Department of Agricultural Economics

No Abstract!

No Abstract!

No Abstract!

No Abstract!

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

Over the last six years there has been a tremendous development of infrastructure projects in virtually all corners of Kenya. This has taken the form of Road Improvement Project, Water and sewerage improvement project and the Electricity Transmission Improvement Project as envisioned in the Kenya Vision 2030. The purpose of this paper is to investigate the principles of compulsory land acquisition and way leaves in the three sectors in Kenya by looking at the current legislative framework governing the entire process of acquisition. In considering the process, the paper explores the various provisions of the relevant act which governs the particular utility envisaged for improvement project component in the Kenya Vision 2030. A critical evaluation of the procedures adopted is outlined in each case and the general public apprehensions towards such acquisitions. The second part of the paper focuses on suggestions on the choice of valuation methodology in making claims for compensation for land for various infrastructure projects in Kenya. This is borne out of the fact that there appear to be very little standardization in the methods adopted by the various bodies. The paper cites several cases under the Electricity Transmission Improvement Project where a large proportion of way leaves are dealt with at local level, with little consistency. Coupled to this is the public concern that electricity lines have potentially serious health effects that continue to attract research and media interest. The paper concludes with a description of the various cases on how to improve compensation paid to those affected by compulsory acquisition in cases of land and way leaves.

This study was designed to determine whether there was any difference in the T-cell subset counts and serum immunoglobulin concentrations in patients with chronic renal failure as compared to normal controls. Ninety individuals participated in the study. These were divided into three groups as follows; (i) 30 subjects with normal renal function; (ii) 30 subjects with chronic renal failure (CRF)(creatinine clearance 10-50 mls/min), not requiring haemodialysis and; (iii) 30 subjects with end stage renal disease (creatinine clearance < 10 mls/min) on haemodialysis. The subjects in the three groups were matched for age and sex. In addition, it was ascertained that none of the subjects was on any medication or suffered from any ailment known to interfere with the immune system. The T-cell subset counts were carried out using flow cytometry while the serum concentration of immunoglobulins was measured using the radio-immunodiffusion method. Patients with CRF, whether on haemodialysis or not, had significantly lower lymphocyte counts as a proportion of total white cell count (19% and 19.2% respectively versus 39%) and low absolute CD4 cell counts per mm3 (337 +/- 94 and 449 +/- 116 respectively versus 891 +/- 360) and CD8 cell counts per mm3 (437 +/- 234 and 490 +/- 176 respectively versus 644 +/- 228) as compared to normals, with no statistically significant difference between the two groups with CRF. The CD4: CD8 ratios in the three groups studied were 1.487 +/- 0.233, 0.961 +/- 0.326 and 0.751 +/- 0.167 respectively, being significantly higher in normal controls than in any of the groups with CRF (p < 0.05) and in the group with CRF not requiring dialysis than in those requiring it (p < 0.05). The serum concentration of immunoglobulins in the two groups with CRF were similar to those in the group with normal renal function. It is concluded that CRF represents a state of immunodeficiency not significantly corrected by haemodialysis.

Autosomal dominant polycystic kidney disease [ADPKB] is one of the commonest genetic diseases. Apart from the involvement of the kidneys, several other organs, viz. the liver, the central nervous system, the pancreas, the spleen, the ovaries and the gut, amongst others, are also sometimes involved. This makes ADFKD more of a systemic rather than an isolated renal disorder. This becomes more so considering that the involvement of the other organs contribute significantly to the morbidity and mortality of ADPKD. This review looks at the pattern and prevalence of involvement of other organs, apart from the kidney in ADPKD.

Autosomal dominant polycystic kidney disease [ADPKB] is one of the commonest genetic diseases. Apart from the involvement of the kidneys, several other organs, viz. the liver, the central nervous system, the pancreas, the spleen, the ovaries and the gut, amongst others, are also sometimes involved. This makes ADFKD more of a systemic rather than an isolated renal disorder. This becomes more so considering that the involvement of the other organs contribute significantly to the morbidity and mortality of ADPKD. This review looks at the pattern and prevalence of involvement of other organs, apart from the kidney in ADPKD.

The health, economic and social costs of smoking are enormous and well known to physicians. Smoking results in a lot of morbidity and mortality mainly related to cardiovascular disease, cancer and pulmonary disease. The effect of smoking on the kidneys is little appreciated. It is the purpose of this review article to give evidence from available literature that smoking is indeed deleterious to the kidneys and may result in progression of chronic renal failure to end stage renal disease. It is concluded that nephrologists, and indeed all physicians, should make a concerted effort to save their patients from this vice.

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

Estimating spatial variability of trace geothermal signatures is an important factor is evaluating the geothermal field potential.  It is expected that a particular geothermal feature (hot spring, fumarole, geyser, etc.) exhibits unique 'marker' trace element/ and             radiogenic signatures that may be used to prospect the field over large spatial dimension (for example mapping of passive sites) based on the results of a few measurements on the feature.  Geostatistical methods provide means to study the heterogeneous nature of the 'marker' spatial distribution especially in an area of poor accessibility.  The geothermal signatures in this study are trace elements in thermal water that uniquely characterize the Kerio Valley geothermal field, which lies in the mid Rift System of Kenya.  The region has been associated with elevated background radiation to the extent that certain areas in have been characterized as high background radiation areas (HBRA) thereby providing a   perfect setting to understand the relations between geothermal characterizing trace elements and naturally occurring radioactive material (NORM) signatures.  X-Ray       Fluorescence (XRF) analysed Sr, K, Rb, Br, Ca and Cr showed a strong positive  correlation with water temperature and were considered for mapping their variability and  prediction of unsampled areas.  Variogram and Kriging analysis was performed using ArchMap 9.3.  The results show that the spatial distribution of the sampling points is insufficient to map the whole area of interest.  Various variogram models fit well for Sr, Rb and Cr.  However, a fitting model for K, Br, and Ca could not be found.  This is due to the unharmonized nature of the covariance between the sampled points.  The kriging maps, which are a product of the variograms, capture the sense  and importance of        sampling design (DoE) in geostatistical modelling.  This study therefore serves as a base for the design and systematic sampling approach for the sparse nature of the Kerio Valley goethermal signatures.  Springs of elevated thermal gradient have been identified as the sampling points.  Both water and soil (i.e. sediment) will be sample accordingly to 'markers' have shown a strong positive correlation with thermal gradient in water, and the soil has provided the same correlation pattern as the water.  Therefore in cases of dried springs, soil samples can confidently provide a good model.

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

Sixty-four patients atteending the Kenyatta National Hospital psychiatric clinic with minor p.yychiatric disorders were assessed using the Enugu Somatization Scale with a view of eliciting the nature and types of somatic complaints they had. A control group of 66, 5th year medical student, was used. The average scores for the head and body symptoms were 10.9 and 22.1 for the neurotics and 0.9 and 1.5 for the controls respectively. Overall the commonest complaints among the patients were vague, the highest positive scores in order a/frequency being. 'What worries me is not steady." . 3.7%), "parts of my body are out of order" (87.3%), "my whole body is not all right" (87.3%), ':feeling various parts of the body shiver" (85. 7%) and ':feeling dizzy" (84. 1 %). The complaints were not related to age, sex, education, occupation or p,\ychiatric diagno,yis. The average scores for the Kenyan neurotic, were higher than that obtained from the Nigerian (head: 8.14; body: 15.2) and Indian neurotics (head: 8.75: body: 11.78) in previous .ytudies. On the other hand the Kenyan controls had lower scores compared to the other 2 groups. The implication of these findings is discussed.

Isolated mouse interstitial cells were incubated with different concentrations of khat (Catha edulis) extract (0.06 mg/ml, 0.6 mg/ml. 6 mg/ml. 30 mg/ml and 60 mg/ml) and cell viability as well as testosterone concentration measured at 30 min intervals over a 3 h incubation period. High concentrations of khat extract (30 mg/ml and 60 mg/ml) significantly inhibited testosterone production while low concentrations (0.06 mg/ml. 0.6 mg/ml and 6 mg/ml) significantly stimulated (P < 0.05) testosterone production by mouse interstitial cells. Similarly, at concentrations of 30 mg/ml and 60 mg/ml, there was a significant decrease in interstitial cell viability, whereas at 0.06 mg/ml, 0.6 mg/ml and 6 mg/ml there was no significant decrease. There was only a weak correlation (r= 0.39) between testosterone production and viable interstitial cells. We postulate that khat extract at high concentrations may cause reproductive function impairment in the user but at low concentrations. may enhance testosterone production with accompanying effects on reproductive functions in male mice. @2006 Publishedby Elsevier Ireland Ltd. Kel'lVords: In dtro; Khat; Testosterone; Interstitial cells; Mouse

|7 Skulls of the waterbuck (kobus ellipsiprynnus defassa) ithree lake systems of the central Kenyan Rift Valley (viz. tfakuru, Elementaita and Naivasha) were examined for bnormalities, as a result of chronic signs of ill health, in ome of the animals in the region. The waterbuck were ulled randomly and weighed. Several parameters were leasured. A post mortem examination was carried out on ach of the animals culled. Bone samples were stripped F all tissue by boiling. The skulls were weighed and amined for any abnormalities. The teeth were used for eing the animals.
lemean age of the waterbuck was 5.1±1.7 years. 67% of Bimals in poor body condition showed skeletal normalities including pathological eruption and growth • wear of teeth. The teeth had black stains along the gual and buccal surfaces but no evidence of fluorosis. |je abnormalities observed in the skulls could be uted to mineral imbalances in some of the areas in the al Kenyan Rift Valley region. Abnormal eruption of i could in turn play a role in poor feeding of the affected als thus contributing to poor health.

Statement of the Problem
\
Atmospheric concentrations of greenhouse gases have been increasing rapidly (IPCC 1994). This increase has been attributed mainly to human activities. The composition of the atmosphere has thus changed considerably and will continue to do so in future. Such changes are capable of affecting the surface climate of the earth and can have possible consequences on both natural and man-made resources, thereby threatening both marine and terrestrial ecosystems. Deleterious effects of these consequences will affect the well-being of man through impacts on important sectors such as health, agriculture, transport, industry, and water resources (IPCC 1990; 1995). To these sectors, energy is crucial for their development but energy itself is also vulnerable to the effects of climate change. Negative changes in energy production will therefore seriously affect global industrialization programs as well as national economies considering that global demands for energy have been rising at an annual rate of 2% (IPCC, 1995).
Kenya, like most developing countries relies on biomass (mostly woodfuel and charcoal^as the biggest source of energy, contributing about 73% of the total energy requirements. It is used by over 80% of the rural population, mostly for cooking and heating. In addition to biomass, the other two major sources of energy in Kenya are petroleum and electricity. The domestic sector is the largest consumer (59%), followed by industry (15%), transportation (11%), agriculture (10%), and commercial (5%) sectors (Kenya/Canada Energy Advisory Project, 1991).
When considered in terms of social-economic development, human settlement infrastructure, as well as manufacturing, electricity is the most important form of energy in Kenya Currently, it is generated from several sources including hydropower, gas turbines, geothermal power and diesel engines. Of the total amount generated, hydropower contributes over 76%.
Hydroelectricity generation depends on availability of water, which in turn depends on the prevailing climate. Fluctuations in rainfall and temperature can affect evapotranspiration rates which in turn can determine the channel flow and power generation rates. In this regard, the hydro-power source of electricity becomes the most vulnerable to climate change effects. This study therefore focuses on hydro-power development in Kenya in relation to the impacts of climate change that are anticipated in future.

No Abstract!

No Abstract!

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.

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

This is a descriptive cross sectional study. A structured questionnaire was used to interview 300 respondents who had infibulation as a form of female genital circumcision.The interviews were conducted at Garissa General Hosptial Gynaecology out-patient clinic. The objective of this study was to establish the factors that enhance the practice of female circumcision.
Female circumcision was performed between 3 to 14 years of age with the peak age of 7 years. In 83% of the respondents the event was arranged by the mother of the respondents. The three leading reasons why the practice was carried out in the community were, religious demand(66.3%), prevention of enlargement of clitoris(51%), and protection of virginity (48.3%).
In conclusion FGM is a harmful traditional practice that is traditionally justified but has no medical support.

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

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

Increasing numbers of HIV-infected adults in Africa need hospital care. It remains unclear what impact this has on health care services or on how hospitals respond. The aim of this study was to describe the effects of a rising case load of adult HIV-related disease by comparing results from a prospective cross-sectional study of acute adult medical admissions to a government hospital in Nairobi conducted in 1992 with results from a previous study done in 1988 and 1989 in the same hospital, using the same study design and protocol. Data on age, gender, number admitted, length of stay, HIV status, clinical AIDS, final diagnosis, case mix, and outcome were compared. In 1992, 374 consecutive patients were admitted in 15 24-hour periods (24.9 patients/period) compared with the 1988 to 1989 study, which enrolled 506 patients in 22 24-hour periods (23.0 patients/period). Patients' age, gender, and length of hospital stay were similar in both studies. In 1992, 39% of patients were HIV-positive compared with 19% in 1988 to 1989 (p < 10(-6)); whereas seropositive admissions rose 123% between the two periods (p < .0001), HIV-negative admissions declined 18% (p < .05). Clinical surveillance for AIDS consistently identified <40% of HIV-positive patients. Irrespective of HIV status, tuberculosis and pneumococcal pneumonia were the leading diagnoses in both surveys. No change was found in the diagnoses recorded for HIV-positive patients, but in HIV-negative patients, reductions were significant in the case mix (p < .00001) and range of diagnoses (p < .001) seen in 1992. Outcome remained unchanged for HIV-positive patients with approximately 35% mortality in both surveys. Outcome significantly worsened, in relative and absolute terms, for HIV-negative patients: in 1992, mortality was 23%, compared with 13.9% in 1988 to 1989 (p < .005), with 3.5 deaths per 24-hour period in 1992 compared with 2.6 deaths per 24-hour period in 1988 to 1989 (p < .05, one-tailed). These data suggest that increasing selection for admission is taking place as demand for care increases because of HIV/AIDS. This process appears to favor HIV-positive patients at the expense of HIV-negative patients who seem to be crowded out and, once admitted, experience higher mortality rates. The true social costs of the HIV epidemic are underestimated by not including the effects on HIV-negative people. PIP: The impact of the escalating demand for HIV/AIDS-related care on hospital services in Nairobi, Kenya, was investigated in two prospective cross-sectional studies conducted at Kenyatta National Hospital. Data on age, gender, number of admissions, length of stay, HIV status, clinical AIDS, final diagnosis, case mix, and outcome were compared in a 1988-89 study that enrolled 506 consecutive patients in a total of 22 24-hour periods and in a 1992 study of 374 patients admitted in 15 24-hour periods. 18.7% of hospital patients in 1988-89 were HIV-positive compared with 38.5% in 1992, with a concomitant decline of 18% in the number of HIV-negative admissions. Clinical surveillance for AIDS consistently identified less than 40% of HIV-positive patients. Tuberculosis and pneumococcal pneumonia were the leading diagnoses in both surveys among HIV-positive and HIV-negative patients. Diagnoses recorded for HIV-positive patients did not change over time; however, among HIV-negative patients, there was a significant narrowing in the range of diagnoses seen. Mortality among HIV-positive patients remained constant at 35% in both surveys. Among HIV-negative patients, mortality increased from 13.9% in 1988-89 to 23% in 1992 (2.6 and 3.5 deaths per 24-hour period, respectively). These findings suggest that increasing demand for hospital care by HIV-positive patients has been accompanied by deteriorating conditions for HIV-negative patients, especially an admissions selection process that favors HIV/AIDS patients. Recommended to address the worsening crisis in health care delivery are general guidelines on admission criteria that neither crowd out HIV-negative patients nor discriminate against those with HIV/AIDS.

No Abstract!

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

Osteogenic Sarcoma at Kenyatta Naitonal Hospital Medicom 13(1): 15, 1998

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

Warenius LU, Faxelid EA, Chishimba PN, Musandu JO, Ong'any AA, Nissen EB.

Division of International Health, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden. Linnea.Warenius@ki.se

Adolescent sexuality is a highly charged moral issue in Kenya and Zambia. Nurse-midwives are the core health care providers of adolescent sexual and reproductive health services but public health facilities are under-utilised by adolescents. The aim of this study was to investigate attitudes among Kenyan and Zambian nurse-midwives (n=820) toward adolescent sexual and reproductive health problems, in order to improve services for adolescents. Data were collected through a questionnaire. Findings revealed that nurse-midwives disapproved of adolescent sexual activity, including masturbation, contraceptive use and abortion, but also had a pragmatic attitude to handling these issues. Those with more education and those who had received continuing education on adolescent sexuality and reproduction showed a tendency towards more youth-friendly attitudes. We suggest that critical thinking around the cultural and moral dimensions of adolescent sexuality should be emphasised in undergraduate training and continuing education, to help nurse-midwives to deal more empathetically with the reality of adolescent sexuality. Those in nursing and other leadership positions could also play an important role in encouraging wider social discussion of these matters. This would create an environment that is more tolerant of adolescent sexuality and that recognises the beneficial public health effect for adolescents of greater access to youth-friendly sexual and reproductive health services.

PMID: 16713886 [PubMed - indexed for MEDLINE]

n/a

n/a

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

Fresh blood lymphocytes from nine health donors have been compared with samples from the same donors, recovered after period of 2 to 21 months storage in liquid nitrogen, for the capacity to respond to a range of mitogens in vitro. A microculture assay was used, requireing aliquots of only 25,000 cells. The mean levels of 14C-thymidine uptake for fresh and frozen samples were closely comparable when the cells had been stimulated by PHA, Pokeweed or mitomycin-C-treated allogeneic lymphoblastoid cells. Lymphocytes from six East African donors, frozen by a very simple technique, were recovered after 3 or more years storage in liquid nitrogen. Five of the samples were in good condition as judged by cell viability and the capacity to form spontaneous 'E' rosettes with sheep erythrocytes. These five samples also responded extremely well to PHA, PWM and mitomycin-C-treated allogeneic lymphoblastoid cells using the microculture assay. This study extends the range of applications of cell banks in which small aliquots of blood lymphocytes are stored in liquid nitrogen for periods of several years.

Computers were first developed to process business transactions; the trend has been to have computers also support management in decision making. This led to the evolution of Management Information Systems (MIS). The concept of MIS can be traced from four major areas, namely, managerial accounting, management science or operations research, management theory and computer science. MIS is supported by a comprehensive set of data for business operations referred to as a database. There are several databases in any given organization. Organizations have realized that valuable information is hidden in separate databases which might sometimes contain overlapping and contradictory information, and are coming up with data warehouses. A data warehouse provides a platform for advanced, complex and efficient data analysis using On-Line Analytical Processing (OLAP) for data mining or Knowledge Data Discovery (KDD) to extract previously unknown strategic business information or business intelligence (BI). There are a lot of similarities between data warehousing and operations research (OR), they both require analytical processing to support executive decision making, yet OR, MIS and IT exist as separate communities, right from the education level to the organizations. There are many challenges facing data warehousing, with organizations viewing it as a purely IT project. The objective of the paper was to establish how some of the challenges of data warehousing could be addressed so as to reduce the failure rate of BI projects. It was concluded that data warehousing would be more successful if its development was a joint effort of both the OR & MIS community and the IT community. It is recommended that OR and MIS be taught as one discipline whose graduates will work very closely with IT specialists.

This report describes an investigation into the effect of oxamniquine on systemic clearance of theophylline in rat. Male Wister rats (N=12, 5 weeks old) were divide into 3 groups (N=4 per group) and administered buffer plus theophylline (10 mg/kg), controls, oxamniquine( 5 mg/kg), and theophylline (10 mg/kg) oxamniquine (20 mg/kg) intravenously. Theophylline clearance was estimated from a single plasma sample obtained 6 hours post drug administration. Oxamniquine had no effect on theophylline clearance compared to controls. It was concluded that clinically important interaction between oxamniquine and theophylline is unlikely to occur.

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

The principal objective of this study was to identify the factors that the management of verticaly integrated firms consider in making decisions to integrate either backword or forward. In order to meet this objective, the information sought for the study was collected through the use of a questionnaire. The sample consisted of 52 vertically integrated firms. 31 questionnaires were completed and provided the information used in this report. The study found out that he fator that influence a firm's decision to integrate vertically include certainity of demand for the firm's products, availability of adequate manufacturing facilities, investment costs, and the need for high market share. For textile and steel manufacturers, certain factor were important. The factors were: the need for improved co-ordination for a firm's activities, need for synergies, need for greater control over the firm's economic resources, level of competition in the industries and the mining firms, the need to control the firm's economic resources, the need to build new infrastructures, sze of buiness, and the level of competition in the industry are important

Clinical hematological values have been established for healthy cattle of several breeds in various parts of the world. However, values of some blood components differ between laboratories (Schalm 1980) creating a problem when interpreting blood profiles for any particular area if the normal blood component values for the area are not known.

This report concerns an outbreak that occurred during July/August 1997. Ten pigs from a herd of 181 pigs in a medium-scale, semi-closed piggery in Kiambu District, Kenya, contracted the clinical disease. The main clinical findings in affected pigs included: fever (40.5-41.8 degrees C), prostration, inappetence, dog-sitting posture, abortion, erythema and raised, firm to the touch and easily palpated light pink to dark purple diamond-shaped to square/rectangular spots on the skin around the belly and the back. Based on the pathognomonic skin lesions, a clinical diagnosis of swine erysipelas was made. The diagnosis was confirmed by the isolation of Erysipelothrix rhusiopathiae organisms from the blood and skin biopsies taken from the affected pigs. Response to treatment with a combination of procaine penicillin and dihydrostreptomycin at the dosage rate of 20,000 IU/kg body weight (based on procaine penicillin) for 3 days was good and all the affected pigs recovered fully. The farm was placed under quarantine to prevent spread of the disease

This report concerns an outbreak that occurred during July/August 1997. Ten pigs from a herd of 181 pigs in a medium-scale, semi-closed piggery in Kiambu District, Kenya, contracted the clinical disease. The main clinical findings in affected pigs included: fever (40.5-41.8 degrees C), prostration, inappetence, dog-sitting posture, abortion, erythema and raised, firm to the touch and easily palpated light pink to dark purple diamond-shaped to square/rectangular spots on the skin around the belly and the back. Based on the pathognomonic skin lesions, a clinical diagnosis of swine erysipelas was made. The diagnosis was confirmed by the isolation of Erysipelothrix rhusiopathiae organisms from the blood and skin biopsies taken from the affected pigs. Response to treatment with a combination of procaine penicillin and dihydrostreptomycin at the dosage rate of 20,000 IU/kg body weight (based on procaine penicillin) for 3 days was good and all the affected pigs recovered fully. The farm was placed under quarantine to prevent spread of the disease

This report concerns an outbreak that occurred during July/August 1997. Ten pigs from a herd of 181 pigs in a medium-scale, semi-closed piggery in Kiambu District, Kenya, contracted the clinical disease. The main clinical findings in affected pigs included: fever (40.5-41.8 degrees C), prostration, inappetence, dog-sitting posture, abortion, erythema and raised, firm to the touch and easily palpated light pink to dark purple diamond-shaped to square/rectangular spots on the skin around the belly and the back. Based on the pathognomonic skin lesions, a clinical diagnosis of swine erysipelas was made. The diagnosis was confirmed by the isolation of Erysipelothrix rhusiopathiae organisms from the blood and skin biopsies taken from the affected pigs. Response to treatment with a combination of procaine penicillin and dihydrostreptomycin at the dosage rate of 20,000 IU/kg body weight (based on procaine penicillin) for 3 days was good and all the affected pigs recovered fully. The farm was placed under quarantine to prevent spread of the disease

This report concerns an outbreak that occurred during July/August 1997. Ten pigs from a herd of 181 pigs in a medium-scale, semi-closed piggery in Kiambu District, Kenya, contracted the clinical disease. The main clinical findings in affected pigs included: fever (40.5-41.8 degrees C), prostration, inappetence, dog-sitting posture, abortion, erythema and raised, firm to the touch and easily palpated light pink to dark purple diamond-shaped to square/rectangular spots on the skin around the belly and the back. Based on the pathognomonic skin lesions, a clinical diagnosis of swine erysipelas was made. The diagnosis was confirmed by the isolation of Erysipelothrix rhusiopathiae organisms from the blood and skin biopsies taken from the affected pigs. Response to treatment with a combination of procaine penicillin and dihydrostreptomycin at the dosage rate of 20,000 IU/kg body weight (based on procaine penicillin) for 3 days was good and all the affected pigs recovered fully. The farm was placed under quarantine to prevent spread of the disease

This report concerns an outbreak that occurred during July/August 1997. Ten pigs from a herd of 181 pigs in a medium-scale, semi-closed piggery in Kiambu District, Kenya, contracted the clinical disease. The main clinical findings in affected pigs included: fever (40.5-41.8 degrees C), prostration, inappetence, dog-sitting posture, abortion, erythema and raised, firm to the touch and easily palpated light pink to dark purple diamond-shaped to square/rectangular spots on the skin around the belly and the back. Based on the pathognomonic skin lesions, a clinical diagnosis of swine erysipelas was made. The diagnosis was confirmed by the isolation of Erysipelothrix rhusiopathiae organisms from the blood and skin biopsies taken from the affected pigs. Response to treatment with a combination of procaine penicillin and dihydrostreptomycin at the dosage rate of 20,000 IU/kg body weight (based on procaine penicillin) for 3 days was good and all the affected pigs recovered fully. The farm was placed under quarantine to prevent spread of the disease

This report concerns an outbreak that occurred during July/August 1997. Ten pigs from a herd of 181 pigs in a medium-scale, semi-closed piggery in Kiambu District, Kenya, contracted the clinical disease. The main clinical findings in affected pigs included: fever (40.5-41.8 degrees C), prostration, inappetence, dog-sitting posture, abortion, erythema and raised, firm to the touch and easily palpated light pink to dark purple diamond-shaped to square/rectangular spots on the skin around the belly and the back. Based on the pathognomonic skin lesions, a clinical diagnosis of swine erysipelas was made. The diagnosis was confirmed by the isolation of Erysipelothrix rhusiopathiae organisms from the blood and skin biopsies taken from the affected pigs. Response to treatment with a combination of procaine penicillin and dihydrostreptomycin at the dosage rate of 20,000 IU/kg body weight (based on procaine penicillin) for 3 days was good and all the affected pigs recovered fully. The farm was placed under quarantine to prevent spread of the disease

No Abstract!

OBJECTIVES: The aim was to study dimensional time-dependence of resin/ionomer formulations from 5 min age to one month and to separate out the intrinsic setting shrinkage and hygroscopic expansion effects, by using non-aqueous and aqueous storage media, respectively. METHODS: Materials studied included: A: resin-, B: metal- and C: polyphosphonate-modified glass-ionomer cements [GICs]; and controls of D: poly-acid modified composite [compomer]; and E: resin-composite. Separate specimen groups (n = 5) were stored in different storage-media: (i) silicone fluid; (ii) de-ionized water. Experiments were repeated at 23 and 37 degrees C. Volumetric changes of specimens (4 mm diameter x 6 mm height) were obtained via accurate mass measurements (to 10(-4) g), using Archimedes principle, with silicone or water also used as the Archimedean fluid. These measurements were made periodically over a 30 day period, post fabrication. RESULTS: In silicone at 23 degrees C, all materials underwent further gradual intrinsic shrinkage (after 5 min from mix). This was highly significant (p < 0.05) for the RM-GIC (A). At 37 degrees C, however the RM-GIC expanded, indicating that its cure is temperature-sensitive. In water, at 23 and 37 degrees C, the shrinkage was either partially offset (materials C, D, E), or replaced by appreciable expansions (materials A and B). Differences between RM-GIC (A) and MM-GIC (B) were significant (p < 0.05). SIGNIFICANCE: The deployment of dual storage media made an important contribution to the separate analysis of the volumetric changes due to the on-going setting chemistry in these systems and the time-dependent effects of an aqueous environment.

No Abstract!

No Abstract!

No Abstract!

No Abstract!

There is an increasing need to incorporate into agricultural research an element of community participation. Community involvement in the identification of problems and solutions is seen as the key to adoption ands adaptation of new technologies. These two processes have been identified as crucial for sustainable agriculture and hence sustainable rural communities.

A wide gap exists between researchers in the various institutions and the farmer. Yet the latter is the end user of the products thereof. This is an approach to the top-down approach to agricultural extension where extension agents tell farmer's what ought to be done with little regard to the farmers experience and circumstances. Participatory action research (PAR) techniques bridge the gap between the farmer's experiences and the research/extension services. It enables analysis of problem situations and opportunities by farmers and researchers in a participatory and inclusive process. Within the agro-ecosystem health framework PAR is the process that generates a farmer driven demand for research and technology development. This paper describes how PAR is being used in an integrated assessment of agricultural communities in Kiambu agro-ecosystem.

ABSTRACT The literature and research on domestic violence against women have

received increased attention in the 1980's and 1990's, but research on wife beating/battering

is still sparse. This paper reports from a research project in Nairobi that focused on the legal

experiences of battered women and their perceptions of the violence. Findings reveal that the

problem of battering is rampant and most battered women do not seek legal intervention. It

was also found that a majority of the women remained in intimate relationships with their

batterers due to economic dependence on the batterers and lack of alternatives outside the

relationship.

Key Words: Domestic violence; Legal Experiences; Nairobi; Kenya.

No Abstract!

No Abstract!

{

OBJECTIVE: To assess the clinical outcome of successful percutaneous transluminal coronary angioplasty (PTCA) in patients with poor ventricular function. METHODS: Analysis of angiographic, echocardiographic and clinical records of patients with severe LV dysfunction who underwent PTCA from January 1, 1995 to December 31, 1997 was undertaken. Forty-one patients aged 63+/-10 years, 36 men, all with significant coronary artery disease and impaired LV function (fractional shortening, FS<or=20%) were identified. Patients' data before and after angioplasty were analyzed. RESULTS: Post PTCA: angiographic success was 95.2%. Major complications occurred in 19.5% and hospital mortality was 2.7%. At 6 months after PTCA:LV fractional shortening (FS) increased from 15.9+/-3.4% to 19.6+/-6.6%

Four new prenylated flavanones, abyssinone-V 4'-methyl ether (1) and abyssinoflavanones IV (2), V (3), and VI (4), have been isolated as minor flavanones from the African medicinal plant, Erythrina abyssinica, together with a known flavanone, sigmoidin D. The structure elucidation of compounds 1-4 by spectroscopic studies is described.

No Abstract!

No Abstract!

Few chemotherapeutic agents are available for the medical management of hydatid disease caused by the parasite Echinococcusgranulosus. In order to test the potential of oxfendazole forthe treatment of infection with this parasite, nine infected goatsand four sheep were given oxfendazole twice weekly at a dose of30 mg/kg of body weight for 4 weeks and monitored by ultrasoundfor an additional 4 weeks. Efficacy was finally evaluated by postmortemexamination, including determination of protoscolex viabilityand cyst wall histology. In treated animals, protoscolices weredead or absent in 97% of cysts from oxfendazole-treated animalscompared to 28% of cysts from untreated control animals. On postmortemexamination, 53% of cysts from treated animals were found to begrossly degenerate. A sample of those cysts that appeared potentiallyviable all demonstrated evidence of severe damage to the cystwall. By light microscopy, cysts showed severe disorganizationof the adventitial layer with invasion of inflammatory cells andin some cases frank necrosis with no apparent adventitial layer.The follow-up period for assessment of the drug's ability to causecomplete degeneration and resorption of cysts was relatively short.This study, however, indicates that oxfendazole is at least aseffective as and is easier to administer than albendazole forthe treatment of hydatid disease.

Few chemotherapeutic agents are available for the medical management of hydatid disease caused by the parasite Echinococcusgranulosus. In order to test the potential of oxfendazole forthe treatment of infection with this parasite, nine infected goatsand four sheep were given oxfendazole twice weekly at a dose of30 mg/kg of body weight for 4 weeks and monitored by ultrasoundfor an additional 4 weeks. Efficacy was finally evaluated by postmortemexamination, including determination of protoscolex viabilityand cyst wall histology. In treated animals, protoscolices weredead or absent in 97% of cysts from oxfendazole-treated animalscompared to 28% of cysts from untreated control animals. On postmortemexamination, 53% of cysts from treated animals were found to begrossly degenerate. A sample of those cysts that appeared potentiallyviable all demonstrated evidence of severe damage to the cystwall. By light microscopy, cysts showed severe disorganizationof the adventitial layer with invasion of inflammatory cells andin some cases frank necrosis with no apparent adventitial layer.The follow-up period for assessment of the drug's ability to causecomplete degeneration and resorption of cysts was relatively short.This study, however, indicates that oxfendazole is at least aseffective as and is easier to administer than albendazole forthe treatment of hydatid disease.

Few chemotherapeutic agents are available for the medical management of hydatid disease caused by the parasite Echinococcusgranulosus. In order to test the potential of oxfendazole forthe treatment of infection with this parasite, nine infected goatsand four sheep were given oxfendazole twice weekly at a dose of30 mg/kg of body weight for 4 weeks and monitored by ultrasoundfor an additional 4 weeks. Efficacy was finally evaluated by postmortemexamination, including determination of protoscolex viabilityand cyst wall histology. In treated animals, protoscolices weredead or absent in 97% of cysts from oxfendazole-treated animalscompared to 28% of cysts from untreated control animals. On postmortemexamination, 53% of cysts from treated animals were found to begrossly degenerate. A sample of those cysts that appeared potentiallyviable all demonstrated evidence of severe damage to the cystwall. By light microscopy, cysts showed severe disorganizationof the adventitial layer with invasion of inflammatory cells andin some cases frank necrosis with no apparent adventitial layer.The follow-up period for assessment of the drug's ability to causecomplete degeneration and resorption of cysts was relatively short.This study, however, indicates that oxfendazole is at least aseffective as and is easier to administer than albendazole forthe treatment of hydatid disease.

Few chemotherapeutic agents are available for the medical management of hydatid disease caused by the parasite Echinococcusgranulosus. In order to test the potential of oxfendazole forthe treatment of infection with this parasite, nine infected goatsand four sheep were given oxfendazole twice weekly at a dose of30 mg/kg of body weight for 4 weeks and monitored by ultrasoundfor an additional 4 weeks. Efficacy was finally evaluated by postmortemexamination, including determination of protoscolex viabilityand cyst wall histology. In treated animals, protoscolices weredead or absent in 97% of cysts from oxfendazole-treated animalscompared to 28% of cysts from untreated control animals. On postmortemexamination, 53% of cysts from treated animals were found to begrossly degenerate. A sample of those cysts that appeared potentiallyviable all demonstrated evidence of severe damage to the cystwall. By light microscopy, cysts showed severe disorganizationof the adventitial layer with invasion of inflammatory cells andin some cases frank necrosis with no apparent adventitial layer.The follow-up period for assessment of the drug's ability to causecomplete degeneration and resorption of cysts was relatively short.This study, however, indicates that oxfendazole is at least aseffective as and is easier to administer than albendazole forthe treatment of hydatid disease.

{ OBJECTIVES To compare sociodemographic profiles, child care, child feeding practices and growth indices of children born to HIV-1 seropositive and seronegative mothers. METHODS: A cohort study of 234 children (seropositive and seronegative) born to HIV-1 seropositive mothers and 139 children born to seronegative mothers in Pumwani Maternity Hospital which serves a low-income population in Nairobi, Kenya from December 1991 and January 1994. RESULTS: With few exceptions, at the time of their birth children in all three cohorts had parents with similar characteristics, lived in similar housing in similar geographical areas, had their mothers as their primary care givers, had similar feeding practices and similar growth status and patterns. However, the HIV-1 seropositive mothers were slightly younger (23.8 years vs. 25.0 years, P < 0.01), if married they were less likely to be their husband's first wife (79% vs. 91%

{ OBJECTIVES To compare sociodemographic profiles, child care, child feeding practices and growth indices of children born to HIV-1 seropositive and seronegative mothers. METHODS: A cohort study of 234 children (seropositive and seronegative) born to HIV-1 seropositive mothers and 139 children born to seronegative mothers in Pumwani Maternity Hospital which serves a low-income population in Nairobi, Kenya from December 1991 and January 1994. RESULTS: With few exceptions, at the time of their birth children in all three cohorts had parents with similar characteristics, lived in similar housing in similar geographical areas, had their mothers as their primary care givers, had similar feeding practices and similar growth status and patterns. However, the HIV-1 seropositive mothers were slightly younger (23.8 years vs. 25.0 years, P < 0.01), if married they were less likely to be their husband's first wife (79% vs. 91%

{ OBJECTIVES To compare sociodemographic profiles, child care, child feeding practices and growth indices of children born to HIV-1 seropositive and seronegative mothers. METHODS: A cohort study of 234 children (seropositive and seronegative) born to HIV-1 seropositive mothers and 139 children born to seronegative mothers in Pumwani Maternity Hospital which serves a low-income population in Nairobi, Kenya from December 1991 and January 1994. RESULTS: With few exceptions, at the time of their birth children in all three cohorts had parents with similar characteristics, lived in similar housing in similar geographical areas, had their mothers as their primary care givers, had similar feeding practices and similar growth status and patterns. However, the HIV-1 seropositive mothers were slightly younger (23.8 years vs. 25.0 years, P < 0.01), if married they were less likely to be their husband's first wife (79% vs. 91%

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

SUMMARY LIII)' lIIorpllOlogiClI changcs ill the goat ,csris after:. sillgle illlraperilOlieal injec,ioll of ethalle ,lillie' I.:lIIeslll"llOnarc (EI )S) werc investigatcd mint; (1Orh liglH alld deCll'On microscopy. The (olllpolind was ;almillistered at two dose Icvels: 75 mgll

SUMMARY LIII)' lIIorpllOlogiClI changcs ill the goat ,csris after:. sillgle illlraperilOlieal injec,ioll of ethalle ,lillie' I.:lIIeslll"llOnarc (EI )S) werc investigatcd mint; (1Orh liglH alld deCll'On microscopy. The (olllpolind was ;almillistered at two dose Icvels: 75 mgll

SUMMARY LIII)' lIIorpllOlogiClI changcs ill the goat ,csris after:. sillgle illlraperilOlieal injec,ioll of ethalle ,lillie' I.:lIIeslll"llOnarc (EI )S) werc investigatcd mint; (1Orh liglH alld deCll'On microscopy. The (olllpolind was ;almillistered at two dose Icvels: 75 mgll

SUMMARY LIII)' lIIorpllOlogiClI changcs ill the goat ,csris after:. sillgle illlraperilOlieal injec,ioll of ethalle ,lillie' I.:lIIeslll"llOnarc (EI )S) werc investigatcd mint; (1Orh liglH alld deCll'On microscopy. The (olllpolind was ;almillistered at two dose Icvels: 75 mgll

SUMMARY LIII)' lIIorpllOlogiClI changcs ill the goat ,csris after:. sillgle illlraperilOlieal injec,ioll of ethalle ,lillie' I.:lIIeslll"llOnarc (EI )S) werc investigatcd mint; (1Orh liglH alld deCll'On microscopy. The (olllpolind was ;almillistered at two dose Icvels: 75 mgll

SUMMARY LIII)' lIIorpllOlogiClI changcs ill the goat ,csris after:. sillgle illlraperilOlieal injec,ioll of ethalle ,lillie' I.:lIIeslll"llOnarc (EI )S) werc investigatcd mint; (1Orh liglH alld deCll'On microscopy. The (olllpolind was ;almillistered at two dose Icvels: 75 mgll

SUMMARY LIII)' lIIorpllOlogiClI changcs ill the goat ,csris after:. sillgle illlraperilOlieal injec,ioll of ethalle ,lillie' I.:lIIeslll"llOnarc (EI )S) werc investigatcd mint; (1Orh liglH alld deCll'On microscopy. The (olllpolind was ;almillistered at two dose Icvels: 75 mgll

SUMMARY LIII)' lIIorpllOlogiClI changcs ill the goat ,csris after:. sillgle illlraperilOlieal injec,ioll of ethalle ,lillie' I.:lIIeslll"llOnarc (EI )S) werc investigatcd mint; (1Orh liglH alld deCll'On microscopy. The (olllpolind was ;almillistered at two dose Icvels: 75 mgll

SUMMARY LIII)' lIIorpllOlogiClI changcs ill the goat ,csris after:. sillgle illlraperilOlieal injec,ioll of ethalle ,lillie' I.:lIIeslll"llOnarc (EI )S) werc investigatcd mint; (1Orh liglH alld deCll'On microscopy. The (olllpolind was ;almillistered at two dose Icvels: 75 mgll

SUMMARY LIII)' lIIorpllOlogiClI changcs ill the goat ,csris after:. sillgle illlraperilOlieal injec,ioll of ethalle ,lillie' I.:lIIeslll"llOnarc (EI )S) werc investigatcd mint; (1Orh liglH alld deCll'On microscopy. The (olllpolind was ;almillistered at two dose Icvels: 75 mgll

SUMMARY LIII)' lIIorpllOlogiClI changcs ill the goat ,csris after:. sillgle illlraperilOlieal injec,ioll of ethalle ,lillie' I.:lIIeslll"llOnarc (EI )S) werc investigatcd mint; (1Orh liglH alld deCll'On microscopy. The (olllpolind was ;almillistered at two dose Icvels: 75 mgll

This paper seeks to identify some the factors that underlie regional variation in infant mortality in Kenya. The data drawn from the 1988/89 Kenya Demographic and Health Survey were used for this purpose. Logistic regression is used to analyse the data. On the basis of infant mortality estimates obtained, provinces were grouped into two groups: High (HMP) and low (LMP). The results obtained show that the values of explanatory variables in LMP region than in the high mortality region. However, their differences did not explain much of the variation in infant mortality between the two mortality regions. Decomposing the results revealed that the differences were largely due to the differences in the nature or structure of relationships, as represented by logit coefficients, between mortality and explanatory variables. The results indicate that the lower average level of maternal education, higher proportion of preceding child loss, higher proportion mothers belonging to low economic status households and a lower proportion of mothers belonging to households possessing livestock and lower use of modern contraception modestly contributed to high infant mortality in the high mortality region

This article seeks to identify some of the factors underlying regional variation in child mortality in Kenya. The data drawn from the 1988/89 Kenya Demographic and Health Survey are used for the purpose. Logistic regression is used to analyse the data. On the basis of child mortality estimates obtained, provinces were grouped into two mortality groups: High (HLM) and Low (LMP). The results show that the values of explanatory variables in LMP were significantly high than in the high mortality region. However, their differences did not explain much of the differences in the variation in child mortality between the two regions. Decomposing the results revealed that the differences were largely due to nature or structure of relations between mortality and explanatory variables.

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

This paper argues that problems in education are caused by non-professional teachers who are employed when trained teachers move in search of promotion friendly activities or financially rewarding duties. This shift of focus means that policy makers in education act without adequate professional guidance. The problems in education, therefore, result from demands made on mainstream education based on misconceptions about what education can offer. It is argued that the implementation of e-learning in education faces the risk of developing on the basis of unproven theories. This scenario increasingly sees the replacement of formal education activities in institutions of learning with non-formal and informal education practices. Given that the contents and influences of non-formal and informal education are not under the control of the teacher, the experiences that learners bring to education settings are increasingly difficult to manage. The paper proposes that by integrating e-learning in teacher education and rewarding 'good teaching', there is a potential for a successful e-learning revolution in education.

This paper argues that problems in education are caused by non-professional teachers who are employed when trained teachers move in search of promotion friendly activities or financially rewarding duties. This shift of focus means that policy makers in education act without adequate professional guidance. The problems in education, therefore, result from demands made on mainstream education based on misconceptions about what education can offer. It is argued that the implementation of e-learning in education faces the risk of developing on the basis of unproven theories. This scenario increasingly sees the replacement of formal education activities in institutions of learning with non-formal and informal education practices. Given that the contents and influences of non-formal and informal education are not under the control of the teacher, the experiences that learners bring to education settings are increasingly difficult to manage. The paper proposes that by integrating e-learning in teacher education and rewarding 'good teaching', there is a potential for a successful e-learning revolution in education.

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

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

Department of Obstetrics and Gynaecology, University of Nairobi, Kenya. BACKGROUND: A WHO expert group and the International Planned Parenthood Federation recommend against use of intrauterine devices (IUDs) in HIV-1-infected women based on theoretical concerns about pelvic infection and increased blood loss. We investigated whether the risk of complications after IUD insertion is higher in HIV-1-infected women than in non-infected women. METHODS: 649 (156 HIV-1 infected 493 non-infected) women in Nairobi, Kenya, who requested and met local eligibility criteria for insertion of an IUD were enrolled. We gathered information on IUD-related complications, including pelvic inflammatory disease, removals due to infection, pain, or bleeding, expulsions, and pregnancies at 1 and 4 months after insertion. Patients' HIV-1 status was masked from physicians. FINDINGS: Complications were identified in 48 of 615 women (11 [7.6%] HIV-1-infected women, 37 [7.9%] non-infected). Incident pelvic inflammatory disease (two [1.4%] HIV-1 infected, one [0.2%] non-infected) and infection-related complications (any tenderness, removal of IUD for infection or pain; ten [6.9%] HIV-1 infected, 27 [5.7%] non-infected) were also rare and similar in the two groups. Complication rates were similar by CD4 (immune) status. Multivariate analyses suggested no association between HIV-1 infection and increased risks for overall complications (odds ratio 0.8 [95% CI 0.4-1.7]) or infection-related complications (1.0 [0.5-2.3]), adjusted for marital status, study site, previous IUD use, ethnic origin, and frequency of sexual intercourse, but a slight increase cannot be ruled out. INTERPRETATION: Our data suggest that IUDs may be a safe contraceptive method for appropriately selected HIV-1-infected women with continuing access to medical services. PIP: Both the International Planned Parenthood Federation and the World Health Organization have warned against use of IUDs in HIV-infected women due to theoretical concerns about pelvic infection and increased blood loss. No published studies have investigated this concern, however. The validity of this recommendation was investigated in a comparative study of 156 HIV-1-infected and 493 non-infected women from two public family planning clinics (Kenyatta National Hospital and Riruta City Clinic) in Nairobi, Kenya, who requested and met local eligibility criteria for IUD insertion. At 1 and 4 months after insertion, information was collected from physicians–blinded as to the patient's HIV status–on IUD-related complications such as pelvic inflammatory disease (PID), removals, expulsions, and pregnancies. Complications were identified in 11 (7.6%) HIV-positive and 37 (7.9%) HIV-negative women. There were only 3 incident cases of PID, 2 of which occurred in HIV-infected women. IUD removal due to pain or infection occurred in 10 (6.9%) HIV-infected and 27 (5.7%) noninfected women. There were no differences in overall IUD complications in HIV-1-infected women by CD4 status (severely, moderately, or mildly immunocompromised). After adjustment for marital status, study site, previous IUD use, ethnic origin, and frequency of sexual intercourse, multivariate analysis suggested no association between HIV-1 infection and increased risks for overall IUD-related complications (odds ratio (OR), 0.8; 95% confidence interval (CI), 0.4-1.7) or infection-related complications (OR, 1.0; 95% CI, 0.5-2.3). These findings suggest that the IUD may be a safe contraceptive method for appropriately selected HIV-infected women with continuing access to medical services.

Department of Obstetrics and Gynaecology, University of Nairobi, Kenya. BACKGROUND: A WHO expert group and the International Planned Parenthood Federation recommend against use of intrauterine devices (IUDs) in HIV-1-infected women based on theoretical concerns about pelvic infection and increased blood loss. We investigated whether the risk of complications after IUD insertion is higher in HIV-1-infected women than in non-infected women. METHODS: 649 (156 HIV-1 infected 493 non-infected) women in Nairobi, Kenya, who requested and met local eligibility criteria for insertion of an IUD were enrolled. We gathered information on IUD-related complications, including pelvic inflammatory disease, removals due to infection, pain, or bleeding, expulsions, and pregnancies at 1 and 4 months after insertion. Patients' HIV-1 status was masked from physicians. FINDINGS: Complications were identified in 48 of 615 women (11 [7.6%] HIV-1-infected women, 37 [7.9%] non-infected). Incident pelvic inflammatory disease (two [1.4%] HIV-1 infected, one [0.2%] non-infected) and infection-related complications (any tenderness, removal of IUD for infection or pain; ten [6.9%] HIV-1 infected, 27 [5.7%] non-infected) were also rare and similar in the two groups. Complication rates were similar by CD4 (immune) status. Multivariate analyses suggested no association between HIV-1 infection and increased risks for overall complications (odds ratio 0.8 [95% CI 0.4-1.7]) or infection-related complications (1.0 [0.5-2.3]), adjusted for marital status, study site, previous IUD use, ethnic origin, and frequency of sexual intercourse, but a slight increase cannot be ruled out. INTERPRETATION: Our data suggest that IUDs may be a safe contraceptive method for appropriately selected HIV-1-infected women with continuing access to medical services. PIP: Both the International Planned Parenthood Federation and the World Health Organization have warned against use of IUDs in HIV-infected women due to theoretical concerns about pelvic infection and increased blood loss. No published studies have investigated this concern, however. The validity of this recommendation was investigated in a comparative study of 156 HIV-1-infected and 493 non-infected women from two public family planning clinics (Kenyatta National Hospital and Riruta City Clinic) in Nairobi, Kenya, who requested and met local eligibility criteria for IUD insertion. At 1 and 4 months after insertion, information was collected from physicians–blinded as to the patient's HIV status–on IUD-related complications such as pelvic inflammatory disease (PID), removals, expulsions, and pregnancies. Complications were identified in 11 (7.6%) HIV-positive and 37 (7.9%) HIV-negative women. There were only 3 incident cases of PID, 2 of which occurred in HIV-infected women. IUD removal due to pain or infection occurred in 10 (6.9%) HIV-infected and 27 (5.7%) noninfected women. There were no differences in overall IUD complications in HIV-1-infected women by CD4 status (severely, moderately, or mildly immunocompromised). After adjustment for marital status, study site, previous IUD use, ethnic origin, and frequency of sexual intercourse, multivariate analysis suggested no association between HIV-1 infection and increased risks for overall IUD-related complications (odds ratio (OR), 0.8; 95% confidence interval (CI), 0.4-1.7) or infection-related complications (OR, 1.0; 95% CI, 0.5-2.3). These findings suggest that the IUD may be a safe contraceptive method for appropriately selected HIV-infected women with continuing access to medical

No Abstract!

In semi arid Kenya, the occurrence of flush floods and soil erosion on agricultural watersheds is attributed to intense rainstorm events of short duration. Thus when agricultural watersheds have no erosion control structures in place, the generation of direct runoff would increase with cultivation. Of the two components of runoff namely, runoff volume and peak runoff discharge, the consideration of peak runoff discharge rate is critical to the design of effective hydraulic structures for controlling floods and soil erosion. In order to accurately predict a watershed's peak runoff discharge, it is important to select a model that is deterministic and yet simple to use. The model should be able to consider the time distribution of runoff response as influenced by Watershed characteristics. The time to peak runoff discharge is largely influenced by the time of concentration. The time of concentration depends on the shape, size and relief of the watershed. In Iiuni Watershed, the Nash model, a parsimonious deterministic model, was selected to predict peak runoff discharges. This model uses the instantaneous unit hydrograph principle to simulate the direct runoff hydrographs and estimate peak runoff discharge. The Nash model was applied using input parameters derived from the watershed's rainfall-runoff characteristics. The results obtained showed that the Nash model was good in predicting peak runoff discharges. This statistic of comparison, R2 (coefficient of efficiency) for the model was above 70% for the model which is indicative of good model prediction of peak runoff discharge (Nash and Sutcliffe, 1970). From this analysis, the Nash model is recommended for the estimation of peak runoff discharge from un-gauged agricultural watersheds in Kenya.

In semi arid Kenya, the occurrence of flush floods and soil erosion on agricultural watersheds is attributed to intense rainstorm events of short duration. Thus when agricultural watersheds have no erosion control structures in place, the generation of direct runoff would increase with cultivation. Of the two components of runoff namely, runoff volume and peak runoff discharge, the consideration of peak runoff discharge rate is critical to the design of effective hydraulic structures for controlling floods and soil erosion. In order to accurately predict a watershed's peak runoff discharge, it is important to select a model that is deterministic and yet simple to use. The model should be able to consider the time distribution of runoff response as influenced by Watershed characteristics. The time to peak runoff discharge is largely influenced by the time of concentration. The time of concentration depends on the shape, size and relief of the watershed. In Iiuni Watershed, the Nash model, a parsimonious deterministic model, was selected to predict peak runoff discharges. This model uses the instantaneous unit hydrograph principle to simulate the direct runoff hydrographs and estimate peak runoff discharge. The Nash model was applied using input parameters derived from the watershed's rainfall-runoff characteristics. The results obtained showed that the Nash model was good in predicting peak runoff discharges. This statistic of comparison, R2 (coefficient of efficiency) for the model was above 70% for the model which is indicative of good model prediction of peak runoff discharge (Nash and Sutcliffe, 1970). From this analysis, the Nash model is recommended for the estimation of peak runoff discharge from un-gauged agricultural watersheds in Kenya.

In semi arid Kenya, the occurrence of flush floods and soil erosion on agricultural watersheds is attributed to intense rainstorm events of short duration. Thus when agricultural watersheds have no erosion control structures in place, the generation of direct runoff would increase with cultivation. Of the two components of runoff namely, runoff volume and peak runoff discharge, the consideration of peak runoff discharge rate is critical to the design of effective hydraulic structures for controlling floods and soil erosion. In order to accurately predict a watershed's peak runoff discharge, it is important to select a model that is deterministic and yet simple to use. The model should be able to consider the time distribution of runoff response as influenced by Watershed characteristics. The time to peak runoff discharge is largely influenced by the time of concentration. The time of concentration depends on the shape, size and relief of the watershed. In Iiuni Watershed, the Nash model, a parsimonious deterministic model, was selected to predict peak runoff discharges. This model uses the instantaneous unit hydrograph principle to simulate the direct runoff hydrographs and estimate peak runoff discharge. The Nash model was applied using input parameters derived from the watershed's rainfall-runoff characteristics. The results obtained showed that the Nash model was good in predicting peak runoff discharges. This statistic of comparison, R2 (coefficient of efficiency) for the model was above 70% for the model which is indicative of good model prediction of peak runoff discharge (Nash and Sutcliffe, 1970). From this analysis, the Nash model is recommended for the estimation of peak runoff discharge from un-gauged agricultural watersheds in Kenya.

In semi arid Kenya, the occurrence of flush floods and soil erosion on agricultural watersheds is attributed to intense rainstorm events of short duration. Thus when agricultural watersheds have no erosion control structures in place, the generation of direct runoff would increase with cultivation. Of the two components of runoff namely, runoff volume and peak runoff discharge, the consideration of peak runoff discharge rate is critical to the design of effective hydraulic structures for controlling floods and soil erosion. In order to accurately predict a watershed's peak runoff discharge, it is important to select a model that is deterministic and yet simple to use. The model should be able to consider the time distribution of runoff response as influenced by Watershed characteristics. The time to peak runoff discharge is largely influenced by the time of concentration. The time of concentration depends on the shape, size and relief of the watershed. In Iiuni Watershed, the Nash model, a parsimonious deterministic model, was selected to predict peak runoff discharges. This model uses the instantaneous unit hydrograph principle to simulate the direct runoff hydrographs and estimate peak runoff discharge. The Nash model was applied using input parameters derived from the watershed's rainfall-runoff characteristics. The results obtained showed that the Nash model was good in predicting peak runoff discharges. This statistic of comparison, R2 (coefficient of efficiency) for the model was above 70% for the model which is indicative of good model prediction of peak runoff discharge (Nash and Sutcliffe, 1970). From this analysis, the Nash model is recommended for the estimation of peak runoff discharge from un-gauged agricultural watersheds in Kenya.

In semi arid Kenya, the occurrence of flush floods and soil erosion on agricultural watersheds is attributed to intense rainstorm events of short duration. Thus when agricultural watersheds have no erosion control structures in place, the generation of direct runoff would increase with cultivation. Of the two components of runoff namely, runoff volume and peak runoff discharge, the consideration of peak runoff discharge rate is critical to the design of effective hydraulic structures for controlling floods and soil erosion. In order to accurately predict a watershed's peak runoff discharge, it is important to select a model that is deterministic and yet simple to use. The model should be able to consider the time distribution of runoff response as influenced by Watershed characteristics. The time to peak runoff discharge is largely influenced by the time of concentration. The time of concentration depends on the shape, size and relief of the watershed. In Iiuni Watershed, the Nash model, a parsimonious deterministic model, was selected to predict peak runoff discharges. This model uses the instantaneous unit hydrograph principle to simulate the direct runoff hydrographs and estimate peak runoff discharge. The Nash model was applied using input parameters derived from the watershed's rainfall-runoff characteristics. The results obtained showed that the Nash model was good in predicting peak runoff discharges. This statistic of comparison, R2 (coefficient of efficiency) for the model was above 70% for the model which is indicative of good model prediction of peak runoff discharge (Nash and Sutcliffe, 1970). From this analysis, the Nash model is recommended for the estimation of peak runoff discharge from un-gauged agricultural watersheds in Kenya.

In semi arid Kenya, the occurrence of flush floods and soil erosion on agricultural watersheds is attributed to intense rainstorm events of short duration. Thus when agricultural watersheds have no erosion control structures in place, the generation of direct runoff would increase with cultivation. Of the two components of runoff namely, runoff volume and peak runoff discharge, the consideration of peak runoff discharge rate is critical to the design of effective hydraulic structures for controlling floods and soil erosion. In order to accurately predict a watershed's peak runoff discharge, it is important to select a model that is deterministic and yet simple to use. The model should be able to consider the time distribution of runoff response as influenced by Watershed characteristics. The time to peak runoff discharge is largely influenced by the time of concentration. The time of concentration depends on the shape, size and relief of the watershed. In Iiuni Watershed, the Nash model, a parsimonious deterministic model, was selected to predict peak runoff discharges. This model uses the instantaneous unit hydrograph principle to simulate the direct runoff hydrographs and estimate peak runoff discharge. The Nash model was applied using input parameters derived from the watershed's rainfall-runoff characteristics. The results obtained showed that the Nash model was good in predicting peak runoff discharges. This statistic of comparison, R2 (coefficient of efficiency) for the model was above 70% for the model which is indicative of good model prediction of peak runoff discharge (Nash and Sutcliffe, 1970). From this analysis, the Nash model is recommended for the estimation of peak runoff discharge from un-gauged agricultural watersheds in Kenya.

The in vitro antimalarial activity of the root extract in partly supports the ethnobotanical use of the plant to manage malaria. Clematis brachiata Thunberg (Ranunculaceae) is used in Kenya for the management of headaches, malaria and other febrile illnesses, abdominal disorders, yaws and for skin disorders. Old stems and leaves are chewed for the management of toothaches and sore throats. Extracts of the plant were subjected to tests for antimalarial, antibacterial and antifungal activity. The toxicity of the extracts was assessed using the brine shrimp lethality bioassay. The root extract gave the highest in vitro antimalarial activity against the inulitidrug resistant strain, Plasmodium falciparum VI/S (IC50=39.24 jig/nil). The stem and leaf extracts had insignificant antiplasmodial activity. The leaf, stein and root extracts had no bacterial or fungal inhibitory effects even at very high concentrations of 10 mg/ml. The Lll50 values of the stem and leaf methanol extracts against the brine shrimp larvae was 365.60 and 66.5 jig/ml, respectively. Key Words: Clematis brachiata, Ranuneulaceae, antimalarial, antibacterial, antifungal, brine shrimp.

The in vitro antimalarial activity of the root extract in partly supports the ethnobotanical use of the plant to manage malaria. Clematis brachiata Thunberg (Ranunculaceae) is used in Kenya for the management of headaches, malaria and other febrile illnesses, abdominal disorders, yaws and for skin disorders. Old stems and leaves are chewed for the management of toothaches and sore throats. Extracts of the plant were subjected to tests for antimalarial, antibacterial and antifungal activity. The toxicity of the extracts was assessed using the brine shrimp lethality bioassay. The root extract gave the highest in vitro antimalarial activity against the inulitidrug resistant strain, Plasmodium falciparum VI/S (IC50=39.24 jig/nil). The stem and leaf extracts had insignificant antiplasmodial activity. The leaf, stein and root extracts had no bacterial or fungal inhibitory effects even at very high concentrations of 10 mg/ml. The Lll50 values of the stem and leaf methanol extracts against the brine shrimp larvae was 365.60 and 66.5 jig/ml, respectively. Key Words: Clematis brachiata, Ranuneulaceae, antimalarial, antibacterial, antifungal, brine shrimp.

Chloroquine is extensively used in the management of malaria in Kenya. It is widely available for self medication. Often it is used concurrently with other drugs. In the present paper, possible drug interactions with Chloroquine have been investigated. Isolated rat phrenic nerve diaphragm preparation was used to study the effect of Chloroquine alone and in combination with several drugs on neuromuscular impulse transmission. Chloroquine in the dose range 0.025 - 0.3 vg/m1 organ bath concentration induced a dose-dependent neuromuscular junction (NMJ) transmission blockade. The drug significantly potentiated the NMJ transmissionblockade induced by commonly used agents gallamine, succinylcholine and lignocaine. It antagonised the NMJ facilitatory action of physostigmine, calcium chloride and barium chloride. Chloraquine could. be interfering with ion conductance processes. It is suggested that Chloroquine should be used with caution in conditions characterised by muscle contractile disorders or during treatment with drugs that cause decreased skeletal muscle activity. Key Words: Chloroquine, interactions, neuromuscular junction.

OBJECTIVES: To study the burden of disease of reproductive tract infections (RTIs) and cervical dysplasia in women attending a family planning clinic in Nairobi, Kenya, and to assess the acceptability of integrating reproductive healthcare services into existing family planning facilities. METHODS: In a family planning clinic in Nairobi, Kenya, 520 women were enrolled in a study on RTI and cervical dysplasia. RESULTS: RTI pathogens were detected in over 20% of women, the majority being asymptomatic. HIV-1 testing was positive in 10.2%. The diagnosis of cervical dysplasia was made on 12% of the cytology smears (mild in 5.8%, moderate in 3.5%, severe in 1.2%), and 1.5% had invasive cervical cancer. The intervention of case detection of RTI and Papanicolaou smear taking was well received by clients and considered feasible by the staff. CONCLUSIONS: Early detection and treatment of potentially curable cervical lesions and RTI provide a unique opportunity to improve women's health. In Kenya, where the current contraceptive prevalence rate is 33%, family planning clinics are excellent sites to introduce health interventions.

OBJECTIVES: To study the burden of disease of reproductive tract infections (RTIs) and cervical dysplasia in women attending a family planning clinic in Nairobi, Kenya, and to assess the acceptability of integrating reproductive healthcare services into existing family planning facilities. METHODS: In a family planning clinic in Nairobi, Kenya, 520 women were enrolled in a study on RTI and cervical dysplasia. RESULTS: RTI pathogens were detected in over 20% of women, the majority being asymptomatic. HIV-1 testing was positive in 10.2%. The diagnosis of cervical dysplasia was made on 12% of the cytology smears (mild in 5.8%, moderate in 3.5%, severe in 1.2%), and 1.5% had invasive cervical cancer. The intervention of case detection of RTI and Papanicolaou smear taking was well received by clients and considered feasible by the staff. CONCLUSIONS: Early detection and treatment of potentially curable cervical lesions and RTI provide a unique opportunity to improve women's health. In Kenya, where the current contraceptive prevalence rate is 33%, family planning clinics are excellent sites to introduce health interventions.

HIV-specific cytotoxic T lymphocytes (CTL) are believed to play a major role in controlling virus levels through the asymptomatic period of HIV infection. For the rational design of an HIV vaccine, we need to know whether protective immunity can ever develop following HIV exposure in people who remain uninfected. We have detected HIV-specific CTL in 5/6 repeatedly exposed, persistently seronegative female sex-workers in The Gambia. Their CTL, repeatedly detected over two years, recognise epitopes presented by HLA-B35 which are cross-reactive between HIV-1 & HIV-2, suggesting they could have been primed first by HIV-2 exposure and subsequently boosted by exposure to HIV-1. Using previously identified clade B HIV-1 epitope peptides, we have now detected HIV-specific CTL in 6/15 highly exposed and apparently HIV-resistant Kenyan prostitutes, predominantly towards epitopes highly conserved between B and the Kenyan A & D clades of HIV-1. This CTL activity towards conserved virus epitopes may represent protective immunity to HIV generated in response to repeated exposure, and prophylactic HIV vaccines should aim to generate similar CTL responses.

PIP: During the asymptomatic phase of HIV infection, HIV-specific cytotoxic T lymphocytes (CTL) are believed to play a major role in controlling virus levels. The design of an HIV vaccine requires knowledge about whether protective immunity can ever develop after exposure to the virus and the mechanisms underlying such natural immunity. The authors' research has focused on HIV-specific CTL responses in highly HIV-exposed commercial sex workers in The Gambia, West Africa, and in Nairobi, Kenya. HIV CTL was detected in 5 of 6 repeatedly exposed, persistently seronegative female sex workers in The Gambia. Their CTL recognized epitopes presented by HLA-835 that are cross-reactive between HIV-1 and HIV-2, suggesting they could have been primed first by HIV-2 exposure and subsequently boosted by exposure to HIV-1. Through use of previously identified clade B HIV-1 epitope peptides, the authors also detected HIV-specific CTL in 6 of 15 highly exposed and apparently resistant Kenyan prostitutes, predominantly toward epitopes highly conserved between B and Kenyan A and D clades of HIV-1. This CTL activity toward conserved virus epitopes may represent protective immunity to HIV in response to HIV generated by repeated exposure. HIV vaccines should aim to generate similar CTL responses. There is currently no evidence that genetic factors, other than weak HLA associations, influence susceptibility or resistance to HIV infection.

{ We aimed to determine if the clinical and histological features of chancroid are altered by HIV infection. Male patients presenting to the Nairobi special treatment clinic with a clinical diagnosis of chancroid were eligible for the study. A detailed history, physical examination, swabs for Haemophilus ducreyi culture and blood for HIV serology, syphilis serology and CD4 counts were obtained from all patients. Punch biopsies from an ulcer were obtained from 10 patients and either fixed in 10% formalin or snap frozen in Optimum Cutting Temperature (OCT) medium compound at -70 degrees C. Patients were treated with erythromycin and followed for 3 weeks. Chi-square and Student's t-test were used to determine if the clinical and laboratory features of chancroid differed between HIV-seropositive and seronegative individuals. Cox regression survival analysis was used to determine if HIV infection altered cure rates of chancroid at 21 days. Immunohistochemical staining was performed using lymphocytic and macrophage markers and tissue sections were analysed by 2 pathologists in a blinded manner. Between February and November 1994, 109 HIV-seropositive and 211 HIV-seronegative individuals were enrolled in the study. HIV patients had ulcers of longer duration than HIV-seronegative patients (P=0.03). Although cure rates were similar at 3 weeks, HIV patients had lower cure rates at 1 week (23% v 54%

No Abstract!

No Abstract!

BACKGROUND: Pregnancy among adolescents is unplanned in many instances. Although some pregnant adolescents carry the pregnancy to term, abortion, in many instances unsafely induced, is a commonly sought solution in Kenya. OBJECTIVE: To determine adolescents' perceptions of induced abortion. DESIGN: A cross-sectional descriptive study carried out between July 1995 and June 1996. SETTING: An urban and a rural district in Kenya. PARTICIPANTS: Adolescents aged 10-19 years in schools in Nairobi and Kiambu districts, and a group of immediate post-abortion adolescent girls in some health facilities in Nairobi. MAIN OUTCOME MEASURES: The number of health programmes formulated and put into use, which are adolescent-friendly and providing information, education and communication on abortion issues. DATA COLLECTION: One thousand eight hundred and twenty adolescents were subjected to a self-administered questionnaire that collected demographic and health data as well as perceptions of induced abortion. Focus group discussions on perceptions of abortion were held with 12 groups of adolescents in schools and the information obtained recorded on paper and in a tape-recorder. RESULTS: One thousand nine hundred and fifty two adolescents, comprising of 1048 school girls (SG), 580 boys (SB), 192 post-abortion girls (PA) and 132 adolescents in the focus group discussions, formed the study sample. More than 90% were aware of induced abortion (IA). Knowledge of IA correlated positively with level of education (P < 0.01). Seventy one per cent of SG, 84% of PA and 40% of SB were aware of abortion-related complications, the most common being infections, death and infertility. Eighty three per cent of PA felt that complications were preventable by seeking care from a qualified doctor compared to one quarter each for the SB and SG. 56% PA, 69% SB and 72% SG felt that abortions were preventable. However, less than 40% proposed abstinence as a primary strategy. The most important source of information on abortion was the media followed by friends and teachers. CONCLUSION: Adolescents are aware of abortion and the related complications, but there is more variability in their knowledge and preventive measures.

            Fluoride determinations were made with a fluoride ion selective electrode on 60 river water samples collected at readily accessible sites in Central and Nairobi provinces of Kenya. The highest fluoride concentration was 0.85 ppm in Laikipia District and the lowest was 0.08 ppm in Murang'a District. By region and district, the mean fluoride concentration ranged from 0.12 ppm for rivers in Laikipia to 0.24 ppm for rivers in Nairobi, with 0.32 ppm in the Upper Basin of the Athi River. The results indicate that the rivers are relatively low in fluoride and are therefore safe in this respect for domestic and industrial use.

Division of Bacterial and Mycotic Diseases, Centers for Disease Control, Atlanta, GA 30333. An epidemic of meningococcal disease occurred in Nairobi, Kenya, during 1989, outside the "meningitis belt" of sub-Saharan Africa. About 3800 cases occurred between April and November (250/100,000 population). The case-fatality rate was 9.4% among hospitalized patients. Areas that included Nairobi's largest slums had particularly high attack rates. The epidemic displayed an unusual age distribution, with high attack rates among those 20-29 years old. A vaccination campaign was conducted. By early January, the weekly case count had fallen to 25 from a high of 272 (in September). A case-control study estimated the vaccine efficacy to be 87% (95% confidence interval, 67%-95%). A model estimated that the vaccination campaign reduced the number of cases by at least 20%. Multilocus enzyme electrophoretic typing demonstrated that the strain responsible for this large epidemic is closely related to strains that caused other recent epidemics, documenting further spread of what may be a particularly virulent clonal complex of group A Neisseria meningitidis.

Division of Bacterial and Mycotic Diseases, Centers for Disease Control, Atlanta, GA 30333. An epidemic of meningococcal disease occurred in Nairobi, Kenya, during 1989, outside the "meningitis belt" of sub-Saharan Africa. About 3800 cases occurred between April and November (250/100,000 population). The case-fatality rate was 9.4% among hospitalized patients. Areas that included Nairobi's largest slums had particularly high attack rates. The epidemic displayed an unusual age distribution, with high attack rates among those 20-29 years old. A vaccination campaign was conducted. By early January, the weekly case count had fallen to 25 from a high of 272 (in September). A case-control study estimated the vaccine efficacy to be 87% (95% confidence interval, 67%-95%). A model estimated that the vaccination campaign reduced the number of cases by at least 20%. Multilocus enzyme electrophoretic typing demonstrated that the strain responsible for this large epidemic is closely related to strains that caused other recent epidemics, documenting further spread of what may be a particularly virulent clonal complex of group A Neisseria meningitidis.

Division of Bacterial and Mycotic Diseases, Centers for Disease Control, Atlanta, GA 30333. An epidemic of meningococcal disease occurred in Nairobi, Kenya, during 1989, outside the "meningitis belt" of sub-Saharan Africa. About 3800 cases occurred between April and November (250/100,000 population). The case-fatality rate was 9.4% among hospitalized patients. Areas that included Nairobi's largest slums had particularly high attack rates. The epidemic displayed an unusual age distribution, with high attack rates among those 20-29 years old. A vaccination campaign was conducted. By early January, the weekly case count had fallen to 25 from a high of 272 (in September). A case-control study estimated the vaccine efficacy to be 87% (95% confidence interval, 67%-95%). A model estimated that the vaccination campaign reduced the number of cases by at least 20%. Multilocus enzyme electrophoretic typing demonstrated that the strain responsible for this large epidemic is closely related to strains that caused other recent epidemics, documenting further spread of what may be a particularly virulent clonal complex of group A Neisseria meningitidis.

No Abstract!

No Abstract!

No Abstract!

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

A study of clinical presentation and management of renal cell carcinoma (RCC) in 35 patients during the period 1983 to 1997 is presented. The peak age was 40-50 years. Haematuria, abdominal pain, fever of unknown origin and abdominal mass were the commonest presenting features. Computerised tomographic (CT) scanning, intravenous urography (IVU) and magnetic resonance imaging (MRI) were the important diagnostic tools. Early diagnosis and surgery are the most important approaches in management.

At the Kenyatta National Hospital (KNH) and other private hospitals in Nairobi urinary stone disease is not being correctly diagnosed. Over a 15 year period (1980-1995) only 56 patients have been confirmed to have urinary tract stones out of the expected number of 220 patients. The age range was 10-60 years. The peak age was 30-40 years. Pain and haematuria were the commonest presenting symptoms. Ultrasonography and plane abdominal radiology were the commonest methods of diagnosis. Open surgery and endoscopic stone removal were the commonest modes of management. Extracorporeal shortwave lithotripsy (ESWL) has recently been introduced into the Nairobi Hospital, but was not functional at the time of this study. Percutaneous nephrolithotomy (PCNL) is possible but has not been adequately used due to lack of correct equipment. Septicaemia and haemorrhage were the commonest complications of the open surgery.

Field trips to herbalists' practices in an area about 200 miles around Nairobi (Kenya) enabled us to make a list of medicinal plant species preferentially used to treat malaria. Ajuga remota and Caesalpinia volkensii were further investigated as being the most frequently used species. Aqueous decoctions, ethanol macerates, and petroleum ether, methanol and water Soxhlet extracts of these plants were further tested for their in vitro antimalarial properties in a chloroquine sensitive (FCA/20GHA) and resistant (W2) strain of Plasmodium falciparum. The activity was assessed by the parasite lactate dehydrogenase (pLDH) assay method. There was a concentration-dependent inhibition by the vegetal extracts of both plants. The IC(50) of the most active A. remota extract (ethanol macerate) was 55 and 57 microg/ml against FCA/20GHA and W2, respectively. For C. volkensii, it was the Soxhlet-water extract which was most active against FCA/20GHA with an IC(50) of 404 microg/ml while the petroleum ether extract exhibited the most activity against W2 with an IC(50) of 250 microg/ml. Further phytochemical work is being done in order to identify the active principles.

Field trips to herbalists' practices in an area about 200 miles around Nairobi (Kenya) enabled us to make a list of medicinal plant species preferentially used to treat malaria. Ajuga remota and Caesalpinia volkensii were further investigated as being the most frequently used species. Aqueous decoctions, ethanol macerates, and petroleum ether, methanol and water Soxhlet extracts of these plants were further tested for their in vitro antimalarial properties in a chloroquine sensitive (FCA/20GHA) and resistant (W2) strain of Plasmodium falciparum. The activity was assessed by the parasite lactate dehydrogenase (pLDH) assay method. There was a concentration-dependent inhibition by the vegetal extracts of both plants. The IC(50) of the most active A. remota extract (ethanol macerate) was 55 and 57 microg/ml against FCA/20GHA and W2, respectively. For C. volkensii, it was the Soxhlet-water extract which was most active against FCA/20GHA with an IC(50) of 404 microg/ml while the petroleum ether extract exhibited the most activity against W2 with an IC(50) of 250 microg/ml. Further phytochemical work is being done in order to identify the active principles.

Field trips to herbalists' practices in an area about 200 miles around Nairobi (Kenya) enabled us to make a list of medicinal plant species preferentially used to treat malaria. Ajuga remota and Caesalpinia volkensii were further investigated as being the most frequently used species. Aqueous decoctions, ethanol macerates, and petroleum ether, methanol and water Soxhlet extracts of these plants were further tested for their in vitro antimalarial properties in a chloroquine sensitive (FCA/20GHA) and resistant (W2) strain of Plasmodium falciparum. The activity was assessed by the parasite lactate dehydrogenase (pLDH) assay method. There was a concentration-dependent inhibition by the vegetal extracts of both plants. The IC(50) of the most active A. remota extract (ethanol macerate) was 55 and 57 microg/ml against FCA/20GHA and W2, respectively. For C. volkensii, it was the Soxhlet-water extract which was most active against FCA/20GHA with an IC(50) of 404 microg/ml while the petroleum ether extract exhibited the most activity against W2 with an IC(50) of 250 microg/ml. Further phytochemical work is being done in order to identify the active principles.

Field trips to herbalists' practices in an area about 200 miles around Nairobi (Kenya) enabled us to make a list of medicinal plant species preferentially used to treat malaria. Ajuga remota and Caesalpinia volkensii were further investigated as being the most frequently used species. Aqueous decoctions, ethanol macerates, and petroleum ether, methanol and water Soxhlet extracts of these plants were further tested for their in vitro antimalarial properties in a chloroquine sensitive (FCA/20GHA) and resistant (W2) strain of Plasmodium falciparum. The activity was assessed by the parasite lactate dehydrogenase (pLDH) assay method. There was a concentration-dependent inhibition by the vegetal extracts of both plants. The IC(50) of the most active A. remota extract (ethanol macerate) was 55 and 57 microg/ml against FCA/20GHA and W2, respectively. For C. volkensii, it was the Soxhlet-water extract which was most active against FCA/20GHA with an IC(50) of 404 microg/ml while the petroleum ether extract exhibited the most activity against W2 with an IC(50) of 250 microg/ml. Further phytochemical work is being done in order to identify the active principles.

Field trips to herbalists' practices in an area about 200 miles around Nairobi (Kenya) enabled us to make a list of medicinal plant species preferentially used to treat malaria. Ajuga remota and Caesalpinia volkensii were further investigated as being the most frequently used species. Aqueous decoctions, ethanol macerates, and petroleum ether, methanol and water Soxhlet extracts of these plants were further tested for their in vitro antimalarial properties in a chloroquine sensitive (FCA/20GHA) and resistant (W2) strain of Plasmodium falciparum. The activity was assessed by the parasite lactate dehydrogenase (pLDH) assay method. There was a concentration-dependent inhibition by the vegetal extracts of both plants. The IC(50) of the most active A. remota extract (ethanol macerate) was 55 and 57 microg/ml against FCA/20GHA and W2, respectively. For C. volkensii, it was the Soxhlet-water extract which was most active against FCA/20GHA with an IC(50) of 404 microg/ml while the petroleum ether extract exhibited the most activity against W2 with an IC(50) of 250 microg/ml. Further phytochemical work is being done in order to identify the active principles.

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

No Abstract!

OBJECTIVE: To determine the patient drop out to postoperative follow up for heart patients at the Kenyatta National Hospital. DESIGN SETTING AND PARTICIPANTS: The study analysed the postoperative attendance of heart patients to the surgical outpatient clinic at the KNH. Data on clinic attendance was collected over a one-year period from patient files and from clinic attendance. RESULTS: A total of four hundred and seventy-five open heart operations have been performed at the Kenyatta National Hospital over the last twenty-five years. The patients' mean age is 18.0 years. Clinic follow up rate over this period is 85% at one-year, 62% at five-years, 32% at ten-years and 13% at fifteen-years. A number of patients who had since fallen out to clinic follow up were traced during the study period, when included into the analysis the revised figures are 85%, 70%, 40% and 24% respectively. The difference is statistically significant (p = 0.019). There was no significant statistical difference in the follow up between males and females (p = 0.278), however between patients operated for congenital heart diseases compared to valve patients, the difference was significant (p = 0.007), valve patients having a better follow up. The five-year follow up for isolated mitral, aortic and double valve replacements were 94%, 74% and 78% respectively. CONCLUSION: Despite deceptively good follow up figures, our figures are in fact poor when age is considered. Financial combined with logistical problems are the most likely causes of poor follow up.

No Abstract!

No Abstract!

Reduction of ethyl 3-methyl-, 3-isopropyl- and 3-n-pentyl-3-[dimethyl(phenyl)silyl]propanoates with DIBAL to the aldehydes, enol trifluoromethanesulfonate (triflate) formation using trifluoromethanesulfonic (triflic) anhydride and 2,6-di-tert-butylpyridine, and elimination using LDA, gives the propargyl silanes . The esters could also be prepared enantiomerically enriched, and the final products are the enantiomerically enriched propargyl (homochiral) silanes.

Knowledge of the variant vascular anatomy of the subhepatic region is important for hepatobiliary surgeons in limiting operative complications due to unexpected bleeding. The pattern of arterial blood supply of 102 gallbladders was studied by gross dissection. The cystic artery originated from the right hepatic artery in 92.2% of cases. The rest were aberrant and originated from the proper hepatic artery. Accessory arteries were observed to originate from proper hepatic artery (n = 5), left hepatic artery (n = 2), and right hepatic artery (n = 1). Most of the arteries approached the gallbladder in relation to the common hepatic duct (anterior 45.1%, posterior, 46.1%). The other vessels passed anterior to common bile duct (2.9%), posterior to common bile duct (3.9%), or were given off in Calot's triangle. Cystic arteries in this data set show wide variations in terms of relationship to the duct systems. In about one tenth of patients, an accessory cystic artery may need to be ligated or clipped during cholecystectomy. 2007 Wiley-Liss, Inc

Knowledge of the variant vascular anatomy of the subhepatic region is important for hepatobiliary surgeons in limiting operative complications due to unexpected bleeding. The pattern of arterial blood supply of 102 gallbladders was studied by gross dissection. The cystic artery originated from the right hepatic artery in 92.2% of cases. The rest were aberrant and originated from the proper hepatic artery. Accessory arteries were observed to originate from proper hepatic artery (n = 5), left hepatic artery (n = 2), and right hepatic artery (n = 1). Most of the arteries approached the gallbladder in relation to the common hepatic duct (anterior 45.1%, posterior, 46.1%). The other vessels passed anterior to common bile duct (2.9%), posterior to common bile duct (3.9%), or were given off in Calot's triangle. Cystic arteries in this data set show wide variations in terms of relationship to the duct systems. In about one tenth of patients, an accessory cystic artery may need to be ligated or clipped during cholecystectomy. 2007 Wiley-Liss, Inc