pressure, weight,
height, serum creatinine levels were recorded. Their body mass index and estimated glomerular filtration rate
pre-nephrectomy was then calculated. The prevalence of hypertension and proteinuria was expressed as
proportions. Using a paired student’s t-test, mean changes for serum creatinine, estimated glomerular filtration
rate, diastolic blood pressure and systolic blood pressure were determined. Statistical significance was pegged
at P-value of <0.05.
Results: A total of 52 subjects were enrolled in the study. The mean (± standard deviation) estimated
glomerular filtration rate post-nephrectomy was 79.96mls/min/M² (± 31.95mls/min/M²) which transformed to
85.62% of the pre-nephrectomy estimated glomerular filtration rate. The prevalence of proteinuria, and
hypertension was 21.2% and 9.6% respectively. New onset hypertension was 6%. 40% of the subjects were
either overweight or obese. There was a significant mean change for serum creatinine, estimated glomerular
filtration rate and diastolic blood pressure when pre-neprectomy and post-nephrectomy values were compared
with p values of <0.0001, 0.002 and 0.008 respectively.
Conclusion: At the mean duration of follow up of 15.9 months, the kidney donors studied regained their renal
function with a tendency towards hyperfiltration. The prevalence of proteinuria and hypertension was low. The
results of the study compared well with those obtained from other studies.

OBJECTIVE: To evaluate the use of medical therapy in the management of patients with mild, moderate and severe symptoms of benign prostatic hyperplasia. DESIGN: Prospective study. SETTING: Private urology clinic in Mater Hospital, Nairobi between 1995 and 2005. PATIENTS: Six hundred and eighty patients with benign prostatic hypertrophy aged 50-80 years. RESULTS: Two hundred and eighty (43.8%) patients benefited from the drug treatment alone and were released from the clinic follow up after five years. Two hundred and seventy (42.2%) cases could not complete the five years follow up on drugs alone due to symptoms recurrence or severity or unavailability of drugs. They were removed from the drugs alone treatment and put on other interventions. Ninety (15.9%) cases were operated on based on their decision and insistence or severity of their symptoms or no drugs response. CONCLUSIONS: This observational study confirms that medical treatment is beneficial in the management of benign prostatic hyperplasia (BPH) and is cheap and gives better first line option of treatment choice to many patients. It also gives hopes to the surgical risk patients. The quality of life (QOL) of patients and their family disturbance is also improved.

OBJECTIVES: To provide an overview of the various advancements and problems associated with both live and cadaver donor renal allograft transplantation during the twentieth century.
DATA SOURCE: Major published reviews on renal transplantation during the the last five decades of the twentieth century were reviewed using Medline internet search and the Index Medicus. The developments in immunosuppressive therapy associated with renal transplantation, the problem of the shortage of both live and cadaveric organ donors and post-transplant complications were examined. The future of renal transplantation including cross species transplantation (xenotransplantation) is discussed.
CONCLUSION: Renal transplantation has evolved over the years to become a very successful and routine procedure. However, the transplant waiting lists have remained long due to a continuously shrinking kidney donor pool which is due to improved results of neurosurgical procedures, better emergency and intensive care services and the failure to adequately prevent and treat post transplant chronic renal failure.

To provide an overview of the various advancements and problems associated with both live and cadaver donor renal allograft transplantation during the twentieth century. DATA SOURCE: Major published reviews on renal transplantation during the the last five decades of the twentieth century were reviewed using Medline internet search and the Index Medicus. The developments in immunosuppressive therapy associated with renal transplantation, the problem of the shortage of both live and cadaveric organ donors and post-transplant complications were examined. The future of renal transplantation including cross species transplantation (xenotransplantation) is discussed. CONCLUSION: Renal transplantation has evolved over the years to become a very successful and routine procedure. However, the transplant waiting lists have remained long due to a continuously shrinking kidney donor pool which is due to improved results of neurosurgical procedures, better emergency and intensive care services and the failure to adequately prevent and treat post transplant chronic renal failure.

No abstract available

A 30 year old female with an unexpected right adrenal phaechromacytoma invading the renal vein, the inferior vena cava and extending into the right atrium is presented. She also had BuddChiari syndrome due to invasion of the hepatic veins by the tumour. Additionally, the tumour had metastasised to the liver and the lungs. Despite elevated 24 hour urinary vanillylmandelic acid (VMA) the patient was normotensive pre-operatively. The patient underwent right adrenalectomy and extended nephrectomy with milking of the tumaur from the inferior vena cava. Unfortunately, the patient developed multiple hypotensive episodes and adult respiratory distress syndrome post-operatively and died three weeks after surgery.

Spectrophotometric measurements of photoreceptors 1–6 in the blowfly demonstrate that rhodopsin undergoes a continuous renewal. This involves, in the dark, the slow degradation of rhodopsin whereas metarhodopsin is degraded at a much faster rate. The effect of light is to reduce the rate at which metarhodopsin is degraded, i.e. the rate is inversely related to the intensity of the light. Rhodopsin synthesis is dependent on the presence of 11-cis retinal which is formed via a photoreaction from all-trans retinal resulting from the breakdown of rhodopsin and/or metarhodopsin: the biosynthesis of rhodopsin is therefore a light dependent process. Light of the blue/violet spectral range was found to mediate the isomerization of all-trans retinal into the 11-cis form. It is proposed that this stereospecificity is the result of all-trans retinal being bound to a protein. On the basis of the results a visual pigment cycle is proposed.

This study analyzes the effects of reparameterization of autoregressive distributed lag (ARDL) to vector error correction model (VECM) through cointegration of time series. It further verifies the effects of macroeconomic shocks on youth unemployment in Kenya using VECM. First, the unit root test has been done on youth unemployment (YUN), gross domestic product (GDP), external debt (ED), foreign direct investment (FDI), private investment (PI), youth literacy level (LR), and youth population (POP) to verify stationarity. The Johansen Cointegration Test has been employed and revealed three long run relationships which can be interpreted as a GDP effect, External Debt effect and Foreign Direct Investment effect relations. A structural VECM has been described through restrictions derived from the Cointegration Analysis. Based on the results of the Impulse-Response Function analysis and variance decomposition analysis of the Structural VECM, it is concluded that GDP, literacy level, population, Private Investment, External and FDI shocks have significant effects on Kenyan youth unemployment in the long run. Based on the results of the Impulse-Response Function and variance decomposition analyses of the Structural VECM, it is concluded that GDP, literacy level, population, and FDI shocks have significant effects on Kenyan youth unemployment in the long run. Whereas population, external debt, private investment, and GDP have positive effects, foreign direct investment and literacy rate have negative effects on youth unemployment in the long run. The results provide a statistical basis for assessing and prioritising investment policies and …

The use of unclaimed bodies for anatomical dissection has been the main method of instruction at our institution. There is however a shortage of cadavers for dissection given the increase in the number of medical schools as well as in the number of students enrolling in these schools. This shortage could be mitigated by having voluntary human body donation programs. This study aimed at assessing the attitudes of medical students and surgical residents towards body donation for anatomy learning. We conducted an online survey involving 72 first-year medical students and 41 surgical residents at University of Nairobi who had completed one year of anatomy dissection. For the medical students, this was their first dissection experience while it was the second exposure for the surgery trainees. Most of the surgical trainees (70.7%) and medical students (68.1%) were opposed to self-body donation. This was mainly due to cultural (37%) and religious (20%) barriers. Surprisingly, of those not willing to donate themselves, 67.9% (82.8% surgical trainees, 59.2% medical students) would recommend the practice to other people. Exposure to repeated dissection does not change the perceptions towards body donation. It is noteworthy that culture and religion rank high as clear barriers amongst this "highly informed" group of potential donors.

Introduction to Philosophy of Religion, University of Nairobi, 1988

This article brings to notice the existence of a Late Stone Age (LSA) archaeological site in the Kinugi area near Naivasha, Kenya. Although no excavations were done, a brief survey of the site was undertaken and exposed surface material collected for examination. Results of the examination, in addition to information on the general surrounding environment at the site are presented.

This book is an epic account of life, touching on diverse facets of existence with the Buddhist answers to the riddles of life and those provided by modern science towards the same or similar riddles. In this book, Ikeda catches and conveys to us the impression that living a fulfilling life is attainable, and that the splendour of living such a life has an immutable value that transcends the bounds of the physical death. Fleeting between the past, present and a possible future, the book wrestles with the giant headaches of humankind through a systematic explication of the nature of the cosmos and life, the Buddhist view of life, and the question of life and death. All this is done with the exactitude of a physician carrying out a heart surgery, and with the eloquence of a young man wooing a fair maid. On the whole, the book reduces the recurrent headaches of man to quite curable ailments, no more serious than the common cold or constipation. With respect to the nature of the cosmos and life, the author sinks his teeth into such concepts as the body and the spirit, man and nature, eyes that can see life, the riddle of time and the essence of the cosmos. On the body and the spirit, the author addresses first and foremost, the strange phenomenon of life as it manifests itself in empirical situations

AIM: To evaluate the intraobserver and interobserver reproducibility of macular retinal ganglion cell-inner plexiform layer (GC-IPL) thickness measurement by automated detection on Optical Coherence Tomography (OCT) images in normal, hypertensive (ocular hypertensive (OHT)) and glaucomatous eyes. METHODS: A total of 138 eyes were enrolled in three groups: 69 normal, 35 OHT and 34 primary open-angle glaucoma eyes. All patients underwent a complete ocular examination, 24-2 automated perimetry, biometry and pachymetry. Macular imaging was performed in each eye using the Cirrus HD-OCT 4000 with software V.6.0. (Carl Zeiss Meditec, Dublin, California, USA) three times on the same day by each of two observers, and the GC analysis (GCA) algorithm provided parameters expressed as average, minimum and six sectoral GC-IPL thicknesses. Reproducibility was assessed by intraclass correlation coefficient (ICC), coefficient of variation (CV) and test-retest variability (TRTV) calculated as 1.96 times the SD. RESULTS: Mean GC-IPL thickness was 82.27±7.37 μm, 76.84±7.01 μm and 66.16±11.16 μm in normal, OHT and glaucoma groups, respectively. GC-IPL thickness was significantly lower in glaucomatous eyes than in normal and OHT eyes (p{\textless}0.0001 for all parameters). In all groups, ICC ranged from 96.4 to 99.9% and 92.5 to 99.8%, CV ranged from 0.41 to 2.24% and 0.55 to 1.67%, and TRTV ranged from 0.61 to 2.64 μm and 0.83 to 2.22 μm for intraobserver and interobserver reproducibility, respectively. CONCLUSIONS: To the best of our knowledge, this is the first study of GCA algorithm reproducibility in normal, OHT and glaucomatous eyes. The reproducibility of GC-IPL thickness measurements using the Cirrus HD-OCT GCA algorithm was found to be highly satisfactory. GC-IPL thickness may be a promising new OCT parameter for analysis of ganglion cell damage in glaucoma.

This study provided baseline performance of breeding pigs information on local sow productivity that was previously lacking. The objective was to investigate performance of breeding pigs in rural smallholder communities of Western Kenya. A random sample of 288 smallholder farms in Busia and Kakamega districts was selected pigs. The farms were visited three times in the course of the study period, 2006 to 2008. Data on management and productivity were gathered by means of questionnaires administered to sow owners. The average number of sows owned per farm was 1.3±0.6. Sows were bred for an average of 2.18±1.08 days during one estrus. Sows were 12.1±4.S months old when they farrowed for the first time. They were bred 1.9±1.6 month after piglets were weaned. Sources of breeding boars included borrowed boars from the neighbourhood (77%), farmers' own boars (14%), group-owned boars (0.4%) and those that were free roaming (2%). The average litter size was 7.8±2.6 while the average number weaned was 6.8±3.1. Piglets were weaned at S.4±3.3 weeks of age. Piglets were reportedly cheaper in Busia (USD 6.36±0.71) than they were in Kakamega (USD 9.71±2.18) (p

n/a

Department of Periodontology/ Community and Preventive Dentistry, School of Dental Sciences, University of Nairobi, P.O. Box 19676 - 00202, Nairobi, Kenya. OBJECTIVE: To determine the influence of oral hygiene habits and practices on the risk of developing oral leukoplakia. DESIGN: Case control study. SETTING: Githongo sublocation in Meru District. SUBJECTS: Eighty five cases and 141 controls identified in a house-to-house screening. RESULTS: The relative risk (RR) of oral leukoplakia increased gradually across the various brushing frequencies from the reference RR of 1.0 in those who brushed three times a day, to 7.6 in the "don't brush" group. The trend of increase was statistically significant (X2 for Trend : p = 0.001). The use of chewing stick as compared to conventional tooth brush had no significant influence on RR of oral leukoplakia. Non-users of toothpastes had a significantly higher risk of oral leukoplakia than users (RR = 1.8; 95% confidence levels (CI) = 1.4-2.5). Among tobacco smokers, the RR increased from 4.6 in those who brushed to 7.3 in those who did not brush. Among non-smokers, the RR of oral leukoplakia in those who did not brush (1.8) compared to those who brushed was also statistically significant (95% CL = 1.6-3.8). CONCLUSION: Failure to brush teeth and none use of toothpastes are significantly associated with the development of oral leukoplakia, while the choice of brushing tools between conventional toothbrush and chewing stick is not. In addition, failure to brush teeth appeared to potentiate the effect of smoking tobacco in the development of oral leukoplakia. Recommendations: Oral health education, instruction and motivation for the improvement of oral hygiene habits and practices; and therefore oral hygiene status, should be among the strategies used in oral leukoplakia preventive and control programmes.

There is a strong need for research capacity strengthening in developing countries. In this paper we present achievements and lessons learnt from a South-North collaboration. The collaboration is situated within the Kenyan-Danish Health Research Project (KEDAHR) which started in 1994 and lasted till 2004. A total of
41students (27 Kenyans and 14 Danish) undertaking studies at post-graduate and doctoral levels were involved over this period and more than 37 articles published in peer-reviewed journals and in edited books. In addition, there are other intangible benefits that have accrued over time.We conclude that the collaboration between the five institutions involved has been very productive. The focus on capacity development has led to a large pool of well trained anthropologists who are now forming a critical mass of expertise within which we expect future collaborations to be based.

Six cases of bovine papillomatosis were reported to the University of Nairobi veterinary clinic. Diagnosis was based on presented clinical signs and histopathology of affected skin lesions. The histological samples of the warts confirmed the diagnosis of papillomatosis. An autogenous formalin killed bovine specific wart vaccine was prepared from the wart samples and injected into four calves on day 0, 10 and 30, while two calves were left as undosed controls. The warts started regressing three weeks post vaccination and completely disappeared by the seventh week. This case represents a successfully management of a case of papillomatosis with a bovine specific autogenous vaccine

Conflict results from a combination of factors, which are intertwined and often deeply rooted in cultural traditions both within and between nations. Poverty is one of the underlying causes of conflict and also one of its consequences. The pastoralists in Isiolo struggle to survive on a fragile ecosystem, which is ravaged by drought, poverty, insecurity and seemingly endless conflict over resources. Given its deleterious effects on development, conflict in Isiolo continues to undermine the underlying resource base for sustainable production systems and the pastoralists' capacity to broaden their livelihoods thereby exacerbating rural poverty. All the actors involved in the Isiolo conflict prevention and resolution and poverty reduction strategies at different levels will underpin their efforts by strengthening governance and helping the local communities to diversify their livelihoods. To be sustainable, the various peace initiatives must be accompanied by a broad range of preventive development strategies, which promote increased access to productive resources by vulnerable groups, recognize the role of women in peace building and encourage peaceful settlement of disputes

Development planners in both the public and private sectors, especially those
interested in urban planning and development have now established a
consensus that different social structural processes could constitute both
driving shafts to stimulate urban development on the one hand, and also devastating
bottlenecks on the other. Peace and security are integral ingredients in establishing
an environment that is conducive to successful efforts in development project planning
and implementation. In this context, crime and street families are also viewed as
critical social structural features that require informed understanding, in order to
enhance security in Nairobi and its environs. This, in effect, contributes to creation
of a user-friendly information base for reference by urban-based development
stakeholders.
The stu.dy on which this paper is based, focused mainly on crir.e and street families
in the Eastlands area of Nairobi City, and in particular, the socio-demographic aspects
relating to crime. Beyond personal characteristics, efforts were made to establish the
residents' perception of crime, as well as causes of crime, characteristics of criminals,
commonest victims of crime, tolerance and management of crime. Other key variables
included the role and social credibility of those involved in controlling crime, and
other socio-economic activities undertaken by people on the streets.

Introduction to Philosophy of Religion, University of Nairobi, 1988