OBJECTIVE: To determine the prevalence of Xerophthalmia among Kenyan children aged four to seven years in high risk using Conjuctival Impression Cytology and transfer. DESIGN: A cross sectional community based study. SETTING: Mathare slum in Nairobi and Tiva/Ithiani area of Kitui. SUBJECTS: Children aged four to seven years residing in the above areas were assessed for both clinical and cytological features of vitamin A deficiency. RESULTS: Of the 342 children included in this study, 316 (92.0%) were normal, five (1.5%) had XN, 19 (5.9% had XIA and two (0.6%) had XIB. No signs of corneal Xerophthalmia were seen in this study. Conjuctival impression cytology and transfer (CICT) was used to asses for squamous metaplastic changes associated with Vitamin A deficiency (VAD). Seventy five (23.1%) of the children were normal by CICT while 249 (76.9%) were abnormal. In comparing the two areas of study, only 13.2% of the children in Mathare had normal CICT compared to 50% in Kitui. For each of the age groups studied there was significant difference between the two areas with children from Mathare being more deficient than those from Kitui. CONCLUSION: VAD is a significant health problem in the high risk areas assessed by CICT in this study.

OBJECTIVES: To estimate the prevalence of active trachoma (TF) in children aged one to nine years and potentially blinding trachoma (TT) in adults aged 15 years and older in six known trachoma-endemic districts in Kenya. DESIGN: Community based survey. SETTING: Six known trachoma endemic districts in Kenya (Samburu, Narok, West Pokot, Kajiado Baringo and Meru North). SUBJECTS: A total of 6,982 children aged one to nine years and 8,045 adults aged 15 years and older were randomly selected in a two stage random cluster sampling method: Twenty sub-locations (clusters) per district and three villages per sub-location were randomly selected. Eligible children and adults were enumerated and examined for signs of trachoma. RESULTS: Blinding trachoma was found to be a public health problem in all the surveyed districts. Active trachoma was a district wide public health problem in four districts (Samburu, Narok, West Pokot and Kajiado) and only in some of the sub-locations of the other two (Baringo and Meru North). CONCLUSIONS: There is need for district trachoma control programmes preferably using the WHO recommended SAFE strategy in all the surveyed districts. Extrapolation of these survey results to the entire country could not be justified. There is need to survey the remaining 12 suspected endemic districts in Kenya.

Measures of rabbit eyes and retinal wholemounts were used to evaluate the development of retinal area and shape. The retina is shown to have a horizontal axis about a third longer than the vertical axis just before birth, and to adopt an almost symmetrical shape during postnatal development to adulthood. In general, retinal thickness is shown to decrease after birth, but differently in particular retinal regions: the reduction is marked in the periphery, and less pronounced in the visual streak. As an exception, the myelinated region–after it becomes really myelinated, from 9 days p.p.–even increases in thickness. In all regions of the retina, the absolute and relative thickness of the nuclear layers decreases, whereas the relative thickness of plexiform and fibrous layers increases. Proliferation of cells within the rabbit retina was studied during the first three postnatal weeks. 3H-thymidine incorporation was used to demonstrate DNA synthesis autoradiographically in histological sections as well as in enzymatically isolated retinal cells. A first proliferation phase occurs in the neuroblastic cell layer and ceases shortly after birth in the retinal center, but lasts for about one week in the retinal periphery. We found, however, a few 3H-thymidine-labeled cells as late as in the third postnatal week. These late-labeled cells were found within the nerve fiber layer and in the inner plexiform layer. The latter cells were shown to express antigens detected by antibodies directed to the intermediate-sized filament protein vimentin, which are known to label Müller cells and neuroepithelial stem cells. This was confirmed in our preparation of enzymatically isolated cells; all cells with autoradiographically labeled nuclei revealed a characteristic elongated morphology typical for Müller radial glia (and also for early neuroepithelial stem cells). 3H-thymidine-labeled cells in the nerve fiber layer were most probably astrocytic. In analogy to the brain, we conclude that the mammalian retina undergoes a series of proliferation phases: first an early phase producing both neurons and glial cells, and then a late phase producing glial cells, e.g., in the nerve fiber layer. Most probably, the late phase within the inner nuclear layer is glial as well, i.e., consists of dividing Müller cells; it cannot be excluded, however, that there may remain some mitotically active stem cells.

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Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

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Effects of CO2‐induced climatic changes on irrigation‐water requirements (IR) in the Great Plains region were evaluated using results of global atmospheric‐circulation models with a water balance‐IR model. Increases were predicted for evapotranspiration Et due to predicted increases in air temperature, solar radiation, and wind speed under doubled concentrations of atmospheric carbon dioxide (2×CO2). Predicted increases in humidity under the 2×CO2 scenarios and shifting of crop life cycles to months with lower levels of solar radiation moderated predicted increases in Et. Increases in irrigation requirements were caused primarily by increases in evaporative demands and changes in precipitation patterns. Increases in net seasonal IR for alfalfa were larger due to predicted increases in length of frost‐free growing seasons and higher evaporative demands as compared to winter wheat and corn. Decreases or only modest increases in seasonal irrigation requirements were projected under 2×CO2 scenarios for com and winter wheat due to reductions in length of crop life cycles and projected increases in bulk stomatal resistances.

Presents results of a trial carried out in Kilifi District, Coast Province in Kenya to evaluate genetic and environmental factors affecting birth weight, preweaning average daily gain, weaning weight (at 5 months) and preweaning survival for 8 genotypes of crossbred and straightbred of Ayrshire, Friesian and Sahiwal calves.

Analyzing why the rate of transmission of AIDS varies widely in Africa is the basis for designing strategies for intervention. Promiscuity, i.e. high rates of sex partner change, is not the only reason for rapid transmission, but it is a prerequisite for the explosive spread seen in certain groups. High frequency groups include mobile single men and prostitutes. Research and strategies must focus on sex practices, concepts of personal vulnerability, and possibility of behavioral change. The sexually transmitted diseases that are thought to increase susceptibility to HIV, i.e., genital ulcer diseases, can be controlled with appropriate strategies. Male circumcision is associated with lower HIV seroprevalence. Thus strategies must be concentrate on sustained prevention among high STD transmitters, providing early, effective care for STDs, increasing economic alternatives for women, and offering voluntary circumcision where culturally acceptable.

Kamau RK, Osoti AO, Njuguna EM. Department of Obstetrics and Gynaecology, College of Health Sciences, University of Nairobi, P.O. Box 1%76-00202, Nairobi, Kenya. BACKGROUND: Cancer of the uterine cervix is the most common female cancer in Kenya. Despite being preventable, it is often diagnosed when it is already late. For this reason, only palliative therapy is provided. Hence, it is expected that their daily routines and that of their caregivers are severely disrupted. OBJECTIVES: To determine the extent to which diagnosis and treatment of inoperable cervical carcinoma affects quality of life (QOL). DESIGN: Cross-sectional descriptive study. Setting Radiotherapy Department at the Kenyatta National Hospital. SUBJECTS: Women undergoing radiotherapy for inoperable cervical cancer. RESULTS: There is high prevalence of profound disruptions in nearly all domains of QOL. In the social domain, between 33% and 44% had the perception that family members and friends had withdrawn social support. Reduction in various economic facets was reported by 47.4%-52.6%, with 44.7% reporting a fall in the overall living standards. There were significant changes in the sexual domain, as a result in which 28.3% reported marital discordance. In the personality domain, decreased self-esteem and self-projection in life occurred in 30.9% and 36.2% respectively. On functional outcomes (EORTC QLQ-C30), only 32%-41% reported not being affected in the various facets of emotional function. Physical functions were affected in 19%-79%, role functions in 69%-75%; symptoms in 49%-80%; cognitive functions in 46%-56%; social functions in 63%-71% and financial aspects by 63%. On global QOL, 53% and 47% respectively reported high level disruption in overall physical health and overall QOL. CONCLUSION: Severe deterioration of QOL occurs as a result of diagnosis of inoperable cervical cancer and subsequent therapies. For this reason there is need to establish severe disease and end-of-life research and management services that would ensure better coping with cancer for patients and for home-based caregivers. PMID: 17633581 [PubMed - indexed for MEDLINE]

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Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

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Kamau RK, Osoti AO, Njuguna EM. Department of Obstetrics and Gynaecology, College of Health Sciences, University of Nairobi, P.O. Box 1%76-00202, Nairobi, Kenya. BACKGROUND: Cancer of the uterine cervix is the most common female cancer in Kenya. Despite being preventable, it is often diagnosed when it is already late. For this reason, only palliative therapy is provided. Hence, it is expected that their daily routines and that of their caregivers are severely disrupted. OBJECTIVES: To determine the extent to which diagnosis and treatment of inoperable cervical carcinoma affects quality of life (QOL). DESIGN: Cross-sectional descriptive study. Setting Radiotherapy Department at the Kenyatta National Hospital. SUBJECTS: Women undergoing radiotherapy for inoperable cervical cancer. RESULTS: There is high prevalence of profound disruptions in nearly all domains of QOL. In the social domain, between 33% and 44% had the perception that family members and friends had withdrawn social support. Reduction in various economic facets was reported by 47.4%-52.6%, with 44.7% reporting a fall in the overall living standards. There were significant changes in the sexual domain, as a result in which 28.3% reported marital discordance. In the personality domain, decreased self-esteem and self-projection in life occurred in 30.9% and 36.2% respectively. On functional outcomes (EORTC QLQ-C30), only 32%-41% reported not being affected in the various facets of emotional function. Physical functions were affected in 19%-79%, role functions in 69%-75%; symptoms in 49%-80%; cognitive functions in 46%-56%; social functions in 63%-71% and financial aspects by 63%. On global QOL, 53% and 47% respectively reported high level disruption in overall physical health and overall QOL. CONCLUSION: Severe deterioration of QOL occurs as a result of diagnosis of inoperable cervical cancer and subsequent therapies. For this reason there is need to establish severe disease and end-of-life research and management services that would ensure better coping with cancer for patients and for home-based caregivers. PMID: 17633581 [PubMed - indexed for MEDLINE]

Presents results of a study carried out to analyse growth traits of the Dorper sheep. Data on 969 lambs collected over a 10-year period (1978 to 1987) at Magogo, Kenya were used in the study. Lamb traits studied were weights from birth to yearling and absolute growth rates between adjacent stages of growth. All the fixed effects studied influenced growth in one way or another.

This study was undertaken to evaluate: 1. The efficacy of netilmycin and vancomycin as combined first line antimicrobial regime, compared to cefuroxime, in the treatment of peritonitis. 2. To measure the levels of netilmycin and vancomycin in the serum and dialysate. 3. To report on the use of this combination over a one year period and compare it with that of cefuroxime used during the previous one year.

We standardized a serologic enzyme immunoassay (EIA) for human immunoglobulin G and M antibodies against Haemophilus ducreyi. We evaluated the performance of this test with respect to the time from acute chancroid and coinfection with human immunodeficiency virus (HIV). Antibody to a crude, soluble bacterial antigen of one H. ducreyi strain was detected in a panel of serum samples from clinically and microbiologically confirmed cases of chancroid and from controls. Test interpretation was standardized for optimal sensitivity and specificity. Performance of the EIA was enhanced in the period of early convalescence from acute primary chancroid and was not diminished in the presence of HIV coinfection. The EIA performed adequately as a serologic screening test for field evaluation and epidemiologic application in conjunction with sexually transmitted disease and HIV detection and control efforts.

During a 4 year period (January 1983 to December 1986), 418 requests for drug analysis were received in the Drug Analysis and Research Unit, Department of Pharmacy, University of Nairobi. Of these requests, 212 were from Medical Supplies Coordination Unit, 190 from Government hospitals and health research institutions, 11 from the Ministry of Health Headquarters (Director of Medical Services and Chief Pharmacist) and 5 came from local pharmaceutical manufacturers. Of the samples analysed, 70.8% were from local manufacturers, 26.1% were imported and 3.1% were from undeclared sources. Failure to comply with test for quality, as set out in official compendia (B.P. Eur. ph. Ip, etc.) were observed at 45.8% for locally manufactured drugs and 31.4% for imported drug products.

Kamau RK, Osoti AO, Njuguna EM. Department of Obstetrics and Gynaecology, College of Health Sciences, University of Nairobi, P.O. Box 1%76-00202, Nairobi, Kenya. BACKGROUND: Cancer of the uterine cervix is the most common female cancer in Kenya. Despite being preventable, it is often diagnosed when it is already late. For this reason, only palliative therapy is provided. Hence, it is expected that their daily routines and that of their caregivers are severely disrupted. OBJECTIVES: To determine the extent to which diagnosis and treatment of inoperable cervical carcinoma affects quality of life (QOL). DESIGN: Cross-sectional descriptive study. Setting Radiotherapy Department at the Kenyatta National Hospital. SUBJECTS: Women undergoing radiotherapy for inoperable cervical cancer. RESULTS: There is high prevalence of profound disruptions in nearly all domains of QOL. In the social domain, between 33% and 44% had the perception that family members and friends had withdrawn social support. Reduction in various economic facets was reported by 47.4%-52.6%, with 44.7% reporting a fall in the overall living standards. There were significant changes in the sexual domain, as a result in which 28.3% reported marital discordance. In the personality domain, decreased self-esteem and self-projection in life occurred in 30.9% and 36.2% respectively. On functional outcomes (EORTC QLQ-C30), only 32%-41% reported not being affected in the various facets of emotional function. Physical functions were affected in 19%-79%, role functions in 69%-75%; symptoms in 49%-80%; cognitive functions in 46%-56%; social functions in 63%-71% and financial aspects by 63%. On global QOL, 53% and 47% respectively reported high level disruption in overall physical health and overall QOL. CONCLUSION: Severe deterioration of QOL occurs as a result of diagnosis of inoperable cervical cancer and subsequent therapies. For this reason there is need to establish severe disease and end-of-life research and management services that would ensure better coping with cancer for patients and for home-based caregivers. PMID: 17633581 [PubMed - indexed for MEDLINE]

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Kamau RK, Osoti AO, Njuguna EM. Department of Obstetrics and Gynaecology, College of Health Sciences, University of Nairobi, P.O. Box 1%76-00202, Nairobi, Kenya. BACKGROUND: Cancer of the uterine cervix is the most common female cancer in Kenya. Despite being preventable, it is often diagnosed when it is already late. For this reason, only palliative therapy is provided. Hence, it is expected that their daily routines and that of their caregivers are severely disrupted. OBJECTIVES: To determine the extent to which diagnosis and treatment of inoperable cervical carcinoma affects quality of life (QOL). DESIGN: Cross-sectional descriptive study. Setting Radiotherapy Department at the Kenyatta National Hospital. SUBJECTS: Women undergoing radiotherapy for inoperable cervical cancer. RESULTS: There is high prevalence of profound disruptions in nearly all domains of QOL. In the social domain, between 33% and 44% had the perception that family members and friends had withdrawn social support. Reduction in various economic facets was reported by 47.4%-52.6%, with 44.7% reporting a fall in the overall living standards. There were significant changes in the sexual domain, as a result in which 28.3% reported marital discordance. In the personality domain, decreased self-esteem and self-projection in life occurred in 30.9% and 36.2% respectively. On functional outcomes (EORTC QLQ-C30), only 32%-41% reported not being affected in the various facets of emotional function. Physical functions were affected in 19%-79%, role functions in 69%-75%; symptoms in 49%-80%; cognitive functions in 46%-56%; social functions in 63%-71% and financial aspects by 63%. On global QOL, 53% and 47% respectively reported high level disruption in overall physical health and overall QOL. CONCLUSION: Severe deterioration of QOL occurs as a result of diagnosis of inoperable cervical cancer and subsequent therapies. For this reason there is need to establish severe disease and end-of-life research and management services that would ensure better coping with cancer for patients and for home-based caregivers. PMID: 17633581 [PubMed - indexed for MEDLINE]

Kamau RK, Osoti AO, Njuguna EM. Department of Obstetrics and Gynaecology, College of Health Sciences, University of Nairobi, P.O. Box 1%76-00202, Nairobi, Kenya. BACKGROUND: Cancer of the uterine cervix is the most common female cancer in Kenya. Despite being preventable, it is often diagnosed when it is already late. For this reason, only palliative therapy is provided. Hence, it is expected that their daily routines and that of their caregivers are severely disrupted. OBJECTIVES: To determine the extent to which diagnosis and treatment of inoperable cervical carcinoma affects quality of life (QOL). DESIGN: Cross-sectional descriptive study. Setting Radiotherapy Department at the Kenyatta National Hospital. SUBJECTS: Women undergoing radiotherapy for inoperable cervical cancer. RESULTS: There is high prevalence of profound disruptions in nearly all domains of QOL. In the social domain, between 33% and 44% had the perception that family members and friends had withdrawn social support. Reduction in various economic facets was reported by 47.4%-52.6%, with 44.7% reporting a fall in the overall living standards. There were significant changes in the sexual domain, as a result in which 28.3% reported marital discordance. In the personality domain, decreased self-esteem and self-projection in life occurred in 30.9% and 36.2% respectively. On functional outcomes (EORTC QLQ-C30), only 32%-41% reported not being affected in the various facets of emotional function. Physical functions were affected in 19%-79%, role functions in 69%-75%; symptoms in 49%-80%; cognitive functions in 46%-56%; social functions in 63%-71% and financial aspects by 63%. On global QOL, 53% and 47% respectively reported high level disruption in overall physical health and overall QOL. CONCLUSION: Severe deterioration of QOL occurs as a result of diagnosis of inoperable cervical cancer and subsequent therapies. For this reason there is need to establish severe disease and end-of-life research and management services that would ensure better coping with cancer for patients and for home-based caregivers. PMID: 17633581 [PubMed - indexed for MEDLINE]

Kamau RK, Osoti AO, Njuguna EM. Department of Obstetrics and Gynaecology, College of Health Sciences, University of Nairobi, P.O. Box 1%76-00202, Nairobi, Kenya. BACKGROUND: Cancer of the uterine cervix is the most common female cancer in Kenya. Despite being preventable, it is often diagnosed when it is already late. For this reason, only palliative therapy is provided. Hence, it is expected that their daily routines and that of their caregivers are severely disrupted. OBJECTIVES: To determine the extent to which diagnosis and treatment of inoperable cervical carcinoma affects quality of life (QOL). DESIGN: Cross-sectional descriptive study. Setting Radiotherapy Department at the Kenyatta National Hospital. SUBJECTS: Women undergoing radiotherapy for inoperable cervical cancer. RESULTS: There is high prevalence of profound disruptions in nearly all domains of QOL. In the social domain, between 33% and 44% had the perception that family members and friends had withdrawn social support. Reduction in various economic facets was reported by 47.4%-52.6%, with 44.7% reporting a fall in the overall living standards. There were significant changes in the sexual domain, as a result in which 28.3% reported marital discordance. In the personality domain, decreased self-esteem and self-projection in life occurred in 30.9% and 36.2% respectively. On functional outcomes (EORTC QLQ-C30), only 32%-41% reported not being affected in the various facets of emotional function. Physical functions were affected in 19%-79%, role functions in 69%-75%; symptoms in 49%-80%; cognitive functions in 46%-56%; social functions in 63%-71% and financial aspects by 63%. On global QOL, 53% and 47% respectively reported high level disruption in overall physical health and overall QOL. CONCLUSION: Severe deterioration of QOL occurs as a result of diagnosis of inoperable cervical cancer and subsequent therapies. For this reason there is need to establish severe disease and end-of-life research and management services that would ensure better coping with cancer for patients and for home-based caregivers. PMID: 17633581 [PubMed - indexed for MEDLINE]

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

Kamau RK, Osoti AO, Njuguna EM. Department of Obstetrics and Gynaecology, College of Health Sciences, University of Nairobi, P.O. Box 1%76-00202, Nairobi, Kenya. BACKGROUND: Cancer of the uterine cervix is the most common female cancer in Kenya. Despite being preventable, it is often diagnosed when it is already late. For this reason, only palliative therapy is provided. Hence, it is expected that their daily routines and that of their caregivers are severely disrupted. OBJECTIVES: To determine the extent to which diagnosis and treatment of inoperable cervical carcinoma affects quality of life (QOL). DESIGN: Cross-sectional descriptive study. Setting Radiotherapy Department at the Kenyatta National Hospital. SUBJECTS: Women undergoing radiotherapy for inoperable cervical cancer. RESULTS: There is high prevalence of profound disruptions in nearly all domains of QOL. In the social domain, between 33% and 44% had the perception that family members and friends had withdrawn social support. Reduction in various economic facets was reported by 47.4%-52.6%, with 44.7% reporting a fall in the overall living standards. There were significant changes in the sexual domain, as a result in which 28.3% reported marital discordance. In the personality domain, decreased self-esteem and self-projection in life occurred in 30.9% and 36.2% respectively. On functional outcomes (EORTC QLQ-C30), only 32%-41% reported not being affected in the various facets of emotional function. Physical functions were affected in 19%-79%, role functions in 69%-75%; symptoms in 49%-80%; cognitive functions in 46%-56%; social functions in 63%-71% and financial aspects by 63%. On global QOL, 53% and 47% respectively reported high level disruption in overall physical health and overall QOL. CONCLUSION: Severe deterioration of QOL occurs as a result of diagnosis of inoperable cervical cancer and subsequent therapies. For this reason there is need to establish severe disease and end-of-life research and management services that would ensure better coping with cancer for patients and for home-based caregivers. PMID: 17633581 [PubMed - indexed for MEDLINE]

Kamau RK, Osoti AO, Njuguna EM. Department of Obstetrics and Gynaecology, College of Health Sciences, University of Nairobi, P.O. Box 1%76-00202, Nairobi, Kenya. BACKGROUND: Cancer of the uterine cervix is the most common female cancer in Kenya. Despite being preventable, it is often diagnosed when it is already late. For this reason, only palliative therapy is provided. Hence, it is expected that their daily routines and that of their caregivers are severely disrupted. OBJECTIVES: To determine the extent to which diagnosis and treatment of inoperable cervical carcinoma affects quality of life (QOL). DESIGN: Cross-sectional descriptive study. Setting Radiotherapy Department at the Kenyatta National Hospital. SUBJECTS: Women undergoing radiotherapy for inoperable cervical cancer. RESULTS: There is high prevalence of profound disruptions in nearly all domains of QOL. In the social domain, between 33% and 44% had the perception that family members and friends had withdrawn social support. Reduction in various economic facets was reported by 47.4%-52.6%, with 44.7% reporting a fall in the overall living standards. There were significant changes in the sexual domain, as a result in which 28.3% reported marital discordance. In the personality domain, decreased self-esteem and self-projection in life occurred in 30.9% and 36.2% respectively. On functional outcomes (EORTC QLQ-C30), only 32%-41% reported not being affected in the various facets of emotional function. Physical functions were affected in 19%-79%, role functions in 69%-75%; symptoms in 49%-80%; cognitive functions in 46%-56%; social functions in 63%-71% and financial aspects by 63%. On global QOL, 53% and 47% respectively reported high level disruption in overall physical health and overall QOL. CONCLUSION: Severe deterioration of QOL occurs as a result of diagnosis of inoperable cervical cancer and subsequent therapies. For this reason there is need to establish severe disease and end-of-life research and management services that would ensure better coping with cancer for patients and for home-based caregivers. PMID: 17633581 [PubMed - indexed for MEDLINE]

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

Ceftriaxone in a dose of 250 mg given intramuscularly is currently recommended for the treatment of chancroid. Among 133 men in Nairobi, Kenya, with culture-proven chancroid, who were treated with ceftriaxone, treatment failed in 35%. Poor outcome was associated with human immunodeficiency virus type 1 seropositivity. Thus, treatment recommendations for chancroid should be reevaluated.

This article reveals that the concept of education as a process of growth is a difficult one. Philosophers are, therefore, justified in being weary when pondering over its meaning, both in theory and practice. By way of conclusion, the article appreciates the complexities inherent in the growth theory of education, summarizing its major strength and weaknesses. Then it cautions educational planners and practitioners to be weary when, and if, they translate the theory into practice, so that they utilize the strengths inherent in the theory whilst paying attention to the dangers of its inherent weaknesses.

For over 100 years the recognized surface marking for the appendix has been McBurney's point (the junction of the lateral and middle thirds of a line joining the umbilicus with the right anterior superior iliac spine (ASIS)). In order to test its validity, the relationship between McBurney's point and the appendix was determined on 275 double contrast barium enemas (DCBE). A wide spread of distribution of the site of the appendix base was seen. Only 35% of appendix bases were found to lie within 5 cm of McBurney's point, and 15% were more than 10 cm distant. Seventy-five per cent of appendix bases were below and medial to a line joining the umbilicus with the right ASIS. These findings are in agreement with world-wide studies conducted by the World Organisation of Gastroenterology which showed that less than half of all patients with appendicitis have tenderness maximal over McBurney's point. A record was also made in 93 cases of the position of the appendix in relation to the caecum. The importance of these results in the diagnosis and management of patients with suspected appendicitis is discussed.

To provide a quantitative description of postnatal retinal expansion in rabbits, a new procedure was developed to map the retinae, which cover the inner surface of hemispheres or parts of rotation ellipsoids, in situ, onto a single plane. This method, as well as the known distribution of Müller cells per unit retinal surface area, were used to estimate the redistribution of specific subpopulations of Müller cells within different topographic regions of the retinae. Müller cells are known to exist as a stable population of cells 1 week after birth and can therefore be used as “markers” for determining tissue expansion. Our results show that differential retinal expansion occurs during development. Peripheral retinal regions expand at least twice as much as the central ones. Furthermore, there is a greater vertical than horizontal expansion. This differential retinal expansion leads to a corresponding redistribution of 5-hydroxytryptamine (5-HT) accumulating amacrine cells. Differential retinal expansion, however, does not account for all of the changes in the centro-peripheral density gradient of cells in the ganglion cell layer (GCL) — mostly retinal ganglion cells — during postnatal development. The changes in the ganglion cell layer were evaluated in Nissl-stained wholemount retinal preparations. Additionally, the difference between expansion-related redistribution of cells in the GCL and Müller cells was confirmed in wholemount preparations where Müller cells (identified as vimentin positive) and cells in the GCL (identified by fluorescent supravital dyes) were simultaneously labeled. It is assumed that many of the ganglion cells within the retinal center are not translocated during retinal expansion, possibly because their axons are fixed. In contrast, 5-HT accumulating amacrine cells — which are interneurons without a retinofugal axon — display a passive redistribution together with the surrounding retinal tissue.

This article reveals that the concept of education as a process of growth is a difficult one. Philosophers are, therefore, justified in being weary when pondering over its meaning, both in theory and practice. By way of conclusion, the article appreciates the complexities inherent in the growth theory of education, summarizing its major strength and weaknesses. Then it cautions educational planners and practitioners to be weary when, and if, they translate the theory into practice, so that they utilize the strengths inherent in the theory whilst paying attention to the dangers of its inherent weaknesses.

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In the mammalian retina, rod signals are transmitted by rod bipolars to the narrow-field, bistratified (AII) amacrine cell. This neuron, in turn, makes gap junctions with the axonal arborization of cone bipolar cells that reside in the vitreal half (sublamina b) of the inner plexiform layer (IPL). After examining rod bipolars and AII amacrines in the rabbit retina, we have now reconstructed from electron micrographs of continuous series of thin sections the synaptic connections of the axonal arborizations of cone bipolar cells that make the highest number of gap junctions with AII amacrines. These axonal arborizations were narrowly confined to stratum 4 (S4) of the IPL and made ribbon synapses to dyads of postsynaptic dendrites that belonged to either ganglion or amacrine cells. In the population of postsynaptic processes, 30% were ganglion cell dendrites. These dendrites were probably originating, at least in part, from on-center ganglion cells because their course was confined to sublamina b of the IPL. Of the remaining postsynaptic processes, 51.7% belonged to amacrine cells and 18.3% were not identified. Among the postsynaptic amacrine cell processes, 33.3% returned a reciprocal synapse onto the cone bipolar endings. These reciprocal synapses represented 21.3% of the total input onto the axonal arborizations, the remaining fraction (78.7%) arising from a heterogeneous population of amacrine dendrites that were purely presynaptic to the cone bipolars endings. Pre- and postsynaptic amacrines were part of several distinct microcircuits which suggest complex local processing of both rod and cone signals. Thus, the cone bipolars that make gap junctions with AII amacrines in sublamina b of the rabbit IPL exhibit a substantial output onto ganglion cells. This fact, in conjunction with our previous observations that in this sublamina ganglion cells receive negligible input from rod bipolars and AII amacrines, demonstrates that in the rabbit cone bipolars represent a necessary link in the pathway followed by rod signals to enter on-center ganglion cells. Thus, rod and cone signals ultimately share the same integrating mechanisms and converge onto the same set of ganglion cells.

In the mammalian retina, rod signals are transmitted by rod bipolars to the narrow-field, bistratified (AII) amacrine cell. This neuron, in turn, makes gap junctions with the axonal arborization of cone bipolar cells that reside in the vitreal half (sublamina b) of the inner plexiform layer (IPL). After examining rod bipolars and AII amacrines in the rabbit retina, we have now reconstructed from electron micrographs of continuous series of thin sections the synaptic connections of the axonal arborizations of cone bipolar cells that make the highest number of gap junctions with AII amacrines.These axonal arborizations were narrowly confined to stratum 4 (S4) of the IPL and made ribbon synapses to dyads of postsynaptic-dendrites that belonged to either ganglion or amacrine cells. In the population of postsynaptic processes, 30% were ganglion cell dendrites. These dendrites were probably originating, at least in part, from on-center ganglion cells because their course was confined to sublamina b of the IPL. Of the remaining postsynaptic processes, 51.7% belonged to amacrine cells and 18.3% were not identified. Among the postsynaptic amacrine cell processes, 33.3% returned a reciprocal synapse onto the cone bipolar endings. These reciprocal synapses represented 21.3% of the total input onto the axonal arborizations, the remaining fraction (78.7%) arising from a heterogeneous population of amacrine dendrites that were purely presynaptic to the cone bipolars endings. Pre- and postsynaptic amacrines were part of several distinct microcircuits which suggest complex local processing of both rod and cone signals.Thus, the cone bipolars that make gap junctions with AII amacrines in sublamina b of the rabbit IPL exhibit a substantial output onto ganglion cells. This fact, in conjunction with our previous observations that in this sublamina ganglion cells receive negligible input from rod bipolars and AII amacrines, demonstrates that in the rabbit cone bipolars represent a necessary link in the pathway followed by rod signals to enter on-center ganglion cells. Thus, rod and cone signals ultimately share the same integrating mechanisms and converge onto the same set of ganglion cells. © 1994 Wiley-Liss, Inc.

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The anatomic position of the appendiceal tip is cited in many surgical and anatomical texts as being fixed in the retrocecal position in as many as two-thirds of cases studied. The reference most often quoted to support this observation is Wakeley (1933), but this frequency did not correspond to the clinical experience of the surgical staff at the authors' institution. Accordingly, a prospective survey of the in vivo location of the vermiform appendix was undertaken over a 6-month period. The results demonstrated that the retrocecal position was indeed the most common location, but occurred in only 33% of instances. This observation may encourage greater utilization of laparoscopic appendectomy, since it suggests that retroperitoneal dissection will not be necessary to locate the appendiceal tip in the majority of cases. © 1994 Wiley-Liss, Inc.

Kamau RK, Osoti AO, Njuguna EM. Department of Obstetrics and Gynaecology, College of Health Sciences, University of Nairobi, P.O. Box 1%76-00202, Nairobi, Kenya. BACKGROUND: Cancer of the uterine cervix is the most common female cancer in Kenya. Despite being preventable, it is often diagnosed when it is already late. For this reason, only palliative therapy is provided. Hence, it is expected that their daily routines and that of their caregivers are severely disrupted. OBJECTIVES: To determine the extent to which diagnosis and treatment of inoperable cervical carcinoma affects quality of life (QOL). DESIGN: Cross-sectional descriptive study. Setting Radiotherapy Department at the Kenyatta National Hospital. SUBJECTS: Women undergoing radiotherapy for inoperable cervical cancer. RESULTS: There is high prevalence of profound disruptions in nearly all domains of QOL. In the social domain, between 33% and 44% had the perception that family members and friends had withdrawn social support. Reduction in various economic facets was reported by 47.4%-52.6%, with 44.7% reporting a fall in the overall living standards. There were significant changes in the sexual domain, as a result in which 28.3% reported marital discordance. In the personality domain, decreased self-esteem and self-projection in life occurred in 30.9% and 36.2% respectively. On functional outcomes (EORTC QLQ-C30), only 32%-41% reported not being affected in the various facets of emotional function. Physical functions were affected in 19%-79%, role functions in 69%-75%; symptoms in 49%-80%; cognitive functions in 46%-56%; social functions in 63%-71% and financial aspects by 63%. On global QOL, 53% and 47% respectively reported high level disruption in overall physical health and overall QOL. CONCLUSION: Severe deterioration of QOL occurs as a result of diagnosis of inoperable cervical cancer and subsequent therapies. For this reason there is need to establish severe disease and end-of-life research and management services that would ensure better coping with cancer for patients and for home-based caregivers. PMID: 17633581 [PubMed - indexed for MEDLINE]

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Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

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The sexual transmission of human immunodeficiency virus type 1 (HIV-1) continues at an alarming rate in sub-Saharan Africa despite the fact that awareness of AIDS is high. One explanation for this alarming rate may be that individuals do not believe that they are personally at risk for AIDS and are not sufficiently motivated to make changes in their behavior. We conducted a cross-sectional study of men with genital ulcer disease to assess their sexual behavior and their perceived risk of AIDS. We studied 787 men between the ages of 17 and 54 years who presented to a referral clinic for sexually transmitted diseases (STDs) in Nairobi, Kenya. Of these 787 men, 188 (24%) were infected with HIV-1. Awareness of AIDS was essentially universal in this population; however, only 64 men (8%) thought that they were personally at risk of developing AIDS. A logistic regression analysis found that men who believed they were personally at risk knew someone with AIDS (odds ratio [OR], 8.9; 95% confidence interval [CI], 4.0-19.7), received information about AIDS from television or video (OR, 3.0; 95% CI, 1.7-5.5), or had previously had an STD (OR, 2.2; 95% CI, 1.2-4.1). Except for a modest increase in condom use, there was no significant difference in sexual behavior between the group who considered themselves to be at risk for AIDS and the group who did not consider themselves to be at risk. The results of this study challenge the current strategies on HIV/AIDS education and prevention for urban men in Kenya.

Studies were commenced to collect and identify the phlebotomine sandflies found in Nairobi. These studies were also aimed at determining their numbers as well as assessing the effects of seasonal changes on the sandfly population. Four trapping methods, namely, light traps, sticky traps, aspiration and human bait were employed. Eight species and one undescribed species were recorded over a period of 6 months. The identified species included Phlebotomus guggisbergi (Kirk and Lewis), P. rodhaini (Parrot), Sergentomyia adleri (Theodor), S. harveyi (Heisch, Guggisberg and Teesdale) and S. bedfordi (Newstead) and an undescribed species. Most of the sandfly species trapped showed seasonal prevalence. The seasonal variation was closely related to the weather conditions. Sandflies were found in termite mounds, animal burrows, caves and dugouts some of which were near human habitations. Termite mounds and animal burrows were the most preferred habitats.

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Data relating to reproductive parameters of German shepherd bitches were collected from registered German shepherd dog (GSD) breeders with information kept over a 15-year period (1982-1997). The information obtained was verified using the East African Kennel Club records. A total of 594 bitches from 280 breeders were recorded. From these, 798 heats were observed, 594 of which were used for breeding, resulting in 3592 puppies. The mean age at puberty was 519.0 +/- 41 days. Heats occurred throughout the year, although significantly (P < 0.05) higher and lower incidences were observed in October and April respectively Pregnancy significantly (P < 0.01) increased interoestrous interval, which was 247.8 +/- 99.6 and 183 +/- 52 days among bred/pregnant and non-bred bitches respectively. Most bitches in oestrus (73.7%) were bred, and breeding was carried out throughout the year, with a distribution closely related to that of heat incidence. Subsequently, whelping occurred throughout the year, and 95.5% of the bitches that were mated whelped. A mean gestation period of 60.6 +/- 5.1 days was observed. The mean litter size was 6.4 +/- 0.4 puppies, and did not differ significantly between months. The preweaning losses were low, with 2.3% stillbirths, 0.9% culls and 11.4% mortalities.

This analysis attempted to capture the key economic and financial trends in the budget in the 1995/6 year and to provide the rationale for them. These trends were linked to fundamental requisites for development and sustainable growth.

This analysis attempted to capture the key economic and financial trends in the budget in the 1995/6 year and to provide the rationale for them. These trends were linked to fundamental requisites for development and sustainable growth.

The cellular immune responses to fractionated Haemophilus ducreyi antigens, coated on latex beads, were assessed in patients with chancroid and in controls, using an in vitro lymphocyte proliferation assay. Several fractions of H. ducreyi antigen revealed stimulating activity. However, only the molecular size ranges 91-78 kD, 59-29 kD, and 25-21 kD induced proliferation that may be specifically related to H. ducreyi infection. Lymphocytes from four HIV- patients, successfully treated for chancroid, were not stimulated by H. ducreyi antigen. In general, lymphocytes from HIV+ chancroid patients were less responsive to H. ducreyi antigen compared with those from HIV- chancroid patients. However, two HIV-infected patients showed exceptionally strong responses to high molecular weight fractions. To our knowledge this is the first report demonstrating that H. ducreyi contains specific T cell-stimulating antigens. Based on this work, further identification and purification of the T cell antigens is feasible.

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Transcultural psychiatry, whose scientific founder Emil Kraepelin is considered as, in its 100 years of tradition has not only developed a varied range of methods but has also brought about a change in the respective scientific questions as well as in related research and clinical applications. Whereas transcultural research on the psychopathology of depression contributed to the further development of psychiatric nosology, transcultural psychiatry has recently been increasingly faced with issues concerning phenomena of social change and globalization. One region, where such conditions can be observed in particular is Africa, where the dissolving of traditional standards and support systems and growing economic insecurity causes a considerable burden especially on women. As an example, results from a cross-sectional study on East African women using a two step design as well as qualitative and quantitative, standardized psychiatric methods are discussed concerning the association of social change, psycho-social risk factors and the development of depressive disorders. Efficient clinical methods towards diagnosis and treatment of new risk groups will have to be developed, of which an important aspect will be crisis intervention

OBJECTIVES: To estimate the prevalence of active trachoma (TF) in children aged one to nine years and potentially blinding trachoma (TT) in adults aged 15 years and older in six known trachoma-endemic districts in Kenya. DESIGN: Community based survey. SETTING: Six known trachoma endemic districts in Kenya (Samburu, Narok, West Pokot, Kajiado Baringo and Meru North). SUBJECTS: A total of 6,982 children aged one to nine years and 8,045 adults aged 15 years and older were randomly selected in a two stage random cluster sampling method: Twenty sub-locations (clusters) per district and three villages per sub-location were randomly selected. Eligible children and adults were enumerated and examined for signs of trachoma. RESULTS: Blinding trachoma was found to be a public health problem in all the surveyed districts. Active trachoma was a district wide public health problem in four districts (Samburu, Narok, West Pokot and Kajiado) and only in some of the sub-locations of the other two (Baringo and Meru North). CONCLUSIONS: There is need for district trachoma control programmes preferably using the WHO recommended SAFE strategy in all the surveyed districts. Extrapolation of these survey results to the entire country could not be justified. There is need to survey the remaining 12 suspected endemic districts in Kenya.

OBJECTIVE: To estimate the prevalence and pattern of conjuctival squamous cell carcinoma (CSCC) in patients with HIV infection. DESIGN: A hospital based cross sectional study. SETTING: Kenyatta National Hospital (KNH) and Kikuyu Eye Unit (KEU) during the period November 2003 and May 2004. SUBJECTS: Four hundred and nine HIV positive patients. RESULTS: Four hundred and nine HIV positive patients aged 25 to 53 years were screened. Male to Female ratio was 1:1. One hundred and three had conjunctival growths. Thirty two had histologically proven conjunctiva squamous cell carcinoma (CSCC). Estimated prevalence of CSCC among HIV positive patients was 7.8%. The average duration of growth of the conjunctival masses was 21.8 months. The average size of the lesions at the time of presentation was 6.6 mm. Twenty two (68.8%) patients had primary CSCC, while ten (31.2%) had recurrent lesions. The pattern of the histopathology results was: fifteen (46.9%) patients had poorly differentiated squamous cell carcinoma; nine (28%) had moderately differentiated squamous cell carcinoma; five patients (15.6%) had CIN; two patients (6.3%) had dysplasia and one patient (3.1%) had a well differentiated squamous cell carcinoma. CONCLUSIONS: Prevalence of CSCC in HIV/AIDS patients was 7.8%. Patients present late with advanced lesions. Recurrence rates from previous surgery are high. The often uncharacteristic complaints and findings on presentation complicate the clinical diagnosis. Active search for early manifestations of CSCC in HIV / AIDS patients, complete surgical excision and close follow up is necessary. Alternative treatment methods and techniques like the topical use of antimetabolites should be explored further.

OBJECTIVES: To estimate the prevalence of active trachoma (TF) in children aged one to nine years and potentially blinding trachoma (TT) in adults aged 15 years and older in six known trachoma-endemic districts in Kenya. DESIGN: Community based survey. SETTING: Six known trachoma endemic districts in Kenya (Samburu, Narok, West Pokot, Kajiado Baringo and Meru North). SUBJECTS: A total of 6,982 children aged one to nine years and 8,045 adults aged 15 years and older were randomly selected in a two stage random cluster sampling method: Twenty sub-locations (clusters) per district and three villages per sub-location were randomly selected. Eligible children and adults were enumerated and examined for signs of trachoma. RESULTS: Blinding trachoma was found to be a public health problem in all the surveyed districts. Active trachoma was a district wide public health problem in four districts (Samburu, Narok, West Pokot and Kajiado) and only in some of the sub-locations of the other two (Baringo and Meru North). CONCLUSIONS: There is need for district trachoma control programmes preferably using the WHO recommended SAFE strategy in all the surveyed districts. Extrapolation of these survey results to the entire country could not be justified. There is need to survey the remaining 12 suspected endemic districts in Kenya.

United States International University-Africa, Nairobi, Kenya. OBJECTIVE: To investigate the prevalence and pattern of substance use among an undergraduate population in a Kenyan university. DESIGN: Cross-sectional survey, cluster sampling of classrooms, self-administered questionnaires. SETTING: Private international university in Nairobi province, Kenya. PARTICIPANTS: Five hundred fifty eight undergraduate students of both sexes, age range 16-50 and mean age (S.E) of 21.1 +/- 0.2. MAIN OUTCOME MEASURES: Self-reported use of psychoactive substances. RESULTS: Percentages of lifetime prevalence rates of commonly used substances were tobacco, 54.7%; alcohol, 84.2%; cannabis, 19.7% and inhalants, 7.2%. The corresponding "past use" and "current use" rates were relatively lower but followed the same pattern. The percentage rates were significantly higher in males than females (p < 0.005). Rates for regular use (> 20 days/month) were higher for tobacco (24.7%) than alcohol (11.5%). The lifetime prevalence rates of other drugs (heroin, cocaine, mandrax, amphetamines and LSD) were low (< 5%), while modest rates were recorded for tranquilizers (10.8%), local brews (13.6%) and cough mixtures (35.1%). Less than 20% of respondents initiated substance use in lower primary school, while more than 50% started using in upper primary and secondary school and 11% to 25% started using substances at university. CONCLUSION: Substances most commonly used by respondents studied were of the licit variety (alcohol and tobacco). The rate of use of the two substances is rather high. The use of illicit drugs seems to be growing and may soon escalate to alarming levels. The findings suggest an urgent need to gather more data, which can be used to guide formulation of health promotion and prevention programmes.

United States International University-Africa, Nairobi, Kenya. OBJECTIVE: To investigate the prevalence and pattern of substance use among an undergraduate population in a Kenyan university. DESIGN: Cross-sectional survey, cluster sampling of classrooms, self-administered questionnaires. SETTING: Private international university in Nairobi province, Kenya. PARTICIPANTS: Five hundred fifty eight undergraduate students of both sexes, age range 16-50 and mean age (S.E) of 21.1 +/- 0.2. MAIN OUTCOME MEASURES: Self-reported use of psychoactive substances. RESULTS: Percentages of lifetime prevalence rates of commonly used substances were tobacco, 54.7%; alcohol, 84.2%; cannabis, 19.7% and inhalants, 7.2%. The corresponding "past use" and "current use" rates were relatively lower but followed the same pattern. The percentage rates were significantly higher in males than females (p < 0.005). Rates for regular use (> 20 days/month) were higher for tobacco (24.7%) than alcohol (11.5%). The lifetime prevalence rates of other drugs (heroin, cocaine, mandrax, amphetamines and LSD) were low (< 5%), while modest rates were recorded for tranquilizers (10.8%), local brews (13.6%) and cough mixtures (35.1%). Less than 20% of respondents initiated substance use in lower primary school, while more than 50% started using in upper primary and secondary school and 11% to 25% started using substances at university. CONCLUSION: Substances most commonly used by respondents studied were of the licit variety (alcohol and tobacco). The rate of use of the two substances is rather high. The use of illicit drugs seems to be growing and may soon escalate to alarming levels. The findings suggest an urgent need to gather more data, which can be used to guide formulation of health promotion and prevention programmes.

This paper reports on a prospective study conducted between June 1990 and June 1992 to determine method acceptability, user satisfaction and continuation rates for three highly effective and reversible contraceptive methods currently available in Kenya: the CuT 380A (IUCD), the injectable, Depo-Provera and the low-dose oral contraceptive pill, Microgynon. A non-randomised sample of volunteer participants was used. One thousand and seventy-six users were followed up for a period of one year or up to the time of discontinuation of the method, whichever came earlier. Analysis revealed method specific differences in users' characteristics. The OC users were younger and had fewer children than the IUCD or Depo-Provera users. The Depo-Provera users were older, and had the largest family sizes. Many OC users (almost 40%) were single, while almost three-quarters of IUCD and Depo-Provera users were married. IUCD users were also more educated compared to OC and Depo-Provera users. Survival analysis was used to calculate cumulative life table discontinuation rates by method for the 12 month period. Discontinuation rates were highest for OC users (80%) and lowest for IUCD users (20%) and intermediate for Depo-Provera users (39%). Ninety percent of OC and Depo-Provera users and 86% of IUCD users said they were satisfied with their respective methods. While OCs are among the most popular family planning methods in Kenya, they are also one of the most problematic, while IUCD has the fewest compliance problems. Service providers need to address the issue of high discontinuation rates among the young OC users.
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This paper reports on a prospective study conducted between June 1990 and June 1992 to determine method acceptability, user satisfaction, and continuation rates for three highly effective and reversible contraceptive methods currently available in Kenya: the CuT 380A IUD; the injectable Depo-Provera; and the low-dose oral contraceptive Microgynon. A nonrandomized sample of volunteer participants was used. 1076 users were followed up for a period of 1 year or up to the time of discontinuation of the method, whichever came earlier. Analysis revealed method-specific differences in users' characteristics. The OC users were younger and had fewer children than the IUD or Depo-Provera users. The Depo-Provera users were older and had the largest family sizes. Many OC users (almost 40%) were single, while almost three-quarters of the IUD and Depo-Provera users were married. IUD users were also more educated compared to OC and Depo-Provera users. Survival analysis was used to calculate cumulative life table discontinuation rates by method for the 12-month period. Discontinuation rates were highest for OC users (80%), lowest for IUD users (20%), and intermediate for Depo-Provera users (39%). 90% of OC and Depo-Provera users and 86% of IUD users said they were satisfied with their respective methods. While OCs are among the most popular family planning methods in Kenya, they are also one of the most problematic, while IUDs have shown the fewest compliance problems. Service providers need to address the issue of high discontinuation rates among young OC users

Recent studies have suggested that Epstein-Barr virus (EBV) may play a role in the etiology of Hodgkin's disease (HD). In a previous study, we used a latent membrane protein 1 (LMP1)-specific antibodies to examine archival material from 74 British children with HD and found 50% of cases to be positive. It is known that there are geographic and ethnic variations in the incidence of HD. We have investigated LMP1 status in formalin-fixed, paraffin wax-embedded lymph nodes with HD involvement from 53 children and 48 adults from Kenya using immunohistochemical staining. We also developed sensitive and specific in vitro gene amplification protocols for examining the EBV strain type in such material using several combinations of primers derived from the EBNA 2 and EBNA 3 coding regions. LMP1 positivity was present in 100% of the pediatric cases (two lymphocyte-predominant, 25 nodular sclerosis, 16 mixed cellularity, 5 lymphocyte depletion, and 5 unclassified) and in 66% of the adult cases (two of three lymphocyte-predominant, 26 of 39 nodular, sclerosis, two of two mixed cellularity, and two of four lymphocyte depletion). Tests to type the EBV strain were undertaken in 25 EBV-positive pediatric cases. A combination of type-specific polymerase chain reactions for EBNA 2 and EBNA 3C genes indicated that seven patients had type 1, eight had type 2, and 10 had dual infections with both types. Five cases with dual infections were further investigated using a sensitive in situ hybridization for the EBV-encoded, small nuclear nonpolyadenylated RNAs (EBERs). EBER transcripts were detected in Reed-Sternberg and Hodgkin cells and in occasional infiltrating lymphocytes. These observations indicate that in Kenya EBV is consistently associated with pediatric cases of HD, and that biopsies from a number of such cases appear to carry both type 1 and type 2 viral sequences.

Phosphate binders are necessary to control hyperphosphataemia in the majority of dialysis patients. Whilst aluminium salts are efficient phosphate binders, their use is associated with toxic side effects. Calcium salts are a widely used alternative, but hypercalcaemia is a common side effect, limiting their use and raising concern about metastatic calcification. Reduction of the dialysis fluid calcium concentration has been shown to reduce hypercalcaemia in haemodialysis patients, with an associated decrease in serum PTH. We analysed the effect of reduced calcium/magnesium (1.25/0.25 mmol/l), 40 mmol/l lactate, PD fluid (PD4) on 11 CAPD patients with uncontrollable hypercalcaemia (> 2.65 mmol/l) and hyperphosphataemia (> 1.80 mmol/l). Only 1 patient remained hypercalcaemic, while phosphate fell in 6 patients (2.23 +/- 0.16 on no binder, to 1.68 +/- 0.08 mmol/l at 6 months (p < 0.05), but was unchanged in 5 (2.10 +/- 0.15 to 2.48 +/- 0.14 mmol/l [p = NS]). Overall mean calcium x phosphate product changed little. However, in a subgroup it fell significantly (p < 0.05). Geometric mean iPTH rose, but not significantly. The subgroup of patients whose calcium x phosphate product fell, exhibited a much smaller rise in iPTH than the others (57.3-73.2 vs. 52.8-167.1 pg/ml). 1.25-Dihydroxyvitamin D3 was subnormal in all patients. Mean serum magnesium fell from 1.24 +/- 0.06 to 0.89 +/- 0.04 mmol/l (p < 0.001), whilst mean serum bicarbonate rose significantly (25.2 +/- 0.4 to 28.9 +/- 1.2 mmol/l; p < 0.01). Withdrawal of aluminium-containing phosphate binders resulted in mean serum aluminium falling significantly from 31.1 +/- 5.7 at start of PD4 to 15.4 +/- 2.7 mu g/l at 6 months (p < 0.05). In summary, in around 50% of CAPD patients with persistent hypercalcaemia and hyperphosphataemia, reduction in PD fluid calcium can produce significant improvement in phosphate, reduction of calcium x phosphate product, and enable avoidance of aluminium-containing phosphate binders. Patients whose calcium and phosphate control remains poor, still benefit from the reduction, or cessation, of oral aluminium intake.

The Metropolis-Hastings Markov Chain Monte Carlo algorithm uses a proposal
distribution to sample from a given target distribution. The proposal distribution has to be
tuned beforehand which is an expensive exercise. However, adaptive algorithms
automatically tune the proposal distribution based on knowledge from past samples,
reducing the tuning cost. In this study we first examine Adaptive Metropolis, Metropolis
Gaussian Adaptation and Covariance Matrix Adaptation Evolutionary Strategies.

Fruits from the East African tree, Melia volkensii (Gurke) contain terpenoid compounds with well-establishcd insecticidal activity. At high doses a concentrated M. volkensii extract (Mv) causes death or lack of physical fitness in locusts by irreversible paralysis of the locust skeletal muscles, without affecting the malpighian tubules or the pulsation of the dorsal heart. This effect is temperature related, with lower doses becoming more effective as the temperature increases. This action favours Mv toxicity against locusts in hot desert areas. Mammalian toxicological studies showed that Mv does not present any acute or chronic toxicity effects when orally administered to laboratory mice. It was thus not possible to establish an oral LD50 for the product in mice. Mv production in bulk and shelf-life are discussed with a view to demonstrating its advantages as a possible locust control product.

Isolation rates for Listeria monocytogenes and the other Listeria spp. typically improve when samples are enriched in more than one primary enrichment medium. This study evaluated the abilities of two primary enrichment media, University of Vermont-modified Listeria enrichment broth (UVM) and Listeria repair broth (LRB), to recover different ribotypes of Listeria spp. from raw meat and poultry samples. Forty-five paired 25-g retail samples of ground beef, pork sausage, ground turkey, and chicken (160 samples) underwent primary enrichment in UVM and LRB (30 degrees C for 24 h) followed by secondary enrichment in Fraser broth (35 degrees C for 24 and 40 h) and plating on modified Oxford agar. After 24 h of incubation of 35 degrees C, 608 Listeria colonies from selected positive samples were biochemically confirmed as L. monocytogenes (245 isolates), L innocua (276 isolates), and L. welshimeri (89 isolates) and then ribotyped with the automated Riboprinter microbial characterization system (E. I. du Pont de Nemours & Co., Inc.). Thirty-six different Listeria strains comprising 16 L. monocytogenes (including four known clinical ribotypes), 12 L. innocua, and 8 L. welshimeri ribotypes were identified from selected positive samples (15 samples of each product type; two UVM and two LRB isolates per sample). Twenty-six of 36(13 L. monocytogenes) ribotypes were detected with both UVM and LRB, whereas 3 of 36 (1 L. monocytogenes) and 7 of 36 (3 L. monocytogenes) Listeria ribotypes were observed with only UVM or LRB, respectively. Ground beef, pork sausage, ground turkey, and chicken yielded 22 (8 L. monocytogenes), 21 (12 L. monocytogenes), 20 (9 L. monocytogenes), and 19 (11 L. monocytogenes) different Listeria ribotypes, respectively, with some Listeria ribotypes confined to a particular product. More importantly, major differences in both the number and distribution of Listeria ribotypes, including previously recognized clinical and nonclinical ribotypes of L. monocytogenes, were observed when 10 UVM and 10 LRB isolates from five samples of each product were ribotyped. When a third set of six samples per product type was examined from which two Listeria isolates were obtained by using only one of the two primary enrichment media, UVM and LRB failed to detect L. monocytogenes (both clinical and nonclinical ribotypes) in two and four samples, respectively. These findings stress the importance of using more than one primary enrichment medium and picking a sufficient number of colonies per sample when attempting to isolate specific L. monocytogenes strains during investigations of food-borne listeriosis.

The objective of the study was to determine the efficacy of chloroquine in pregnant women with Plasmodium falciparum parasitemia at therapeutic doses of 25 mg/kg body weight divided over 3 days. METHODS: Three-hundred pregnant women in Kilifi Hospital at the coast of Kenya were screened for malaria parasitemia using Giemsa stained thick blood smears. In vivo and in vitro parasite sensitivity to chloroquine was determined. RESULTS: P. falciparum infections were present in 65 (22%) of 300 pregnant women. The in vivo tests showed that 46% of all the P. falciparum infections were resistant to chloroquine predominantly at RI and RII levels. The in vitro tests showed a resistance rate of 35%. CONCLUSIONS: A large proportion of pregnant women with malaria do not respond to chloroquine therapy and alternative drugs are required

OBJECTIVE: To determine the local aetiological spectrum of surgically relevant causes of abdominal pain. DESIGN: A prospective descriptive study was carried out. SETTING: Kenyatta National Hospital, Nairobi, Kenya during the month of October 2002. SUBJECTS: Patients aged 13 years and older presenting to the casualty department with abdominal pain were followed through the hospital system to determine whether they would undergo laparotomy and, in those cases who underwent laparotomy, to determine the nature of the pathology found at laparatomy. RESULTS: Abdominal pain was a presenting complaint in 1557 (16.7%) of patients presenting to the casualty department during the study period. Abdominal pain accounted for 17.9% (398 out of 2225 patients) of all admissions via the casualty department. Laparotomy was performed on 68 (4.4%) of patients who presented with abdominal pain to the casualty department. In female patients presenting with abdominal pain, the incidence of ectopic pregnancy and acute appendicitis was 65.3% and 16.3% respectively. The incidence of neoplasia found at laparatomy, for abdominal pain, on patients admitted to the general surgical ward was 3.0%. The incidence of neoplasia, as a cause of abdominal pain resulting in laparatomy was 3.3%. CONCLUSION: The results highlight the fact, with respects to abdominal pain, that there are significant differences between the disease patterns in different geographical locations. Assuming the converse could adversely affect the management of patients with abdominal pain locally.

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Maize, the most important cereal crop in Kenya, is grown from sea level to more than 2300 m elevation. With the use of geographic information system (GIS) techniques, six distinct maize agro- climatic zones have been defined for the main rainy season in Kenya. The objective of this study was to characterize each of these zones for the degree and timing of drought stress. For each of the six maize zones, two representative sites with extensive weather records were used. Long term means for rainfall for 10 d periods were compared to the potential evapotranspiration of the same period at each site. Maize phenological development was superimposed on these data. In the highland and moist transitional zones, which comprise 75 Per cent of the maize area, drought occurrences were limited. The moist midaltitude zone had the greatest variability in moisture stress between sites, and late season drought is consistently a problem. The dry midaltitude and dry transitional zones experience the most severe drought, especially during grain filling and early in the season. In the lowland tropics, significant moisture stress occurs during the first 20 d of the season and during the last 40 d of growth. These data suggest that drought tolerance is needed for germplasm being developed for four of the six zones.

Acid diffusion in the presence of hexamethyldisiloxane (HMDS) enables complete recovery of ionic fluoride from standards containing varying concentrations of aluminium as one of the main interfering ions. Acid diffusion without HMDS shows a decrease in fluoride recovery as aluminium ion concentration increases. The fluoride concentration in the trapping solution is determined directly on the diffusion cover with a combination fluoride electrode after neutralising and buffering. The same procedure was used for the analysis of fluoride in soil and plant materials containing high concentrations of aluminium ions. For the same samples, the concentrations of aluminium, iron and silicon were determined using atomic absorption spectrophotometer (AAS).

The purpose of this study was to assess the effect of malaria infection on benzodiazepine binding in rat brain. Young male Wistar rats were infected with the rodent parasite Plasmodium berghei, while age-matched control rats (n = 5) received normal saline intraperitoneally. Parasitemia was determined in blood of infected animals. Animals were killed after two weeks, and synaptosomal brain membrane homogenate was prepared from cerebral cortex. Membrane homogenate was incubated in duplicate with 3H-flunitrazepam (0.2-10 nM in buffer, pH 7.4) and binding parameters determined. The number of receptors (Bmax) was decreased marginally but significantly (P = 0.047) in malaria-infected (MI) rats (MI rats: 1.12 +/- 0.1 pmol.mg-1 protein; control rats: 1.42 +/- 0.08 pmol.mg-1 protein) while binding affinity (Kd) was not altered (MI rats: 1.18 +/- 0.3 nM; control rats: 1.02 +/- 0.15 nM). These results suggest that malaria may be associated with decreased benzodiazepine activity

The Kenyan Maasai traditional built form in Kajiado District is changing. It is being replaced by the newly developed homesteads and houses which are inadequately planned, designed and lacking in symbolism. The latter are inconsistent with social arrangements and cultural needs of the contemporary Maasai lifestyle. It was the hypothesis of this study that the culture of the Maasai influences the architecture of their built forms. Multiple research tools were used in the collection of data. These included Observation, Focus Group Discussion, Questionnaires and Interviews. Among the techniques used in analysing the data are the chi-square statistics and qualitative analytical procedures based on the material collected through cluster sampling of 92 homesteads which were presented graphically. It is clear that the architectural conditions of Maasai buildings are a result of culture change variables identified as occupation, religion, rituals, education, family set-up and land tenure which have consistently evolved cultural values such as social status, independence, privacy and sedentary lifestyle. The study concludes that, in view of the changed culture of the maasai, the new built form is satifactory in the incorporating the emerging architectural design concepts such as nuclear family house, linearity, divisibility and permanence in response to emerging spaces and artifacts. These concepts symbolise the changing Maasai culture in the built form.