Risk factors and outcomes of acute kidney injury among covid-19 patients at a tertiary hospital in Kenya

Background: Corona Virus Disease 2019 (COVID-19), a novel infection caused by the SARS-Cov-2 virus, was declared a global pandemic on March 11, 2020. Three years later, 350,000 Kenyans had gotten the infection, with approximately 5,700 reported related deaths. Despite emerging research on the new virus, studies from the African continent on the impact of COVID-19 on the kidneys have been few. Early studies suggest that up to 75% of patients with COVID-19 have a derangement in their kidney function as evidenced by new onset proteinuria and hematuria. That said, the prevalence of acute kidney injury has varied greatly across populations, ranging from nine to fifty-five percent depending on the geographical area, differences in COVID-19 infection severity, race, age, and the socioeconomic status of the patient population. Being of African descent in particular has been identified as an independent risk factor for AKI in many of these studies. Acute kidney injury in hospitalized patients is associated with increased mortality risk and a prolonged duration of hospital stay, with higher odds seen among patients with COVID-19 infection. In addition, AKI-recovered patients are less likely to have complete recovery of their renal function, even after clearance of the infection, and have been shown to have a faster progression in chronic kidney disease on follow-up. Objective: The study aims to determine the impact of COVID-19 infection on the kidneys. The primary objective is to determine the prevalence and risk factors of acute kidney injury in COVID-19 patients at a tertiary-level hospital in Nairobi, Kenya. The secondary objective is to assess the short-term outcomes of AKI in these patients at the time of hospital discharge. These outcomes include in-hospital mortality rate, the duration of hospital stay, and the status of renal recovery. Methods: In this retrospective cohort study, COVID-19 patients above the age of 18 years admitted between April 1st 2020 and October 31st 2021 were included. Patients without serial creatinine results and those with end-stage renal disease met the exclusion criteria. Data was collected on demographic and clinical characteristics. After determining the AKI period prevalence, bivariate analysis was carried out to determine statistically significant associations of these factors with AKI, with a p-value set at 0.05. A logistic regression model was then applied to determine independent associations with AKI, with results reported as an odds ratio with a 95% confidence interval, and adjusted for age and gender. The iv outcomes of AKI were stratified based on the stage of AKI and reported as percentages, medians, and interquartile ranges. Methods: In this retrospective cohort study, COVID-19 patients above the age of 18 years admitted between April 1st 2020 and October 31st 2021 were included. Patients without serial creatinine results and those with end-stage renal disease met the exclusion criteria. Data was collected on demographic and clinical characteristics. After determining the AKI period prevalence, bivariate analysis was carried out to determine statistically significant associations of these factors with AKI, with a p-value set at 0.05. A logistic regression model was then applied to determine independent associations with AKI, with results reported as an odds ratio with a 95% confidence interval, and adjusted for age and gender. The iv outcomes of AKI were stratified based on the stage of AKI and reported as percentages, medians and interquartile ranges. Conclusion: Acute kidney injury is a less recognized complication of COVID-19 infection. We found significantly higher odds of AKI with increasing age, gender, hypertension, diabetes and severity of COVID-19 illness. We also demonstrated a strong independent association between AKI in COVID-19 and mortality and an impact of AKI in COVID-19 on hospital duration and renal recovery

The Effects of Capital Structure on Firm’s Profitability: Evidence from Kenya’s Banking Sector

Capital structure is considered important corporate financial management context and is mainly related to the establishment of an ideal debt policy. The determination of a company’s capital structure constitutes a difficult decision, one that involves several and antagonistic factors, such as risk and profitability. Despite of substantial theoretical developments in the field of corporate finance over the past several decades, the rift between theory and practice still needs to be reconciled. This paper empirically investigates the relationship between capital structure and the firm’s profitability of banking industry in Kenya, by using panel data extracted from the financial statements of the companies listed on the Nairobi Stock Exchange from year 2004-2012.The rationale behind the industry specific analysis is the fact that exogenous variables appear to force institutions in the same industry in similar fashion, thus leading to the existence of an industry specific capital structure. It is found that a significant positive relationship exists between the short term debt and profitability and statistically significant negative relationship between long term debt and profitability. The results are partially consistent with the previous studies as the negative relationship between long term debt and the firm performance tends to sport the dominant pecking order theory. The association of short term debt and the financial performance in contrast attests the static trade-off theory. Total debt as a whole has no association with the firm’s performance because of the inherited different characteristics of short term debt and long term debt. Key words: Capital Structure, Profitability, Banking industry, Exogenous variables

Do bloggers who criticize the press ultimately matter? (Re)defining media accountability in the age of citizen participation

Els anomenats bloggers que critiquen els mitjans tradicionals sobre la mala qualitat del periodisme són considerats instruments potencialment influents de la rendició de comptes i la responsabilitat dels mitjans de comunicació. Aquest article qüestiona si, en retrospectiva, el vell ordre de la rendició de comptes de mitjans encara té rellevància en un entorn cada vegada més interconnectat. L'objectiu és proposar un marc per comprendre com els bloggers que fan crítica de la pràctica del periodisme tradicional poden ser examinats en un estudi sobre la responsabilitat dels mitjans en l'era digital. Aquest assaig analitza el concepte de rendició de comptes dels mitjans i la importància de la crítica que actors com els bloggers fan de la pràctica del periodisme.Bloggers criticizing the traditional media over poor quality journalism are being touted as potentially influential instruments of media accountability. This paper questions whether in retrospect the old order of media accountability still has relevance in an increasingly networked media environment. The aim of the paper is to suggest a framework for understanding how bloggers criticizing the traditional journalism practice can be examined in a study on media accountability in the digital era. The essay interrogates the concept of media accountability and the significance of bloggers' criticism on journalism practice

A 23 Kyrs Record Of Environmental Change From Cherangani Hills, Kenya

The sensitivity of East Africa’s environment to anthropogenic and natural climatic changes is poorly understood. Therefore, there is need to incorporate continuous high-resolution records to provide insights into the timings of climatic signals to reconstruct East Africa’s paleoenvironment. This study presents sediment core data (KAP-01) from Kapkanyar Swamp, Cherangani Hills, based on fungal spores, Loss-On-Ignition (LOI) and microscopic charcoal analyses. The climate during the Last Glacial Maximum (LGM) was generally cold and dry with intermittent presence of moist environmental conditions evidenced by the minimal presence of coprophilous taxa, a well-known taxon used to signify presence herbivores, representing diminished fauna. Presence of charcoal in the LGM reflects probable natural fires suggesting dry environmental conditions. The deglaciation period, on the other hand, was relatively colder and drier compared to any other period in the last ~23 Kyrs with scanty preservation fungal spores. The Holocene period is characterized by increased fungal assemblages, indicative of a moist environment punctuated by drought episodes evidenced by fires and fungal spores such as Tetraploa, Meliola, and Glomus. In the Late Holocene, fires are more frequent and with potential fire breaks suggesting anthropogenic controlled fires. Our results depict anthropogenic imprints in the environment in the Late Holocene period, ~4 Kyrs to the present

Screening for Binge Eating Disorder in Patients Undergoing a Weight Loss Program

Background: Binge eating disorder (BED) is the most common eating disorder in the United States, it is more prevalent than Anorexia Nervosa and Bulimia combined. BED is characterized by recurrent episodes of binge eating accompanied by feeling a lack of control and marked distress over one’s eating behaviors. BED is a serious condition that impairs health-related quality of life (HRQL) and increases health care costs. Purpose: The purpose of this project was to identify patients at risk for binge eating disorder at an outpatient weight loss clinic using the validated BEDS-7 screening tool. Evidence-based Intervention: The 7-item Binge-Eating Disorder Screener (BEDS-7), a brief screening tool for BED, can assist providers in identifying patients who may have BED providing evidence-based treatment options and/or referrals for additional assessment and potential diagnosis of BED. Evaluation/Results: Screening for binge eating was conducted on all new patients seeking weight loss at the clinic over a 3-month period. Patients who screened positive for binge eating according to the BEDS-7 screening tool were provided with evidence-based treatment options including both pharmacological treatment and referral for psychotherapy and counseling. Implications for Practice: Screening for Binge eating promotes recognition of binge eating habits in patients undergoing weight loss treatment and awareness about binge eating and its influence on overall quality of life