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

Settlement pattern studies are concerned with relics of human occupation in the past. In an archaeological record, these relics either appear in clusters or individually in the form of pestholes, house floors, house foundations or as middens. On aerial photographs and topographic maps relics of past human occupation can be identified by the presence of circular or rectangular depressional features and stunted vegetation cover in the midst of a flourishing vegetation community. Past human settlements can also be identified in actual field observation as ruins: building structures, walled fortresses, moats, monuments and mounds.

Irrespective of their nature and conditions of preservation, past settlements are a reflection of human behaviour through time and space. The archaeological evidence that is found preserved in them can shed much light on our knowledge of past culture. The essential archaeological problem in the analysis and interpretation of settlement, however, is that architectural remains and other settlement data cannot be understood simply by their description, distribution, cultural attribution and chronology - as they have been from the early anthropological work of Morgan (1881) and Mindeleff (1890) through the first large-scale regional archaeological syntheses, such as Childe's (e.g. 1934) in Europe and Willey (1953) in South America up to the common archaeological survey work of today.

With the influence of modern cultural ecology, geography and sociobiology, settle­ment analysis has been transformed into a concern with environmental and ecological processes. Settlements are part of a complex integration of culture and ecology within a regional environment. As a result, settlement analysis in archaeology must attend not only to the physical layout of the environment, but also to the social and historical aspects of environmental interaction.

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

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.

S.W. Guthua , D.L. Mwaniki and F.G. Macigo. Faculty of Dental Sciences, University of Nairobi , Kenya J. of Dental Research 1999, Vol. 78 Keloids are soft tissues growths which develop as a complication in later stages of wound healing. They occur more commonly in blacks in comparison to other racial groups. Although hereditary factors are implicated in individual selection and pathogenesis of keloids, the aetiology is unknown. The individuals who succumb to this disfiguring condition are usually psychologically traumatized thereby influencing their self-esteem. The management of these lesions is challenging and surgery alone without adjuvant radiotherapy shows high recurrence rate. 10 patients with keloids in the cervicofacial region are presented. The patients were divided in two categories. Category I patients (N=5) were managed with surgery and local steroid therapy. Category II patients (N=5) Received adjuvant superficial radiotherapy treatment (SXRT) after surgery. In two of the patients, in Category I, there was recurrence whereas in Category II, there was none. Complications observed in category I patients included; hypopigmentation and lipotrophy while in Category II patients, localized dermatitis, sloughing of the skin and local tissue necrosis (N=1) were observed. The complications related to SXRT improved and no invasive intervention was required. SXRT if meticulously fractionated and monitored seems to be the most favourable adjuvant modality in the management of keloids among the black population .

Settlement pattern studies are concerned with relics of human occupation in the past. In an archaeological record, these relics either appear in clusters or individually in the form of pestholes, house floors, house foundations or as middens. On aerial photographs and topographic maps relics of past human occupation can be identified by the presence of circular or rectangular depressional features and stunted vegetation cover in the midst of a flourishing vegetation community. Past human settlements can also be identified in actual field observation as ruins: building structures, walled fortresses, moats, monuments and mounds.

Irrespective of their nature and conditions of preservation, past settlements are a reflection of human behaviour through time and space. The archaeological evidence that is found preserved in them can shed much light on our knowledge of past culture. The essential archaeological problem in the analysis and interpretation of settlement, however, is that architectural remains and other settlement data cannot be understood simply by their description, distribution, cultural attribution and chronology - as they have been from the early anthropological work of Morgan (1881) and Mindeleff (1890) through the first large-scale regional archaeological syntheses, such as Childe's (e.g. 1934) in Europe and Willey (1953) in South America up to the common archaeological survey work of today.

With the influence of modern cultural ecology, geography and sociobiology, settle­ment analysis has been transformed into a concern with environmental and ecological processes. Settlements are part of a complex integration of culture and ecology within a regional environment. As a result, settlement analysis in archaeology must attend not only to the physical layout of the environment, but also to the social and historical aspects of environmental interaction.

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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.

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Temporomandibular joint (TMJ) ankylosis is a distressing affliction that denies the victim the benefit of normal diet, careers that require normal speech and causes severe facial disfigurement that aggravates psychological stress. Opinions in current literature portray controversy in its management. Hurried clinicians take shortcuts and partially treat symptoms and often make the condition worse. Others ignore shortcomings and erroneously prescribe their preferred techniques as absolute indication to the peril of the affected children. Gap arthroplasty if applied in a growing maxillofacial skeleton as in children, causes iatrogenic arrest of facial growth. The intended correction of facial disfigurement is therefore not achieved. Early detection and immediate psychological support by excision and reconstruction of ankylosed TMJ with a costochondral graft, improves patient comfort and rehabilitation when used as a planned part of a comprehensive therapy. This paper questions prior varied opinions and discusses scientific baseline considerations in management of long standing TMJ ankylosis in children in relatively affordable circumstances.

Field experiments were conducted to investigate the response of grain legumes to rhizobia inoculation, farmyard manure and inorganic fertilizer nitrogen. The grain legumes were common bean (Phaseolus vulgaris L.var GLP 2), lima bean (Phaseolus lunatus L.), green gram (Vigna radiate L.) and lablab (Lablab purpureus L.). The experimental design was a randomized complete block design with split plot arrangement and replicated thrice. Parameters determined were the number of nodules and nodule dry weight per plant, seed yield and yield components. Nitrogen fertilizer application significantly reduced the number of nodules in most of the legume species. In contrast, rhizobia inoculation increased number of nodules and nodule dry matter in most species but this was not translated into increase in plant growth or grain yield. Application of manure improved nodulation and grain yield only in the short rains. However, fertilizer application significantly increased dry matter in both seasons and total grain yield during short rains. The study indicated that the effect of rhizobia inoculation, farmyard manure and nitrogen fertilizer on grain legumes is variable depending on species, parameter being measured and other environmental factors. Keywords: Dry matter, grain legumes, grain yield, nitrogen source, nodulation.

Department of Obstetrics and Gynaecology, College of Health Sciences, University of Nairobi, Kenya. The effect of a low-oestrogen combined pill, progestogen-only pill and medroxyprogesterone acetate on oral glucose tolerance test was studied in 29, 30 and 9 indigenous Kenyan women respectively. Glucose tolerance test was performed before treatment was started and then after 1,3 and 6 months in microgynon users. The mean areas under the glucose curves were also significantly elevated. Significant increase in blood glucose values were noted only at 30 minutes after 6 months of use of the progestogen-only oral contraceptive but the mean blood glucose values were higher than in the control after 1,3 and 6 months of use. However, the mean values of the areas under the glucose curves were significantly elevated after 1,3, and 6 months of use. Medroxyprogesterone acetate users showed significantly lower fasting blood glucose values at 60 and 90 minutes after 1 month of use, after which the blood glucose values returned to the pre-treatment values. The mean values of the glucose curve areas showed no significant change. It is concluded that both microgynon and minipill cause relative impairment of glucose tolerance test as early as after 1 month of use. Medroxyprogesterone acetate does not impair oral glucose tolerance for at least the first 6 months of use. The implications of these findings are discussed. PIP: Researchers followed 68 women who attended the Family Welfare Clinic at the Kenyatta National Hospital in Nairobi, Kenya to determine if the low estrogen combined oral contraceptive (OC) Microgynon, a progestogen only OC, and Depo-Provera induce changes in the oral glucose test. These women did not take any steroidal contraceptives before entry into the study. Blood glucose levels were significantly higher after 60, 90 and 120 minutes than the control levels for women taking Microgynon. In addition, the mean areas under the glucose curves were substantially elevated after 1, 3, and 6 months above the control (p.002, .005, and .01 respectively). The only significant change in blood glucose levels in women taking the progestogen only OC occurred at 30 minutes after 6 months. Yet the mean areas under the curve were significantly higher than the control after ,1 2, and 3 months (p.005, .05 and .002 respectively). As for Depo-Provera, significantly lowered blood glucose levels only occurred after 1 month at 30, 50, and 90 minutes although no significant changes occurred after 1, 3, and 6 months in the mean areas under the glucose curves. Metabolic change occurred earlier and more often in Microgynon users than progestogen only OC users. This could be due to the progestogen levonorgestrel which has been shown to interrupt glucose metabolism. These changes could possible adversely effect women who are predisposed to developing diabetes, since 1 woman did develop a diabetic curve after 1 month of using Microgynon. Nevertheless no pattern towards abnormal glucose tolerance existed. Standard deviations of areas under the curves indicated that the number of women who develop glucose intolerance may increase with duration of use.

The desire for self-mutilation in the absence of any discernible psychopathology is relatively rare. Self-mutilation is most commonly a manifestation of an underlying psychopathology such as depression, schizophrenia, personality disorder, transexuality, body dysmorphic disorder and factitious disorder. In this article, a case in which a 29-year-old single Kenyan lady of African origin demanded a surgical operation to modify and reduce the size of her external genitalia is presented. Although female genital mutilation is still widespread in the country, this case is of interest in that the woman did not seek the usual circumcision but sought to specifically reduce the size of her labia minora so that she could feel like a normal woman. The unique challenges in her management are discussed. Possible aetiological factors in patients who demand surgical removal or modification of parts of their bodies without an obvious cause is discussed.

Loss of 1st and 2nd molars among adolescents due to dental caries is not uncommon in developing countries. Whilst their replacement is indicated, conventional methods of treatment, namely, bridging and dentures are in most cases inaccessible because of prohibitive cost. Given that it is in the same age group that diagnosis of unfavourably embedded wisdom teeth becomes feasible, autotransplantation of the latter to replace the unsalvageable 1st and 2nd molars could be an alternative treatment. Available literature suggests a success rate of over 82% based on follow-up studies of over ten years. Observations at the Dental School Clinic of the University of Nairobi, Kenya, indicate that the time it takes the transplant to 'take' and assume its functional position is 4 to 8 weeks and 2.5 to 3.5 months respectively. Since the method is relatively straightforward, we are of the view that training undergraduates and practising dental surgeons in this technique should enhance utilisation of otherwise "useless" teeth to replace the lost 1st and 2nd molars in occlusal rehabilitation.

A survey was carried out during 2004 harvesting season in five agroecological zones in Nakuru and 4 agroecological zones in Nyandarua district. Fusarium species were isolated from wheat kernels and were identified based on cultural and morphological characteristics. Mycotoxin content in the wheat grains was determined by direct competitive Enzyme-Linked Immunosorbent Assay.The major fungal genera isolated from wheat grain samples were Epicoccum, Alternaria, Fusarium, Aspergillus and Penicillium. Fusarium species isolated were F. poae, F. chlamydosporum, F. oxysporum, F. graminearum, F. equiseti, F. moniliforme, F. avenaceum, F. semitectum, F. crookwellense, F. lateratium, F. sporotrichioides, F. scirpi, F. sambucinum and F. solani.Most of the wheat grain samples were contaminated with mycotoxins deoxynivalenol, T-2 toxin and zearalenone. The incidence and levels of the mycotoxins varied in samples from different agro-ecological zones.The study showed that Fusarium head blight pathogens are highly prevalent in the wheat-growing district of Nakuru and Nyandarua.

S.W. Guthua* and D.L. Mwaniki** Afr. Dental Journal 1992, 6: 30-33 SUMMARY: Analysis of 110 records of patients who presented with impacted mandibular 3 rd molars was carried out to determine the frequency of occurrence of unilateral and bilateral impactions and their characteristics. 68.2% of the patients had bilaterial impactions. Among the patients with bilateral impactions, 72% had mesioangular impaction occurring either bilaterally or in combination with other types of impaction. Furthermore, 38.7% mesioangular impactions were observed on the right and left sides in the patients with bilateral impactions. Among the patients with unilateral impactions, 40.2% presented with mesioangular impaction, while 25.7% presented with distoangular impactions. While these observations support the general consensus regarding aetiology of mandibular 3 rd molar impactions as being tooth-tissue discrepancy, the possible influence of other factors is suggested.

Fusarium culmorum is an important pathogen of wheat causing seedling blight, foot rot, and head blight (FHB) or scab. The pathogen is dominant in cooler areas like north, central and western Europe. The fungus reproduces asexually by means of conidia, which form the main mode of dispersal. Head blight is by far the most serious concern of Fusarium infection on pre-harvest wheat and other small grain cereals. The significance of F. culmorum in wheat production is attributed to both head blight and mycotoxin contamination of the grain harvested from infected ears. Ear infection mainly occurs during anthesis and is favoured by wet weather or high humidity and warm temperatures. The major mycotoxins produced by F. culmorum are deoxynivalenol, nivalenol and zearalenone, which are a potential health hazard for both humans and animals. The mycotoxins, especially deoxynivalenol, are believed to play a role in disease development. Available options of managing Fusarium head blight include use of fungicides, cultural practices, resistant varieties and biological agents. However, no wheat variety is completely resistant to Fusarium head blight while fungicides are at most 70% effective against natural infection. This review seeks to document and infer information on F. culmorum, with special emphasis on wheat head blight infection process, mechanisms of mycotoxin production, the role the mycotoxins play in pathogenesis, and the possible management options.

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

BACKGROUND: Road Traffic Accidents (RTAs) are a major cause of morbidity and mortality in Kenya. Victims may suffer multiple injuries including maxillofacial injuries. In most developing countries RTAs are the leading cause of maxillofacial injuries. In an attempt to reduce RTAs, the government of Kenya has enacted a legislation requiring mandatory fitting of speed governors and safety belts by passenger service vehicles. OBJECTIVE: To describe the characteristics and pattern of maxillofacial and associated injuries sustained in road traffic accidents. DESIGN: A cross-sectional study. SETTING: Kenyatta National Hospital (KNH). SUBJECTS: All patients involved in RTAs brought to casualty and the dental department of KNH as well as accident victims admitted to the KNH mortuary over a four- month period from September 2004 to December 2004. RESULTS: Four hundred and thirteen (85.7%) had non-fatal injuries whereas 69 (14.3%) had sustained fatal injuries. Males in the 21-30-year age group were the most affected. Most accidents occurred during weekends with pedestrians being the leading casualties in 59.5% and 71.4% of non-fatal and fatal cases respectively. Most accidents were caused by passenger service vehicles (matatus) which were responsible for 62% and 40.6% of non-fatal and fatal injuries respectively. Non-use of safety belts was reported in 56.6% of the cases who suffered non-fatal injuries. In the non-fatal category 89.6% of the casualties had soft tissue injuries (STIs) involving the craniofacial region with facial cuts being the majority (69.2%). Two hundred and seventy three (66.1%) incidents of other STIs than those of the head region were noted, the lower limbs accounting for 45.4% of these. Only 5.1% of the casualties with non-fatal injuries had fractures involving the maxillofacial skeleton. Skeletal injuries other than those involving the maxillofacial region were found in 142 (34.1%) incidents. In the fatal category head injury alone was the leading cause of death accounting for 37.7% of the cases followed by head and chest injuries combined which were responsible for 13% of the cases. CONCLUSION: Injuries to the maxillofacial skeleton appear to be uncommon in this series. Pedestrians in their third decade of life are most affected with passenger service vehicles being responsible in the majority of the cases. RECOMMENDATIONS: Interventional programmes targeting pedestrians and those in the third and fourth decades of life should be enacted.

Analysis of 355 cases with fractures of the mandible indicated that 74.9% of the cases were due to interpersonal violence and 13.8% were caused by road traffic accidents. The men to women ratio was 8.4:1 and 75.5% of the fracture cases had single fractures while 24.5% had multiple fractures. In cases with a single fracture, the most commonly involved mandibular site was the body (42.2%). The angle of mandible was most frequently fractured (50.5%) in cases with multiple fractures.

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A new antiplasmodial coumarin, 5,7-dimethoxy-8-(3'-hydroxy-3'methyl-1'-butene)-coumarin (1), has been isolated from the roots of Toddalia asiatica. This finding supports the traditional use of this plant for the treatment of malaria.

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

A sacred site is a place which is considered holy, and is partially or wholly reserved for magico-religious or ceremonial functions. Because of this it is venerated and revered and is kept free from contamination by sin and evil. Sacred sites vary in size from very small places covering a few square metres to large areas covering several hectares of land. They are usually characterized by the presence of artefacts, ecofacts and features that are unique to them; they may be in the open air, or in rockshelters, caves and forests. In many cases, sacred sites have frightening tales told about them, in order to scare off those who would want to destroy or defile them. In the archaeological record, sacred sites may initially be identifiable as burial sites, ceremonial sites or butchery sites. It is on the basis of such clues that other attributes that are typical of sacred sites can be identified, isolated and studied. It is against this background that this chapter discusses the Mijikenda kaya (pi. makaya) as a sacred site.

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

Purpose:

Although the incidence of maxillofacial injuries caused by wildlife in Kenya is not known, it is estimated to be 2 to 5%. In Kenya, the tourism industry is the main source of foreign revenue. Therefore, the country invests a substantial amount of money in promoting tourism and improvement of the country's parks/game reserves. On rare occasions, some of the wild animals will leave their natural habitat, within the confines of the national parks, and pose a threat to the people living in the neighbourhood. The animals particularly implicated include lions, buffalos, hippopotamus, leopards and hyenas.

Material and method:

Within a period of 4 years, seven patients aged between 22 and 35 years, mean age 28 years, were referred for management of overwhelming maxillofacial injuries caused by wild animals. The injuries involved the upper face, midface and lower face. The midface was more involved than the rest of the face. The most common injuries diagnosed were crushing and mutilation types of injuries. Apart from the oro-maxillofacial region, upper extremities were commonly involved.

Results:

The duration before presentation ranged from 6 hours to 6 days. One of the patients, Female aged 35 years, was evacuated late and presented with severe tissue necrosis and irreversible damage of the right eyeball. Management comprised of surgical toilet, debridement and primary repair or crushing injuries. Mutilated injuries required repeated debridement and staged reconstruction of the defects. The latter injuries were particularly caused by lions and leopards and secondarily hyenas. Tetanus toxoid was administered to all the patients, whereas antirabies vaccination was given only to patients with mutilation injuries.

Conclusions:

In assessment of patients with severe maxillofacial injuries caused by wild animals, a similar approach to that of patients with multiple injuries caused by motor vehicle accidents should be employed. Meticulous examination, life support measures and relevant surgical procedures should be instituted immediately to minimize morbidity and mortality arising from these injuries.

Settlement pattern studies are concerned with relics of human occupation in the past. In an archaeological record, these relics either appear in clusters or individually in the form of pestholes, house floors, house foundations or as middens. On aerial photographs and topographic maps relics of past human occupation can be identified by the presence of circular or rectangular depressional features and stunted vegetation cover in the midst of a flourishing vegetation community. Past human settlements can also be identified in actual field observation as ruins: building structures, walled fortresses, moats, monuments and mounds.

Irrespective of their nature and conditions of preservation, past settlements are a reflection of human behaviour through time and space. The archaeological evidence that is found preserved in them can shed much light on our knowledge of past culture. The essential archaeological problem in the analysis and interpretation of settlement, however, is that architectural remains and other settlement data cannot be understood simply by their description, distribution, cultural attribution and chronology - as they have been from the early anthropological work of Morgan (1881) and Mindeleff (1890) through the first large-scale regional archaeological syntheses, such as Childe's (e.g. 1934) in Europe and Willey (1953) in South America up to the common archaeological survey work of today.

With the influence of modern cultural ecology, geography and sociobiology, settle­ment analysis has been transformed into a concern with environmental and ecological processes. Settlements are part of a complex integration of culture and ecology within a regional environment. As a result, settlement analysis in archaeology must attend not only to the physical layout of the environment, but also to the social and historical aspects of environmental interaction.

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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.

Ninety seven patients were examined for dental caries using two standard methods: (a) clinical examination based on WHO Basic Methods Oral Health surveys and (b) radiographic examination. Clinical examination method under records caries by upto 40%. Such under recording may give an impression of a decreasing caries prevalence in epidemiological studies.

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This chapter attempts to re-evaluate the history of the East African coast and the Comores between the seventh and eleventh centuries. This is being done with a view to correcting the false picture painted by historians and/or archaeologists of the colonial school of thought, who presented rather a history of foreign traders and colonizers credited with the civilization of the coast. The role of outsiders in the early history of the East African coast cannot be denied, but it is one thing to be part of a process of change and completely another to claim responsibility for the process. Recent research, however, is slowly but surely making it very clear that the history of the East African coast is the history of indigenous African populations and their interaction with the environment

The prevalence of oral leukoplakia and related lesions in a Kenyan rural population was determined in a systematic house to house survey of individuals aged 15 years and above. Among the 803 individuals examined, the following prevalence of lesions was observed: leukoedema (26%), melanosis (12.7%), leukoplakia (10.6%), palatal keratosis (6.4%), frictional keratosis (5.5%), pre-leukoplakia (4.1%), borderline leukoplakia (2.4%), cheek/lip biting (1.3%), and snuff dippers lesion (0.4%). 48.6% of the subjects had at least one of these lesions. Statistically significant preponderance was demonstrated for oralleukoplakia, palatalkeratosis, leukoedema and frictional keratosis among males and melanosis among females. With regard to clinical classification of oral leukoplakia, the prevalence was 10% for homogeneous and 0.6% for nonhomogeneous lesions. On the basis of aetiological classification; the prevalence was 8.3% for tobacco associated and 2.2% for idiopathic leukoplakia. 22.5% of leukoplakia lesions biopsied had evidence of epithelial dysplasia. In view of the premalignant potential of oral leukoplakia, our findings suggest a need for greater attention towards prevention and control of this lesion in the study community.

PIP: The effects of the triphasic oral contraceptive (OC) ethinyl estradiol (EE) and levonorgestrel (LNG) on lipid and lipoprotein metabolism were evaluated in 97 black Kenyan women. Subjects were recruited from the Family Planning Clinic and were followed for 12 months. There was an increase in fasting levels of total cholesterol. These changes were not statistically significant. However, the triglyceride increase was statistically significant at 9 months and 12 months (p0.05). The high density cholesterol remained unchanged. Thus, this triphasic OC was found to have minimal effect on lipid and lipoprotein metabolism. author's modified

Loss of 1st and 2nd molars among adolescents due to dental caries is not uncommon in developing countries. Whilst their replacement is indicated, conventional methods of treatment, namely, bridging and dentures are in most cases inaccessible because of prohibitive cost. Given that it is in the same age group that diagnosis of unfavourably embedded wisdom teeth becomes feasible, autotransplantation of the latter to replace the unsalvageable 1st and 2nd molars could be an alternative treatment. Available literature suggests a success rate of over 82% based on follow-up studies of over ten years. Observations at the Dental School Clinic of the University of Nairobi, Kenya, indicate that the time it takes the transplant to 'take' and assume its functional position is 4 to 8 weeks and 2.5 to 3.5 months respectively. Since the method is relatively straightforward, we are of the view that training undergraduates and practising dental surgeons in this technique should enhance utilisation of otherwise "useless" teeth to replace the lost 1st and 2nd molars in occlusal rehabilitation.

Ethnographic evidence and traditional methods of characterization have been frequently applied in the reconstruction of manufacture and distribution of ceramics. This article introduces the method of xeroradiography as a potential tool in the study of ceramic composition and contrasts it with attributes and attribute combinations to provide a holistic understanding of ceramic manufacture and inter-island exchange patterns in the Admiralty Islands.

S.W. Guthua* and D.L. Mwaniki** Afr. Dental Journal 1992, 6: 30-33 SUMMARY: Analysis of 110 records of patients who presented with impacted mandibular 3 rd molars was carried out to determine the frequency of occurrence of unilateral and bilateral impactions and their characteristics. 68.2% of the patients had bilaterial impactions. Among the patients with bilateral impactions, 72% had mesioangular impaction occurring either bilaterally or in combination with other types of impaction. Furthermore, 38.7% mesioangular impactions were observed on the right and left sides in the patients with bilateral impactions. Among the patients with unilateral impactions, 40.2% presented with mesioangular impaction, while 25.7% presented with distoangular impactions. While these observations support the general consensus regarding aetiology of mandibular 3 rd molar impactions as being tooth-tissue discrepancy, the possible influence of other factors is suggested.

Fusarium culmorum is an important pathogen of wheat causing seedling blight, foot rot, and head blight (FHB) or scab. The pathogen is dominant in cooler areas like north, central and western Europe. The fungus reproduces asexually by means of conidia, which form the main mode of dispersal. Head blight is by far the most serious concern of Fusarium infection on pre-harvest wheat and other small grain cereals. The significance of F. culmorum in wheat production is attributed to both head blight and mycotoxin contamination of the grain harvested from infected ears. Ear infection mainly occurs during anthesis and is favoured by wet weather or high humidity and warm temperatures. The major mycotoxins produced by F. culmorum are deoxynivalenol, nivalenol and zearalenone, which are a potential health hazard for both humans and animals. The mycotoxins, especially deoxynivalenol, are believed to play a role in disease development. Available options of managing Fusarium head blight include use of fungicides, cultural practices, resistant varieties and biological agents. However, no wheat variety is completely resistant to Fusarium head blight while fungicides are at most 70% effective against natural infection. This review seeks to document and infer information on F. culmorum, with special emphasis on wheat head blight infection process, mechanisms of mycotoxin production, the role the mycotoxins play in pathogenesis, and the possible management options.

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Analysis of 355 cases with fractures of the mandible indicated that 74.9% of the cases were due to interpersonal violence and 13.8% were caused by road traffic accidents. The men to women ratio was 8.4:1 and 75.5% of the fracture cases had single fractures while 24.5% had multiple fractures. In cases with a single fracture, the most commonly involved mandibular site was the body (42.2%). The angle of mandible was most frequently fractured (50.5%) in cases with multiple fractures.

The sample is ashed in a nickel crucible over an open flame with calcium hydroxide as thefixative; fluoride is separated by micro-diffusion and measured with a fluoride-selective electrode.The calcium hydroxide fixative permits a temperature of 800—850°C during the final ashing, sothat insoluble silicates are decomposed and fluoride is converted to an acid-soluble form. Otheradvantages over furnace ashing at 600°C are less contamination and more rapid ashing (20 mincompared to 6 h). The interference of aluminium and silica on microdiffusion was studied: per-chloric acid was found to be preferable to sulphuric acid as medium. A new way for preparingcalcium hydroxide suspension, low in fluoride, is described. The values found by the proposedmethod generally compare well with those obtained by oxygen flask combustion. Direct diffusion(i.e. without ashing) gave much lower values than the ashing methods, except for tea leaves.

Myrica salicifolia Hoechst (Myricaceae) root extract was found to have analgesic activity in mice. In rats there was antipyretic but no antiinflammatory activity. Copyright 2002 John Wiley & Sons, Ltd.

Analysis of 355 cases with fractures of the mandible indicated that 74.9% of the cases were due to interpersonal violence and 13.8% were caused by road traffic accidents. The men to women ratio was 8.4:1 and 75.5% of the fracture cases had single fractures while 24.5% had multiple fractures. In cases with a single fracture, the most commonly involved mandibular site was the body (42.2%). The angle of mandible was most frequently fractured (50.5%) in cases with multiple fractures.

The precolonial trading systems of the East African interior have a great antiquity ml can best be understood by employing a multidisciplinary approach including archaeology, oral traditions, linguistic evidence and documentary sources. Two types oj trade, namely subsistence-oriented and nonsubsistence-oriented or long-distance frai, can be identified. In general, the nonsubsistence-oriented trade was a response demands for unevenly distributed resources at both local and international levels, This is demonstrated by some of the coastal and hinterland settlements for which there is evidence for periods of prosperity. Archaeological evidence from the pre-tenth-century AD settlements on the coast, and documentary evidence of the same period, show how this prosperity emanated from trade transactions between the coast and the interior in response to industrial and labor-force demands in the lands beyond the Indian Ocean, particularly the Orient and Mediterranean Europe. The steadily expanding market for commodities from the interior, particularly ivory and slaves, provided by the international maritime trade especially after the fifteenth century, brought new opportunities for the expansion of long-distance trade. These created and strengthened contacts between the East African interior and the coast, in order to satisfy the needs of the expanding markets in Europe and the Orient, for instance, the Akamba, the Nyamwezi, and the Yao caravans, to name just a few, collaborated with the Mijikenda, the Swahili, and Arab caravan traders to deplete tht interior of its resources for the markets overseas. Trade with the interior not only increased in volume but also witnessed the supplementing of traditional commodities with new ones. From the coast, for example, interior communities got luxury items such as cloth, beads, porcelain, glass, and later guns, which had not been seen in the interior before. In addition to these were cowrie shells, now as a form of currency, certain foodstuffs, and salt. These were exchanged for interior products of the hunt and jar slaves. It seems that interior communities never took the first initiative in tk international trade that characterized this region in the period under review. Ik initiative was always taken by coastal communities in response to industrial growth and labor-force demands overseas. Analyzing the balance sheet of this trade, it my k concluded that precolonial African societies in the interior were not what we would now call astute business people with long-term investment programs. There is little evidence to show that they benefited very much from these transactions, in spite of the active role that they played.

A methanol extract of Syzygium guineense bark inhibited intrinsic contractions of rabbit isolated ileum. The inhibition, at bath concentrations of 0.5 - 2.0 mg/ml, was dose-related but non-linear. It produced sustained hypotension in anaesthetized rats. A dose of 5 ug lowered systolic, diastolic and mean blood pressure by 16%, 22% and 17%, respectively below the pre-drug levels. Maximum effect was obtained at a dose of 40 ug when the systolic, diastolic and mean blood pressures fell by 23%, 36% and 28%, respectively below the pre-drug levels. The greater fall in blood pressure was in diastolic than systolic blood pressure. The extract caused a weaker but similar effect to isoprenaline on rabbit isolated heart. While the effect on rabbit isolated ileum supports the folkloric use of the plant as an antispasmodic, further work is required to confirm and categorize the observed pharmacological activities.

The problem of timely access to Veterinary Doctors by Livestock farmers has paused great deal on livestock mobile health (mHealth) in Bumula Sub County, Bungoma County. This problem is traceable at the initial stage of locating and communicating to veterinary doctor for the veterinary service. The project’s aim was to investigate application of modern Information Technology (ICT) in addressing accessibility to veterinary doctors by locating the nearest veterinary doctor and request for livestock treatment. The specific objectives that project sought to address include; Determining communication needs for the livestock farmers, propose & design Veterinary Notification Service prototype in which livestock farmers would locate and request the nearest Veterinary Doctor as soon as livestock fall sick. In this project, a case study of Bumula Sub County in Bungoma County was used to study livestock farmers’ challenges in reaching out to Veterinary Doctor. Tests and evaluation findings indicated that application of integrated services of simple message service (SMS), Web application and Mobile application have positive outcome in veterinary notification process necessitated by mapping the nearest Veterinary Doctors to the livestock farmers’ treatment requests. The introduction of veterinary notification service for livestock farmers is a solution that would greatly improve in animal husbandry healthcare, treatment and real time consultancies in Bumula Sub County. Further study should also explore methods that can be used to facilitate other services on the prototype such as information and videolized basic livestock careThe problem of timely access to Veterinary Doctors by Livestock farmers has paused great deal on livestock mobile health (mHealth) in Bumula Sub County, Bungoma County. This problem is traceable at the initial stage of locating and communicating to veterinary doctor for the veterinary service. The project’s aim was to investigate application of modern Information Technology (ICT) in addressing accessibility to veterinary doctors by locating the nearest veterinary doctor and request for livestock treatment. The specific objectives that project sought to address include; Determining communication needs for the livestock farmers, propose & design Veterinary Notification Service prototype in which livestock farmers would locate and request the nearest Veterinary Doctor as soon as livestock fall sick. In this project, a case study of Bumula Sub County in Bungoma County was used to study livestock farmers’ challenges in reaching out to Veterinary Doctor. Tests and evaluation findings indicated that application of integrated services of simple message service (SMS), Web application and Mobile application have positive outcome in veterinary notification process necessitated by mapping the nearest Veterinary Doctors to the livestock farmers’ treatment requests. The introduction of veterinary notification service for livestock farmers is a solution that would greatly improve in animal husbandry healthcare, treatment and real time consultancies in Bumula Sub County. Further study should also explore methods that can be used to facilitate other services on the prototype such as information and videolized basic livestock care

Settlement pattern studies are concerned with relics of human occupation in the past. In an archaeological record, these relics either appear in clusters or individually in the form of pestholes, house floors, house foundations or as middens. On aerial photographs and topographic maps relics of past human occupation can be identified by the presence of circular or rectangular depressional features and stunted vegetation cover in the midst of a flourishing vegetation community. Past human settlements can also be identified in actual field observation as ruins: building structures, walled fortresses, moats, monuments and mounds.

Irrespective of their nature and conditions of preservation, past settlements are a reflection of human behaviour through time and space. The archaeological evidence that is found preserved in them can shed much light on our knowledge of past culture. The essential archaeological problem in the analysis and interpretation of settlement, however, is that architectural remains and other settlement data cannot be understood simply by their description, distribution, cultural attribution and chronology - as they have been from the early anthropological work of Morgan (1881) and Mindeleff (1890) through the first large-scale regional archaeological syntheses, such as Childe's (e.g. 1934) in Europe and Willey (1953) in South America up to the common archaeological survey work of today.

With the influence of modern cultural ecology, geography and sociobiology, settle­ment analysis has been transformed into a concern with environmental and ecological processes. Settlements are part of a complex integration of culture and ecology within a regional environment. As a result, settlement analysis in archaeology must attend not only to the physical layout of the environment, but also to the social and historical aspects of environmental interaction.

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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.

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This chapter attempts to re-evaluate the history of the East African coast and the Comores between the seventh and eleventh centuries. This is being done with a view to correcting the false picture painted by historians and/or archaeologists of the colonial school of thought, who presented rather a history of foreign traders and colonizers credited with the civilization of the coast. The role of outsiders in the early history of the East African coast cannot be denied, but it is one thing to be part of a process of change and completely another to claim responsibility for the process. Recent research, however, is slowly but surely making it very clear that the history of the East African coast is the history of indigenous African populations and their interaction with the environment

FG Macigo, DL Mwaniki and SW Guthua East Afr. Med. Journal 1995, 72: 778 - 782 SUMMARY: The prevalence of oral leukoplakia and related lesions in a Kenyan rural population was determined in a systematic house to house survey of individuals aged 15 years and above. Among the 803 individual examined, the following prevalence of lesions was observed: leukoedema (26%), melanosis (12.7%), leukoplakia (10.6%), palatal keratosis (6.4%), frictional keratosis (5.5%), pre-leukoplakia (4.1%), borderline leukoplakia (2.4%), cheek/lip biting (1.3%), and snuff dippers lesion (0.4%), 48.6% of the subjects had at least one of these lesions. Statistically significant preponderance was demonstrated for oral leukoplakia, palatal keratosis, leukoedema and frictional keratosis among males and melanosis among females. With regard to clinical classification of oral leukoplakia, the prevalence was 10% for homogeneous and 0.6% for non-homogeneous lesions. On the basis of aetiological classification, the prevalence was 8.3% for tobacco associated and 2.2% for idiopathic leukoplakia, 22.5% of leukoplakia lesions biopsied had evidence of epithelial dysplasia. In view of the premalignant potential of oral leukoplakia, our findings suggest a need for greater attention towards prevention and control of this lesion in the study community.

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

Participatory epidemiological Research was conducted in Turkana to identify the two most important livestock diseases, and then characterize their incidence and the economic impact. The study was carried out between 12th to 26th September 2011. Semi-structured interviews, guided by checklists were completed with groups of respondents in each of the 16 randomly selected villages (adakars) to collect
data on livestock diseases and their impact on the livelihood of the people. Simple ranking techniques,
proportional piling exercises and matrix scoring methods were used to collect data on the importance of
the diseases identified. Matrix scoring of clinical signs was used to correlate the disease terms provided by the respondents in local language with the scientific names. The research focused on Lomooh or peste des petit ruminants (PPR) and Loukoi or contagious caprine pleuropneumonia (CCPP). Disease impact matrix scoring (DIMS) was used to correlate the diseases to the economic losses, while participatory mapping, time lines and seasonal calendars were used describe the spatial and seasonal distribution of the diseases. Transect drives was used to collect data on the pasture conditions. Lomooh (peste des petits ruminants) was reported to occur in outbreaks with a median morbidity of 65% and a range of 25% to 90% and a case fatality rate median and range of 95% and 75, to 100% respectively. Loukoi (CCPP) on the other hand was described to be an endemic disease known by the community for a long time and had a median morbidity rate of 50% (with range of 39 to 75% and a median and range case fatality rate of 62% and 40 to 85%, respectively). These losses led to reduced income and food insecurity at the household levels. The biggest challenge to livestock farming (which contributed to 75% of the livelihood) was recurrent drought, insecurity and diseases, with CCPP and PPR being considered as having the largest impact. Respondents indicated that these challenges have made people worse off than they were 20 and 10 years ago and more reliant on external food aid.

A case is reported of a 13 year old Kenyan girl who presented at the Kenyatta National Hospital Dental Clinic with multiple mandibular and maxillary cysts, cutaneous lesions and mandibular prognathism. This combination of clinical and radiographic features led to a diagnosis of basal cell nevus syndrome. This paper is the first reported case of the syndrome in Kenya. The significance of thorough clinical inspection and radiographic screening of suspected cases is discussed.

PIP: Menstrual blood loss (MBL) was evaluated in 74 nulliporous Kenyan women aged between 20 and 27 years. The hemoglobin levels were all in normal range with the mean of 13.65 +or- 0.8, 13.84 +or- 1.2 and 13.04 +or- 1.2 g/100 ml respectively in 3 populations. The MBL was comparable in the 3 populations with the mean of 35.1 +or- 12.6, 30.6 +or- 8.7 and 32.2 +or- 9.4 ml respectively. There was no difference of statistical significance between the 2 periods studied per each individual. This study objectively assesses the menstrual blood loss in 3 population groups–2 urban and 1 rural. The data can be used to evaluate menstrual blood loss before and after initiation of various contraceptives used in Kenya. Subjects were volunteers who were not on any contraception except barrier or natural rhythm methods, not under psychological stress and who exhibited normal physical female characteristics on examination. Those who wished to drop out, became pregnant or desired contraception, were excluded. The study confirms the individual constancy of the menstrual blood loss in this population. This has important practical implications since a single determination of the menstrual blood loss may be a fairly good expression for the average blood loss in a woman. The immediate effect of various treatments such as IUD insertion or oral contraceptives on the MBL may easily be evaluated quantitatively by measurements in consecutive periods using only 1 period as a control. The quick method can be easily used in evaluating pathological conditions e.g. iron-deficiency due to heavy bleeding, IUD-associated hemorrhage, menorrhagia and uterine fibroid. PMID: 12267056 [PubMed - indexed for MEDLINE]

S.W. Guthua* and D.L. Mwaniki** Afr. Dental Journal 1992, 6: 30-33 SUMMARY: Analysis of 110 records of patients who presented with impacted mandibular 3 rd molars was carried out to determine the frequency of occurrence of unilateral and bilateral impactions and their characteristics. 68.2% of the patients had bilaterial impactions. Among the patients with bilateral impactions, 72% had mesioangular impaction occurring either bilaterally or in combination with other types of impaction. Furthermore, 38.7% mesioangular impactions were observed on the right and left sides in the patients with bilateral impactions. Among the patients with unilateral impactions, 40.2% presented with mesioangular impaction, while 25.7% presented with distoangular impactions. While these observations support the general consensus regarding aetiology of mandibular 3 rd molar impactions as being tooth-tissue discrepancy, the possible influence of other factors is suggested.

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Fusarium culmorum is an important pathogen of wheat causing seedling blight, foot rot, and head blight (FHB) or scab. The pathogen is dominant in cooler areas like north, central and western Europe. The fungus reproduces asexually by means of conidia, which form the main mode of dispersal. Head blight is by far the most serious concern of Fusarium infection on pre-harvest wheat and other small grain cereals. The significance of F. culmorum in wheat production is attributed to both head blight and mycotoxin contamination of the grain harvested from infected ears. Ear infection mainly occurs during anthesis and is favoured by wet weather or high humidity and warm temperatures. The major mycotoxins produced by F. culmorum are deoxynivalenol, nivalenol and zearalenone, which are a potential health hazard for both humans and animals. The mycotoxins, especially deoxynivalenol, are believed to play a role in disease development. Available options of managing Fusarium head blight include use of fungicides, cultural practices, resistant varieties and biological agents. However, no wheat variety is completely resistant to Fusarium head blight while fungicides are at most 70% effective against natural infection. This review seeks to document and infer information on F. culmorum, with special emphasis on wheat head blight infection process, mechanisms of mycotoxin production, the role the mycotoxins play in pathogenesis, and the possible management options.

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

Measurement of tooth lengths was carried out on 537 extracted human teeth. The teeth were collected from adults aged 17 years and above and preserved in formalin. The tooth lengths were obtained by taking measurements off calibrated graph paper. The lengths obtained in this study were comparable to previous data reported in the literature. However, this new data will provide useful guidelines in Kenya for the management of endodontic patients especially in the purchase and stocking of the most appropriate endodontic instruments.

There is no uniformity in the role of different aetiologic factors in mandibular fractures in different cities of the world. Cultural and socioeconomic factors appear to have important contribution to the aetiologies. The condyle and the angle-body regions are most commonly fractured. There is no obvious relationship between aetiology and the site of fracture. Structural considerations suggest that differences between dentate (open section structure) and non dentate (closed section structure) regions are important determinants of fracture sites. Some modifications of standard teaching materials are recommended.

Fusarium culmorum is an important pathogen of wheat causing seedling blight, foot rot, and head blight (FHB) or scab. The pathogen is dominant in cooler areas like north, central and western Europe. The fungus reproduces asexually by means of conidia, which form the main mode of dispersal. Head blight is by far the most serious concern of Fusarium infection on pre-harvest wheat and other small grain cereals. The significance of F. culmorum in wheat production is attributed to both head blight and mycotoxin contamination of the grain harvested from infected ears. Ear infection mainly occurs during anthesis and is favoured by wet weather or high humidity and warm temperatures. The major mycotoxins produced by F. culmorum are deoxynivalenol, nivalenol and zearalenone, which are a potential health hazard for both humans and animals. The mycotoxins, especially deoxynivalenol, are believed to play a role in disease development. Available options of managing Fusarium head blight include use of fungicides, cultural practices, resistant varieties and biological agents. However, no wheat variety is completely resistant to Fusarium head blight while fungicides are at most 70% effective against natural infection. This review seeks to document and infer information on F. culmorum, with special emphasis on wheat head blight infection process, mechanisms of mycotoxin production, the role the mycotoxins play in pathogenesis, and the possible management options.

Labile fluoride in soil samples was extracted using sodium citrate - EDTA, sodium citrate - TISAB II, ammonium lactate, IMhydrochloric acid and water. Hydrochloric acid was found to give the highest fluoride level while water gave the lowest fluoride level.Shaking time andamount of sample showed that 1 1/2 hours shaking and lgm sample gave the best results with ammonium lactateextracting media Recovery of fluoride using ammonium lactate was found to be 90-100% efficient while medium clay samples gaveless than 90% fluoride.

The purpose of this investigation was to evaluate the effect of matrix crosslinking and solute size on release of a random coil macromolecular solute from crosslinked gelatin matrices. Gelatin hydrogel matrices crosslinked with different molar ratios of 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC):epsilon-amino groups on gelatin (1:1, 4:1, and 10:1) were prepared containing dextran of molecular weights 12, 20, and 77 kDa, and hydrodynamic diameters 54, 74, and 133 A, respectively. The extent of matrix crosslinking was determined quantitatively and used to calculate the molecular weight between crosslinks (Mc). The Mc parameter and equilibrium swelling ratio (Qm) were used to calculate an estimated matrix mesh size (xi). The in vitro release of incorporated dextran was evaluated at 37 degrees C in PBS at pH 7.4 for approximately 80 h. The one-, four- and 10-fold molar ratios of crosslinking agent EDC yielded 24, 41, and 78% of gelatin matrix crosslinking, respectively. The calculated average matrix mesh size ranged from 338 to 90 A. The effect of matrix crosslinking varied with solute size, from retarding diffusional release of the dextran to completely entrapping it inside the crosslinked matrices. These results support the threshold concept of solute size relative to matrix mesh size for release of a flexible, random coil macromolecular solute from a hydrogel.

End stage renal disease requiring renal replacement therapy is a common complication of several renal diseases that are seen in the tropics. World over, the costs of the various modalities of therapy that constitute renal replacement therapy, including hemodialysis, continuous ambulatory peritoneal dialysis and renal transplantation, is prohibitive. All the above modes of therapy are provided in Kenya, unlike most countries with similar level of socioeconomic development. This article analyses the factors behind the limited success that renal replacement therapy enjoys in Kenya, which is faced with more pressing basic problems of malnutrition and infection.

The precolonial trading systems of the East African interior have a great antiquity ml can best be understood by employing a multidisciplinary approach including archaeology, oral traditions, linguistic evidence and documentary sources. Two types oj trade, namely subsistence-oriented and nonsubsistence-oriented or long-distance frai, can be identified. In general, the nonsubsistence-oriented trade was a response demands for unevenly distributed resources at both local and international levels, This is demonstrated by some of the coastal and hinterland settlements for which there is evidence for periods of prosperity. Archaeological evidence from the pre-tenth-century AD settlements on the coast, and documentary evidence of the same period, show how this prosperity emanated from trade transactions between the coast and the interior in response to industrial and labor-force demands in the lands beyond the Indian Ocean, particularly the Orient and Mediterranean Europe. The steadily expanding market for commodities from the interior, particularly ivory and slaves, provided by the international maritime trade especially after the fifteenth century, brought new opportunities for the expansion of long-distance trade. These created and strengthened contacts between the East African interior and the coast, in order to satisfy the needs of the expanding markets in Europe and the Orient, for instance, the Akamba, the Nyamwezi, and the Yao caravans, to name just a few, collaborated with the Mijikenda, the Swahili, and Arab caravan traders to deplete tht interior of its resources for the markets overseas. Trade with the interior not only increased in volume but also witnessed the supplementing of traditional commodities with new ones. From the coast, for example, interior communities got luxury items such as cloth, beads, porcelain, glass, and later guns, which had not been seen in the interior before. In addition to these were cowrie shells, now as a form of currency, certain foodstuffs, and salt. These were exchanged for interior products of the hunt and jar slaves. It seems that interior communities never took the first initiative in tk international trade that characterized this region in the period under review. Ik initiative was always taken by coastal communities in response to industrial growth and labor-force demands overseas. Analyzing the balance sheet of this trade, it my k concluded that precolonial African societies in the interior were not what we would now call astute business people with long-term investment programs. There is little evidence to show that they benefited very much from these transactions, in spite of the active role that they played.

Persons with congenital or acquired immunosuppression have long been known to have an increased incidence of lymphoproliferative disorders. Unsurprisingly, therefore, the acquired immunodeficiency syndrome (AIDS), caused by the human immunodeficiency virus (HIV), is associated with an increased incidence of lymphoma. Three cases with HIV-associated lymphoma aged 30, 32 and 35 years respectively are presented. Two had cutaneous non-Hodgkin's lymphoma while one had Hodgkin's lymphoma. Standard chemotherapy for lymphoma was given with good tumour regression. Two of the patients died within six months of lymphoma diagnosis due to other complications of HIV.

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

Settlement pattern studies are concerned with relics of human occupation in the past. In an archaeological record, these relics either appear in clusters or individually in the form of pestholes, house floors, house foundations or as middens. On aerial photographs and topographic maps relics of past human occupation can be identified by the presence of circular or rectangular depressional features and stunted vegetation cover in the midst of a flourishing vegetation community. Past human settlements can also be identified in actual field observation as ruins: building structures, walled fortresses, moats, monuments and mounds.

Irrespective of their nature and conditions of preservation, past settlements are a reflection of human behaviour through time and space. The archaeological evidence that is found preserved in them can shed much light on our knowledge of past culture. The essential archaeological problem in the analysis and interpretation of settlement, however, is that architectural remains and other settlement data cannot be understood simply by their description, distribution, cultural attribution and chronology - as they have been from the early anthropological work of Morgan (1881) and Mindeleff (1890) through the first large-scale regional archaeological syntheses, such as Childe's (e.g. 1934) in Europe and Willey (1953) in South America up to the common archaeological survey work of today.

With the influence of modern cultural ecology, geography and sociobiology, settle­ment analysis has been transformed into a concern with environmental and ecological processes. Settlements are part of a complex integration of culture and ecology within a regional environment. As a result, settlement analysis in archaeology must attend not only to the physical layout of the environment, but also to the social and historical aspects of environmental interaction.

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.

.

This chapter attempts to re-evaluate the history of the East African coast and the Comores between the seventh and eleventh centuries. This is being done with a view to correcting the false picture painted by historians and/or archaeologists of the colonial school of thought, who presented rather a history of foreign traders and colonizers credited with the civilization of the coast. The role of outsiders in the early history of the East African coast cannot be denied, but it is one thing to be part of a process of change and completely another to claim responsibility for the process. Recent research, however, is slowly but surely making it very clear that the history of the East African coast is the history of indigenous African populations and their interaction with the environment

FG Macigo, DL Mwaniki and SW Guthua East Afr. Med. Journal 1995, 72: 778 - 782 SUMMARY: The prevalence of oral leukoplakia and related lesions in a Kenyan rural population was determined in a systematic house to house survey of individuals aged 15 years and above. Among the 803 individual examined, the following prevalence of lesions was observed: leukoedema (26%), melanosis (12.7%), leukoplakia (10.6%), palatal keratosis (6.4%), frictional keratosis (5.5%), pre-leukoplakia (4.1%), borderline leukoplakia (2.4%), cheek/lip biting (1.3%), and snuff dippers lesion (0.4%), 48.6% of the subjects had at least one of these lesions. Statistically significant preponderance was demonstrated for oral leukoplakia, palatal keratosis, leukoedema and frictional keratosis among males and melanosis among females. With regard to clinical classification of oral leukoplakia, the prevalence was 10% for homogeneous and 0.6% for non-homogeneous lesions. On the basis of aetiological classification, the prevalence was 8.3% for tobacco associated and 2.2% for idiopathic leukoplakia, 22.5% of leukoplakia lesions biopsied had evidence of epithelial dysplasia. In view of the premalignant potential of oral leukoplakia, our findings suggest a need for greater attention towards prevention and control of this lesion in the study community.

Temporomandibular joint (TMJ) ankylosis is a distressing affliction that denies the victim the benefit of normal diet, careers that require normal speech and causes severe facial disfigurement that aggravates psychological stress. Opinions in current literature portray controversy in its management. Hurried clinicians take shortcuts and partially treat symptoms and often make the condition worse. Others ignore shortcomings and erroneously prescribe their preferred techniques as absolute indication to the peril of the affected children. Gap arthroplasty if applied in a growing maxillofacial skeleton as in children, causes iatrogenic arrest of facial growth. The intended correction of facial disfigurement is therefore not achieved. Early detection and immediate psychological support by excision and reconstruction of ankylosed TMJ with a costochondral graft, improves patient comfort and rehabilitation when used as a planned part of a comprehensive therapy. This paper questions prior varied opinions and discusses scientific baseline considerations in management of long standing TMJ ankylosis in children in relatively affordable circumstances.

Effects of calcium supplementation in patient at risk of pregnancy induced Hypertension. (This was an experimental double blind randomized clinical trial.) J. Obset. Gynaecol. East Cent.Afr 2005, 18:49-59

S.W. Guthua* and D.L. Mwaniki** Afr. Dental Journal 1992, 6: 30-33 SUMMARY: Analysis of 110 records of patients who presented with impacted mandibular 3 rd molars was carried out to determine the frequency of occurrence of unilateral and bilateral impactions and their characteristics. 68.2% of the patients had bilaterial impactions. Among the patients with bilateral impactions, 72% had mesioangular impaction occurring either bilaterally or in combination with other types of impaction. Furthermore, 38.7% mesioangular impactions were observed on the right and left sides in the patients with bilateral impactions. Among the patients with unilateral impactions, 40.2% presented with mesioangular impaction, while 25.7% presented with distoangular impactions. While these observations support the general consensus regarding aetiology of mandibular 3 rd molar impactions as being tooth-tissue discrepancy, the possible influence of other factors is suggested.

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Fusarium culmorum is an important pathogen of wheat causing seedling blight, foot rot, and head blight (FHB) or scab. The pathogen is dominant in cooler areas like north, central and western Europe. The fungus reproduces asexually by means of conidia, which form the main mode of dispersal. Head blight is by far the most serious concern of Fusarium infection on pre-harvest wheat and other small grain cereals. The significance of F. culmorum in wheat production is attributed to both head blight and mycotoxin contamination of the grain harvested from infected ears. Ear infection mainly occurs during anthesis and is favoured by wet weather or high humidity and warm temperatures. The major mycotoxins produced by F. culmorum are deoxynivalenol, nivalenol and zearalenone, which are a potential health hazard for both humans and animals. The mycotoxins, especially deoxynivalenol, are believed to play a role in disease development. Available options of managing Fusarium head blight include use of fungicides, cultural practices, resistant varieties and biological agents. However, no wheat variety is completely resistant to Fusarium head blight while fungicides are at most 70% effective against natural infection. This review seeks to document and infer information on F. culmorum, with special emphasis on wheat head blight infection process, mechanisms of mycotoxin production, the role the mycotoxins play in pathogenesis, and the possible management options.

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This is a case report of a 23 year old multiparous woman who presented with intestinal obstruction and a right hypochondrial mass. Laparatomy revealed an infarcted 1.4 Kg spleen in the right lumbar region compressing the ascending colon. There was also ileal volvulus around the splenic pedicle. This is probably the first documented case of wandering spleen in the right hypochondrium, presenting as right large bowel obstruction, to be reported in our region. Wandering spleen is a rare condition, often asymptomatic, but may present as an acute abdomen. Pre-operative diagnosis is difficult and rarely made. Laboratory tests are seldom useful, but imaging studies do assist. Up to 1971 only 350 cases had been reported in the western literature. Review of English literature from 1900 to 1991 reported only 51 cases in children. In our region 11 cases were reported in Uganda between 1968 and 1971. No other literature is available from our region. Clinical presentation, aetiology, investigation, and management of wandering spleen is discussed.

Joint exhibition of paintings and sculptures

"

Analysis of 110 records of patients who presented with impacted mandibular 3rd molars was carried out to determine the frequency of occurrence of unilateral and bilateral impactions and their characteristics. 68.2% of the patients had bilateral impactions. Among the patients with bilateral impactions, 72% had mesioangular impaction occurring either bilaterally or in combination with other types of impaction. Furthermore, 38.7% mesioangular impactions were observed on the right and left sides in the patients with bilateral impactions. Among the patients with unilateral impactions 40.2% presented with mesioangular impaction, while 25.7% presented with distoangular impactions. While these observations support the general consensus regarding aetiology of mandibular 3rd molar impactions as being tooth-tissue discrepancy, the possible influence of other factors is suggested.

Fusarium culmorum is an important pathogen of wheat causing seedling blight, foot rot, and head blight (FHB) or scab. The pathogen is dominant in cooler areas like north, central and western Europe. The fungus reproduces asexually by means of conidia, which form the main mode of dispersal. Head blight is by far the most serious concern of Fusarium infection on pre-harvest wheat and other small grain cereals. The significance of F. culmorum in wheat production is attributed to both head blight and mycotoxin contamination of the grain harvested from infected ears. Ear infection mainly occurs during anthesis and is favoured by wet weather or high humidity and warm temperatures. The major mycotoxins produced by F. culmorum are deoxynivalenol, nivalenol and zearalenone, which are a potential health hazard for both humans and animals. The mycotoxins, especially deoxynivalenol, are believed to play a role in disease development. Available options of managing Fusarium head blight include use of fungicides, cultural practices, resistant varieties and biological agents. However, no wheat variety is completely resistant to Fusarium head blight while fungicides are at most 70% effective against natural infection. This review seeks to document and infer information on F. culmorum, with special emphasis on wheat head blight infection process, mechanisms of mycotoxin production, the role the mycotoxins play in pathogenesis, and the possible management options.

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research theories for high school students

This paper describes the methodology and presents preliminary results of an economic appraisal of a community based health care project in Kenya. Community health workers, trained for 12 weeks and deployed in two locations in Kenya's Western Province, act as first contact providers of basic health care and promoters of selected health, sanitation and nutrition practices. A Cost Benefit Analysis has been undertaken using the Willingness to Pay approach to compare the costs of the project and its benefits. The benefits are in the form of more easily accessible basic health care and are measured as consumer surplus accruing to the community. Gain in consumer surplus is consequent on the fall of average user costs and rise in utilisation of the project established points of first contact with primary health care. The argument for the economic viability of the project is validated by the large Net Present Value and Benefit Cost Ratio obtained for the whole of the project area and for the two locations separately. Although the evaluation technique used faces the problem of valuation of community time, aggregation of health care services at all points of first contact and the partial nature of cost benefit analysis evaluations, the results are strongly in favour of decentralisation of primary health care on similar lines in the rest of the country.

Analysis of 355 cases with fractures of the mandible indicated that 74.9% of the cases were due to interpersonal violence and 13.8% were caused by road traffic accidents. The men to women ratio was 8.4:1 and 75.5% of the fracture cases had single fractures while 24.5% had multiple fractures. In cases with a single fracture, the most commonly involved mandibular site was the body (42.2%). The angle of mandible was most frequently fractured (50.5%) in cases with multiple fractures.

This paper reports on work which was done on the upper Tana in Eastern Kenya. The work revealed a number of iron-using sites which included smelting areas, so-called Gumba earth works and lot of pottery, belonging to triangular incised (TIW) and Kwale Ware. It is concluded that TIW post date Kwale Ware and it is likely the TIW makers/users were responsible for the iron working in the Area.

Persons with congenital or acquired immunosuppression have long been known to have an increased incidence of lymphoproliferative disorders. Unsurprisingly, therefore, the acquired immunodeficiency syndrome (AIDS), caused by the human immunodeficiency virus (HIV), is associated with an increased incidence of lymphoma. Three cases with HIV-associated lymphoma aged 30, 32 and 35 years respectively are presented. Two had cutaneous non-Hodgkin's lymphoma while one had Hodgkin's lymphoma. Standard chemotherapy for lymphoma was given with good tumour regression. Two of the patients died within six months of lymphoma diagnosis due to other complications of HIV.

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

Settlement pattern studies are concerned with relics of human occupation in the past. In an archaeological record, these relics either appear in clusters or individually in the form of pestholes, house floors, house foundations or as middens. On aerial photographs and topographic maps relics of past human occupation can be identified by the presence of circular or rectangular depressional features and stunted vegetation cover in the midst of a flourishing vegetation community. Past human settlements can also be identified in actual field observation as ruins: building structures, walled fortresses, moats, monuments and mounds.

Irrespective of their nature and conditions of preservation, past settlements are a reflection of human behaviour through time and space. The archaeological evidence that is found preserved in them can shed much light on our knowledge of past culture. The essential archaeological problem in the analysis and interpretation of settlement, however, is that architectural remains and other settlement data cannot be understood simply by their description, distribution, cultural attribution and chronology - as they have been from the early anthropological work of Morgan (1881) and Mindeleff (1890) through the first large-scale regional archaeological syntheses, such as Childe's (e.g. 1934) in Europe and Willey (1953) in South America up to the common archaeological survey work of today.

With the influence of modern cultural ecology, geography and sociobiology, settle­ment analysis has been transformed into a concern with environmental and ecological processes. Settlements are part of a complex integration of culture and ecology within a regional environment. As a result, settlement analysis in archaeology must attend not only to the physical layout of the environment, but also to the social and historical aspects of environmental interaction.

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 chapter examines the theory that security of tenure leads to higher yields through its effects on credit, inputs, and land improvements. A survey of 406 households in the densely populated Nyeri and Kakanega districts of Kenya was conducted during 1988. The chapter provides an overview of the prevailing land tenure systems in Kenya; describes the patterns of land holdings, modes of acquisition, and land transactions in the study area; examines security of tenure and its relationship to credit, investment in land improvement and land productivity; and examines policy implications. The hypothesis that security of tenure leads to higher yields through its effect on credit, inputs and land improvements was not supported by the evidence. This situation is probably explained by the limited use of land titles in obtaining formal credit: farmers are reluctant to apply for credit because they lack confidence in their ability to repay the loans and fear losing their land.

Osteosarcoma (OS) is a highly malignant tumour and is the most common primary neoplasm of bone; although rare, especially in the maxillofacial skeleton. This article presents 14 Kenyan cases of OS of the maxillofacial bones seen between January 1991 and July 1997: 11 in the mandible, two in the maxilla and one in the right zygomatic arch. Patients ranged in age from one week to 50 years (Mean = 29.7), with an equal gender distribution. While pain and rapid swelling were the commonest clinical features, the radiographic and histopathological characteristics were as varied as has been described elsewhere. Generally, effective management of most of the cases was poor due to late presentation for treatment.

.

This chapter attempts to re-evaluate the history of the East African coast and the Comores between the seventh and eleventh centuries. This is being done with a view to correcting the false picture painted by historians and/or archaeologists of the colonial school of thought, who presented rather a history of foreign traders and colonizers credited with the civilization of the coast. The role of outsiders in the early history of the East African coast cannot be denied, but it is one thing to be part of a process of change and completely another to claim responsibility for the process. Recent research, however, is slowly but surely making it very clear that the history of the East African coast is the history of indigenous African populations and their interaction with the environment

This research examines the relationship between commercial banks (CBs) and the small enterprise sector (SES) and identifies constraints' which impede the flow of financial assistance from the commercial banks to the latter in Kenya. The variables that were examined included; requirements for successful loan application, lending levels, degree of risk attached to small enterprise lending, levels of economic impact and stages in business development at which banks become willing to support. For the small enterprises, the study sought to profile the business and its owner and, to examine its financing. The sampling units were drawn from CBs and SES within Nairobi. In data collection, questionnaires, interview and document review was employed. The study found that high interest rates and long processing procedures kept small businesses away from banks. The study established that, on the part of the banks, the entrepreneurs lacked business management skills and did not keep proper records. Moreover, the banks experienced general reproach from the small business owners, based upon conventional beliefs.

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.

Background: Multiple Myeloma (MM) is a
haematological cancer characterized by complications
of end-organ damage and subsequently high mortality.
Previously, there were few therapies available with
minimal survival benefit for most patients. Survival
was less than a year in many countries. The survival of
MM patients can range from 6 months to over 10 years,
with a median of 6 years, depending on stage of the
disease at diagnosis and prognostic factors. However,
with the advent of newer immune modulating agents
and novel therapies, there exists an opportunity to
improve the management of MM.
Objective: The purpose of this review is to discuss
the current chemotherapy and novel agents available
for treatment of Multiple Myeloma and highlight
emerging therapies in treatment of Multiple Myeloma,
some of which are now locally available in Kenya.
Data Sources: International Guidelines on Treatment
of Multiple Myeloma; Published articles from peerreviewed
journals; ESMO, NCCN guidelines on
Multiple Myeloma
Conclusion: New MM therapies have been shown to
improve progression-free survival and overall survival
of to upto 82% at four years. Some of these therapies
are now accessible locally through government
funding. In combination with a wholesome approach
which includes appropriate supportive care, there
exists an opportunity to improve the quality and
standard of care of MM patients in Kenya to replicate
the success of that in developed countries.
Key words: Multiple myeloma, Cancer

Temporomandibular joint (TMJ) ankylosis is a distressing affliction that denies the victim the benefit of normal diet, careers that require normal speech and causes severe facial disfigurement that aggravates psychological stress.  Opinions in current literature portray controversy in its management.  Hurried clinicians take shortcuts and partially treat symptoms and often make the condition worse.  Others ignore shortcomings and erroneously prescribe their preferred techniques as absolute indication to the peril of the affected children.  Gap arthroplasty if applied in a growing maxillofacial skeleton as in children, causes iatrogenic arrest of facial growth.  The intended correction of facial disfigurement is therefore not achieved.  Early detection and immediate psychological support by excision and reconstruction of ankylosed TMJ with a costochondral graft, improves patient comfort and rehabilitation when used as a planned part of a comprehensive therapy.  This paper questions prior varied opinions and discusses scientific baseline considerations in management of long standing TMJ ankylosis in children in relatively affordable circumstances.

Temporomandibular joint (TMJ) ankylosis is a distressing affliction that denies the victim the benefit of normal diet, careers that require normal speech and causes severe facial disfigurement that aggravates psychological stress. Opinions in current literature portray controversy in its management. Hurried clinicians take shortcuts and partially treat symptoms and often make the condition worse. Others ignore shortcomings and erroneously prescribe their preferred techniques as absolute indication to the peril of the affected children. Gap arthroplasty if applied in a growing maxillofacial skeleton as in children, causes iatrogenic arrest of facial growth. The intended correction of facial disfigurement is therefore not achieved. Early detection and immediate psychological support by excision and reconstruction of ankylosed TMJ with a costochondral graft, improves patient comfort and rehabilitation when used as a planned part of a comprehensive therapy. This paper questions prior varied opinions and discusses scientific baseline considerations in management of long standing TMJ ankylosis in children in relatively affordable circumstances.

No abstract available.

Loss of 1st and 2nd molars among adolescents due to dental caries is not uncommon in developing countries. Whilst their replacement is indicated, conventional methods of treatment, namely, bridging and dentures are in most cases inaccessible because of prohibitive cost. Given that it is in the same age group that diagnosis of unfavourably embedded wisdom teeth becomes feasible, autotransplantation of the latter to replace the unsalvageable 1st and 2nd molars could be an alternative treatment. Available literature suggests a success rate of over 82% based on follow-up studies of over ten years. Observations at the Dental School Clinic of the University of Nairobi, Kenya, indicate that the time it takes the transplant to 'take' and assume its functional position is 4 to 8 weeks and 2.5 to 3.5 months respectively. Since the method is relatively straightforward, we are of the view that training undergraduates and practising dental surgeons in this technique should enhance utilisation of otherwise "useless" teeth to replace the lost 1st and 2nd molars in occlusal rehabilitation.

Fusarium culmorum is an important pathogen of wheat causing seedling blight, foot rot, and head blight (FHB) or scab. The pathogen is dominant in cooler areas like north, central and western Europe. The fungus reproduces asexually by means of conidia, which form the main mode of dispersal. Head blight is by far the most serious concern of Fusarium infection on pre-harvest wheat and other small grain cereals. The significance of F. culmorum in wheat production is attributed to both head blight and mycotoxin contamination of the grain harvested from infected ears. Ear infection mainly occurs during anthesis and is favoured by wet weather or high humidity and warm temperatures. The major mycotoxins produced by F. culmorum are deoxynivalenol, nivalenol and zearalenone, which are a potential health hazard for both humans and animals. The mycotoxins, especially deoxynivalenol, are believed to play a role in disease development. Available options of managing Fusarium head blight include use of fungicides, cultural practices, resistant varieties and biological agents. However, no wheat variety is completely resistant to Fusarium head blight while fungicides are at most 70% effective against natural infection. This review seeks to document and infer information on F. culmorum, with special emphasis on wheat head blight infection process, mechanisms of mycotoxin production, the role the mycotoxins play in pathogenesis, and the possible management options.

n/a

Joint exhibition of paintings and sculptures

"

Analysis of 110 records of patients who presented with impacted mandibular 3rd molars was carried out to determine the frequency of occurrence of unilateral and bilateral impactions and their characteristics. 68.2% of the patients had bilateral impactions. Among the patients with bilateral impactions, 72% had mesioangular impaction occurring either bilaterally or in combination with other types of impaction. Furthermore, 38.7% mesioangular impactions were observed on the right and left sides in the patients with bilateral impactions. Among the patients with unilateral impactions 40.2% presented with mesioangular impaction, while 25.7% presented with distoangular impactions. While these observations support the general consensus regarding aetiology of mandibular 3rd molar impactions as being tooth-tissue discrepancy, the possible influence of other factors is suggested.

Fusarium culmorum is an important pathogen of wheat causing seedling blight, foot rot, and head blight (FHB) or scab. The pathogen is dominant in cooler areas like north, central and western Europe. The fungus reproduces asexually by means of conidia, which form the main mode of dispersal. Head blight is by far the most serious concern of Fusarium infection on pre-harvest wheat and other small grain cereals. The significance of F. culmorum in wheat production is attributed to both head blight and mycotoxin contamination of the grain harvested from infected ears. Ear infection mainly occurs during anthesis and is favoured by wet weather or high humidity and warm temperatures. The major mycotoxins produced by F. culmorum are deoxynivalenol, nivalenol and zearalenone, which are a potential health hazard for both humans and animals. The mycotoxins, especially deoxynivalenol, are believed to play a role in disease development. Available options of managing Fusarium head blight include use of fungicides, cultural practices, resistant varieties and biological agents. However, no wheat variety is completely resistant to Fusarium head blight while fungicides are at most 70% effective against natural infection. This review seeks to document and infer information on F. culmorum, with special emphasis on wheat head blight infection process, mechanisms of mycotoxin production, the role the mycotoxins play in pathogenesis, and the possible management options.

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Cardiovascular activities of nitidine chloride from Zanthoxylunt chalybeum have been compared with those of 9-methoxychelerythrine. Whereas nitidinc chloride was found to show significant hypotensive activity in rabbits, 9-methoxychelerythrine chloride showed no hypotensive activity. The effect of nitidine chloride on isolated rabbit heart was also compared with those of adrenaline and acetylcholine. 9-Methoxychelerythrine, which has hitherto been regarded as an artefact formed by recrystallization of chelerythrine base from methanol, has been shown in this work to be a true natural constituent of Zanthoxylum chalybeum. Keywords: 9-inethoxychelerythrine; nitidine chloride; cardiovascular properties; hypotensive effect; Zanthoxylum chalybeum.

OBJECTIVE: To determine the range of ablative surgery and rehabilitative procedures performed on maxillofacial structures. DESIGN: A retrospective descriptive study. SETTING: University of Nairobi Dental Teaching Hospital. SUBJECTS: Patients operated on at the institutions theatre, and followed up at the University of Nairobi Dental Teaching Hospital Oral Surgery Outpatient Clinic during the period February 1996, August 1998. RESULTS: Forty four patients underwent ablative surgery during the study period. Complete records were available for 38 patients, 27 females and 11 males aged 10 to 79 years (mean 32.6 years). Surgical procedures performed included: partial mandibulectomy, marginal mandibular resection, subtotal maxillectomy, sequestrectomy and enucleation. Six (15.8%) patients who underwent mandibular resection had rigid bone plating. Five (13.2%) patients who had maxillary involvement were given surgical obturators post-operatively with one receiving a complete denture after full recovery. A total of 22 (57.9%) patients who would have reaped benefits from prostheses therapy received none. Individual patient follow-up periods ranged from seven days for two patients who had cyst enucleation to two years for three cases with ameloblastoma, and two cases with squamous cell carcinoma. CONCLUSION: It is concluded that prosthetic rehabilitation of patients undergoing extensive surgery at the University of Nairobi Dental Teaching Hospital is largely inadequate.

Analysis of 355 cases with fractures of the mandible indicated that 74.9% of the cases were due to interpersonal violence and 13.8% were caused by road traffic accidents. The men to women ratio was 8.4:1 and 75.5% of the fracture cases had single fractures while 24.5% had multiple fractures. In cases with a single fracture, the most commonly involved mandibular site was the body (42.2%). The angle of mandible was most frequently fractured (50.5%) in cases with multiple fractures.

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

The desire for self-mutilation in the absence of any discernible psychopathology is relatively rare. Self-mutilation is most commonly a manifestation of an underlying psychopathology such as depression, schizophrenia, personality disorder, transexuality, body dysmorphic disorder and factitious disorder. In this article, a case in which a 29-year-old single Kenyan lady of African origin demanded a surgical operation to modify and reduce the size of her external genitalia is presented. Although female genital mutilation is still widespread in the country, this case is of interest in that the woman did not seek the usual circumcision but sought to specifically reduce the size of her labia minora so that she could feel like a normal woman. The unique challenges in her management are discussed. Possible aetiological factors in patients who demand surgical removal or modification of parts of their bodies without an obvious cause is discussed.

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

Settlement pattern studies are concerned with relics of human occupation in the past. In an archaeological record, these relics either appear in clusters or individually in the form of pestholes, house floors, house foundations or as middens. On aerial photographs and topographic maps relics of past human occupation can be identified by the presence of circular or rectangular depressional features and stunted vegetation cover in the midst of a flourishing vegetation community. Past human settlements can also be identified in actual field observation as ruins: building structures, walled fortresses, moats, monuments and mounds.

Irrespective of their nature and conditions of preservation, past settlements are a reflection of human behaviour through time and space. The archaeological evidence that is found preserved in them can shed much light on our knowledge of past culture. The essential archaeological problem in the analysis and interpretation of settlement, however, is that architectural remains and other settlement data cannot be understood simply by their description, distribution, cultural attribution and chronology - as they have been from the early anthropological work of Morgan (1881) and Mindeleff (1890) through the first large-scale regional archaeological syntheses, such as Childe's (e.g. 1934) in Europe and Willey (1953) in South America up to the common archaeological survey work of today.

With the influence of modern cultural ecology, geography and sociobiology, settle­ment analysis has been transformed into a concern with environmental and ecological processes. Settlements are part of a complex integration of culture and ecology within a regional environment. As a result, settlement analysis in archaeology must attend not only to the physical layout of the environment, but also to the social and historical aspects of environmental interaction.

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

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.

S.W. Guthua , D.L. Mwaniki and F.G. Macigo. Faculty of Dental Sciences, University of Nairobi , Kenya J. of Dental Research 1999, Vol. 78 Keloids are soft tissues growths which develop as a complication in later stages of wound healing. They occur more commonly in blacks in comparison to other racial groups. Although hereditary factors are implicated in individual selection and pathogenesis of keloids, the aetiology is unknown. The individuals who succumb to this disfiguring condition are usually psychologically traumatized thereby influencing their self-esteem. The management of these lesions is challenging and surgery alone without adjuvant radiotherapy shows high recurrence rate. 10 patients with keloids in the cervicofacial region are presented. The patients were divided in two categories. Category I patients (N=5) were managed with surgery and local steroid therapy. Category II patients (N=5) Received adjuvant superficial radiotherapy treatment (SXRT) after surgery. In two of the patients, in Category I, there was recurrence whereas in Category II, there was none. Complications observed in category I patients included; hypopigmentation and lipotrophy while in Category II patients, localized dermatitis, sloughing of the skin and local tissue necrosis (N=1) were observed. The complications related to SXRT improved and no invasive intervention was required. SXRT if meticulously fractionated and monitored seems to be the most favourable adjuvant modality in the management of keloids among the black population .

Settlement pattern studies are concerned with relics of human occupation in the past. In an archaeological record, these relics either appear in clusters or individually in the form of pestholes, house floors, house foundations or as middens. On aerial photographs and topographic maps relics of past human occupation can be identified by the presence of circular or rectangular depressional features and stunted vegetation cover in the midst of a flourishing vegetation community. Past human settlements can also be identified in actual field observation as ruins: building structures, walled fortresses, moats, monuments and mounds.

Irrespective of their nature and conditions of preservation, past settlements are a reflection of human behaviour through time and space. The archaeological evidence that is found preserved in them can shed much light on our knowledge of past culture. The essential archaeological problem in the analysis and interpretation of settlement, however, is that architectural remains and other settlement data cannot be understood simply by their description, distribution, cultural attribution and chronology - as they have been from the early anthropological work of Morgan (1881) and Mindeleff (1890) through the first large-scale regional archaeological syntheses, such as Childe's (e.g. 1934) in Europe and Willey (1953) in South America up to the common archaeological survey work of today.

With the influence of modern cultural ecology, geography and sociobiology, settle­ment analysis has been transformed into a concern with environmental and ecological processes. Settlements are part of a complex integration of culture and ecology within a regional environment. As a result, settlement analysis in archaeology must attend not only to the physical layout of the environment, but also to the social and historical aspects of environmental interaction.

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.

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Temporomandibular joint (TMJ) ankylosis is a distressing affliction that denies the victim the benefit of normal diet, careers that require normal speech and causes severe facial disfigurement that aggravates psychological stress. Opinions in current literature portray controversy in its management. Hurried clinicians take shortcuts and partially treat symptoms and often make the condition worse. Others ignore shortcomings and erroneously prescribe their preferred techniques as absolute indication to the peril of the affected children. Gap arthroplasty if applied in a growing maxillofacial skeleton as in children, causes iatrogenic arrest of facial growth. The intended correction of facial disfigurement is therefore not achieved. Early detection and immediate psychological support by excision and reconstruction of ankylosed TMJ with a costochondral graft, improves patient comfort and rehabilitation when used as a planned part of a comprehensive therapy. This paper questions prior varied opinions and discusses scientific baseline considerations in management of long standing TMJ ankylosis in children in relatively affordable circumstances.

Field experiments were conducted to investigate the response of grain legumes to rhizobia inoculation, farmyard manure and inorganic fertilizer nitrogen. The grain legumes were common bean (Phaseolus vulgaris L.var GLP 2), lima bean (Phaseolus lunatus L.), green gram (Vigna radiate L.) and lablab (Lablab purpureus L.). The experimental design was a randomized complete block design with split plot arrangement and replicated thrice. Parameters determined were the number of nodules and nodule dry weight per plant, seed yield and yield components. Nitrogen fertilizer application significantly reduced the number of nodules in most of the legume species. In contrast, rhizobia inoculation increased number of nodules and nodule dry matter in most species but this was not translated into increase in plant growth or grain yield. Application of manure improved nodulation and grain yield only in the short rains. However, fertilizer application significantly increased dry matter in both seasons and total grain yield during short rains. The study indicated that the effect of rhizobia inoculation, farmyard manure and nitrogen fertilizer on grain legumes is variable depending on species, parameter being measured and other environmental factors. Keywords: Dry matter, grain legumes, grain yield, nitrogen source, nodulation.

Department of Obstetrics and Gynaecology, College of Health Sciences, University of Nairobi, Kenya. The effect of a low-oestrogen combined pill, progestogen-only pill and medroxyprogesterone acetate on oral glucose tolerance test was studied in 29, 30 and 9 indigenous Kenyan women respectively. Glucose tolerance test was performed before treatment was started and then after 1,3 and 6 months in microgynon users. The mean areas under the glucose curves were also significantly elevated. Significant increase in blood glucose values were noted only at 30 minutes after 6 months of use of the progestogen-only oral contraceptive but the mean blood glucose values were higher than in the control after 1,3 and 6 months of use. However, the mean values of the areas under the glucose curves were significantly elevated after 1,3, and 6 months of use. Medroxyprogesterone acetate users showed significantly lower fasting blood glucose values at 60 and 90 minutes after 1 month of use, after which the blood glucose values returned to the pre-treatment values. The mean values of the glucose curve areas showed no significant change. It is concluded that both microgynon and minipill cause relative impairment of glucose tolerance test as early as after 1 month of use. Medroxyprogesterone acetate does not impair oral glucose tolerance for at least the first 6 months of use. The implications of these findings are discussed. PIP: Researchers followed 68 women who attended the Family Welfare Clinic at the Kenyatta National Hospital in Nairobi, Kenya to determine if the low estrogen combined oral contraceptive (OC) Microgynon, a progestogen only OC, and Depo-Provera induce changes in the oral glucose test. These women did not take any steroidal contraceptives before entry into the study. Blood glucose levels were significantly higher after 60, 90 and 120 minutes than the control levels for women taking Microgynon. In addition, the mean areas under the glucose curves were substantially elevated after 1, 3, and 6 months above the control (p.002, .005, and .01 respectively). The only significant change in blood glucose levels in women taking the progestogen only OC occurred at 30 minutes after 6 months. Yet the mean areas under the curve were significantly higher than the control after ,1 2, and 3 months (p.005, .05 and .002 respectively). As for Depo-Provera, significantly lowered blood glucose levels only occurred after 1 month at 30, 50, and 90 minutes although no significant changes occurred after 1, 3, and 6 months in the mean areas under the glucose curves. Metabolic change occurred earlier and more often in Microgynon users than progestogen only OC users. This could be due to the progestogen levonorgestrel which has been shown to interrupt glucose metabolism. These changes could possible adversely effect women who are predisposed to developing diabetes, since 1 woman did develop a diabetic curve after 1 month of using Microgynon. Nevertheless no pattern towards abnormal glucose tolerance existed. Standard deviations of areas under the curves indicated that the number of women who develop glucose intolerance may increase with duration of use.

Loss of 1st and 2nd molars among adolescents due to dental caries is not uncommon in developing countries. Whilst their replacement is indicated, conventional methods of treatment, namely, bridging and dentures are in most cases inaccessible because of prohibitive cost. Given that it is in the same age group that diagnosis of unfavourably embedded wisdom teeth becomes feasible, autotransplantation of the latter to replace the unsalvageable 1st and 2nd molars could be an alternative treatment. Available literature suggests a success rate of over 82% based on follow-up studies of over ten years. Observations at the Dental School Clinic of the University of Nairobi, Kenya, indicate that the time it takes the transplant to 'take' and assume its functional position is 4 to 8 weeks and 2.5 to 3.5 months respectively. Since the method is relatively straightforward, we are of the view that training undergraduates and practising dental surgeons in this technique should enhance utilisation of otherwise "useless" teeth to replace the lost 1st and 2nd molars in occlusal rehabilitation.

Greenhouse experiments were conducted over two cropping cycles to investigate the effect of fungicide seed treatment and fungal root rot pathogens on nodulation and dry matter accumulation of selected food legumes. The legumes were common bean (Phaseolus vulgaris L. variety GLP 2), green gram (Vigna radiata L. variety M66) and lablab (Lablab purpureus L.). Treatments included, inoculation of legumes with pathogen alone (Fusarium oxysporum f.sp. phaseoli or Macrophomina phaseolina or Sclerotinia sclerotiorum or Rhizoctonia solani), or with appropriate rhizobia alone or application of fungicide (copper oxychloride) or their combinations. Results of the study indicated that fungicide seed treatment reduced disease incidence on Sclerotinia and Rhizoctonia inoculated plants. However, fungicide treatment significantly (p=0.05) depressed nodulation of the legumes but its effect on nodulation was significantly suppressed when applied together with rhizobia on treated seeds. Fungicide application significantly reduced seedlings mortality (pre-emergence damping off) and number of nodules per plant but had no effect on dry matter accumulation. Combination of fungicide and rhizobia inoculation improved nodulation and reduced disease incidence. It is therefore concluded that this combination yields better results if the aim is to reduce root rot incidence while improving nodulation concurrently.

This study was done to determine the nature of utilization of dental auxiliaries and medical emergencies in private dental surgeries in Kenya. A self administering questionnaire with pre-paid postage was mailed to 138 dentists. 27.5% responded. 81.6% used dental auxiliaries and the main reason was to improve efficiency in managing patients. 93.5% of the auxiliaries were on job trained secondary school graduates. 63.2% of the respondents delegated duties which were mainly non-clinical. 26.3% did not delegate any duties. In a descending order, the reasons for non delegation were: that it would be risky to patients, not allowed by law, they did not find it necessary and that auxiliaries were not held responsible if something went wrong. The main duties delegated to the auxiliaries were cleaning of instruments and sterilization, mixing of restorative materials and preparing amalgam. Delegation was done primarily based on auxiliaries capability to perform the procedure and meet the set standards. 57.9% indicated that they rarely encountered medical emergencies. Syncope was the commonest emergency encountered. 72.7% indicated that auxiliaries could not handle medical emergencies because they were not trained. It is concluded that most dentists did not delegate clinical duties to dental auxiliaries and medical emergencies were rare.

S.W. Guthua* and D.L. Mwaniki** Afr. Dental Journal 1992, 6: 30-33 SUMMARY: Analysis of 110 records of patients who presented with impacted mandibular 3 rd molars was carried out to determine the frequency of occurrence of unilateral and bilateral impactions and their characteristics. 68.2% of the patients had bilaterial impactions. Among the patients with bilateral impactions, 72% had mesioangular impaction occurring either bilaterally or in combination with other types of impaction. Furthermore, 38.7% mesioangular impactions were observed on the right and left sides in the patients with bilateral impactions. Among the patients with unilateral impactions, 40.2% presented with mesioangular impaction, while 25.7% presented with distoangular impactions. While these observations support the general consensus regarding aetiology of mandibular 3 rd molar impactions as being tooth-tissue discrepancy, the possible influence of other factors is suggested.

Fusarium culmorum is an important pathogen of wheat causing seedling blight, foot rot, and head blight (FHB) or scab. The pathogen is dominant in cooler areas like north, central and western Europe. The fungus reproduces asexually by means of conidia, which form the main mode of dispersal. Head blight is by far the most serious concern of Fusarium infection on pre-harvest wheat and other small grain cereals. The significance of F. culmorum in wheat production is attributed to both head blight and mycotoxin contamination of the grain harvested from infected ears. Ear infection mainly occurs during anthesis and is favoured by wet weather or high humidity and warm temperatures. The major mycotoxins produced by F. culmorum are deoxynivalenol, nivalenol and zearalenone, which are a potential health hazard for both humans and animals. The mycotoxins, especially deoxynivalenol, are believed to play a role in disease development. Available options of managing Fusarium head blight include use of fungicides, cultural practices, resistant varieties and biological agents. However, no wheat variety is completely resistant to Fusarium head blight while fungicides are at most 70% effective against natural infection. This review seeks to document and infer information on F. culmorum, with special emphasis on wheat head blight infection process, mechanisms of mycotoxin production, the role the mycotoxins play in pathogenesis, and the possible management options.

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

Analysis of 355 cases with fractures of the mandible indicated that 74.9% of the cases were due to interpersonal violence and 13.8% were caused by road traffic accidents. The men to women ratio was 8.4:1 and 75.5% of the fracture cases had single fractures while 24.5% had multiple fractures. In cases with a single fracture, the most commonly involved mandibular site was the body (42.2%). The angle of mandible was most frequently fractured (50.5%) in cases with multiple fractures.

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BACKGROUND: The viral safety of blood depends on donor selection and screening of the blood for viruses. OBJECTIVE: To determine the frequency of human immunodeficiency viruses 1 and 2, hepatitis B virus and hepatitis C virus in a population of donors. DESIGN: Retrospective study including all blood donations at a hospital-based transfusion unit between January 1995 and August 1998. RESULTS: A significant declining trend in the frequency of the human immunodeficiency virus from 4.5% in 1995 to 3.0% in 1998 was noted. Hepatitis B virus (HBV) decreased from 4.2% in 1995 to 3.9% in 1998, while hepatitis C (HCV) increased from 1.5% in 1996 to 1.8% in 1998. The changes for both HBV and HCV were not statistically significant. CONCLUSION: The safety of blood and blood products with respect to HIV, HBV and HCV is very high. It is important to educate donors regarding transfusion transmitted infections. It is recommended that HCV screening be implemented as a standard test for all donations.

A sacred site is a place which is considered holy, and is partially or wholly reserved for magico-religious or ceremonial functions. Because of this it is venerated and revered and is kept free from contamination by sin and evil. Sacred sites vary in size from very small places covering a few square metres to large areas covering several hectares of land. They are usually characterized by the presence of artefacts, ecofacts and features that are unique to them; they may be in the open air, or in rockshelters, caves and forests. In many cases, sacred sites have frightening tales told about them, in order to scare off those who would want to destroy or defile them. In the archaeological record, sacred sites may initially be identifiable as burial sites, ceremonial sites or butchery sites. It is on the basis of such clues that other attributes that are typical of sacred sites can be identified, isolated and studied. It is against this background that this chapter discusses the Mijikenda kaya (pi. makaya) as a sacred site.

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

S.W. Guthua , D.L. Mwaniki and F.G. Macigo. Faculty of Dental Sciences, University of Nairobi , Kenya J. of Dental Research 1999, Vol. 78 Keloids are soft tissues growths which develop as a complication in later stages of wound healing. They occur more commonly in blacks in comparison to other racial groups. Although hereditary factors are implicated in individual selection and pathogenesis of keloids, the aetiology is unknown. The individuals who succumb to this disfiguring condition are usually psychologically traumatized thereby influencing their self-esteem. The management of these lesions is challenging and surgery alone without adjuvant radiotherapy shows high recurrence rate. 10 patients with keloids in the cervicofacial region are presented. The patients were divided in two categories. Category I patients (N=5) were managed with surgery and local steroid therapy. Category II patients (N=5) Received adjuvant superficial radiotherapy treatment (SXRT) after surgery. In two of the patients, in Category I, there was recurrence whereas in Category II, there was none. Complications observed in category I patients included; hypopigmentation and lipotrophy while in Category II patients, localized dermatitis, sloughing of the skin and local tissue necrosis (N=1) were observed. The complications related to SXRT improved and no invasive intervention was required. SXRT if meticulously fractionated and monitored seems to be the most favourable adjuvant modality in the management of keloids among the black population .

Settlement pattern studies are concerned with relics of human occupation in the past. In an archaeological record, these relics either appear in clusters or individually in the form of pestholes, house floors, house foundations or as middens. On aerial photographs and topographic maps relics of past human occupation can be identified by the presence of circular or rectangular depressional features and stunted vegetation cover in the midst of a flourishing vegetation community. Past human settlements can also be identified in actual field observation as ruins: building structures, walled fortresses, moats, monuments and mounds.

Irrespective of their nature and conditions of preservation, past settlements are a reflection of human behaviour through time and space. The archaeological evidence that is found preserved in them can shed much light on our knowledge of past culture. The essential archaeological problem in the analysis and interpretation of settlement, however, is that architectural remains and other settlement data cannot be understood simply by their description, distribution, cultural attribution and chronology - as they have been from the early anthropological work of Morgan (1881) and Mindeleff (1890) through the first large-scale regional archaeological syntheses, such as Childe's (e.g. 1934) in Europe and Willey (1953) in South America up to the common archaeological survey work of today.

With the influence of modern cultural ecology, geography and sociobiology, settle­ment analysis has been transformed into a concern with environmental and ecological processes. Settlements are part of a complex integration of culture and ecology within a regional environment. As a result, settlement analysis in archaeology must attend not only to the physical layout of the environment, but also to the social and historical aspects of environmental interaction.

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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.

.

This chapter attempts to re-evaluate the history of the East African coast and the Comores between the seventh and eleventh centuries. This is being done with a view to correcting the false picture painted by historians and/or archaeologists of the colonial school of thought, who presented rather a history of foreign traders and colonizers credited with the civilization of the coast. The role of outsiders in the early history of the East African coast cannot be denied, but it is one thing to be part of a process of change and completely another to claim responsibility for the process. Recent research, however, is slowly but surely making it very clear that the history of the East African coast is the history of indigenous African populations and their interaction with the environment

Temporomandibular joint (TMJ) ankylosis is a distressing affliction that denies the victim the benefit of normal diet, careers that require normal speech and causes severe facial disfigurement that aggravates psychological stress. Opinions in current literature portray controversy in its management. Hurried clinicians take shortcuts and partially treat symptoms and often make the condition worse. Others ignore shortcomings and erroneously prescribe their preferred techniques as absolute indication to the peril of the affected children. Gap arthroplasty if applied in a growing maxillofacial skeleton as in children, causes iatrogenic arrest of facial growth. The intended correction of facial disfigurement is therefore not achieved. Early detection and immediate psychological support by excision and reconstruction of ankylosed TMJ with a costochondral graft, improves patient comfort and rehabilitation when used as a planned part of a comprehensive therapy. This paper questions prior varied opinions and discusses scientific baseline considerations in management of long standing TMJ ankylosis in children in relatively affordable circumstances.

Department of Obstetrics and Gynaecology, College of Health Sciences, University of Nairobi, Kenya. The effect of a low-oestrogen combined pill, progestogen-only pill and medroxyprogesterone acetate on oral glucose tolerance test was studied in 29, 30 and 9 indigenous Kenyan women respectively. Glucose tolerance test was performed before treatment was started and then after 1,3 and 6 months in microgynon users. The mean areas under the glucose curves were also significantly elevated. Significant increase in blood glucose values were noted only at 30 minutes after 6 months of use of the progestogen-only oral contraceptive but the mean blood glucose values were higher than in the control after 1,3 and 6 months of use. However, the mean values of the areas under the glucose curves were significantly elevated after 1,3, and 6 months of use. Medroxyprogesterone acetate users showed significantly lower fasting blood glucose values at 60 and 90 minutes after 1 month of use, after which the blood glucose values returned to the pre-treatment values. The mean values of the glucose curve areas showed no significant change. It is concluded that both microgynon and minipill cause relative impairment of glucose tolerance test as early as after 1 month of use. Medroxyprogesterone acetate does not impair oral glucose tolerance for at least the first 6 months of use. The implications of these findings are discussed. PIP: Researchers followed 68 women who attended the Family Welfare Clinic at the Kenyatta National Hospital in Nairobi, Kenya to determine if the low estrogen combined oral contraceptive (OC) Microgynon, a progestogen only OC, and Depo-Provera induce changes in the oral glucose test. These women did not take any steroidal contraceptives before entry into the study. Blood glucose levels were significantly higher after 60, 90 and 120 minutes than the control levels for women taking Microgynon. In addition, the mean areas under the glucose curves were substantially elevated after 1, 3, and 6 months above the control (p.002, .005, and .01 respectively). The only significant change in blood glucose levels in women taking the progestogen only OC occurred at 30 minutes after 6 months. Yet the mean areas under the curve were significantly higher than the control after ,1 2, and 3 months (p.005, .05 and .002 respectively). As for Depo-Provera, significantly lowered blood glucose levels only occurred after 1 month at 30, 50, and 90 minutes although no significant changes occurred after 1, 3, and 6 months in the mean areas under the glucose curves. Metabolic change occurred earlier and more often in Microgynon users than progestogen only OC users. This could be due to the progestogen levonorgestrel which has been shown to interrupt glucose metabolism. These changes could possible adversely effect women who are predisposed to developing diabetes, since 1 woman did develop a diabetic curve after 1 month of using Microgynon. Nevertheless no pattern towards abnormal glucose tolerance existed. Standard deviations of areas under the curves indicated that the number of women who develop glucose intolerance may increase with duration of use.

Loss of 1st and 2nd molars among adolescents due to dental caries is not uncommon in developing countries. Whilst their replacement is indicated, conventional methods of treatment, namely, bridging and dentures are in most cases inaccessible because of prohibitive cost. Given that it is in the same age group that diagnosis of unfavourably embedded wisdom teeth becomes feasible, autotransplantation of the latter to replace the unsalvageable 1st and 2nd molars could be an alternative treatment. Available literature suggests a success rate of over 82% based on follow-up studies of over ten years. Observations at the Dental School Clinic of the University of Nairobi, Kenya, indicate that the time it takes the transplant to 'take' and assume its functional position is 4 to 8 weeks and 2.5 to 3.5 months respectively. Since the method is relatively straightforward, we are of the view that training undergraduates and practising dental surgeons in this technique should enhance utilisation of otherwise "useless" teeth to replace the lost 1st and 2nd molars in occlusal rehabilitation.

Although a relationship between Lapiat and post-Lapita ceramic traditions has long been suspected, a systematic and detailed examination of the similarities and differences has not been previously made. An important first step is to determine the nature of change from one to the other by examining pottery from sites which have the full ceramic sequence. My analyses of the assemblages from Manus and New Island demonstrate continuity between the two traditions.

S.W. Guthua* and D.L. Mwaniki** Afr. Dental Journal 1992, 6: 30-33 SUMMARY: Analysis of 110 records of patients who presented with impacted mandibular 3 rd molars was carried out to determine the frequency of occurrence of unilateral and bilateral impactions and their characteristics. 68.2% of the patients had bilaterial impactions. Among the patients with bilateral impactions, 72% had mesioangular impaction occurring either bilaterally or in combination with other types of impaction. Furthermore, 38.7% mesioangular impactions were observed on the right and left sides in the patients with bilateral impactions. Among the patients with unilateral impactions, 40.2% presented with mesioangular impaction, while 25.7% presented with distoangular impactions. While these observations support the general consensus regarding aetiology of mandibular 3 rd molar impactions as being tooth-tissue discrepancy, the possible influence of other factors is suggested.

Fusarium culmorum is an important pathogen of wheat causing seedling blight, foot rot, and head blight (FHB) or scab. The pathogen is dominant in cooler areas like north, central and western Europe. The fungus reproduces asexually by means of conidia, which form the main mode of dispersal. Head blight is by far the most serious concern of Fusarium infection on pre-harvest wheat and other small grain cereals. The significance of F. culmorum in wheat production is attributed to both head blight and mycotoxin contamination of the grain harvested from infected ears. Ear infection mainly occurs during anthesis and is favoured by wet weather or high humidity and warm temperatures. The major mycotoxins produced by F. culmorum are deoxynivalenol, nivalenol and zearalenone, which are a potential health hazard for both humans and animals. The mycotoxins, especially deoxynivalenol, are believed to play a role in disease development. Available options of managing Fusarium head blight include use of fungicides, cultural practices, resistant varieties and biological agents. However, no wheat variety is completely resistant to Fusarium head blight while fungicides are at most 70% effective against natural infection. This review seeks to document and infer information on F. culmorum, with special emphasis on wheat head blight infection process, mechanisms of mycotoxin production, the role the mycotoxins play in pathogenesis, and the possible management options.

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