The pathology of calves that died from experimental water intoxication was investigated. Oedema of the brain and urinary bladder, and renal damage were significant pathological findings in these calves. The findings were attributed to positive water balance in calves suffering from water intoxication

Ultrasound examination of the liver and right lung followed by postmortem examination was performed in 300 animals (16 sheep and 284 goats). Thirty one (10.3%) were positive for hydatid cysts on ultrasound examination and 46 (15.3%) were positive on postmortem examination. Twenty-one hydatid positives on postmortem examination were falsely identified as negatives on ultrasound examination. Of the 254 animals negative on postmortem examination 6 (2.4%) were falsely identified as positive on ultrasound examination. The Sensitivity and specificity of ultrasound examination in detection of hydatid cysts in sheep and goats was 54.36% and 97.645 respectively. The positive predictive value was 80.64% while the negative predictive value was 92.19%.

A study was done to determine the prevalence of hydatid cysts in goats using ultrasonography. A total of 1,390 goats were examined, 43,6 % (606/1,390) of them from north-western Turkana, Kenya, and 56,4% (784/1,390) from Toposaland, southern Sudan. Hydatid cysts were visualized in 1,82 % (11/ 606) of the goats from north-western Turkana and 4,34% (34/784) of those from Toposaland. Unlike abattoir surveys, the prevalence data obtained in this study were unbiased because entire flocks were examined. The lower prevalence rate of the disease in goats from Turkana was attributed to the hydatid disease control programme in that area, which is absent in Toposaland.

Water intoxication is a condition that is common in cattle, and has also been reported in other domestic animals and man. A comprehensive description of the condition is lacking. For a better understanding of the condition, this paper reviews work that has been reported previously by various authors.

In an attempt to establish the prevalence of cystic echinococcosis, a study was conducted in slaughter animals in three divisions of northern Turkana, Kenya. A total of 5752 goats, 588 sheep, 381 cattle and 70 camels were examined at slaughter. Echinococcus granulosus metacestodes were found in 19.4% of the cattle, 3.6% of sheep, 4.5% of goats and 61.4% of camels. The prevalence of cystic echinococcosis in cattle, sheep and goats was higher in Lokichogio than in either Kakuma or Central divisions. On the other hand, the prevalence of the disease in camels was higher in Central (84.6%) than either Lokichogio (70.6%) or Kakuma (50%). The differences in prevalence rates in different study areas are attributed to differences in environmental conditions, livestock stocking intensity and cross-border migration of livestock

OBJECTIVE: To determine the status of environmental and occupational lead exposure in selected areas in Nairobi, Kenya. DESIGN: Cross sectional study. SETTING: Kariobangi North, Babadogo, Waithaka and Pumwani for assessment of environmental exposure to lead (Pb) and Ziwani Jua Kali works for assessment of occupational lead exposure. Olkalou in Nyandarua District was the covariate study area. SUBJECTS: Three hundred and eight children and adults participated. RESULTS: Blood lead levels (BLLs) obtained for the entire sample (n = 308) ranged from 0.4 to 65 microg/dl of blood. One hundred and sixty nine (55%) of the total sample had levels equal to or below 4.9 microg/dl, while 62 (20%) of the sample had levels ranging from 5.0 to 9.9 microg/dl. Blood lead levels above 10 microg/dl were recorded in 77 (25%) of the total sample. Within Nairobi, 32 (15.3%) of the study subjects in areas meant for assessment of environmental lead exposure had levels above the WHO/CDC action levels of 10 microg/dl of blood. The mean BLL for the occupationally exposed (Ziwani Jua kali) was 22.6 +/- 13.4 microg/dl. Among the workers, 89% had BLLs above 10 microg/dl. In general, 15% of the entire sample (for both environmental and occupational groups) in Nairobi had BLLs above 15 microg/dl. The covariate group at Olkalou had a mean BLL of 1.3 +/- 0.9 microg/dl. CONCLUSION: The prevalence of environmental lead exposure to the general public is high in Nairobi compared to Olkalou where non exposure was reported. Occupational lead exposure has been identified to be at alarming levels and urgent intervention measures are recommended.

OBJECTIVE: To determine the status of environmental and occupational lead exposure in selected areas in Nairobi, Kenya. DESIGN: Cross sectional study. SETTING: Kariobangi North, Babadogo, Waithaka and Pumwani for assessment of environmental exposure to lead (Pb) and Ziwani Jua Kali works for assessment of occupational lead exposure. Olkalou in Nyandarua District was the covariate study area. SUBJECTS: Three hundred and eight children and adults participated. RESULTS: Blood lead levels (BLLs) obtained for the entire sample (n = 308) ranged from 0.4 to 65 microg/dl of blood. One hundred and sixty nine (55%) of the total sample had levels equal to or below 4.9 microg/dl, while 62 (20%) of the sample had levels ranging from 5.0 to 9.9 microg/dl. Blood lead levels above 10 microg/dl were recorded in 77 (25%) of the total sample. Within Nairobi, 32 (15.3%) of the study subjects in areas meant for assessment of environmental lead exposure had levels above the WHO/CDC action levels of 10 microg/dl of blood. The mean BLL for the occupationally exposed (Ziwani Jua kali) was 22.6 +/- 13.4 microg/dl. Among the workers, 89% had BLLs above 10 microg/dl. In general, 15% of the entire sample (for both environmental and occupational groups) in Nairobi had BLLs above 15 microg/dl. The covariate group at Olkalou had a mean BLL of 1.3 +/- 0.9 microg/dl. CONCLUSION: The prevalence of environmental lead exposure to the general public is high in Nairobi compared to Olkalou where non exposure was reported. Occupational lead exposure has been identified to be at alarming levels and urgent intervention measures are recommended.

Antibody responses to a conventional rabies preexposure regimen of a new purified Vero cell rabies vaccine (PVRV) and a human diploid cell vaccine (HDCV) were compared in 80 healthy Kenyan veterinary students. Forty-three of the students received the PVRV and 37 received the HDCV on days 0, 7, and 28. Antibody responses were monitored using the rapid fluorescent-focus inhibition test (RFFIT) and an inhibition enzyme immunoassay (INH EIA) on days 0, 7, 28, and 49. Both vaccines elicited a rapid antibody response. A good correlation between the RFFIT titers and the INH EIA titers was obtained (r = 0.90). Our results also showed that the INH EIA was more reproducible and might therefore be a suitable substitute for the more expensive and less reproducible RFFIT. The geometric mean titers determined by both tests in the two groups of students were statistically similar during the test period. The RFFIT and the INH EIA gave comparable geometric mean titers, which differed significantly only on day 28 in the PVRV group. The effect of the new PVRV is comparable to that of the more expensive HDCV, as determined by the present test systems. The PVRV could therefore be the vaccine of choice, especially in tropical rabies-endemic areas, where the high cost of the HDCV has confined its use to a privileged few.

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

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This study investigated the effectiveness of three physical-chemical methods namely; pH adjustment, precipitation with alum and the use of polyelectrolytes. In the treatment of diary wastewater from Brookeside milk processing plant. It also investigated the drainability of the sludge produced by each of the three methods. Laboratory tests were carried out in three different batches, one for each of the three methods. In the alum method enough alum was added to the wastewater samples to cause precipitation by sweep floc. In the pH adjustment method, the pH of samples were lowered to the iso-electric point of the casein proteins of approximately pH 4.5 leading to their precipitation as a result of solubility changes. The polyelectrolytes method involved the use of two polyelectrolytes, Sudfloc 3820 and Sudfloc 3860 each of which was used to coagulate the dirty wastewater. For each of the three methods, the samples were taken in one-litre beakers and subjected to Jar tests to determine the optimum dosages. After one hour of settling the supernatants were decanted and subjected to standard Chemical Oxygen Demand (COD) tests, turbidity and pH measurements. The settled sludge was subjected to drainability studies. Results showed the treatment of dairy wastewater by the three physical-chemical methods to be effective. There were COD removals of between 60% and 90% and turbidity reduction of over 90%. The use of the sudfloc polyelectrolytes was found to be the least demanding in terms of effluent quality control as no pH adjustments of either the wastewater or the effluent was required. The use of polyelectolytes produced the least volumes of sludge and also the better drainability and solids concentration. Sudfloc 3820 was found to achieve better results than Sudfloc 3860 in terms of COD reduction and the drainability of sludge produced although both achieved the same drainability studies. This study showed that each of the three physical-chemical methods can be used effectively to remove the white colour of dairy wastewater as well as the bulk of the proteins and fats, hence, enabling the discharge of the effluents into natural waters to be of good assimilative capacity.

This study investigated the effectiveness of three physical-chemical methods namely; pH adjustment, precipitation with alum and the use of polyelectrolytes. In the treatment of diary wastewater from Brookeside milk processing plant. It also investigated the drainability of the sludge produced by each of the three methods. Laboratory tests were carried out in three different batches, one for each of the three methods. In the alum method enough alum was added to the wastewater samples to cause precipitation by sweep floc. In the pH adjustment method, the pH of samples were lowered to the iso-electric point of the casein proteins of approximately pH 4.5 leading to their precipitation as a result of solubility changes. The polyelectrolytes method involved the use of two polyelectrolytes, Sudfloc 3820 and Sudfloc 3860 each of which was used to coagulate the dirty wastewater. For each of the three methods, the samples were taken in one-litre beakers and subjected to Jar tests to determine the optimum dosages. After one hour of settling the supernatants were decanted and subjected to standard Chemical Oxygen Demand (COD) tests, turbidity and pH measurements. The settled sludge was subjected to drainability studies. Results showed the treatment of dairy wastewater by the three physical-chemical methods to be effective. There were COD removals of between 60% and 90% and turbidity reduction of over 90%. The use of the sudfloc polyelectrolytes was found to be the least demanding in terms of effluent quality control as no pH adjustments of either the wastewater or the effluent was required. The use of polyelectolytes produced the least volumes of sludge and also the better drainability and solids concentration. Sudfloc 3820 was found to achieve better results than Sudfloc 3860 in terms of COD reduction and the drainability of sludge produced although both achieved the same drainability studies. This study showed that each of the three physical-chemical methods can be used effectively to remove the white colour of dairy wastewater as well as the bulk of the proteins and fats, hence, enabling the discharge of the effluents into natural waters to be of good assimilative capacity.

This study investigated the effectiveness of three physical-chemical methods namely; pH adjustment, precipitation with alum and the use of polyelectrolytes. In the treatment of diary wastewater from Brookeside milk processing plant. It also investigated the drainability of the sludge produced by each of the three methods. Laboratory tests were carried out in three different batches, one for each of the three methods. In the alum method enough alum was added to the wastewater samples to cause precipitation by sweep floc. In the pH adjustment method, the pH of samples were lowered to the iso-electric point of the casein proteins of approximately pH 4.5 leading to their precipitation as a result of solubility changes. The polyelectrolytes method involved the use of two polyelectrolytes, Sudfloc 3820 and Sudfloc 3860 each of which was used to coagulate the dirty wastewater. For each of the three methods, the samples were taken in one-litre beakers and subjected to Jar tests to determine the optimum dosages. After one hour of settling the supernatants were decanted and subjected to standard Chemical Oxygen Demand (COD) tests, turbidity and pH measurements. The settled sludge was subjected to drainability studies. Results showed the treatment of dairy wastewater by the three physical-chemical methods to be effective. There were COD removals of between 60% and 90% and turbidity reduction of over 90%. The use of the sudfloc polyelectrolytes was found to be the least demanding in terms of effluent quality control as no pH adjustments of either the wastewater or the effluent was required. The use of polyelectolytes produced the least volumes of sludge and also the better drainability and solids concentration. Sudfloc 3820 was found to achieve better results than Sudfloc 3860 in terms of COD reduction and the drainability of sludge produced although both achieved the same drainability studies. This study showed that each of the three physical-chemical methods can be used effectively to remove the white colour of dairy wastewater as well as the bulk of the proteins and fats, hence, enabling the discharge of the effluents into natural waters to be of good assimilative capacity.

The pathology of calves that died from experimental water intoxication was investigated. Oedema of the brain and urinary bladder, and renal damage were significant pathological findings in these calves. The findings were attributed to positive water balance in calves suffering from water intoxication

Water intoxication is a condition that is common in cattle, and has also been reported in other domestic animals and man. A comprehensive description of the condition is lacking. For a better understanding of the condition, this paper reviews work that has been reported previously by various authors

No abstract available.

Objectives: To determine the occurrence of food borne disease outbreaks in Kenya and the efforts employed to combat them. Design: A cross-sectional survey. Setting: Forty two districts in Kenya between 1970 and 1993. Study subjects: Food-borne disease outbreak episodes due to Staphylococcus aureus, Clostridium perfringens, Clostridium botulinum, Bacillus cereus, Escherichia coli, campylobacter jejuni, Yersinia enterocolitica, Listeria monocytogenes, chemicals, aflatoxins, plant and animal poisons. Outcome measures: Number and aetiological causes of food-borne disease outbreaks reported in the study period. Results: Thirty seven food poisoning outbreaks were reported to the Ministry of Health from various parts of the country in the study period 1970 to 1993, and only 13 of these involving a total of 926 people were confirmed to be due to particular aetiological agents. Foods that were involved included milk and milk products, meat and meat products, maize flour, bread scones and other wheat products, vegetables and lemon pie pudding. A high number of food poisoning cases were treated as outpatients in various health facilities. Conclusions: Under-reporting, inadequate investigation of outbreaks and inadequate diagnostic facilities suggest that food-borne disease outbreaks are more that is recorded by the Ministry of Health.

No abstract available.

A cross sectional study of 115 patients admitted at the Department of Orthopedics, Kenyatta National Hospital, Nairobi, Kenya was carried out to determine the prevalence and antibiotic susceptibility of Staphylococcus aureus isolated from infected wounds. The prevalence of Staphylococcus aureus was 33.0 %. The drugs tested and their corresponding sensitivity was amoxycillin (13.2 %), co-amoxyclav (39.5 %), oxacillin (55.3 %), erythromycin (44.7 %), gentamicin (60.5 %), ciprofloxacin (62.2 %), minocycline (86.8 %), cefuroxime (57.9 %), and clidamycin (84.2 %). These results show the sensitivity profile of Staphylococcus aureus and can be used to choose suitable drugs in the management of wounds for hospitalized patients.

A cross sectional study of 115 patients admitted at the Department of Orthopedics, Kenyatta National Hospital, Nairobi, Kenya was carried out to determine the prevalence and antibiotic susceptibility of Staphylococcus aureus isolated from infected wounds. The prevalence of Staphylococcus aureus was 33.0 %. The drugs tested and their corresponding sensitivity was amoxycillin (13.2 %), co-amoxyclav (39.5 %), oxacillin (55.3 %), erythromycin (44.7 %), gentamicin (60.5 %), ciprofloxacin (62.2 %), minocycline (86.8 %), cefuroxime (57.9 %), and clidamycin (84.2 %). These results show the sensitivity profile of Staphylococcus aureus and can be used to choose suitable drugs in the management of wounds for hospitalized patients.

A cross sectional study of 115 patients admitted at the Department of Orthopedics, Kenyatta National Hospital, Nairobi, Kenya was carried out to determine the prevalence and antibiotic susceptibility of Staphylococcus aureus isolated from infected wounds. The prevalence of Staphylococcus aureus was 33.0 %. The drugs tested and their corresponding sensitivity was amoxycillin (13.2 %), co-amoxyclav (39.5 %), oxacillin (55.3 %), erythromycin (44.7 %), gentamicin (60.5 %), ciprofloxacin (62.2 %), minocycline (86.8 %), cefuroxime (57.9 %), and clidamycin (84.2 %). These results show the sensitivity profile of Staphylococcus aureus and can be used to choose suitable drugs in the management of wounds for hospitalized patients.

OBJECTIVE: To determine the levels of both TSA and HD antibody in sera of patients with various malignancies and evaluate their potential role as diagnostic and/ or prognostic markers. DESIGN: Laboratory based analysis. SETTINGS: Kenyatta National Hospital, Kenya Medical Research Institute and the Department of Biochemistry, University of Nairobi. SUBJECTS: A total of 909 serum samples, 420 from cancer patients recruited at Kenyatta National Hospital and 509 from normal blood donors recruited at Nairobi Hospital. RESULTS: The mean age for the patients and controls was 36 and 37 years respectively. Carcinoma patients constituted 54%, sarcoma 12.1%, lymphoma 16.4% and 17.4% had other types of tumours. The mean TSA in patients was 0.86 mg/ml +/- 0.026 compared to 0.82 mg/ml +/- 0.014 in controls. The TSA level was significantly higher in patients compared to controls (Student's t-test p = 0.031 at 0.05 confidence level). The TSA increased with age in both study groups. In patient sera, both gender gave the same mean of 0.83 mg/ml while it was 0.82 mg/ml and 0.83 mg/ml in control females and in males respectively. Sarcomas had the highest amount of 0.93 mg/ml but there was no significant statistical variation between tumour types (p = 0.076). The HD antibody mean readings were 0.004 in pathologic sera compared to 0.011 in controls. The values were significantly elevated in patients (p = 0.03) with females giving a higher value for both study groups (p = 0.628). HD antibody readings was significantly higher in carcinomas (p = 0.017) compared to those of sarcomas and lymphomas. There was no association between antibody readings and age of patient (p = 0.601). CONCLUSION: Both TSA and HD antibody values were significantly elevated in patients compared to clinically healthy controls and while TSA levels increased with age and was independent of gender, HD antibody levels were independent of age, gender and also tumour type. The study demonstrates that although TSA is normally elevated in malignancy, most of the sialic acid shed is of N-acetyl type as some patients do not express HD antibody directed to the N-glycolyl sialic acid. The reason why some tumours would express Neu5Gc at any one time needs further evaluation.

No abstract available.

In contrast with mammalian cells, little is known about the control of Ca2+ entry into primitive protozoans. Here we report that Ca2+ influx in pathogenic Trypanosoma brucei can be regulated by phospholipase A2 (PLA2) and the subsequent release of arachidonic acid (AA). Several PLA2 inhibitors blocked Ca2+ entry; 3-(4-octadecyl)-benzoylacrylic acid (OBAA; IC50 0.4+/-0.1 microM) was the most potent. We identified in live trypanosomes PLA2 activity that was sensitive to OBAA and could be stimulated by Ca2+, suggesting the presence of positive feedback control. The cell-associated PLA2 activity was able to release [14C]AA from labelled phospholipid substrates. Exogenous AA (5-50 microM) also initiated Ca2+ entry in a manner that was inhibited by the Ca2+ antagonist La3+ (100 microM). Ca2+ entry did not depend on AA metabolism or protein kinase activation. The cell response was specific for AA, and fatty acids with greater saturation than tetraeicosanoic acid (AA) or with chain lengths less than C20 exhibited greatly diminished ability to initiate Ca2+ influx. Myristate and palmitate inhibited PLA2 activity and also inhibited Ca2+ influx. Overall, these results demonstrate that Ca2+ entry into T. brucei can result from phospholipid hydrolysis and the release of eicosanoic acids.

PURPOSE: To determine the causes of severe visual impairment and blindness in children attending schools for the blind in Kenya, Malawi, Uganda, and Tanzania and to compare the findings with those of a 1994 study. METHODS: Children attending schools for the blind or annexes in 4 eastern African countries were examined. The major anatomical site of and underlying etiology of severe visual impairment and blindness was recorded using the standardized World Health Organization (WHO) reporting form. RESULTS: A total of 1062 children aged below 16 years were examined of whom 701 (65.2%) had severe visual impairment or blindness. The major anatomical sites of visual loss overall (% and 95% CI) were cornea scar/phthisis bulbi (19%,16.1-21.9), whole globe lesions (15.7%,13.0-18.4), retina (15.4 %, 12.7-18.1), lens related disorders (13.1%, 10.7-15.5), and optic nerve disorders (12.3%, 9.9-14.7). Corneal scar/phthisis was not distributed equally among the countries and was highest in Malawi, similar to findings in 1995. The major etiology of visual loss was childhood factors (29.9%) and an estimated 40% of severe visual impairment and blindness was due to potentially avoidable causes. CONCLUSION: The major causes of severe visual impairment and blindness overall have not changed appreciably since 1995. There are important differences among countries, however, and using overall estimates for planning may be misleading.

PMID: 19437309 [PubMed - indexed for MEDLINE]

In contrast with mammalian cells, little is known about the control of Ca2+ entry into primitive protozoans. Here we report that Ca2+ influx in pathogenic Trypanosoma brucei can be regulated by phospholipase A2 (PLA2) and the subsequent release of arachidonic acid (AA). Several PLA2 inhibitors blocked Ca2+ entry; 3-(4-octadecyl)-benzoylacrylic acid (OBAA; IC50 0.4+/-0.1 microM) was the most potent. We identified in live trypanosomes PLA2 activity that was sensitive to OBAA and could be stimulated by Ca2+, suggesting the presence of positive feedback control. The cell-associated PLA2 activity was able to release [14C]AA from labelled phospholipid substrates. Exogenous AA (5-50 microM) also initiated Ca2+ entry in a manner that was inhibited by the Ca2+ antagonist La3+ (100 microM). Ca2+ entry did not depend on AA metabolism or protein kinase activation. The cell response was specific for AA, and fatty acids with greater saturation than tetraeicosanoic acid (AA) or with chain lengths less than C20 exhibited greatly diminished ability to initiate Ca2+ influx. Myristate and palmitate inhibited PLA2 activity and also inhibited Ca2+ influx. Overall, these results demonstrate that Ca2+ entry into T. brucei can result from phospholipid hydrolysis and the release of eicosanoic acids.

There is a lack of consensus on how to measure poverty in general, even though poverty indices and poverty profiles are increasingly being used as guides in targeting resources to reduce poverty. In order to compare changes in poverty rates for Kenya, this study tests robustness of the observed changes in the poverty using stochastic dominance analysis, a robust way of ranking distributions. This approach avoids the problem that poverty comparisons may not be robust to the subjective choice of a poverty line. It also avoids the potential that small movements across the thresholds may have large impacts on poverty indices. This is then compared with results from other studies to determine the extent to which conclusions differ and the extent to which the findings are sensitive to the choice of poverty lines. Hence this study tries to answer the following questions. Are the results from poverty studies sensitive to the choice of poverty lines especially when the choice is at the discretion of the analyst? How does this affect their robustness? Does the conclusion differ substantially when summary measures (e.g. mean, variance) and stochastic dominance analysis methods are employed? Do we have an improvement in the levels of poverty in

The gene Q13L coding for the Capripoxvirus group specific structural protein P32 was expressed in Escherichia coli using plasmid pGEX-2T as a fusion protein with glutathione-s-transferase and purified on glutathione sepharose affinity chromatography column. The protein was then employed for diagnosis of sheeppox, goatpox and lumpyskin disease, by a latex agglutination test (LAT) using the purified P32 antigen and guinea pig detector antiserum raised against the P32 antigen. The LAT and virus neutralization test (VNT) were used to screen one hundred livestock field sera for antibodies to Capripoxvirus, in comparison the LAT was simpler, rapid and 23% more sensitive than the VNT. In addition the LAT was found to be specific for Carpripoxvirus because it did not pick antibodies to Orthopoxvirus and Parapoxvirus. The LA test can be taken for a simple and quick diagnostic tool for primary screening of Carpripoxvirus infection and will reduce the reliance of diagnostic laboratories on tissue culture facilities. Keywords: Carpripox, latex agglutination test, attachment gene J. Trop. Microbiol. Biotechnol. Vol. 3 (2) 2007: pp. 36-43

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.

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No abstract available.

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No abstract available.

Three tests of nociception were adapted for the use in crocodiles (47.0-65.2cm long). In the capsaicin instillation test, capsaicin in concentrations of 10^<-9> to 10^<-3> g/ml instilled in the eye induced concentration related protective reactions which were counted. In the formalin test, 150 μl of 5% formalin was injected subcutaneously in the fore paw, and the time spent "lifting the foot" and "not using the foot" was recorded. In the hot plate test, the plate temperature was set at 55℃ and the latency until the following behavioural categories occurred was recorded: "lifting toes", "lifting foot", and "attempt to escape". This test could be repeated with similar results after an interval of 60 min. It was concluded that the crocodile has a well developed nociceptive system, and it may be possible to study the function of this system using these modifications of well known tests of nociception.

OBJECTIVE: To identify autotransfusion strategies and their basis in elective surgery patients. DESIGN: A cross sectional prospective study. SETTING: General surgery and orthopaedic wards, Kenyatta National Hospital, Nairobi. SUBJECTS: Adult patients of both sexes planned for elective surgery. MAIN OUTCOME MEASURE: Forevery patient, the following were enquired about and documented: age in years, sex, ethnicity, religion, occupation and educational standard. Blood values of haemoglobin, platelet counts, total and differential white cell counts, urea, electrolytes and liver function tests were assayed. Others were the number of units of blood donated before the operation, the type of surgery performed, time taken from diagnosis to performing the operation and whether the blood was transfused preoperatively, intraoperatively and postoperatively. RESULTS: A total of sixty three cases constituting five per cent of all surgical patients admitted during the period of study were evaluated. Of these 53 (84%) were males and ten (16%) females. The age range was 15 to 65 years with a peak at 45-49 years. There were more Christians (90%) than Muslims (10%). In all, 32 (51.6%) had primary school education, 23 (36.5%) secondary school education, seven (11.3%) no formal education and one (1.6%) had attained college level. Employment pattern showed 50% were civil servants, 30% were self employed and 20% were unemployed. The duration of disease ranged from 1-24 weeks with two peaks at two weeks and six weeks. Orthopaedic cases constituted 78.7% and general surgery 21.3%. Preoperative haemoglobin ranged from 13.5-14.2 g/dl. Transfusions were given intraoperatively to 41 (66.1%) and to 12 (33.9%) postoperatively. Mean duration of hospitalisation was 13 days (range 5 to 21 days). 98.4% deposited only one unit while 1.6% deposited four units of blood. Only one patient required additional transfusion from homologous donors. CONCLUSION: The strategies and basis for autotransfusion have been demonstrated among a majority of adult patients requiring orthopaedic procedures. Major determinants are shown to be baseline blood count profiles and time to operation.

A preliminary short follow-up study of Hanganutziu and Deicher (HD) antibody titre and sialic acid levels in sera from 7 patients with hepatoma was carried out. Weekly HD antibody titres were abnormal in 6 patients with titres of 4 of the 6 falling to normal in some weeks. Sialic acids levels, however were abnormal (3.830-6.82mmol/ l) compared to those of 33 normal sera (1.08-2.73 mmol/1) throughout the 8 week screening period. There was a poor correlation between the antibody tires and the sialic acid levels (r<0.50) suggesting that at some stage of malignancy, the tumour was expressing N-glycolylneuraminic acid (Neu5Gc), the epitope of HD antigens as well as shedding into circulation, excess N-acetylneuraminic acid (Neu5Gc). Neu5Gc is a tumor-associated antigen. Measurement of antibodies to this epitope have shown that the antibodies have a potential of offering an alternative method of determining tumor growth and/or metastases. A major follow-up study incorporating information on cancer type, disease stage, therapy and the immnunological status of the patient is called for.

A preliminary short follow-up study of Hanganutziu and Deicher (HD) antibody titre and sialic acid levels in sera from 7 patients with hepatoma was carried out. Weekly HD antibody titres were abnormal in 6 patients with titres of 4 of the 6 falling to normal in some weeks. Sialic acids levels, however were abnormal (3.830-6.82mmol/ l) compared to those of 33 normal sera (1.08-2.73 mmol/1) throughout the 8 week screening period. There was a poor correlation between the antibody tires and the sialic acid levels (r<0.50) suggesting that at some stage of malignancy, the tumour was expressing N-glycolylneuraminic acid (Neu5Gc), the epitope of HD antigens as well as shedding into circulation, excess N-acetylneuraminic acid (Neu5Gc). Neu5Gc is a tumor-associated antigen. Measurement of antibodies to this epitope have shown that the antibodies have a potential of offering an alternative method of determining tumor growth and/or metastases. A major follow-up study incorporating information on cancer type, disease stage, therapy and the immnunological status of the patient is called for.

This paper discovers that mobility of the nomads is at the same time an expression of a flexibility permeating all spheres of life. It also investigates and seeks answers to the following questions: Why should an economic system (that is, nomadic pastoralism) that has survived for centuries in these dry regions be considered inappropriate and irrational today? Is it not rather a matter of changed general conditions rendering the traditional strategies ineffective? This paper, using the example of the Pokot of Kenya, shows how this ethnic group is environmentally aware and lives and works adapting to the living circumstances, and that their behaviour is not irrational; also that they have a vital interest in preserving their environment and that, if the supporting capacity of their living environment has already been exceeded the cause should not be blamed on the people themselves, but on changes brought about by external factors. The paper concludes by suggesting measures that would enable the nomadic Pokot continue living in their environment, with assurance of the sustainability of their economic activities as dictated by the demands of the existing ecology. The paper acknowledges and appreciates the importance of studying and understanding the socio-anthropology of a people in any operational research, for the sake of success of region-specific development planning and implementation.

Androgens and oestrogens have been implicated in the noted gender differences in the increasing intimal medial thickness. Oestrogens are protective in females while the role of androgens as male disadvantage remains in conflict. There have been reports that androgens are protective while other reports suggest they are bane. The distribution of androgen receptors in the carotid intimal medial thickness may help explain this propensity. Thirty six samples from the proximal, middle and distal carotid artery segments and three sections of prostate gland from three different men were collected within 48 hours of demise were processed for routine light microscopy and immunohistochemistry. The prostate samples were mounted next to the carotid artery samples on the same slide for immunohistochemical staining. They were stained using anti-human mouse androgen receptor monoclonal antibody (AR318) for androgen receptors. All prostate control samples stained for androgen receptors. Androgen receptors were not expressed in any of the carotid arterial walls. The carotid intimomedial thickness is not influenced by the presence of androgen receptors.

This was a prospective study over a period of 10 months from the month of April 2002 to
January 2003. The purpose of the study was to determine the pattern of non metabolic
causes of pathological fractures in Kenyatta National Hospital. The study assessed the
causes, sites, presentation and management of non metabolic causes of pathological
fractures at the hospital.
Methodology: Patients with non metabolic causes of pathological fractures admitted to
the orthopaedic wards were recruited into the study. Demographic data, data on the cause
of the fracture, site of the fracture, presentation and management of the patient was
collected. This data was analysed and presented in tables, charts and graphs.
Results: Thirty eight patients with 53 fractures were recruited into the study. The age
range was between 1 to 74 years with a peak age in the sixth decade, the male to female
ratio was 1:1. The prevalence of non metabolic pathological fractures among patients
with fractures was 2.62%. Te most common causes of these fractures were malignant
causes which formed 47% of the fractures followed by infection with 31% of the
fractures. Osteomyelitis formed 100% of all the peadiatric pathological fractures. The
lower limb was the most common site of pathological fractures in which 47% of these
fractures were located followed by the spine with 43%. Patients with spinal fractures
presented with two main complaints, that of back pain and difficulty in walking. Trivial
trauma was the most common complaint of patients with appendicular skeleton fractures,
found in 45% of these patients. The management of these fractures was mainly
conservative.
Conclusions: While there are some differences in the causes of these fractures from what
is documented in literature, the sites and presentations concur. The most common cause
of non metabolic pathological fractures was malignancy and osteomyelitis was
established as the most common cause of pathological fracture in children.
Recommendations: Studies should be carried out to assess the management outcomes of
the individual causes of pathological fractures especially those due to malignancy and
osteomyelitis. Another study should also be carried out on all the causes of pathological
fractures including metabolic bone disease in order to establish the complete picture of
these fractures.

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Knowledge of cellular composition of aortic tunica media is important to improve understanding
of aortic pathology. The aorta of 6 healthy male goats was studied by electron microscopy to
elucidate cell types within the tunica media. Glutaraldehyde fixed specimens were processed for
durcupan embedding and sectioning, stained with uranyl acetate, counterstained with lead
citrate and ultrathin sections examined at high magnification. Two non muscle cells were
observed, one resembling fibroblasts and the other with features of macrophages. It is
concluded that these cells are normal constituents of the aortic media, involved in synthesis of
extracellular matrix and immunosurveillance respectively. Their involvement in repair and
disease process needs further investigation.
Keywords: tunica media, aorta, fibroblast, macrophage.

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This paper analyses the effect of non-credit services of joint liability credit institutions on smallholder women beekeepers’ honey income. The non-credit services offered to the beekeepers were mainly enterprise development services (including trainings on marketing, business, production and subsector analysis). The study uses cross-sectional data from a survey of women beekeepers participating in group-based credit programmes. The survey was conducted in September 2005 in Makueni district of Kenya. The findings indicated that the number of enterprise development related trainings attended by women beekeepers that are offered by the group-based financial institutions positively and significantly influence honey income. The results confirmed that non-credit services contribute positively to the enhancement of honey income. These results imply that extension and strengthening of group-based financial institutions’ non-credit services in the marginal areas will enhance development of smallholder agriculture for improved income generation.

Analysis of mercury (Hg) in 100 different beauty creams by energy dispersive x-ray fluorescence technique is described. Each sample was brought to a melt by warming on a water bath at 40-50° C, and then poured onto a 2.5 cm diameter mylar-backed aluminium …

[en] Analysis of mercury in 100 different beauty creams by the energy dispersive X ray fluorescence technique is described. Each sample was brought to a melt by warming on a water bath at 40-50 deg. C, and then poured onto a 2.5 cm diameter Mylar backed …

NON-DESTRUCTIVE ANALYSIS OF MERCURY BY THE ENERGY DISPERSIVE X RAY FLUORESCENCE TECHNIQUE IN BEAUTY CREAMS SOLD IN KENYA.
Analysis of mercury in 100 different beauty creams by the energy dispersive X ray fluorescence technique is described. Each sample was brought to a melt by warming on a water bath at 40-50eC, and then poured onto a 2.5 cm diameter Mylar backed aluminium ring so as to acquire the configuration of a homogeneous pellet when cooled. No other physical or chemical treatments were applied to the sample. The results of our mercury level measurements and analysis (u,g/g) showed that: (a) the detection limit for the detector system was 3.3; (b) 'Madonna' (green) (n= 10) had the highest level of mercury: 29 000 + 2800; (c) 'Madonna' (red) (n = 10) had a level of 18 000 ± 1700; (d) 'Pimplex' cream (« = 10) had 6800 ± 690; (e) 'Shirley' (original) (n = 10) registered 14 000 ± 1100; (0 'Bestlady' cream registered 13 000 ± 1300; (g) 'Topsine' (n = 10) had 1600 ± 150; (h) 'Fennel' (n = 10) had 4300 ± 430; (i) 'Shirley' (new), 'Dermovate' and 'Topshirley' creams (n = 10 each) registered mercury levels below the detection limit; (j) there was a significant difference (p < 0.001) in the results for 'Madonna' (red), 'Pimplex' and 'Shirley' (original) for batches bought during March and September 1995. The health implications of some of these high levels of mercury present in some beauty creams in Kenya are discussed.

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.

This research proposal highlights some pertinent issues relating to Non-Governmental Organizations (NGOs) development activities in Kenya. Whereas NGOs havebeen actively involved in a number of development activities, their development approaches have not been adequately and sufficiently researched and documented.

There has been, little attempt at providing empirical data on the contributions of NGOs to research gap by looking at how NGOs facilitate local initiatives which could lead to self sustaining development in the long run. In this respect, some issues relating to projects supported by NGOs are proposed for exploration. These are: needs assessment; project initiation; project management; training; resource mobilization; institutional set-uo and over-all community participation

This research proposal highlights some pertinent issues relating to Non-Governmental Organizations (NGOs) development activities in Kenya. Whereas NGOs havebeen actively involved in a number of development activities, their development approaches have not been adequately and sufficiently researched and documented.

There has been, little attempt at providing empirical data on the contributions of NGOs to research gap by looking at how NGOs facilitate local initiatives which could lead to self sustaining development in the long run. In this respect, some issues relating to projects supported by NGOs are proposed for exploration. These are: needs assessment; project initiation; project management; training; resource mobilization; institutional set-uo and over-all community participation

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Background: Pathological fractures pose a major challenge to surgeon since he has to treat both the fracture and the pathology associated with it. This study was aimed at determining the pattern of non-metabolic causes of pathological fractures in Kenyatta National Hospital.
Methods: Thirty-eight patients with 53 non-metabolic pathological fractures admitted to the orthopaedic wards were recruited into the study during the period of April 2002 and January 2003. Patient’s demographic and clinical data was collected by the lead investigator. Data was collected by the use of a questionnaire designed for the study. The data was analysed using Microsoft excel software.
Results: The age range was between 1 to 74 years with a peak age in the sixth decade; the male to female ratio was 1:1. The most common causes of these fractures were malignancy, which constituted 47% of all fractures, followed by infection (31%). Osteomyelitis was the cause of all the paediatric pathological fractures. The lower limb was the most common site of pathological fractures regardless of age (47%) and the spine was second (43%). While patients with spinal fractures presented with the complaints of back pain and difficulty in walking, trivial trauma was the most common complaint of patients with appendicular skeleton fractures.
Conclusion: The most common cause of non metabolic pathological fractures in adults was malignancy and osteomyelitis was the most common cause of pathological fracture in children. While there are some differences in the aetiology of these fractures in Kenya from what is documented in literature, the sites and mode of presentation concur although a significant percentage of patients present late

Background: Pathological fractures pose a major challenge to surgeon since he has to treat both the fracture and the pathology associated with it. This study was aimed at determining the pattern of non-metabolic causes of pathological fractures in Kenyatta National Hospital.
Methods: Thirty-eight patients with 53 non-metabolic pathological fractures admitted to the orthopaedic wards were recruited into the study during the period of April 2002 and January 2003. Patient’s demographic and clinical data was collected by the lead investigator. Data was collected by the use of a questionnaire designed for the study. The data was analysed using Microsoft excel software.
Results: The age range was between 1 to 74 years with a peak age in the sixth decade; the male to female ratio was 1:1. The most common causes of these fractures were malignancy, which constituted 47% of all fractures, followed by infection (31%). Osteomyelitis was the cause of all the paediatric pathological fractures. The lower limb was the most common site of pathological fractures regardless of age (47%) and the spine was second (43%). While patients with spinal fractures presented with the complaints of back pain and difficulty in walking, trivial trauma was the most common complaint of patients with appendicular skeleton fractures.
Conclusion: The most common cause of non metabolic pathological fractures in adults was malignancy and osteomyelitis was the most common cause of pathological fracture in children. While there are some differences in the aetiology of these fractures in Kenya from what is documented in literature, the sites and mode of presentation concur although a significant percentage of patients present late.

The role of pastoralist women in conflict resolution and management (study funded by SIDA though IMPACT)

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This paper presents calculations demonstrating that non-square quantum well growth
(well shaping) can result in reduced threshold current for tensilely strained quantum well bipolar
diode lasers operating at 1.52μm m. Calculations of subband structure, optical matrix elements and
laser gain are performed for arbitrarily shaped quantum wells based on a 4-band (electron/heavyhole/
light-hole/split off-hole) Hamiltonian. For long wavelength (1.3μm m to 1.55μm) lasers,
Auger recombination dominates the threshold current. Compared to a 1.52 mm optimal square well
just below critical thickness, an InGaAs-InGaAsP (on InP) well incorporating potential ‘spikes’ and
having the same wavelength can be much wider. The wider well, possible with well shaping, results
in a lower value for three-dimensional (3D) carrier density at a given value of modal gain. For low
loss lasers, this implies a reduction in Auger (and hence total) threshold current to a value below the
best obtainable in a laser based on a square quantum well

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OBJECTIVES: We sought to develop a noninvasive technique to quantify the thickness of a segment of the carotid artery wall that incorporates the adventitia and to identify whether differences in this measure are associated with cardiovascular risk factors. BACKGROUND: There is increasing evidence that the arterial adventitia undergoes extensive structural alteration, including thickening, in response to arterial injury. However, there is currently no widely accepted noninvasive technique for studying the thickness of the arterial adventitia in humans. METHODS: The carotid artery and jugular vein were imaged simultaneously in longitudinal section with the use of high-resolution ultrasound. The distance from the jugular intima-lumen interface to the carotid media-adventitia margin was denominated as the carotid extra-media thickness (EMT). This measure includes the arterial adventitia but not the arterial intima or media. We measured the carotid EMT and intima-media thickness (IMT) in 175 subjects, including 54 with diabetes, 43 with dyslipidemia, 26 with other cardiovascular risk factors, and 52 healthy control subjects. RESULTS: When compared with control subjects, the EMT was increased in both the diabetes (p {\textless} 0.0001) and dyslipidemia (p = 0.04) groups. Multivariate linear regression analyses revealed that diabetes, high-density lipoprotein cholesterol (inverse association), and systolic blood pressure (J-shaped association) were the factors most strongly associated with EMT. These associations appear to be independent of carotid IMT. CONCLUSIONS: Carotid EMT can be assessed by ultrasonography. It is physically distinct from IMT and provides additional information concerning the vascular changes associated with cardiovascular risk factors. As such, the measurement of EMT, in addition to IMT, may provide a more complete indication of the structural modification of the vasculature associated with cardiovascular risk factors than that obtained by the measurement of carotid IMT alone.

OBJECTIVES: We sought to develop a noninvasive technique to quantify the thickness of a segment of the carotid artery wall that incorporates the adventitia and to identify whether differences in this measure are associated with cardiovascular risk factors. BACKGROUND: There is increasing evidence that the arterial adventitia undergoes extensive structural alteration, including thickening, in response to arterial injury. However, there is currently no widely accepted noninvasive technique for studying the thickness of the arterial adventitia in humans. METHODS: The carotid artery and jugular vein were imaged simultaneously in longitudinal section with the use of high-resolution ultrasound. The distance from the jugular intima-lumen interface to the carotid media-adventitia margin was denominated as the carotid extra-media thickness (EMT). This measure includes the arterial adventitia but not the arterial intima or media. We measured the carotid EMT and intima-media thickness (IMT) in 175 subjects, including 54 with diabetes, 43 with dyslipidemia, 26 with other cardiovascular risk factors, and 52 healthy control subjects. RESULTS: When compared with control subjects, the EMT was increased in both the diabetes (p {\textless} 0.0001) and dyslipidemia (p = 0.04) groups. Multivariate linear regression analyses revealed that diabetes, high-density lipoprotein cholesterol (inverse association), and systolic blood pressure (J-shaped association) were the factors most strongly associated with EMT. These associations appear to be independent of carotid IMT. CONCLUSIONS: Carotid EMT can be assessed by ultrasonography. It is physically distinct from IMT and provides additional information concerning the vascular changes associated with cardiovascular risk factors. As such, the measurement of EMT, in addition to IMT, may provide a more complete indication of the structural modification of the vasculature associated with cardiovascular risk factors than that obtained by the measurement of carotid IMT alone.

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OBJECTIVE: To determine the pattern and burden of injuries, their causes and action taken in a rural and urban community in Kenya. DESIGN: Household interview survey and focus group discussions. SETTING: Four rural villages and five urban clusters in Kiambu District, Kenya. SUBJECTS: A total of 1,980 members of 200 rural and 230 urban households. RESULTS: The number of reported injuries was 495, corresponding to 300,000 injuries per 100,000 people per year. Most common were cut or piercing (38.4%), followed by fall (16.2%), burn or scald (14.3%), animal bite or kick (10.1%), hit by moving object (5.9%) and road traffic accident (3.6%). Poisoning, sub-mersion/drowning and explosion were uncommon, each below three per cent. Of all reported injuries, 149 (30.1%) sought care from traditional healers, 91 (18.4%) were subject to self-care, 76 (15.4%) obtained service from drug shops, 22 (4.4%) were brought to a health facility for attention and 17 (3.4%) took no action at all. Additional information was obtained through focus group discussions with students, teachers and members of women groups. These generated detailed information about cases of sexual assault within and outside households which had not been captured during the previous household interviews. CONCLUSION: Injuries are very common but most of them are mild, prompting only home care or no action at all. Only one out of 25 injuries were brought to a health facility for attention. Some types of injury, such as domestic violence and sexual assault, are more likely to be captured through focus group discussions than during household interviews. A combination of methods is likely to best reflect the pattern of injury at community level.

BACKGROUND: In Kenya the reported high rates of unwanted pregnancies (more than 90%), among adolescents have subsequently resulted in unsafely induced abortions with the associated high morbidity and mortality rates. OBJECTIVE: To evaluate the adolescents' behaviour regarding induced abortion. DESIGN: A cross-sectional, prospective study done from July 1995 to June 1996. SETTING: Schools and health facilities in Kiambu and Nairobi districts in Kenya. PARTICIPANTS: Interviews were conducted among adolescents aged 10-19 years in schools at the two districts and selected using a multi-stage random sampling procedure, as well as adolescent girls at two hospitals and two clinics in the immediate post-abortion period. MAIN OUTCOME MEASURES: The number of adolescents health programmes, aimed at reducing the dangers of unsafely induced abortion, which are designed and subsequently implemented. DATA COLLECTION: Demographic and health data, as well as data on behaviour regarding induced abortion were collected using a self-administered questionnaire. RESULTS: The study sample comprised 1820 adolescents. These were 1048 school girls (SG), 580 school boys (SB) and 192 post-abortion (PA). Many adolescents were aware of abortion dangers, with the awareness being significantly lower among the SB whose girlfriends (GF) had aborted than those whose GF had not (p < 0.01). The practice of abortion was reported among 3.4% SG, 9.3% SBs' GF and 100% PA. Direct and indirect costs of abortion were heavy on the girls. Knowledge of the abortion dangers had no influence on the choice of the abortionist. Abortion encounter positively influenced approval by the adolescents, of abortion for pregnant school girls (p < 0.01). CONCLUSION: Despite the costs and awareness of abortion dangers by adolescents, they will take risks.

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

Aga Khan Hospital, Nairobi. Forty females, age 14 to 35 years (mean 28.6 years) with chronic renal failure (CRF) were included in the study. Their menstrual patterns were noted. The function of their hypothalamo-pituitary-ovarian axis was assessed by the serum levels of follicle stimulating hormone (FSH), Luteinising hormone (LH), prolactin (PrL), estradiol (E2) and progesterone (P) at different phases of the menstrual cycle in patients who continued to have normal menses (Group 1) and at weekly intervals for six weeks in patients with menstrual disturbances (Group II). The mean hormone levels during the initial contact Luteal phase in group I were FSH 12.0 IU/L (N, 1.0-3.0 IU/L), LH 1.8IU/L (N 1.5-101U/L), PrL 652mIU/L (N, 100-600 mIU/L) mE2 160 pmol/L (N 400-1400 pmol/L) and P5 nmol/L (N 14-60 nmol/L) for group I. Corresponding values for group II were 1.2, 10.3, 250, 600 and 3.0 in relevant units. All patients (fourteen) with end stage renal disease (ESRD) had amenorrhoae. On the other hand, most patients with stable CRF (22/26) had normal menses. Following initiation of therapy (conservative or dialytic), there was no significant alteration in the hormonal profile or menstrual pattern. We conclude that other factors apart from the hormonal imbalances, may be responsible for the menstrual disturbances noted in patients with CRF.

In this paper we present preperties of a norm attaining operator on a Hilbertspace .We show that if T is norm attaining then it satisfies the generalized Daugavet condion

J. O. Midiwo, A. Yenesew, B. F. Juma, S. Dereses, J. A. Ayoo, A. Aluoch and S. Guchu There are several described medicinal plants in Kenya from a flora of approximately 10,000 members. Strong cross-medical information from the 42 ethnic groups points to the high potential of some of these species. The Myrsinaceae are well established ethno-anthelmintics and anti-bacterials. They are harbingers of long alkyl side chain benzoquinones which clearly have a protective function from their histochemical disposition. The main benzoquinone in the sub-family Myrsinodae is embelin while for the Maesodae it is maesaquinone together with its 5-acetyl derivative; the distribution of these benzoquinones by their alkyl side chain length or the presence/absence of a 6-methyl group is in accord with morphological sub-family de-limitation. The benzoquinones showed anti-feedant, anti-microbial, phytotoxic, acaricidal, insecticidal and nematicidal activity. Many other benzoquinones of medium and minor concentration were also isolated and characterised. Some plants belonging to the Polygonaceae which are widely used as ethno-anthelmintics have been studied. The common anthelmintic anthraquinones were obtained from all five Rumex species while the naphthalenic acetogenin derivative, nepodin was more selectively distributed. The leaf of Polygonum senegalense is up to 17% surface exudate; about thirteen non polar flavonoid derivatives (chalcones, dihydrochalcones, flavanones and a flavone) have been isolated from it. From the internal aerial tissues of this plant, the major flavonoids were common flavonoids, quercetin, kaempferol, luteolin and their glycosides. The only unique compound isolated from this plant was 2prime-glucosyl-6prime-hydroxy-4prime-methoxydihydrochalcone whose aglycone, uvangolatin is part of the exudate mixture. Other leaf exudate plants studied include the stomach-ache medicine, Psiadia punctulata (Compositae) from which novel methylated flavonoids, kaurene and trachyloban diterpenes have been found

Nosocomial infection of the urinary tract is a long standing problem that pre-dates the antibiotic era. Hospitals have remained veritable reservoirs of bacteria with increased numbers and types resistant to antibiotic treatment. Most hospitals have epidemiologists and infection control manuals but unfortunately most hospital staff do not follow infection control protocols. Whenever a new class of antibiotics become available, enthusiastic physicians rush to use them discarding the older and slightly less potent ones which are subsequently regarded as obsolete. Some individuals claim that "good medicine is supposed to be practiced by those physicians who give their patients the most up to date drugs available". However, the resistance and sensitivity pattern of bacteria have changed and continue to do so, varying widely even among facilities within the same community. Furthermore, within several years of each antibiotic advancement, a parallel increase in the resistant strains of previously sensitive bacteria has been observed. The problem of resistant pathogens has become particularly important within the context of nosocomial infection of the urinary tract. Reduced hospital stay and avoidance of bacterial resistance by rational and selective use of antibiotics for preoperative prophylaxis and definitive therapy and strict enforcement of the hospital disease control protocols must be encouraged.

In this paper we introduce the notions of an A-self-adjoint, an A-skewadjoint linear operator, where A is a self-adjoint and invertible operator and related classes of operators, which generalize some known classes of operators. We investigate some properties of these operators and show that these operators share some properties with some known classes of operators. We prove some results on some equivalence of these operators and investigate conditions under which these operators are self-adjoint, unitary, skew-adjoint, normal, hyponormal, quasinormal or binormal. We also attempt to locate the spectra of such operators

We discuss basic properties of Analysis and synthesis operators a frame. The structure of matrix
representation of the Synthesis operator is also analysed. This matrix is what most frame constructions in
fact focus on. The frame operator which is just the joining together of the analysis and synthesis
operators is fundamental for the reconstruction of signals from frame coefficients

The almost- similar and similar relations between operators on finitedimensional Hilbert spaces are investigated. It is shown that almost similar operators share some properties with some other classes of operators. Various results on almost-similarity and similarity are proved. An attempt is made to classify those operators where almost similarity implies similarity. We investigate some properties of corresponding parts of operators which enjoy these equivalence relations.