A. A. Fatah, R. D. Arcilesi, T. Chekol, C. H. Lattin, O. A. Sadik, A. Aluoch, The primary purpose of the Guide for the Selection of Biological Agent Detection Equipment for Emergency First Responders is to provide emergency first responders with information to aid them in the selection and utilization of BA detection equipment. The guide is intended to be more practical than technical and provides information on a variety of factors to be considered when purchasing detection equipment, including, but not limited to, sensitivity, specificity, startup and response times, power requirements, cost, durability, and portability

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This integrative review on the teaching of reading in Kenyan primary schools provides a foundation for the growing movement there to improve reading education. In gathering sources for this review, we took an inclusive historical stance. Thus, we did not dismiss research reports that lacked traditional indicators of quality such as being published in peer-reviewed journals. We used multiple methods to find relevant research and associated documents, including two trips to Kenya. The review is organized by six topics: (a) language of instruction, (b) reading instruction, (c) reading materials, (d) reading culture, (e) assessment, and (f) teacher development. The review concludes with six proposals for policymakers, educational researchers, and teacher educators for the development of reading instruction based on what we learned in reviewing the literature. The first proposals are intended specifically to address the teaching of reading in Kenya, but they may be relevant to other sub-Saharan nations. The final proposal encourages others to conduct similar reviews to make possible a handbook of reading in Africa.

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

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

It has been assessed that the majority of trees planted in developing countries are planted by farmers. On-farm tree planting is likely to gain importance in the future as access to natural forests and trees is getting more and more difficult. On-farm tree planting, however, often suffers from lack of access to a diversity of high quality tree planting material. Quality tree seed are normally sold from major seed producers (national tree seed organisations) in a centralised manner, with only 1-3 outlets within the country, and often only in large quantities. Small holders cannot afford to travel long distances and need only small amounts of seed. Therefore the seed will have to be brought to the farmer

It has been assessed that the majority of trees planted in developing countries are planted by farmers. On-farm tree planting is likely to gain importance in the future as access to natural forests and trees is getting more and more difficult. On-farm tree planting, however, often suffers from lack of access to a diversity of high quality tree planting material. Quality tree seed are normally sold from major seed producers (national tree seed organisations) in a centralised manner, with only 1-3 outlets within the country, and often only in large quantities. Small holders cannot afford to travel long distances and need only small amounts of seed. Therefore the seed will have to be brought to the farmers

Kenya’s agricultural sector accounts for 20–30% of the gross domestic product (GDP). Of this, the livestock sector alone makes a contribution of about 50%. Thus, livestock contributes heavily to the GDP and food security of its population. It also provides the necessary thrust for other forms of development in the country. Recent statistics indicate that currently over 50% of the country’s livestock population is based in the arid and semi-arid lands (ASALs), which form about 80% of the country’s land area. However, comparative international statistics show that livestock contributes 88% of the total agricultural output in Botswana even though the country has half Kenya’s livestock population and is of less agricultural potential. Thus, there is a huge potential contribution that livestock can make to the Kenyan national economy. Unfortunately, this sector receives only 10% of the government’s agricultural expenditure and less than one per cent of total spending, yet it is estimated that Kenya’s potential to export livestock products if adequately exploited would earn more than the earnings from tea and coffee combined. This then calls for new thinking about livestock development strategies to harness the arid landsThe livestock sector accounts for 90% of employment and more than 95% of household incomes in the ASALs. Most of the livestock slaughtered in major urban centres originates in these areas, with an annual slaughter of about 1.6 million Tropical Livestock Units. Kenya’s livestock from the ASALs is worth Kshs 60 billion (US$800 million). The internal livestock trade in trade in thepastoral areas alone nets in about 6 billion shillings (US$80 million )a yearIn the arid areas of the ASALs, arable crop production is not possible without some form of irrigation; while in semi-arid areas rainfall may be sufficient for certain types of crops, requiring special management techniques. Therefore, except for the areaunder cropping, the rest of the arid areas is used for livestock.......

Kenya’s agricultural sector accounts for 20–30% of the gross domestic product (GDP). Of this, the livestock sector alone makes a contribution of about 50%. Thus, livestock contributes heavily to the GDP and food security of its population. It also provides the necessary thrust for other forms of development in the country. Recent statistics indicate that currently over 50% of the country’s livestock population is based in the arid and semi-arid lands (ASALs), which form about 80% of the country’s land area. However, comparative international statistics show that livestock contributes 88% of the total agricultural output in Botswana even though the country has half Kenya’s livestock population and is of less agricultural potential. Thus, there is a huge potential contribution that livestock can make to the Kenyan national economy. Unfortunately, this sector receives only 10% of the government’s agricultural expenditure and less than one per cent of total spending, yet it is estimated that Kenya’s potential to export livestock products if adequately exploited would earn more than the earnings from tea and coffee combined. This then calls for new thinking about livestock development strategies to harness the arid landsThe livestock sector accounts for 90% of employment and more than 95% of household incomes in the ASALs. Most of the livestock slaughtered in major urban centres originates in these areas, with an annual slaughter of about 1.6 million Tropical Livestock Units. Kenya’s livestock from the ASALs is worth Kshs 60 billion (US$800 million). The internal livestock trade in trade in thepastoral areas alone nets in about 6 billion shillings (US$80 million )a yearIn the arid areas of the ASALs, arable crop production is not possible without some form of irrigation; while in semi-arid areas rainfall may be sufficient for certain types of crops, requiring special management techniques. Therefore, except for the areaunder cropping, the rest of the arid areas is used for livestock......

Kenya’s agricultural sector accounts for 20–30% of the gross domestic product (GDP). Of this, the livestock sector alone makes a contribution of about 50%. Thus, livestock contributes heavily to the GDP and food security of its population. It also provides the necessary thrust for other forms of development in the country. Recent statistics indicate that currently over 50% of the country’s livestock population is based in the arid and semi-arid lands (ASALs), which form about 80% of the country’s land area. However, comparative international statistics show that livestock contributes 88% of the total agricultural output in Botswana even though the country has half Kenya’s livestock population and is of less agricultural potential. Thus, there is a huge potential contribution that livestock can make to the Kenyan national economy. Unfortunately, this sector receives only 10% of the government’s agricultural expenditure and less than one per cent of total spending, yet it is estimated that Kenya’s potential to export livestock products if adequately exploited would earn more than the earnings from tea and coffee combined. This then calls for new thinking about livestock development strategies to harness the arid landsThe livestock sector accounts for 90% of employment and more than 95% of household incomes in the ASALs. Most of the livestock slaughtered in major urban centres originates in these areas, with an annual slaughter of about 1.6 million Tropical Livestock Units. Kenya’s livestock from the ASALs is worth Kshs 60 billion (US$800 million). The internal livestock trade in trade in thepastoral areas alone nets in about 6 billion shillings (US$80 million )a yearIn the arid areas of the ASALs, arable crop production is not possible without some form of irrigation; while in semi-arid areas rainfall may be sufficient for certain types of crops, requiring special management techniques. Therefore, except for the areaunder cropping, the rest of the arid areas is used for livestock.......

Department of Paediatrics, University of Nairobi, Kenya. Sodium and potassium levels were measured weekly in mothers' milk and in serum and urine of 41 supplemented and 25 unsupplemented very-low-birth-weight infants whose mean birth weights were 1390g and 1332g, respectively (mean gestational age, 31 weeks). Sodium intake was 5.95mmol/kg/day for the supplemented group and 2.75mmol/kg/day for controls. None of the infants in either group was hyponatremic during the 6-week period of study. Urinary sodium in the supplemented group was 15.7mmol/L as compared with 7.5mmol/L in controls. Human milk sodium was significantly lower than reported elsewhere. Growth in the supplemented group was greater than in the unsupplemented group. Since no episode of hyponatremia occurred, it was concluded that routine sodium supplementation was unnecessary.

Texbook:

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

Operations Research techniques involving modelling a situation or a problem and finding an optimal solution for it. These tools are not designed nor intended to replace managerial decision making, but rather their purpose is to aid in the decision-making process by providing a quantitative basis for decision making. Unfortunately, the proliferation of OR tools in organizational decision making has been lacking, with concerns been expressed about the limited awareness of the business community of OR's potential and capability. Current study was based in the premise that students provide an appropriate avenue, as agent of change, in sensitizing and demonstrating the potential and capacity of OR tools/techniques in resolving various problems, both in public and private sector. Study aimed at evaluating the use of OR as tools of data analysis at MBA level. A sample of 100 MBA research projects undertaken between 2005 and 2007 was randomly selected and their objectives and selected data analysis tools recorded. Where OR tools were not used, the research evaluated if there was a possibility of using OR tools. Results indicated low usage of OR as data analysis, though there was a high potential for the use of OR tools.

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Operations Research techniques involving modelling a situation or a problem and finding an optimal solution for it. These tools are not designed nor intended to replace managerial decision making, but rather their purpose is to aid in the decision-making process by providing a quantitative basis for decision making. Unfortunately, the proliferation of OR tools in organizational decision making has been lacking, with concerns been expressed about the limited awareness of the business community of OR's potential and capability. Current study was based in the premise that students provide an appropriate avenue, as agent of change, in sensitizing and demonstrating the potential and capacity of OR tools/techniques in resolving various problems, both in public and private sector. Study aimed at evaluating the use of OR as tools of data analysis at MBA level. A sample of 100 MBA research projects undertaken between 2005 and 2007 was randomly selected and their objectives and selected data analysis tools recorded. Where OR tools were not used, the research evaluated if there was a possibility of using OR tools. Results indicated low usage of OR as data analysis, though there was a high potential for the use of OR tools.

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The spliced leader (SL) RNA plays a key role in mRNA maturation in trypanosomatid protozoa by providing the SL sequence, which is joined to the 5' end of every mRNA. As a first step towards a better understanding of the biogenesis and function of the SL RNA, we expressed a tagged SL RNA gene in a cell-free system of procyclic Trypanosoma brucei cells. Transcription initiates at + 1 can be detected as early as 1 min after addition of extract. Transcription of the SL RNA gene in vitro, as well as in permeable cells, is mediated by an alpha-amanitin/tagetitoxin resistant complex, suggesting a promoter that is intermediate between a classical RNA polymerase II and RNA polymerase III promoter. An analysis of the promoter architecture of the SL RNA gene revealed that regulatory elements are located upstream of the coding region and that the SL sequence, in contrast to the nematode SL sequence, is not required for T. brucei SL RNA gene transcription.

One hundred and seventy five subjects with chronic liver diseases which included patients with chronic active hepatitis (90), liver cirrhosis (31) and asymptomatic hepatitis B carriers (54), were included in the study. Hepatitis B virus (HBV) specific DNA-polymerase activity and HBe-markers were tested as markers of HBV-multiplication. In HBsAg positive samples, DNA-P activity was positive in 44.4% of the HBV carriers, 52.9% of the patients with chronic active hepatitis and 81.8% of the patients with liver cirrhosis. The corresponding figures for the presence of HBeAg in these groups were 18.5, 26.5 and 45.5% respectively. Virus multiplication was also observed in 41.1 and 44.4% patients with chronic active hepatitis and liver cirrhosis respectively, in the absence of HBsAg. The results of the present study show that hepatitis B virus is the most important etiological factor of chronic liver diseases in India. Most of our patients of chronic liver diseases seems to have contacted HBV infection as young adults and the mode of transmission is likely to be horizontal rather than vertical. The virus replicating markers correlate well with the severity of the liver injury and decreased with the age. DNA-P activity is a more sensitive marker of viral multiplication than HBeAg. Viral multiplication was also found to occur in the absence of the usual HBV markers. Continued viral multiplication in patients with chronic active hepatitis and liver cirrhosis is implicated in continued liver injury and progressive liver disease.

Essential thrombocythaemia was diagnosed in a series of 18 patients on the basis of platelet counts greater than 1,000 X 10(9)/1. Radionuclide studies have been carried out to distinguish thrombocythaemia as a primary disease from polycythaemia vera, myelofibrosis and chronic granulocytic leukaemia presenting with high platelet counts. These have included blood volume and spleen function, and radio-iron (52Fe) has been used to demonstrate the presence of extramedullary (splenic) erythropoiesis. The value of these investigations in distinguishing between the various myeloproliferative disorders associated with thrombocythaemia is illustrated. PMID: 3933244 [PubMed - indexed for MEDLINE]

PMID: 614126 [PubMed - indexed for MEDLINE]

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Coronary heart disease (CHD) is the leading cause of mortality in Western societies, affecting about one third of the population before their seventieth year. Over the past decades modifiable risk factors of CHD have been identified, including smoking and diet. These factors when altered can have a significant impact on an individuals' risk of developing CHD, their overall health and quality of life. There is strong evidence suggesting that dietary intake of plant foods rich in fibre and polyphenolic compounds, effectively lowers the risk of developing CHD. However, the efficacy of these foods often appears to be greater than the sum of their recognised biologically active parts. Here we discuss the hypothesis that beneficial metabolic and vascular effects of dietary fibre and plant polyphenols are due to an up regulation of the colon-systemic metabolic axis by these compounds. Fibres and many polyphenols are converted into biologically active compounds by the colonic microbiota. This microbiota imparts great metabolic versatility and dynamism, with many of their reductive or hydrolytic activities appearing complementary to oxidative or conjugative human metabolism. Understanding these microbial activities is central to determining the role of different dietary components in preventing or beneficially impacting on the impaired lipid metabolism and vascular dysfunction that typifies CHD and type II diabetes. This approach lays the foundation for rational selection of health promoting foods, rational target driven design of functional foods, and provides an essential thus-far, overlooked, dynamic to our understanding of how foods recognised as "healthy" impact on the human metabonome.

The morphological adaptations of the fruit bat small intestine to which the high functional efficiency could be related and the possible landmarks delineating the various parts of the gut were examined. The stomach was the carnivorous type with large rugae spanning the entire luminal aspect down to the pyloric sphincter, which was reflected internally as a prominent fold. Externally, the intestine was a continuous tube uninterrupted by any structures. The cranial fifth of the small gut had long, branching and anastomosing villi, which caudally turned to finger-like discrete structures that became rather short and stumpy and diminished at the beginning of the colon. The colon had longitudinal folds that were macroscopically discernible from the mucosal aspect of the opened intestine and that continued into the rectum. The small gut formed 94% of the whole intestinal length, the colon and the rectum taking 4 and 2%, respectively. Ultrastructurally, the enterocyte showed a prominent brush border and the lateral membranes were modified into numerous tortuous interdigitating processes. Adjacent enterocytes were joined by these processes through desmosomes. The processes also participated in pinocytotic fluid uptake from the intercellular spaces with resultant numerous intracellular vacuoles of varied sizes. Solutes absorbed into the cells were probably first passed into the intercellular compartment to create a concentration gradient thus enhancing further absorption into the cell. We conclude that the uniquely elaborate ultrastructure of the enteric epithelium coupled with the vast microvillous surface areas reported elsewhere are partly responsible for the very high absorption rates reported in the fruit bat small intestine.

The vision of the Government of Kenya is to facilitate ICT as a universal tool for education and training. In order to achieve this vision every educational institution, teacher, learner and the respective community should be equipped with appropriate ICT infrastructure, competencies and policies for usage and progress. It calls for recognition of the fact that ICT provides capabilities and skills needed for a knowledge-based economy. It also calls for transforming teaching and learning to incorporate new pedagogies that are appropriate for the 21st  century. The Ministry of Education�s (MOE) mission is to facilitate effective use of ICT to improve access, learning and administration in delivery education programmes and services. The principal objective will be to integrate ICT in the delivery of education and training curricula. XML:NAMESPACE PREFIX = O />  Although not exhaustive, the range of ICT that have been used in the delivery of education to improve access, teaching, learning, and administration includes: Electric Board, Audio Cassette, Radio for Interactive Radio Instructions (IRI), Video/TV-Learning, Computer, Integrated ICT infrastructure and Support Application Systems (SAS).These systems are in use, at various degrees, in most parts of Africa (Charp, 1998). This plan envisages use ofthese digital components to improve access and quality in the delivery of education in Kenya.  The major challenge in respect to this component is limited digital equipment at virtually all levels of education. While the average access rate is one computer to 15 students in most of the developed countries, the access rate in Kenya is approximately one computer to 150 students (EMIS, 2005). Whereas most secondary schools in Kenya have some computer equipment, only a small fraction is equipped with basic ICT infrastructure. In most cases equipment of schools with ICT infrastructure has been through initiatives supported by the parents, government, development agencies and the private sector, including the NEPAD E-Schools programme. Attempts to set up basic ICT infrastructure in primary schools are almost negligible.  According to ICTs in Education Options Paper, one of the main problems is limited penetration of the physical telecommunication infrastructure into rural and low-income areas. Specifically, the main challenge is limited access to dedicated phone lines and high-speed systems or connectivity to access e-mail and Internet resources. The EMIS Survey (2003/2004) indicated that over 70% of secondary schools and a much larger proportion of primary schools require functional telephones. Indeed, many parts of Kenya cannot easily get Internet services because of the poor telephone networks. About 90% of secondary schools need to establish standard Local Area Networks (LANs) in order to improve sharing of learning resources.  Alternative and appropriate technologies for access to Internet resources, including wireless systems remain quite expensive. Indeed, a small proportion of schools have direct access, through Internet Service Providers (ISPs), to high-speed data and communication systems. Furthermore, very few schools in the rural areas use wireless technology such as VSAT to access e-mail and Internet resources. Nearly all of the 6 NEPAD e-Schools are in rural areas and are expected to enjoy internet connectivity through VSAT technology.  While other countries have reported up to 41% of integration of ICT to teaching and learning, the proportion remains substantially low in Africa, Kenya included. Integration aims at the use ICT to support teaching and learning in the delivery of the various curricula to achieve improved education outcomes. Because ICT is interactive media, it facilitates students to develop diversified skills needed for industrialization and a knowledge-based economy. It also allows teachers and learners to proceed at different paces depending on the prevailing circumstances. As a first step, the Ministry of Education has initiated a major ICT project in Secondary schools meant to equip over 200 secondary schools with ICT infrastructure for integration of ICT in teaching/learning process ( KESSP, 2004). Three schools have been chosen in every district of Kenya.

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.

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.

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.

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.

Although great advances in treatment of oro-facial clefts have been made over the past 50 years; in developing countries, due to social stigmas and unavailability of specialised medical facilities and personnel to the majority of the population, there is an increasing incidence of patients coming late for repair of oro-facial clefts. This presents a challenge to both plastic, oral surgeons and associated specialists. The aim of the present article is to demonstrate, in the form of a case report, an alternative surgical technique that has be successful in 8 cases for the late repair of severe bilateral cleft palate utilizing locally available and affordable materials. The objective of managing patients with cleft palate in developing countries is to provide the best repair and rehabilitation with as few operations and in-patient care as possible due to limited financial resources experienced by the majority of in-patients. A multidisciplinary approach to the management of oro-facial clefts is emphasised.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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 .

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.

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.

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.

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.

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.

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.

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.

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. PMID: 7621750 [PubMed - indexed for MEDLINE]

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.

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.

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.

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.

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 .

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Genetic diversity of 50 Phaeoisariopsis griseola isolates collected from different agro ecological zones in Kenya were studied using group specific primers and amplified fragment length polymorphism (AFLP) markers. Group-specific primers differentiated the isolates into Andean and Mesoamerican groups, corresponding to the two common-bean gene pools. Significant polymorphisms were observed with all the AFLP primer combinations used, reflecting a wide genetic diversity in the P. griseola population. A total of 207 finger prints was generated, of which 178 were polymorphic. Cluster analysis of the polymorphic bands also separated the isolates into the two groups defined by group specific primers. All the isolates examined were grouped into three virulence populations; Andean, Afro-Andean and Mesoamerican, and their genetic diversity measured. On average, greater diversity (91%) was detected within populations than between populations (9%). The genetic distance between Andean and Mesoamerican populations was higher (D = 0.0269) than between Andean and Afro-Andean (D = 0.0095). The wide genetic diversity reported here has significant implications in breeding for resistance -to angular leaf spot and should be taken into consideration when screening and deploying resistant bean genotypes.

guyton

The Rose-Bengal plate test (RBPT) was performed on 488 patients with flu-like symptoms from Narok district. There was poor agreement between RBPT results from four health facilities in Narok and from the central veterinary laboratory (CVL). Agreement was poorer for the three rural dispensaries than for the District Hospital. On the other hand, for tests conducted at the CVL, there was good agreement between RBPT, serum agglutination test (SAT) and complement fixation test (CFT) results, indicating that all these tests were probably performing well. Better training and quality control and the use of white rather than a clear background surface for judging agglutination results are recommended to improve the performance of test results in Narok District health facilities.

 
 
 
 

n/a

Phenotypic fluoroquinolone resistance was first reported in Western Kenya in 2009 and later in Coastal Kenya and Nairobi. Until recently gonococcal fluoroquinolone resistance mechanisms in Kenya had not been elucidated. The aim of this paper is to analyze mutations in both gyrA and parC responsible for elevated fluoroquinolone Minimum Inhibitory Concentrations (MICs) in Neisseria gonorrhoeae (GC) isolated from heterosexual individuals from different locations in Kenya between 2013 and 2017.